Cause-specific mortality among male textile workers in Rhode Island

Cause-specific mortality patterns among male textile workers in Rhode Island who died during the period 1968-1978 were examined using the proportionate mortality ratio (PMR) method. Textile worker decedents were identified by the usual occupation and industry statements on Rhode Island death certificates. A statistically significant PMR elevation was observed for nonmalignant respiratory disease (NMRD) among male textile workers (PMR = 110; Observed deaths [Obs] = 433; 95% confidence interval (CI) = 102-120). The PMRs for NMRD by specific textile occupation and by type of textile manufacturing generally exhibited the pattern expected for work-related mortality owing to textile dust exposure. High PMRs were observed among carding, lapping, and combing operatives, the decedents who probably had the highest dust exposure (PMR = 166; Obs = 24; CI = 114-243), and among operatives most likely to have worked in cotton manufacturing (PMR = 137; Obs = 47; CI = 104-179). This is the first report of excess mortality from NMRD among male textile workers in the United States. This finding is consistent with previous evidence that exposure to cotton dust can cause disabling chronic lung disease. Also noteworthy were statistically significant elevated PMRs for cancers of the rectum and esophagus among decedents who had been engaged in textile dyeing and finishing. Owing to the lack of direct information about occupational exposures and smoking habits of the decedents and uncertainties in classifying decedents by type of textile manufacturing, this investigation should be viewed as being exploratory in nature.     

Cancer mortality among northern Georgia carpet and textile workers

Proportionate cancer mortality was analyzed among white male carpet and textile workers in five northwest Georgia counties for the years 1970-1984. Compared with other Georgians, carpet and textile workers had higher proportions of lymphocytic leukemia (proportionate cancer mortality ratio [PCMR] = 2.9; 95% CI = 1.4-5.4]) and testicular cancer (PCMR = 3.2; 95% CI = 1.0-7.5). The excess mortality from lymphocytic leukemia was even higher when the analysis was limited to workers deemed most likely to work directly in production areas (PCMR = 4.2; 95% CI = 1.7-8.7). Further studies are needed to determine if the observed excesses are the result of workplace exposures.     

棉纺女工呼吸系统损害的调查研究

目的 探讨棉尘对棉纺女工呼吸系统的损害。方法 对棉纺厂各车间工序进行劳动卫生学和空气中细菌、真菌污染状况调查,并对302名棉纺女工及64名对照女工呼吸系统症状进行询问调查、X线胸片检查及班前班后肺功能的测定。结果 棉纺各车间工序空气中微生物污染严重,尤以前纺车间为重。接尘女工呼吸系统症状阳性率均显著高于对照女工（P＜0．01）,86名棉纺女工中X线胸片异常者20例,占拍片人数的23．3％。肺功能FVC、FEV1.0、FEE25～75各指标班前班后下降值均较对照组明显。接尘女工肺功能FEV1.0异常急性改变率为52．2％,对照女工为9．4％,差异有显著性（P＜0．01）。前纺车间女工呼吸系统症状阳性率及肺功能FEV1.0异常急性改变率明显高于络筒和织布车间。结论 棉纺女工出现呼吸系统症状阳性率增高及肺功能急性下降,可能与车间空气中微生物污染程度有关。     

Immunological findings and respiratory function in cotton textile workers

Summary Immunological parameters were studied in a group of 24 cotton textile workers. These were volunteers from a cohort of 106 (83 women and 23 men) previously studied textile workers. A group of 30 employees from a bottle packing plant served as a control for the immunologic studies. The subgroup of volunteers undergoing immunologic testing did not differ from the original cohort of textile workers in age, sex, smoking history, or prevalence of most chronic respiratory symptoms, nor were there any significant differences in baseline lung function or across-shift changes. The 24 cotton worker volunteers underwent skin testing with extracts of cotton dust and cotton seed. Eight of these 24 (33.3%) had positive tests, and 5 of the 8 had elevated serum immunoglobulin E (IgE) levels. Only one of the 8 skin-test-positive workers had symptoms of byssinosis. Only 1 of 30 control workers' skin tested with cotton extract reacted, and none had an increased serum IgE level (P < 0.01). Both baseline lung function and across-shift changes did not differ between workers with positive and negative skin test reactions or between workers with normal and elevated IgE levels. Additionally, we studied the response in vitro of nonsensitized guinea pig trachea to cotton bract extract and demonstrated a dose-dependent contractile response. These data suggest that while immunological findings are frequent in textile workers, they correlate poorly with respiratory symptoms and function and may not be the basis for the airway obstruction seen in this disease.Supported in part by grant no. YF 733 from the National Institutes of Health, Bethesda, Maryland, USA, grant no. R01 OHO 2593-01A1 from the National Institute of Occupational Safety and Health, Centers for Disease Control, Atlanta, Georgia, USA, and the Henry and Catherine Gaissman Fund, New York, NY, USA     

Predictors of early leaving from the cotton spinning mill environment in newly hired workers

Objective

This longitudinal study aimed to identify the predictors of leaving during the first year of employment from the cotton spinning mill environment in newly hired workers.

Methods

One hundred and ninety eight consecutively appointed new employees were investigated by questionnaire, lung function test, and skin test. They were examined before employment and at the end of the 1st week, and the 1st, 3rd, 6th, and 12th month after starting work and when possible before leaving their job. 572 personal dust sampling and 191 endotoxin measurements were performed to assess the environmental exposure. For the univariate analysis χ², Student t tests, ANOVA, and Kruskall Wallis tests were used. Cox proportional hazards analysis was used to identify factors associated with leaving the job.

Results

Fifty three per cent of workers left the mill environment during their first working year. Work related lower respiratory tract symptoms reported at the third month were associated with an increase rate of leaving the industry compared to those remaining in the industry (25% v 4.8%; p<0.005). Having respiratory symptoms at the first month of work predicted those leaving the industry at some point in the next 11 months. According to the Cox model, increasing age and having work related lower respiratory tract symptoms were found to be predictors for leaving job at the first working year. Atopic status, dust and endotoxin levels, and lung function changes were not consistently predictive of workers who left the industry in the follow up period.

Conclusion

This study demonstrated that work related respiratory symptoms can predict workers likely to leave the cotton mill environment during the first year of employment, but atopy or acute lung function changes do not.     

Respiratory function of textile workers employed in dyeing cotton and wool fibers

A group of 135 textile dyeing workers (97 male and 38 female) was studied for the prevalence of acute and chronic respiratory symptoms and lung function changes. Respiratory symptoms were elicited by a standardized questionnaire, and lung function testing was performed before and after the morning shift by recording maximum expiratory flow-volume (MEFV) curves. In addition, 103 nonexposed control workers were studied. The prevalence of all chronic respiratory symptoms was significantly higher in the exposed than in the control workers; in particular, the prevalence of occupational asthma was 6%. The exposed nonsmoking workers had more complaints than the controls who were nonsmokers. As expected, most of the symptoms were more prevalent in smokers than in nonsmokers. Nonsmokers with both long- and short-term work exposure had higher prevalences of dyspnea and rhinitis than control workers. Smokers exposed for 10 years or less had significantly higher prevalences of chronic phlegm than nonsmokers with the same duration of exposure (p < 0.05). In workers exposed for >10 years, there were significantly higher prevalences of chronic cough, chronic phlegm, and chronic bronchitis in smokers than in nonsmokers (p < 0.01). A high prevalence of shift-related symptoms was found in exposed workers. Significant across-shift reductions of ventilatory capacity tests were documented in this cohort and varied from an average of 4.0% for FVC to 14.2% for FEF₂₅. Preshift values of ventilatory capacity were significantly lower in this exposed population compared to predicted values suggesting a chronic effect. Our data suggest that textile dyeing workers develop acute and chronic respiratory impairment as a result of their exposures. These findings are exacerbated by cigarette smoking. Am. J. Ind. Med. 31:344–352, 1997. © 1997 Wiley-Liss, Inc.     

Follow-up study of respiratory health of newly-hired female cotton textile workers

BACKGROUND: Numerous studies have investigated adverse effects of exposure to cotton dust on respiratory health, but very limited longitudinal data are available with regard to the early pulmonary response to cotton dust. Moreover, the adverse effects of occupational exposure to cotton dust have been difficult to separate from the confounding effects of smoking. This setting provided a unique opportunity to evaluate early respiratory effects in newly hired and non-smoking female textile workers. METHODS: To identify early pulmonary responses to cotton dust exposure and associated gram-negative bacterial endotoxin, respiratory symptoms and pulmonary function in 225 newly-hired textile workers were assessed at work initiation, and at three and twelve months later. RESULTS: All the workers were females and nonsmokers, with an average age of 18 years. Symptom incidence at three months was 3.6% for usual cough with phlegm, and 6.7% for usual dry cough. Lung function changes were detectable at one year: FEV1 declined by 70 ml and FVC by 124 ml over the year, and workers reporting respiratory symptoms at three months showed a significantly greater cross-shift drop in FEV1 (- 2.3%) than those without the symptoms (- 0.7%). CONCLUSIONS: These results suggest that the occurrence of respiratory symptoms represents the earliest response to cotton dust exposure, followed by lung function changes. Early respiratory symptoms may be a risk factor for subsequent loss of pulmonary function in cotton textile workers.     

A cohort mortality study of construction workers

This report presents a mortality study among the 17,344 members of the Construction Workers' Health Insurance Society of Mie Prefecture in Japan. The study period was between 1973 and 1993. During this period, 480 members died. Age-specific mortality rates of Mie Prefecture were used as comparison standards. Significantly elevated standardized mortality ratio (SMR) and proportionate mortality ratio (PMR) were observed for “accidents and adverse effects.” In addition, the PMRs of all cancers and “cancers of trachea, bronchus and lung” were also significantly elevated. The job classifications were reorganized into three groups, according to the frequency of asbestos exposure the workers experienced on the construction sites. The asbestos exposure was based on job classifications among 7,411 workers who had completed a self-administered survey questionnaire. In the frequent-exposure group, the PMR was significantly elevated for all cancers. In the medium-exposure group, the SMRs were significantly elevated for all cancers and “cancer of trachea, bronchus and lung.” The PMR was significantly elevated for “cancer of trachea, bronchus and lung.” In the less-exposure group, the PMR was significantly elevated for “accidents and adverse effects.” This study provided support for the hypothesis that working in the construction industry might be associated with high risks for asbestos-associated cancers and accidental deaths. Am. J. Ind. Med. 32:35-41, 1997. © 1997 Wiley-Liss, Inc.     

Respiratory findings in synthetic textile workers

We studied 308 female and 92 male textile workers employed in a factory that produced synthetic fiber hosiery. The mean age of the women was 38 years, their mean duration of employment 16 years. The mean age of the men was 39 years with a mean duration of employment of 16 years. A control group of 160 female and 78 male nonexposed workers was also studied. Chronic and acute work related symptoms were recorded for all workers. Ventilatory capacity was measured by recording maximum expiratory flow-volume (MEFV) curves from which the forced vital capacity (FVC), the 1-sec forced expiratory volume (FEV₁) and maximum expiratory flow rates at 50% and the last 25% (FEF₅₀, FEF₇₅) were read. There was a higher prevalence of all chronic respiratory symptoms in exposed than in control workers, although the differences were statistically significant only for dyspnea, sinusitis, and nasal catarrh (P < 0.01) in female synthetic textile workers, and for nasal catarrh (P < 0.01) in male synthetic textile workers. Occupational asthma was recorded in 3 (0.9%) of the women textile workers, and in 1 (1.1%) of male textile workers. There was a high prevalence of acute symptoms during the work shift, which was greatest for cough (female: 46%; male: 59%), dryness of the throat (female: 49%; male: 40%), dryness of the nose (female: 53%; male: 43%) and eye irritation (female: 46%; male: 36%). Ventilatory capacity data among the synthetic textile workers demonstrated significantly decreased FEF₇₅ compared to predicted (P < 0.05). Our data suggest that inhalation of dust in synthetic textile plants causes the respiratory impairment. Am. J. Ind. Med. 33:263–273, 1998. © 1998 Wiley-Liss, Inc.     

Malignant mesothelioma in non-asbestos textile workers in Florence

By means of a review of histological diagnosis in the Pathology Department of the University of Florence, suspected cases of malignant mesothelioma, diagnosed in the period 1979-1984, were identified. Study of histological specimens permitted the selection of 13 cases of malignant mesothelioma resident in the Province of Florence. To these cases, referents were matched for age, sex, and year of hospital admission, with residence weighted for the general population of the Province. Both cases and referents (or their next of kin) completed an occupational questionnaire detailing possible occupational exposures. Out of the 13 cases of mesothelioma, 6 were textile workers and 5 of these were "rag-sorters". There were only 5 textile workers among the 52 controls. No asbestos cloth production plants have been in operation in the area from which the cases and referents are derived. Possible sources of exposure to asbestos in the textile industry of this area are discussed.     

Cause-deleted proportional mortality analysis and the healthy worker effect

This paper evaluates the relationships between various indices of proportional mortality, used in occupational and other settings where denominator data are unavailable. In particular, we examine the necessary conditions for validity of the proportional mortality ratio (PMR) and mortality odds ratio (MOR) as estimates of the standardized mortality ratio (SMR), in general and for the situation where one considers only a subset of deaths, with certain causes of death deleted from the data. We may exclude data in this way to avoid the inflationary effect on the PMRs for some causes of death (e.g. cancer) that results from a 'healthy worker effect' for other causes of death (e.g. heart disease). We find that cause-deleted PMRs and MORs may be unbiased estimates of their corresponding SMR, and these indices appear most useful for specific hazards of employment or relatively infrequent causes of death.     

发达国家和发展中国家降低孕产妇死亡率的实践与回顾

孕产妇死亡率(maternal mortality ratio,MMR)至今在全球诸多地区仍高居不下.据WHO估计,全球每年约529 000名孕产妇在妊娠、分娩或产后期死亡[1].每分钟全球就有1名妇女死于与妊娠或分娩有关的并发症,并且几乎99%的孕产妇死亡在发展中国家,其中有88%～98%的孕产妇死亡是可以避免的[2],这使得MMR成为发达国家与发展中国家之间差异最大的卫生指标.在西非,每12名妇女中就有1名死于妊娠、分娩有关的原因;而在北欧,这一比例仅为1/4000[3].     

A proportional mortality ratio study of workers in a construction equipment and diesel engine manufacturing plant

The mortality of 461 workers who were employed 10 or more years in a Midwest engine and construction equipment plant was examined, using the method of proportional mortality ratios. Both state and national deaths were used as the standard population. Major exposures in this plant included solvents, cutting oils, and metal fumes and dusts. However, precise exposure data were not available. Among white males, no significant deviations from expected deaths were found. Among black males, significant excess deaths were found for all malignant neoplasms combined, for cancer of the pancreas, and for non-Hodgkin's lymphomas. Proportional cancer mortality ratios produced similar results, although the excess of pancreatic cancer in blacks was only significant among those with 20 or more years of service. Although complete occupational histories were not available, these results may provide hypotheses for future studies of workers in heavy machinery production.     

纺织厂挡车工个体噪声暴露测量的评价

目的比较个体计量仪与声级计评价挡车工噪声暴露的异同。方法用个体计量仪采集一工作日内挡车工的噪声暴露动态资料并将数据传输至微机存储和分析。选择前纺、细纱、布机车间使用不同类型机器的6组挡车工作为观察对象,每组3～5人,分别在早、中、晚班各测量1个班次的个体噪声暴露数据。同时采用网格法和普通声级计测量噪声水平。结果个体计量仪测定结果显示,挡车工在一个工作日内噪声暴露的水平是稳定的：对同一组档车工的测量结果表明,挡车工个体间噪声暴露水平的变异大于不同工作日之间的变异。个体计量仪测量的噪声暴露水平等于或高于声级计测量的结果,最大可达4．6dB（A）。结论噪声个体计量仪可以连续动态记录挡车工的实际噪声暴露,其结果高于或等于声级计定点测量结果。在今后噪声暴露评价时应考虑采用这种测量方法。     

A case-referent study of lung tumors in non-asbestos textile workers

A case series in the Province of Florence showed an increased risk of mesothelioma in textile workers (nonasbestos) and a survey of working conditions confirmed potential exposure to asbestos. In order to investigate the risk in textile workers, including some specific job titles, a case-referent study on lung tumors was carried out. The lung cancer cases included 441 males with histologically confirmed primary lung cancer during the period 1980-1983. Referents included 1,075 males selected from two hospitals and matched for age, sex, and smoking habits. Those who had "ever worked" in the textile industry showed an adjusted odds ratio of 1.52 (95% C.I. 1-2.25) compared with other "industrial workers." This moderately increased risk is maintained in selected jobs in the textile industry. An analysis of the modifying effect of time factors showed an increased risk in the period of 15-35 years from the date of first employment in the industry. The results support the hypothesis that a probable risk of lung cancer in textile workers in the Prato area was related to asbestos exposure.     

汽车铸造作业工人队列死因研究

目的 分析危害汽车铸造作业工人健康的主要疾病,探讨铸造作业有害因素对工人寿命的影响.方法 采用流行病学队列研究方法,以某汽车铸造厂1980年在册的3529名职工为研究对象,从1980年随访至2005年底,以全国城市居民年龄别死亡率均值为参照,用标化死亡比(SMR)作为统计指标,并计算95%可信区间.结果 随访至2005年底,共计84 999人年,共死亡265人,死亡率3.12‰,累积死亡率为7.51%.铸工队列全死因SMR为0.96(95%CI:0.85～1.08)与全国平均水平持平,随着年龄增长,全死因SMR呈现升高趋势,50岁以上组工人的SMR均大于1.影响铸造工人寿命的主要疾病按累积死亡率从高到低排序分别是:恶性肿瘤(3.43%)、意外伤害(1.16%)、脑血管疾病(1.08%)、心血管疾病(0.79%).恶性肿瘤占总死亡原因的45.7%.铸造工人中死亡率明显升高的疾病有恶性肿瘤(SMR=7.87)、意外伤害(SMR=2.70)、心血管疾病(SMR=2.68)、消化系统疾病(SMR=2.79).一线作业工人恶性肿瘤死亡是辅助丁人的1.95倍(RR=1.95,P<0.05).结论 铸造作业中粉尘等职业危害因素明显影响工人的健康,恶性肿瘤死亡明显增加,应加强防护.     

中国石棉接触人员癌症死亡队列研究的Meta分析

目的以M eta分析探讨单纯接触温石棉人员癌症是否高发。方法凡满足明确是中国石棉接触人员且为癌症死亡率队列研究的资料均被纳入研究对象,以直接法与随机效应模型法计算主要部位癌症标准化死亡比(SMR)及其95%可信区间(CI),计算Q统计量与Z值检验研究结果异质性及其来源。结果共有13个队列符合入选标准,平均间皮瘤死亡百分比为0.62%,全死因、全癌亡、肺癌的M eta-SMR显著上升(分别为1.51、1.96、4.54),单纯接触温石棉人员肺癌的M eta-SMR也显著上升(4.39),消化系统、喉、乳腺和生殖泌尿系统等其他部位癌症的M eta-SMR未见显著上升。结论单纯温石棉暴露能使作业人员肺癌、间皮瘤显著高发,与其他部位癌症无病因联系。     

上海市青浦区某乡镇企业外来务工人员生活水平现况调查

目的 了解外来务工人员生活质量和主要健康生活方式,为改善和提高其生活质量提供依据.方法 对上海市青浦区某社区企业员工进行整群随机抽样,统一制订调查问卷,采取一对一问卷的方式进行调查,调查主要内容包括收入、居住环境、工作时间、休息时间和嗜好等,用成组比较的方法进行分析.结果 调查1 607名企业员工,其中外来务工人员803人,该地户籍员工804人;外来务工人员主要存在收入低、居住环境差、工作时间长、休息时间无保证等问题;外来务工者中吸烟、饮酒不良嗜好较严重;日均工作时间超过8h,平均在9h以上,周工作时间达6d,收缩压和舒张压均值分别为135和82 mm Hg;日均睡眠时间7.2 h,入睡时间短于20 min;大部分人的月均收入在2 500～3 500元.结论 外来务工人员生活质量尚可,身体健康,但是不能忽视健康工人效应;不良生活习惯对今后的健康潜在威胁.