Occupational Exposure to Ambient Air Pollution: At-Risk Worker Groups, Regulatory and Research Needs An Official American Thoracic Society Workshop Report.

Although health effects of ambient air pollution are well established in the general population, the impact of exposure in working populations remains poorly understood. Outdoor workers are disproportionately exposed to ambient air pollution, particularly with increasing wildfire smoke events and global climate change. An international interdisciplinary group of experts including worker representation assembled to review the current state of knowledge regarding the impact of occupational air pollution exposure on worker health and develop recommendations for research and actions to evaluate, mitigate, and regulate occupational air pollution exposure. The group identified health risks likely resulting from air pollution based on studies of the general population, noting that additional risks may be encountered from coexposures, as well as exertion increasing the work of breathing. High-risk groups were identified, including agricultural workers, construction workers, and wildland firefighters; others working in warehouses and indoor spaces are likely at risk via ambient air pollutant infiltration. It was estimated that at least 20 million outdoor U.S. workers are exposed to air pollution at work, which limits productivity and increases absenteeism. Participants recommended using air quality to guide work modifications and adoption of the hierarchy of exposure controls as a model to reduce exposures, as used by some states and proposed by the National Institute for Occupational Safety and Health for agricultural and other outdoor workers. Existing research supports the urgent need for policies to protect workers from exposure. Research gaps remain, including medical surveillance strategies, improved technology to protect workers, and studies specifically evaluating the impacts of occupational air pollution exposure.