Characteristics and one-year evolution of the PRISm phenotype in construction workers based on spirometry

Abstract

Objectives: To determine the prevalence of preserved ratio impaired spirometry (PRISm), investigate associated factors, and evaluate changes in the PRISm phenotype after one year among construction workers. Materials and Methods: A retrospective descriptive-analytic study was conducted among 196 construction workers from two companies, Unicons and Coteccons, who underwent health examinations in two consecutive years, 2021–2022. PRISm was defined as FEV₁ <80% of the predicted value and FEV₁/FVC ≥ the lower limit of normal (LLN). Data on age, sex, smoking status, and spirometry results were collected from electronic medical records. Statistical analyses were performed using SPSS version 20.0, with p<0.05 considered statistically significant.. Results: The mean age of the study participants was 35.0 ± 7.01 years; 85.2% were male and 42.3% were smokers. At baseline, 52/196 participants (26.5%) had at least one spirometric abnormality. PRISm was the most common phenotype, identified in 28 participants (14.2%). Among participants with PRISm, 24/28 (85.7%) also had spirometric findings suggestive of reduced lung volume. Age was significantly associated with PRISm (p<0.05), whereas no statistically significant associations were observed with sex or smoking status (p>0.05). After one year, the prevalence of PRISm increased to 17.3%. Of the 28 participants with PRISm at baseline, 22 (78.6%) remained in the PRISm phenotype, 4 (14.3%) returned to normal spirometry, and 2 (7.1%) transitioned to an obstructive pattern. Additionally, 12 new cases of PRISm were identified. Conclusion: PRISm is a relatively common spirometric phenotype among construction workers and demonstrates a dynamic pattern over time. Larger studies with longer follow-up are needed to clarify the role of occupational exposures in the development and progression of PRISm.