Additive effect of smoking and cotton dust exposure on respiratory symptoms and pulmonary function of cotton textile workers

One hundred and sixty-nine and 175 cotton textile workers (CTWs) were enrolled in the first (1991) and second (1996) surveys to investigate the prevalence of byssinosis. The synergistic effect of smoking on cotton dust exposure was also evaluated. Although the difference in prevalence of abnormal pulmonary function between the first (38.5%) and second study (38.9%) was not statistically significant, smokers had significantly higher frequency than nonsmokers in both surveys. A significant trend existed between the cotton dust levels and the frequency of abnormal lung function. The significant trend was also noted in both smokers and nonsmokers. The frequency of respiratory symptoms and the prevalence of severe byssinosis in the second survey (14.9% and 12.6%, respectively) were significantly lower than that in the first survey (39.7% and 21.9%, respectively). The reduction of symptoms was due to remodeling of this old cotton mill. The prevalences of respiratory symptoms and byssinosis in smokers being significantly higher than in nonsmokers only found in the first survey, but not found in the second survey. These results indicate that smoking potentiates the effect of cotton dust exposure on respiratory symptoms and byssinosis. The second study reveals high prevalence of byssinosis still existed in Taiwanese cotton mill, although the prevalence was declining. Smoking was found to show an additive effect on cotton dust exposure. Anti-smoking campaign, occupational health program to reduce the dust exposure, and periodical medical examination are measures to prevent from byssinosis.     

煤尘职业性接触对作业人群肺功能和血液学的影响

目的 探讨煤粉尘对职业性接触人群肺功能和血液学常规的影响.方法 用肺功能仪测定10项肺功能指标,全自动生化仪分析14项血常规指标,进行组间t检验分析.结果 肺功能指标中接尘组所有测定指标均低于对照组,差异有显著性(P<0.05);血常规指标中除红细胞、血细胞压积、中性细胞比率和血小板分布宽度外,其余2组之间差异有显著性(P<0.05).结论 长期接触煤粉尘对职业性接触人群的肺通气功能有一定的损伤作用.     

累积接尘量与吸烟指数对钢铁工人肺损伤的影响

以2017年2—6月进行职业健康查体的某钢铁公司粉尘作业职工作为研究对象,采用现况研究方法,对工人进行面对面问卷调查和肺功能检查。共收集有效样本2 709人,肺功能损伤者为993人,损伤率36. 7%。Logistic回归分析,累积接尘量≥40 g/m3与累积接尘量20 g/m3相比肺功能损伤差异有统计学意义,吸烟指数≥400支/年组与不吸烟组相比肺功能损伤差异有统计学意义;交互作用分析显示,累积接尘量、吸烟指数和肺功能损伤无相乘和相加交互作用。     

室内空气污染对呼吸道症状和肺功能的影响

目的 探讨室内空气污染对呼吸道症状和肺功能的影响。方法 通过逐步回归分析方法分析不同生活燃料造成的室内空气污染对肺功能的影响。结果 分析了10892人的调查资料，在调整了混杂因素影响后，家庭内使用有烟煤的人群产生呼吸道症状(气短、咳嗽和咳痰)的危险性高于使用无烟煤。使用有烟煤患有气短、咳嗽和咳痰的OR值分别为1．71、3．30和4．23；使用无烟煤发生咳嗽、咳痰的危险性分别是使用柴的1．35和1．67倍。改炉灶可以降低这些症状的出现率。结论 使用有烟煤造成的室内空气污染是最大呼气流速(PEER)降低的主要危险因素，其次是无烟煤和柴。     

煤矿工人吸烟与粉尘暴露对肺通气功能的影响

目的 探讨吸烟与粉尘暴露对肺通气功能的影响.方法 选择203名接尘工人(暴露组)和102名非接尘人员(对照组)进行问卷调查和FEV1测定,利用STATA统计软件分析.结果 吸烟对FEV1有影响(F＝15.56,P＝0.001),随吸烟时间和吸烟量的增加FEV1下降量增加(F＝4.01,P＝0.000 4;F＝2.37,P＝0.023 2);吸烟与接尘的交互作用对FEV1有影响,且影响大于单独效应(F＝4.11,P＝0.043 7).结论 吸烟及吸烟与粉尘暴露的联合作用可影响肺通气功能.     

Farm work, dust exposure and respiratory symptoms among farmers

OBJECTIVE: Environmental working conditions in rural areas, notably exposure to organic and mineral dusts, have been associated with increases in respiratory diseases. The objective of this study was to evaluate the prevalence of respiratory symptoms among farmers and the associations of these with occupational risk factors. METHODS: This cross-sectional study was undertaken in 1996 with 1,379 farmers from Southern Brazil. Sociodemographic and farming-production parameters were collected, as were levels of exposure to organic and mineral dusts. Respiratory symptoms were assessed by a modified version of American Thoracic Society-Division of Lung Disease questionnaire. Multiple logistic regression analysis was used in analyses, controlling for confounding factors. RESULTS: The majority (52%) of interviewees worked in activities with intense exposure to dust. Workers on farms with better economic indicators had a lower prevalence of respiratory symptoms. Poultry workers showed more symptoms of chronic respiratory disease (OR=1.60; 95% CI: 1.05-2.42). Farmers exposed to high concentrations of dust had more than 70% higher risk of asthma symptoms (OR=1.71; 95% CI: 1.10-2.67) and chronic respiratory disease symptoms (OR=1.77; 95% CI: 1.25-2.50). CONCLUSIONS: The rural workers studied herein were exposed to high levels of organic and mineral dusts. Those exposed to higher dust concentrations, such as poultry workers, showed an increased risk of work-related respiratory symptoms. The implementation of respiratory protection programs is recommended, emphasizing workers involved with poultry production.     

Agricultural dust exposure and respiratory symptoms among California farm operators

OBJECTIVE: To study whether dust exposure in California agriculture is a risk factor for respiratory symptoms. METHODS: A population-based survey of 1947 California farmers collected respiratory symptoms, occupational and personal exposures. Associations between dust and respiratory symptoms were assessed by logistic regression models. RESULTS: The prevalence of persistent wheeze was 8.6%, chronic bronchitis 3.8%, chronic cough 4.2%, and asthma 7.8%. Persistent wheeze was independently associated with dust in a dose-response fashion odds ratio, 1.2 (95% confidence interval[CI]=0.8-2.0) and 1.8 (95% CI=1.1-3.2) for low and high time in dust. A borderline significant association between chronic bronchitis and dust exposure was found. Asthma was associated with keeping livestock, but not with dust exposure. CONCLUSIONS: Occupational dust exposure among California farmers, only one third of whom tended animals, was independently associated with chronic respiratory symptoms.     

稻谷尘对退休粮工呼吸功能影响的调查

本文报道了130例退休粮工及373例无粉尘接触史的退休工人的呼吸道疾患及肺功能检查的结果,显示接触组的慢性呼吸道疾病症状和体征较对照组有显著意义的升高。肺功能的检查结果表明,接触组的FVC、FEV_1、PEF、V_(75)、V_(50)、V_(25)等指标较对照组有显著的下降,两组的差别有显著及极显著意义。对男粮工与对照组进行了肺功能与接尘、吸烟两因素方差分析,结果表明粉尘和吸烟对V_(50)、V_(250及FEF_(25～75)三项指标有显著的交互作用,即吸烟可以加重粉尘对工人肺功能的影响。     

Respiratory symptoms and ventilatory function in sisal dust exposure

Summary A study of respiratory symptoms and ventilatory function was made in a group of 51 non-smoking female workers exposed to sisal dust and 51 control subjects matched in age and height. A higher prevalence of persistent cough (17.6%), persistent phlegm (13.7%), chronic bronchitis (9.8%) and nasal catarrh (19.6%) was found in sisal workers than in controls (5.9, 5.9, 5.9 and 0%, respectively). Not a single case of byssinosis was found in the workers surveyed.In sisal workers, FEV_1.0, FVC and PEF significantly decreased over the work shift (P<0.01). Control workers did not show significant acute changes in ventilatory function over the shift. Inhalation of Alupent (orciprenaline) before the shift significantly diminished acute reductions in ventilatory capacity during the shift. The results suggest that sisal dust does not cause byssinosis but affects ventilatory function of the exposed workers.     

Exposure to grain dust and changes in lung function

Respiratory symptoms and lung function were assessed in 41 seasonal grain handlers and related to duration of employment and level of exposure to grain dust. Ten public works department employees, not exposed to grain dust, were examined during the same period. Respiratory symptoms, forced expired volume in one second (FEV1), and bronchial responsiveness (dose of methacholine provoking a 20% fall in FEV1-PD20) were assessed before starting work and at weekly intervals during a period of employment lasting up to four weeks. Two atopic grainhandlers with pronounced bronchial hyperresponsiveness (PD20 less than 1 mumol) and a history of asthma withdrew from the study within two weeks because they developed severe asthma. Respiratory symptoms were more frequent and more often attributed to work in the grainhandlers than in the non-exposed subjects. In the grainhandlers the FEV1 decreased by a mean (95% confidence intervals) of 321 ml (198-444) (p less than 0.05) and the mean (95% confidence interval) PD20 decreased from 20.6 mumol (10.3-41.2) to 6.0 mumol (2.8-12.5) (p less than 0.05) after one week of work. Over the next three weeks the mean FEV1 returned towards the prestudy values. The mean PD20, however, remained significantly lower than the initial value. The mean FEV1 and PD20 did not change significantly in the non-exposed subjects. The frequency of symptoms and decreases in FEV1 were greater in grainhandlers when working in jobs where total exposure to dust was greater than 20 mg/m3 than when working in jobs where it was less than 10 mg/m3. The results indicate that occupational exposure to grain dust results in respiratory symptoms and changes in lung function, including increased airway responsiveness, within the first week of exposure to grain dust at work. These changes appear to be determined by the degree of dust exposure and suggest a direct effect of grain dust on the lung in these subjects.     

Respiratory symptoms and lung function following exposure in workers exposed to soft paper tissue dust

Summary The objective of this study was to investigate if the dust in a mill producing soft paper tissue caused respiratory symptoms or impaired respiratory function. Using a questionnaire and spirometry, 355 persons were examined. They were divided into three groups according to present exposure to dust; low (< 1 mg/m³), moderate (1–5 mg/m³) and heavy (> 5 mg/m³). There was a dose-dependent increase of symptoms from the upper respiratory tract. However, coughing and coughing with phlegm were not found to be more common among persons with heavy exposure compared to those with low exposure to the dust. There was no difference in FEV, or FVC during a work shift. Persons with long-term (> 10 years) and heavy exposure to dust seemed to have impaired respiratory function compared to those with low and/or short-term exposure to the dust.     

Effect of carbon black exposure on respiratory function and symptoms

Carbon black is a widely used pigment and filler. Some, but not all, previous studies have suggested an effect of long-term exposure upon the lungs. Carbon black production facility employees (1755) participated in the third round of the industry-wide medical surveillance testing. They were employed in 22 North American plants. Spirometry and a systematically administered questionnaire were included in the year 2000 round of the industry-wide medical surveillance program. Industrial hygiene data from an industry-wide survey in 2000-2001, as well as all available exposure assessment data collected since 1979, were integrated with process questionnaires and exposure rating questionnaires completed by plant personnel. Analyses included multiple linear regression and categorical data analyses. Multiple regression analyses showed statistically significant, consistent relationships between cumulative exposure and small reductions in forced expiratory volume in 1 second (FEV1) but not with other spirometry parameters. The estimated slopes were -2 mL FEV1 per mg-year/m3 of cumulative 'total' dust exposure and -0.7 mL FEV1 per mg-year/m3 of cumulative exposure for the inhalable fraction. In addition, heavy cumulative exposures were associated with a small increase in chronic bronchitis in nonsmokers. Recent exposures, typically much lower than in the past, were not demonstrated to be associated with these effects. Consistent with good occupational hygiene practice for any contaminant, workplace exposures to carbon black should be controlled to lowest practical levels.     

Adverse effects of asbestos exposure and smoking on lung function

BACKGROUND: Exposure to asbestos is a well-recognized cause of both malignant and nonmalignant diseases of lung parenchyma and pleura. This study was conducted to determine the adverse effects of exposure to asbestos and smoking on pulmonary function. METHODS: Four hundred and sixty-eight workers who were occupationally exposed to asbestos for an average of 13 years were selected from an asbestos-product factory in China. Of them, 85 workers were diagnosed with asbestosis. Additionally, 282 workers who had no experience of exposure to industrial dust were included as a control group. A questionnaire was administered during a face-to-face interview and spirometric maneuvers and single-breath CO diffusing capacity (DL(CO)) were performed. RESULTS: Multivariate regression analysis showed that exposure to asbestos was more strongly associated with decreased forced vital capacity (FVC) and DL(CO), and asbestosis more strongly associated with decreased FVC, while smoking was a major contributing factor to reduced FEV1/FVC. The results were confirmed by a further analysis where the subjects were grouped exclusively by smoking, asbestos exposure, and chest radiographic changes. No interaction or joint effect was observed between asbestos exposure and smoking. CONCLUSIONS: This analysis suggested that asbestos and smoking might play independent roles, in which asbestos caused mainly a restrictive impairment, and smoking was a major causal factor for airway obstruction in the workers who were intensively exposed to asbestos.     

Exposure to grain dust and changes in lung function.

Respiratory symptoms and lung function were assessed in 41 seasonal grain handlers and related to duration of employment and level of exposure to grain dust. Ten public works department employees, not exposed to grain dust, were examined during the same period. Respiratory symptoms, forced expired volume in one second (FEV1), and bronchial responsiveness (dose of methacholine provoking a 20% fall in FEV1-PD20) were assessed before starting work and at weekly intervals during a period of employment lasting up to four weeks. Two atopic grainhandlers with pronounced bronchial hyperresponsiveness (PD20 less than 1 mumol) and a history of asthma withdrew from the study within two weeks because they developed severe asthma. Respiratory symptoms were more frequent and more often attributed to work in the grainhandlers than in the non-exposed subjects. In the grainhandlers the FEV1 decreased by a mean (95% confidence intervals) of 321 ml (198-444) (p less than 0.05) and the mean (95% confidence interval) PD20 decreased from 20.6 mumol (10.3-41.2) to 6.0 mumol (2.8-12.5) (p less than 0.05) after one week of work. Over the next three weeks the mean FEV1 returned towards the prestudy values. The mean PD20, however, remained significantly lower than the initial value. The mean FEV1 and PD20 did not change significantly in the non-exposed subjects. The frequency of symptoms and decreases in FEV1 were greater in grainhandlers when working in jobs where total exposure to dust was greater than 20 mg/m3 than when working in jobs where it was less than 10 mg/m3. The results indicate that occupational exposure to grain dust results in respiratory symptoms and changes in lung function, including increased airway responsiveness, within the first week of exposure to grain dust at work. These changes appear to be determined by the degree of dust exposure and suggest a direct effect of grain dust on the lung in these subjects.     

吸烟对慢性阻塞性肺疾病及呼吸道症状的影响

  目的   探讨吸烟对慢性阻塞性肺疾病(chronic obstructive pulmonary disease, COPD)及呼吸道症状的影响。   方法   利用多阶段分层整群随机抽样的方法在安徽5个COPD监测点抽取≥40岁调查对象, 并对其进行问卷调查、身体测量和肺功能检测。利用复杂抽样Logistic回归分析模型分析吸烟对COPD及呼吸道症状的影响。   结果   ≥30包年的吸烟者在总人群中占13.9%(95% CI:10.3%~17.5%, P < 0.001), ≥40年的吸烟者在总人群中占8.5%(95% CI:6.7%~10.3%, P < 0.001)。吸烟者平均吸烟年数为32.4 (95% CI:31.2~33.5)年, 吸烟者日均吸烟量为21.1 (95% CI:19.6~22.7)支/天。调整混杂因素后, COPD和呼吸道症状的患病风险均随吸烟包年和吸烟年数的增加而呈上升趋势(均有P_trend < 0.001)。   结论   吸烟增加COPD及呼吸道症状的患病风险, 吸烟包年和吸烟年数越多, 慢阻肺和呼吸道症状的患病风险越大。     

吸烟与粉尘接触对蔺草工人第1秒用力呼气量的影响

目的 探讨蔺草粉尘接触与吸烟对工人第1秒用力呼气量(FEV1.0)的影响.方法 选择蔺草接尘工人122名为接触组,118名非接尘人员为对照组,进行问卷调查和FEVL11.0的测定,分析粉尘接触与吸烟对工人FEV1.0的影响.结果 接尘组FEV1.0%(81.8%±13.9%)明显低于对照组(95.9%±15.3%),差异有统计学意义(t=7.49,P＜0.01).接尘组FEV1.0%异常率为46.7%(57/122)明显高于对照组(8.5%,10/118),差异有统计学意义(x2=43.6,P＜0.01).吸烟组FEV1.0%(82.02%±12.9%)明显低于不吸烟组(93.33%±12.4%),差异有统计意义(t=5.18,P＜0.05).吸烟组FEV1.0%异常率(55.9%)明显高于不吸烟组(16.7%).差异有统计意义(x2=22.2,P＜0.05).接尘工龄与FEV1.0%呈负相关,差异有统计学意义(Rs1=-0.299,P=0.0008).接尘与吸烟对FEV1.0%有影响(F吸烟=42.42,F接尘=259.06.均P＜0.01),且接尘与吸烟的交互作用影响大于单独效应(F=34.70,P＜0.01).结论 粉尘接触、吸烟及其联合作用可影响蔺草工人的肺功能.

Abstract：

Objective To study the effect of smoking and rush-mat dust exposure on pulmonary function. Method 122 rush-mat dust exposed workers and 118 controls without dust exposure were selected.Questionnaire and FEV1.0 measurement were performed on them. Results For dust exposure, FEV1.0% of cases (81.8%±13.9% ) was statistically lower than controls (95.9%±15.3% )(t=-7A9,P＜0.01 ),the abnormal rate of FEV1.0% was 46.7%(57/122) for cases, statistically higher than controls (8.5%,10/118),x2=43.6,P＞＜0. 01. For smoking, FEV1.0% of cases(82.02%±12.9%)was statistically lower than controls(93.33%±12.4%), t=-5.18, P＜0.05,the abnormal rate of FEV1.0% is 55.9% for cases, statistically higher than controls(16.7% ),x2=22.2, P＜0.05.The exposing ages of workers has negative correlation with FEV1.0% (Rs1 =-0.299, P =0.0008).Exposure and smoking could affect FEV1.0% (Fe =259.06, P＜0.01, Fs =42.42, P＜0.01 ),and their interactive effect on FEV1.0%was greater than single ones (F=34.70,P＜0.01). Conclusion Rush-mat dust exposure, smoking and their interaction have influnce on FEV1.0%.     

The joint effect of smoking and respiratory symptoms on risk of lung cancer

In 1962 a cohort of 4604 Finnish men were interviewed about their smoking habits and cardiorespiratory symptoms. The cohort was followed up for deaths and incidence of lung cancer from 1963 to 1980 in order to study the effect of smoking and respiratory symptoms on the risk of lung cancer. The joint effect of smoking, age and respiratory symptoms on the risk of lung cancer was studied using a log-linear modelling technique. When analysed simultaneously with smoking, the symptoms of phlegm, shortness of breath and wheezing were all significantly associated with increased lung cancer risk. The joint effect of smoking and phlegm as well as that of smoking and wheezing was close to being multiplicative. Even if smoking is a causative factor in both these symptoms and in lung cancer, the symptoms seem to have a separate role as predictors of lung cancer risk.     

Effects of chronic organic dust exposure on respiratory function and airway responsiveness in peat moss factory workers

Fifty-two males and 1 female, who were 19 to 62 y of age (median = 26), were employed at an eastern Quebec peat moss plant and were included in this study. Of these 53 workers, 29 were smokers, 5 were ex-smokers, and 19 had never smoked. The workers were divided by level of exposure into 4 groups: (1) group 1--minimal exposure (N = 7); (2) group 2--light exposure (N = 7); (3) group 3--moderate exposure (N = 17); and (4) group 4--heavy exposure (N = 22). Chest radiographs and physical examinations were normal for all subjects. Only 1 subject had precipitins to Penicillium and Monocillium species isolated from the peat moss plant. Pulmonary function tests were normal and similar in all groups. Thirty-three subjects (20 smokers, 4 ex-smokers, and 9 nonsmokers) had chronic bronchitis; these symptoms were related to work exposure for 28 subjects. Bronchial responsiveness to methacholine was measured in 14 subjects who had persistent cough and sputum. No subject had evidence of airway hyper-responsiveness, i.e., PC20 metacholine less than 8 mg/ml. We concluded that the peat moss workers in our study showed no evidence of extrinsic allergic alveolitis; however, chronic exposure to organic dust leads to chronic cough and sputum production, which is not associated with significant lung impairment nor increase in nonspecific airway responsiveness.     

Airway responsiveness to methacholine,respiratory symptoms,and dust exposure levels in grain and flour mill workers in eastern france

Our goal was to assess the relation between dust exposure levels and the respiratory health status of workers in grain and flour mills in eastern France. We studied 118 male workers from 11 mills and 164 unexposed male controls. Dust concentration was measured by personal sampling methods. Outcome variables included respiratory symptoms, routine pulmonary function tests, and indices of airway responsiveness to methacholine. A great within- and between-area variability of inhalable dust concentration was found in all mills. A dose-response relationship was observed between dust exposure levels and chronic respiratory symptoms, suggesting that exposure to grain and flour dust may lead to chronic bronchitis. A significant relation was found between dust exposure and airway hyper-responsiveness; this finding is important since it has been hypothesized that the latter abnormality may lead to or be a predisposing factor in subsequent chronic, irreversible airflow obstruction.     

Small bakeries--a cross-sectional study of respiratory symptoms, sensitization and dust exposure.

This cross-sectional study investigated the prevalence of respiratory symptoms and sensitization to dust components in 224 individuals in 18 small bakeries in Scotland. Each work practice in the bakeries was characterized by an assessment of dust exposure and assigned to a category with either a direct exposure to flour dust of an indirect exposure to flour dust. We found that work-related respiratory symptoms were significantly associated with specific IgE to wheat flour and amylase but not to exposure category (except for nasal/eye symptoms). However, specific IgE to wheat flour was significantly associated with exposure category. There was a higher prevalence of immunological sensitization, reporting of work-related respiratory symptoms and exposure to dust than in other studies and of the 144 personal dust sample results taken, 21 (14.6%) of the total exceeded 10 mg/m3, the substantial dust concentration as outlined by the COSHH Regulations. Follow-up of those with work-related asthma symptoms (questionnaire response) was inconclusive of the work-relatedness of their symptoms, although it did confirm respiratory morbidity.