COPD mortality among workers in the construction industry, by occupation: USA, 2021-2022

Chronic obstructive pulmonary disease (COPD), a progressive lung condition, is a leading cause of disability and death. Cigarette smoking and workplace exposures are important risk factors for COPD. To examine occupations with COPD deaths among decedents with usual lifetime employment in the construction industry.

The 2021-2022 National Vital Statistics System public use multiple cause-of-death data (cross-sectional) were analysed.

Among 6.7 million decedents, 497 031 (10.3%) were employed in the construction industry during most of their life and of those, 11.7% (n=57 937) had COPD listed on the death certificate as the underlying or contributing cause of death. The highest numbers of COPD deaths were among adults 65 years and older (n=44 550), males (n=55 092), non-Hispanic white persons (n=50 903) and persons with ≤high school education (n=46 621). Construction workers had 1.31 (95% CI 1.30 to 1.32) times the odds of COPD deaths as compared with non-construction workers. Within construction occupation groups, roofers (mortality OR (MOR) 2.31, 95% CI 2.10 to 2.55) drywall installers, ceiling tile installers and tapers (MOR 2.29, 95% CI 3.05 to 2.56); painters, paperhangers, pipelayers, plasterers and stucco masons (MOR 2.09; 95% CI 1.92 to 2.28) and insulation workers (MOR 2.00, 95% CI 1.66 to 2.41) COPD mortality risk was significantly increased and the mortality odds were twice or more as compared with the reference group (office and administrative support workers).

Disparities in COPD mortality observed among construction industry workers may be addressed by reducing COPD risk factors, including cigarette smoking and COPD-related workplace exposures, and emphasising the importance of early diagnosis and disease management.