No one disputes that smoking is the major cause of chronic obstructive pulmonary disease (COPD), the difficulty breathing that strikes so many Americans in their twilight years. A new study by Duke University and the Center for Construction Research and Training (CPWR) researchers, however, reminds us that smoking is far from the only cause, and we still have a lot of work to do if we are going to protect construction workers.

Investigators compared the work histories of 834 construction workers with COPD to 1243 controls who did not. Workplace exposures to an unhealthy combination of vapors, gases, dusts and fumes (VGDF) accounted for nearly one in five COPD cases. Many workers with COPD had never smoked a day in their lives; one-third of these cases were attributable to workplace exposure.

A simplistic view of COPD in the workforce might lead employers to begin and end with smoking cessation efforts, but the evidence says otherwise. In construction, at least, occupational exposures remain a major cause of COPD in their own right, and we need to protect workers by getting VGDF under control.

A summary of A case-control study of airways obstruction among construction workers is available from CPWR; the complete report appears in the American Journal of Industrial Medicine.