In 1999 COPD ranked as the fourth leading cause of death with over 124,000 deaths, and was a primary or contributing cause of death for an estimated 8.5% of the U.S. population.  An estimated 16 million individuals in the U.S. had a diagnosis of COPD in 1994. Worldwide, COPD is projected to be the third leading cause of death by 2020.  80 to 90% of COPD is caused, at least in part, by tobacco smoking, but exposure to dust is an important risk as well.  The American Thoracic Society concluded that 15% of COPD was caused by occupational exposures, and that occupational dust and fume exposures can cause clinical bronchitis and loss of lung function in both smokers and nonsmokers.

Smoking is the primary cause of COPD, but smoking alone does not explain all COPD, as only 15-20% of smokers developed COPD and 10% of deaths from COPD occur in persons who never smoked. Occupational exposures to dusts and chemicals (vapors, irritants, fumes) also cause COPD; the specific exposures in construction linked to COPD are wood dusts, cadmium, silica, welding fumes, cement dust, asbestos, and possibly isocyanates.  For someone with heavy dust exposure over many years, the dust contributes as much to COPD as smoking does.  Across all occupations, about 15% of COPD is caused by occupational exposures. 

The U.S. National Health Interview Survey for the years 1988-1994 reported that workers in construction trades had more COPD than other workers; in this survey 13.4% of white men in construction had COPD. A study of sheet metal workers followed over a 10-year period found they lost more lung function if they were exposed to asbestos and also smoked.

Airflow in nonsmokers without respiratory disease declines by 25 to 30 ml per year beginning at about age 35.The rate of decline of airflow is faster for smokers than for nonsmokers, and faster for those exposed to lots of dust. Individuals with COPD have more frequent chest illnesses, which also decrease lung function for several months.

Treatment of COPD focuses on smoking cessation and exposure reduction, medication to increase airflow and decrease phlegm production, and treatment of intermittent chest infections.  Someone with COPD needs a vaccination for pneumococcal pneumonia every 5 years, and annual influenza vaccination.  A small amount of lung function is regained when someone quits smoking, and the lung function decline slows to about the rate seen in never-smokers of the same age.

Most construction workers are at risk of COPD; studies find an elevated prevalence of COPD across many trades, and most trades have tasks that create dust or fumes.  Many construction tasks have exposures to levels of dust which exceed the OSHA permissible exposure limit of 5 mg/m³ for non-specific dust.  Because many construction trades work alongside each other, a construction worker can be over-exposed to dust generated by a co-worker doing a different task.

Some experts have suggested that dust at construction sites is best described as quartz (silica) containing mixed dust, and quartz is clearly one component of dust related to lung injury.  The proportion of quartz in the overall dust exposure of any individual will vary by task, materials, specific years worked, work location, and likely other factors as well.  Tuckpointing had respirable dust levels as high as 8 mg/m³ as an 8 hour TWA, with quartz levels as high as 1.7 mg/m³ as an 8 hour TWA. In one study that looked at both exposure and disease, workers with higher cumulative dust exposures were more likely to have a chest x-ray showing mixed dust pneumoconiosis (lung scarring due to an exposure to mixed dust).  The prevalence of mixed dust pneumoconiosis was significantly increased after 25 years work at a tuckpointer or 33 years work as a concrete driller or grinder. 

Studies of miners have shown that long term exposure to dust at levels of 2 mg/m³ causes COPD, and that as the silica content of the dust increases the total exposure needed to cause disease decreases.  However, other dusts and fumes, including asbestos, cadmium and welding fumes also cause COPD, so silica is only one of the injurious components of construction dust.