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.     

Respiratory symptoms and lung function in wool textile workers

Our study investigated a group of 216 wool textile workers (158 women and 58 men). Respiratory symptoms were assessed by questionnaire in wool textile workers and in 130 not exposed (control) workers. Ventilatory capacity was measured in wool workers by recording maximum expiratory flow-volume (MEFV) curves on Monday before and after the work shift. Forced vital capacity (FVC), 1-second forced expiratory volume (FEV₁), and flow rates at 50% and the last 25% of the vital capacity (FEF₅₀, FEF₂₅) were measured on the MEFV curves. Analysis of the data demonstrated a significantly higher prevalence of all chronic respiratory symptoms in wool workers than in controls. being the highest in wool workers for nasal catarrh (M: 63.8%; F: 44.9%) and for sinusitis (M: 62.1%; F: 43.0%). A high prevalence of acute symptoms, associated with the work shift, was also noted in wool workers. Exposure to wool dust caused significant across-shift reductions of ventilatory capacity varying from 1.4% for FEV, to 9.1% for FEF₅₀. Textile workers exposed to wool for > 10 years in the workplace had similar across-shift reductions of ventilatory capacity tests as those with shorter exposures. In a large number of these wool workers, FEF₅₀ and FEF₂₅ were below 70% of predicted normal values. Smokers had acute and chronic lung function changes similar to those of nonsmokers, indicating that smoking did not account for all the respiratory effects seen in wool processing workers. Our data suggest that dust exposures in wool textile mills may be associated with the development of chronic respiratory symptoms and impaired lung function.     

Longitudinal study of respiratory findings in rubber workers

A cross-sectional assessment of respiratory function and symptoms was performed in 1985 on 409 male rubber workers and 172 unexposed control workers. A follow-up study in 311 of the original rubber workers was performed 6 years later. Ventilatory capacity was measured by recording maximum expiratory flow-volume (MEFV) curves. At the time of the initial study, significantly higher prevalences of all chronic respiratory symptoms, except for asthma, were found among the rubber workers compared to controls. Smokers had a significantly higher prevalence of most of the chronic respiratory symptoms compared with nonsmokers. A high prevalence of acute symptoms during the workshift was recorded among the rubber workers at both surveys. Rubber workers demonstrated significantly lower ventilatory capacity measurements compared to predicted. Ventilatory capacity measurements diminished significantly across the workshift, particularly FEF50 and FEF25. Metaproterenol inhaled at the end of the workshift significantly improved lung function in a small group of sensitive rubber workers. Annual lung function loss among both smokers and nonsmokers was in excess of predicted. Our data suggest that exposure to noxious agents in the rubber industry are associated with the development of acute and chronic respiratory impairment. © 1996 Wiley-Liss, Inc.     

Respiratory function in shoe manufacturing workers

A study of respiratory findings was performed on 376 female workers employed in a shoe manufacturing plant. The mean age of the workers was 32 years and the mean duration of their employment was 12 years. These workers were predominantly nonsmokers. Acute and chronic respiratory symptoms were recorded for each worker, and lung function was measured before and after the work shift. Maximum expiratory flow-volume (MEFV) curves were performed on which forced vital capacity (FVC), 1-second forced expiratory volume (FEV₁), and flow rates at 50% and the last 25% (FEF₅₀, FEF₂₅) were measured. Significantly higher prevalences of all chronic respiratory symptoms were recorded in exposed compared to control workers; in particular, chest tightness (exposed: 44.7%; control: 0%), dyspnea (exposed: 42.6%; control: 2.0%), and rhinitis (exposed: 46.3%; control: 2.4%) were far more prevalent in workers than in controls. Among the shoe workers, there was also a high prevalence of acute symptoms that developed during the work shift, being most pronounced for nose and throat irritation (61.4%). The prevalence of acute and chronic respiratory symptoms increased with duration of employment. Statistically significant across-shift reductions were recorded for all ventilatory capacity tests for the group as a whole. In comparison to predicted, the measured ventilatory capacity parameters were significantly lower for all workers (p < 0.01). Lung function abnormalities increased with duration of employment. Environmental measurements demonstrated that benzene, fur, and synthetic fibers were found at higher than allowable maximal concentrations (Croatian standards). The data suggest that work in the shoe manufacturing industry may be responsible for the development of acute and chronic respiratory impairment. Am. J. Ind. Med. 31:50–55 © 1997 Wiley-Liss, Inc.     

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 and immunological status in workers employed in a latex glove manufacturing plant

A study was performed in 17 female workers employed in a latex glove manufacturing plant. The mean age of these workers was 42 years and the mean duration of their employment was 19 years. The employees were primarily nonsmokers or light smokers. The presence of chronic respiratory symptoms and acute work-related symptoms was recorded for these workers. Ventilatory capacity was measured during the morning work shift by recording maximum expiratory flow-volume curves from which forced vital capacity (FVC), 1-second forced expiratory volume (FEV₁) and maximum expiratory flow at 50%, and the last 25% of the vital capacity (FEF₅₀, FEF₇₅) were measured. A control group of 17 nonexposed women workers was also studied. The prevalence of chronic respiratory symptoms was greater among latex workers than among control confectionry packer workers, varying from 5.9% (vs. 0% in controls) for occupational asthma to 58.8% (vs. 0% in controls) for dyspnea grades 3 or 4. There was also a high prevalence of acute work-related symptoms in this industry, in particular, eye irritation (76.5%), dryness of the nose (70.6%), throat burning (70.6%), dryness of the throat (64.7%), and cough (58.8%). Among exposed workers, measured ventilatory capacity data were significantly lower than among controls, particularly FEF₇₅ (75.1% ± 10.5%). One of the 17 studied workers (5.9%) had a positive skin reaction to latex and had symptoms compatible with occupational asthma. Our data suggest that in addition to occupational asthma, the manufacture of latex gloves is associated with frequent, nonspecific respiratory findings. Am. J. Ind. Med. 33:175–181, 1998. © 1998 Wiley-Liss, Inc.     

Assessment of respiratory symptoms and lung function values among the brick field workers of West Bengal,India

Brick manufacturing process releases large amounts of silica dust into the work environment due to the use of silica-containing materials. The main aim of the study was to investigate the impairment of lung function and prevalence of respiratory symptoms among the different groups of brick field workers in comparison with control subjects. A total of 250 brick field workers and 130 unexposed control subjects were randomly selected in which demographic characteristics, respiratory symptoms, and lung function values were recorded. The result showed significantly lower p value (<.001) in lung function and respiratory symptoms among brick field workers when compared with control group. The prevalence of respiratory symptoms was dyspnea (46.8%), phlegm (39.2%), and chest tightness (27.6%). Dust exposure in working environment affected the lung function values and increased the respiratory symptoms among the brick field workers.     

Respiratory function in vineyard and orchard workers

A group of 174 male vineyard and orchard workers was studied for the prevalence of acute and chronic respiratory symptoms and lung function changes. In addition, 115 male control workers were studied for the prevalence of chronic respiratory symptoms. There was a significantly higher prevalence of dyspnea and chest tightness in exposed compared to control workers. In particular, exposed nonsmokers had significantly higher prevalences of dyspnea and chest tightness than controls; this was found for exposed nonsmokers with both short (≤10 years) and long (>10 years) exposure. Smokers exposed for more than 10 years had significantly higher prevalences of chronic cough, chronic phlegm, chronic bronchitis, and chest tightness than smokers with shorter exposures (p < 0.01 or p < 0.05). Workers employed for more than 10 years had higher prevalences of most of the acute (shift-related) symptoms than those workers with shorter employment; however, the differences were significant only for cough in smokers (p < 0.05). Significantly lower than predicted FVC values were measured in smokers and nonsmokers after both short and long duration of employment. Differences between measured and predicted FEV₁, FEF₅₀, and FEF₂₅ were significant for workers employed for more than 10 years. A separate analysis of individual data as a percent of predicted values demonstrated that many workers had FVC (5.2%), FEV₁ (6.3%), FEF₅₀ (27.6%), and FEF₂₅ (40.2%) lower than 70% of predicted values. These data suggest that vineyard and orchard workers may develop acute and chronic respiratory symptoms and lung function changes which are, in part, related to environmental factors and to cigarette consumption. Am. J. Ind. Med. 31:250–255, 1997. © 1997 Wiley-Liss, Inc.     

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.     

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.     

An environmental and medical study of byssinosis and other respiratory conditions in the cotton textile industry in Egypt

This study was conducted in a typical Egyptian textile plant located in Alexandria. Male workers from all operations (N = 506) were examined and their dust exposures were assessed. Results showed that airborne dust concentrations were very high and that the plant fraction is mostly concentrated in respirable dust. Byssinosis prevailed in 21% of workers in opening and cleaning sections and in 13% in carding and combing rooms, but was found in none of the workers in drawing, twisting, and spinning operations, in only 1.1% in weaving, and in 3.1% of workers in other “auxiliary” occupations. The rare prevalence of byssinosis among the latter workers' groups was attributed to the workers' continuous exposure without fixed weekend interruption, the personal and family history of exposure to cotton, the low proportion of plant materials in dust evolved in related operations, the fine quality of Egyptian cotton, and/or the population characteristics of Egyptian workers. Reduction in FEV_1.0 at the end of the first work shift after absence from work occured more often than byssinosis, which indicates the importance of this test for the early detection of effects of cotton dust exposure. It is suggested that a nationwide study in the cotton textile industry is indicated.     

Respiratory function and immunological status in cocoa and flour processing workers

Respiratory function and immunological status were studied in 40 cocoa and 53 flour processing workers employed as packers in a confectionry industry and in 65 unexposed control workers in the same industry. A high prevalence of chronic respiratory symptoms was recorded in exposed workers, varying from 5.0% to 30.0% in cocoa workers and from 5.7% to 28.3% in flour workers. Occupational asthma was diagnosed in 2 (5%) of the cocoa workers and in 3 (5.7%) of the flour workers. None of the control workers suffered from occupational asthma. The prevalence of almost all chronic respiratory symptoms was significantly greater in cocoa and flour workers than in control workers. There was also a high prevalence of acute symptoms that developed during the work shift, being highest for cough (cocoa: 57.5%; flour: 50.9%) and eye irritation (cocoa: 50.0%; flour: 54.7%). Significant across-shift reductions of ventilatory capacity were recorded in exposed workers, being largest for flow rates at 50% and the last 25% of the vital capacity on maximum expiratory flow-volume (MEFV) curves (FEF₅₀, FEF₇₅). The prevalence of positive skin tests for cocoa (60.2%) was significantly higher than the prevalence of positive skin tests for flour (25.8%) among the 93 exposed workers (p < 0.05). Control workers had significantly lower prevalences of positive skin tests to cocoa (4.6%) and flour (12.3%) than exposed workers (p < 0.01). Increased total serum IgE levels were found in 17.5% of cocoa and in 18.7% of flour workers; none of the control workers had increased IgE levels. Bronchoprovocation testing demonstrated significant decreases in lung function following inhalation of cocoa dust extract and flour dust in workers with respiratory symptoms and large across-shift reductions in lung function. Dust concentrations in the working environment were higher than those recommended by Croatian standards. These data suggest that workers employed in the processing of cocoa and flour may be at a high risk for the development of allergic sensitization and respiratory impairment. Am. J. Ind. Med. 33:24–32, 1998 © 1998 Wiley-Liss, Inc.     

Respiratory function in sewage workers

Respiratory symptoms and ventilatory capacity were studied in a group of 74 sewage workers employed in cleaning the city sewage system of Zagreb, Croatia. Workers were studied by their work stations: closed channels (N + 26), drainage (N + 31), and other sewage workers (N + 17). The prevalence of chronic respiratory symptoms was higher in closed channel and drainage workers than in controls, particularly for chronic cough (range: 41.9–46.2% vs. 14.3%), chronic phlegm (range: 38.7–46.2% vs. 14.3%), chronic bronchitis (range: 32.3–42.3% vs. 8.6%), and chest tightness (range: 29.0–53.8% vs. 0%). In the first two groups of sewage workers there was a high prevalence of acute symptoms which developed during the work shift, being particularly pronounced for eye irritation (range: 16.1–26.9%), dyspnea (16.1–23.1%), dizziness (range: 6.5–23.1%), throat burning (9.7–19.2%), and skin irritation (range: 22.6–26.9%). Baseline ventilatory capacity was significantly decreased compared to predicted values in sewage workers; in particular, values for FEF50 and FEF25 were reduced, suggesting obstructive changes in smaller airways. Our data indicate that sewage workers experience frequent acute and chronic respiratory symptoms and exhibit objective evidence of respiratory dysfunction. © 1993 Wiley-Liss, Inc.     

Respiratory function in workers employed in the glassblowing industry

A group of 80 men employed in the glassblowing industry was studied in order to investigate the effect of this occupational exposure on respiratory function. Eighty nonexposed workers were included in the study as a control group. Glassblowers had a significantly higher prevalence of chronic bronchitis, nasal catarrh, chronic sinusitis, and nasal bleeding than control workers; length of employment in the industry did not affect the prevalence of symptoms. Many of the glassblowers complained of work shift related symptoms. Measurement of lung function among glassblowers showed there were significant increases in the forced vital capacity (FVC) and the maximum flow rates at 50% and 25% of FVC on maximum expiratory flow volume (MEFV) curves (FEF₅₀, FEF₂₅) across the work shift. Glassblowers had significantly larger preshift FVC and forced expiratory volume in 1-second (FEV₁) measurements when compared to controls. Additionally, residual volume (RV) and RV/TLC% for the glassblowers were significantly increased while the diffusing capacity (DLCO) was normal (when compared to predicted values). Our data indicate that employment in the glassblowing industry contributes to the development of chronic respiratory findings. © 1993 Wiley-Liss, Inc.     

接触棉尘工人呼吸系统早期反应──症状与肺功能改变

１６３名棉纺厂新工人（既往无棉麻粉尘接触史）入厂１０周后随访发现：４０人（２４．５％）出现呼吸道刺激症状，未观察到典型＂星期一症状＂。各车间症状阳性率呈现随可吸入棉尘浓度或内毒素水平升高而上升的趋势，γ＝０．９４，Ｐ＜０．０１。肺功能改变：入厂后ＦＶＣ比入厂前平均上升１２５．３ｍｌ，Ｐ＜０．０１；ＦＥＶ１平均上升８７．５９ｍｌ，Ｐ＜０．０１。ＦＥＶ１在入厂后占入厂前的比例平均为１０３．８％，其中仅１例低于８０％。班后ＦＶＣ比班前平均下降４６，０８ｍｌ，Ｐ＜０．０１；ＦＥＶ１平均下降１６．４６ｍｌ，Ｐ＜０．０５。班后ＦＥＶ１下降率≥５％者２２人（１３．５％），≥１０％者７人（４．３％）。上述改变与吸烟、暴露水平等因素无关。     

Respiratory health status in swine producers using respiratory protective devices

A cross-sectional survey on respiratory health in swine producers showed that 30% of 301 examined men usually used a dust mask when working inside a barn. They did not differ significantly from dust mask nonusers in respect to respiratory symptoms and lung function. This analysis was undertaken to determine whether the respiratory health of dust mask users was associated with reasons why they had started individual respiratory protection. The subjects were recontacted in order to identify those who started using a mask to deliberately prevent symptoms (42 men) and those who started protection because of pre-existing respiratory symptoms (44 men). Not unexpectedly, betweengroup comparisons of respiratory symptoms and lung function suggest that swine producers who wear dust masks for preventive purposes have better respiratory health than those who wear dust masks because of symptoms or those who do not use individual respiratory protection. The individual reasons for starting dust mask usage should be examined among potential determinants of the outcomes of prospective studies which can then provide more valid assessment of the effect of individual respiratory protection. © 1993 Wiley-Liss, Inc.     

Pulmonary function abnormality and respiratory tract irritation symptoms in epichlorohydrin-exposed workers in Taiwan

BACKGROUND: Epichlorohydrin (ECH) is a strong irritant of the eyes, respiratory tract, and skin. The aims of this study were to examine the dose-response relationship between observed abnormal pulmonary function tests and respiratory tract irritation symptoms among epichlorohydrin-exposed workers in Taiwan. METHODS: A total of 167 workers were randomly selected from a resin synthesis factory. Sixty-six air samples were taken to determine ECH concentration in the workplace. Demographic data, work history, smoking status, and respiratory tract irritation symptoms were gathered by a standard self-administered questionnaire. Pulmonary function tests were also performed. RESULTS: There were 13 of 41 (31.7%) abnormal mean mid-expiratory flow (MMEF) among the high-ECH-exposed workers, 11 of 38 (29%) among the low-ECH-exposed workers, and 4 of 59 (6.8%) among non-ECH-exposed workers. There was a significant linear trend between ECH exposure and the prevalence of small airway abnormalities (P = 0.007) after adjusting for other factors. There was also a significant dose-response relationship of respiratory tract irritation symptoms (cough, phlegm, chest tightness, and dyspnea) among the ECH-exposed workers. CONCLUSIONS: This study suggests that obstructive lung abnormalities and small airway lung damage are associated with ECH exposure. The study also suggests that exposure to very low concentrations (<0.2 ppm) causes significant higher prevalence of respiratory tract irritation symptoms. Causal inferences from the findings cannot be made from this cross-sectional study and further longitudinal studies are needed to better clarify the nature of the observed associations.     

Respiratory symptoms, lung function and cell surface markers in a group of hemp fiber processors

BACKGROUND: Hemp dust exposure is associated with byssinosis and accelerated lung loss in longitudinal studies. The immunological changes associated with hemp dust exposure are less well understood. METHODS: We studied a small group of current male hemp processors with a mean age of 43 years. Questionnaire data, lung function, serial FEV(1) and blood were collected from all workers. RESULTS: In total, seven workers (64%) complained of at least one respiratory symptom (one with byssinosis). The mean percentage predicted FEV(1) was 91.5, FVC 97.7, PEF 92.1, and FEF(25-75) 79.5. Serial FEV(1) measurements in the two workers with work-related respiratory symptoms revealed a mean change in FEV(1) on the first working day of -12.9%. This contrasted with +6.25% on the last working day. Respective values for the two workers without work-related symptoms were -1.4 and +3.2%. CONCLUSIONS: Lung function changes and abnormalities in a profile of cell surface activation markers and antibodies were noted to relate to the presence of work-related respiratory symptoms, not seen in the control group.