In December, 2000 the federal Occupational Safety and Health Administration (OSHA) carried out a safety and health inspection on a contract site (CO9A4) on Boston's Central Artery/Tunnel (CAT) highway construction project. The inspection was conducted under a National Emphasis Program for silica and a Local Emphasis Program for the CAT. Work on the site involved construction of (1) two tunnels linking Boston's underground central artery to the Massachusetts Turnpike (I-90 West and I-90 East) and (2) an exit ramp connecting I-90 westbound to the central artery. On November 1, 2, and 3, 2001, a health survey of more than 300 construction workers from the CO9A4 site was carried out by Occupational Health Initiatives and the New England Laborers Health and Safety Fund. The survey was done under the auspices of the Building and Construction Trades Council of the Metropolitan District and local unions representing the trades on the site. The focus of the survey was silica. No definite cases of silicosis were identified. However, review of the questionnaires completed by survey participants revealed what appeared to be a high number of positive responses to questions about wheeze and attacks of wheeze associated with shortness of breath. In some, but not all, cases there was a prior history of physician-diagnosed asthma. Only a few reported taking medication for asthma. These findings suggested a higher-than-expected prevalence of asthma (compared with the general population) among construction workers on the site, undiagnosed and untreated for the most part. Based upon these findings, three hypotheses were generated: 1. There is an increased prevalence of asthma defined on the basis of physician diagnosis or symptoms among these heavy and highway construction workers. 2. For many of these workers, asthma is undiagnosed. 3. For many of those with physician-diagnosed asthma, control is not adequate. The present study tests these hypotheses by statistical analysis of the data collected at the time of the survey, and examination and assessment of the results.
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