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Occupational and Environmental Lung Disease |

Spirometric Abnormalities Associated With Chronic Bronchitis, Asthma, and Airway Hyperresponsiveness Among Boilermaker Construction Workers*

Russ Hauser, MD, ScD, MPH; Ellen A. Eisen, ScD; Lucille Pothier, MS; Daniel Lewis, PhD; Toni Bledsoe, MS, MT(ASCP); David C. Christiani, MD, MPH, FCCP
Author and Funding Information

*From the Occupational Health Program (Ms. Pothier and Drs. Hauser and Christiani) Department of Environmental Health, Harvard School of Public Health, Boston, MA; the Department of Work Environment (Dr. Eisen), University of Massachusetts Lowell, Lowell, MA; National Institute for Occupational Safety and Health (Dr. Lewis and Ms. Bledsoe), Morgantown, WV.

Correspondence to: Russ Hauser, MD, ScD, MPH, Harvard School of Public Health, Occupational Health Program, 665 Huntington Ave, Building I, Room 1405, Boston, MA; e-mail: rhauser@hohp.harvard.edu



Chest. 2002;121(6):2052-2060. doi:10.1378/chest.121.6.2052
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Several epidemiologic studies16 have shown an association between occupational exposure to fossil fuel ash and respiratory health effects. The early studies12 reported clinical symptoms and signs, such as upper respiratory tract irritation, a cough with dyspnea, and rhonchi on physical examination resulting from occupational exposure to fuel oil ash. This suggests that fuel oil ash is a respiratory irritant capable of inducing respiratory symptoms, including those suggestive of asthma. However, these early studies12 had limited measures of exposure and effect, and the exposures were generally extremely high compared to current occupational exposure. More recently, a small study3 of 17 men cleaning bottom ash from an oil-fired boiler found marked reductions in lung function (FEV1). In another study of respiratory symptoms, Levy and Hoffman4 investigated a large outbreak of “boilermakers’ bronchitis,” described as asthmatic bronchitis, after 100 boilermakers worked on the oil-to-coal conversion of a utility company power plant. Studies56 on acute (ie, across a work shift) and short-term (over several weeks) changes in FEV1 demonstrated decrements in lung function among workers who overhauled an oil-fired boiler.

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