ABSTRACT
Tunnel construction workers (TCWs) operate in environments that can be hazardous to their health. Various work-related diseases have been reported in TCWs globally. To better understand the nature of these diseases, a comprehensive literature review was conducted which identified 95 relevant studies from 30 countries. Various methodologies are used in the construction of tunnels, including the use of compressed air to create hyperbaric environments. Historically, working in hyperbaric conditions led to a significant disease burden. However, advancements in technology and processes have contributed to improved health outcomes. Conversely, in non-hyperbaric conditions, the literature indicates that important levels of respiratory disorders are frequently reported, silicosis being the most common. This emphasises silicosis as an on-going concern within the tunnelling sector, in contrast with the advancements seen in mitigating diseases associated with hyperbaric conditions. This review supports the need for improved management to prevent exposure to respirable crystalline silica.
