Respiratory disability in ex-flax workers

Acute respiratory effects occur in a high proportion of subjects exposed to textile dusts. The extent to which these lead to permanent respiratory symptoms and loss of lung function is unknown. A survey of random population samples was therefore conducted in ten towns in Northern Ireland in which flax processing had been a major source of employment. The MRC questionnaire on respiratory symptoms was administered and Vitalograph tracings recorded on subjects aged 40 to 74 inclusive. An occupational history was taken at the end of each interview. Lung function in ex-flax workers was slightly lower than in control subjects never exposed to flax dust, but the presence of a positive interaction with age meant that differences were apparent only in the younger subjects. Over about the age of 65 the lung function in the ex-flax workers was comparable with that of the controls and overall the loss was at most about half that due to light smoking (1-14 cigarettes a day). The association between a "dust exposure score" and lung function was inconsistent in the two sexes. In men there was a small decrement with increasing dust exposure. In women there was also a small decrement, but a positive interaction with age meant that the women with the highest dust exposure scores had a lower loss with increasing age than the women with the least dust exposure. There was an excess in symptoms in the ex-flax workers but the size of the excess was greater than would be expected from the lung function results. It is possible that, although the survey was conducted without explicit reference to the flax industry, knowledge throughout Northern Ireland that many flax workers have been awarded compensation on the grounds of respiratory disablement may have led to an increased reporting of symptoms in the ex-flax workers.     

Respiratory disability in ex-cotton workers.

A high proportion of textile workers handling cotton and flax complain of respiratory symptoms and show a loss in lung function. These effects are reversible in the early stages but the degree to which they lead to permanent respiratory disability is unknown. Two surveys were therefore conducted in which respiratory function and symptoms were compared in ex-textile workers and in control subjects who had never been exposed to textile dusts. One survey was of ex-flax workers in Northern Ireland. The present survey was of ex-cotton workers in Lancashire. A survey of random population samples in Oldham and Bolton, in both of which cotton had formerly been the most important source of employment, was conducted. After allowing for age, height, and smoking, lung function was about 2-8% lower in the ex-textile workers than in controls who had never been exposed to any dust. Ex-textile workers were slightly shorter than the controls, suggestive of past social and nutritional deprivation which may have contributed to the decrement in lung function. There was evidence of a small but increasing decrement in lung function with an increase in a "dust exposure" score. For men, about 15 years of heavy dust exposure was associated with a loss in FEV1 equivalent to that shown by light or ex-smokers. For women, 15 years of heavy dust exposure appeared to be associated with a decrement in FEV1 about half that of light smoking.     

Respiratory disability in ex-cotton workers

A high proportion of textile workers handling cotton and flax complain of respiratory symptoms and show a loss in lung function. These effects are reversible in the early stages but the degree to which they lead to permanent respiratory disability is unknown. Two surveys were therefore conducted in which respiratory function and symptoms were compared in ex-textile workers and in control subjects who had never been exposed to textile dusts. One survey was of ex-flax workers in Northern Ireland. The present survey was of ex-cotton workers in Lancashire. A survey of random population samples in Oldham and Bolton, in both of which cotton had formerly been the most important source of employment, was conducted. After allowing for age, height, and smoking, lung function was about 2-8% lower in the ex-textile workers than in controls who had never been exposed to any dust. Ex-textile workers were slightly shorter than the controls, suggestive of past social and nutritional deprivation which may have contributed to the decrement in lung function. There was evidence of a small but increasing decrement in lung function with an increase in a "dust exposure" score. For men, about 15 years of heavy dust exposure was associated with a loss in FEV1 equivalent to that shown by light or ex-smokers. For women, 15 years of heavy dust exposure appeared to be associated with a decrement in FEV1 about half that of light smoking.     

Respiratory morbidity in wollastonite workers.

Medical and environmental surveys were conducted at a wollastonite mine and mill in 1976 and in 1982. Health testing included chest radiography, spirometry, and a questionnaire. Workers at a nearby electronics plant were also examined in 1982 for a comparison of lung function and respiratory symptoms. Both wollastonite and control workers showed significant smoking effects for chronic respiratory symptoms, but differences between the groups were not detected. Pneumoconiosis was found in 3% (3/108) of the wollastonite workers in 1982, but none showed a significant progression from their 1976 radiographs. The lung function tests of the 108 wollastonite workers examined in 1982 showed dust related changes in FEV1, FEV1/FVC ratio, and peak flow rate which were independent of age, height, and smoking habit (p less than 0.01). For non-smokers alone, only the FEV1/FVC ratio declined significantly with dust-years of exposure (p less than 0.01). The comparison of lung function in 1982 between a high dust exposed subgroup of wollastonite workers and the control population showed a significantly lower FEV1/FVC ratio and peak flow rate in the study group (p less than 0.05). Analysis of 1976-82 changes in pulmonary function showed that wollastonite workers with higher dust exposure had a significantly greater decline in peak flow over the period than workers with lower exposures (p less than 0.01). These data suggest that long term cumulative exposure to wollastonite may impair ventilatory capacity as reflected by changes in the FEV1/FVC ratio and peak flow rate.     

Respiratory disease in foundry workers.

A survey was carried out in a steel foundry in Brisbane to evaluate the nature and frequency of respiratory symptoms and to assess ventilatory function. The foundry used many moulding processes including the Furane, Isocure, Shell, carbon dioxide, and oil sand systems. Nasal symptoms and wheeze were often reported, particularly by workers in the general foundry and core shop, and on a semiautomated line. By contrast, workers in the aftercast section not exposed to fumes or vapours from the various moulding processes reported these symptoms less often. Of 46 workers exposed to moulding fumes and vapours, 11 had developed a wheeze while working at the foundry. Wheeze and other respiratory tract symptoms were often attributed by the workers to exposure to substances at work, particularly from the Shell process which uses phenol formaldehyde resin and hexamethylenetetramine. Symptoms were reported also, but less often, on exposure to materials used in the Furane process (urea formaldehyde and furfuryl alcohol) and the Isocure process (methylene diphenyl diisocyanate, phenol formaldehyde, and dimethylethylamine). Ventilatory function studied over Monday and Friday showed a small and inconsistent changes. The six subjects working on the semiautomated line showed a small decrease in FEV1 (+/- SEM) (208 +/- 70 ml) only on Monday; this differed significantly from that in 17 aftercast workers (9 +/- 50 ml, p less than 0.05). Ventilatory function recorded before work on Monday morning showed no evidence of chronic airway obstruction in any group. Most environmental measurements were below the threshold limit values (TLV) except in the general foundry, where furfuryl alcohol was detected at concentrations of up to 50 ppm and formaldehyde at 4 ppm. The onset of symptoms in relation to exposure to various fumes and vapours suggests that both irritant and hypersensitivity mechanisms are present. As environmental modifications had occurred recently the apparent hypersensitivity may relate to past exposure levels above the TLV.     

Respiratory function in coffee workers.

Respiratory function was studied in three groups of workers employed in processing coffee. The prevalence of almost all chronic respiratory symptoms was significantly higher in coffee processors than in control workers. In each group during the Monday work shift there was a significant mean acute decrease in the maximum expiratory flow rate at 50% vital capacity (VC), ranging from 4.0% to 8.7%, and at 25% VC, ranging from 6.0% to 18.5%. Acute reductions in FEV1.0 were considerably lower, ranging from 1.3% to 2.8%. On Thursdays the acute ventilatory function changes were somewhat lower than on Mondays. Acute decreases in flow rates at low lung volumes suggest that the bronchoconstrictor effect of the dust acts mostly on smaller airways. Administration of Intal (disodium cromoglycate) before the shift considerably diminished acute reductions in flow rates. A comparison of Monday pre-shift values of ventilatory capacity in coffee workers with those in controls indicates that exposure to dust in green or roasted coffee processing may lead to persistent loss of pulmonary function.     

Respiratory cancers in furniture workers.

In a 19 year follow up study of 8141 furniture workers nasal adenocarcinoma was 63 X 4 times more common than expected. The findings also indicate an excess risk of adenocarcinoma of the maxillary sinus. No increase in risk was found for laryngeal cancer, lung cancer, or sinonasal cancers other than adenocarcinoma.     

Respiratory function in tea workers.

Respiratory function was studied in five groups of tea workers employed in processing different types of tea. The prevalence of almost all chronic respiratory symptoms was significantly higher in workers processing dog-rose, sage, and gruzyan tea than in control workers. During the Monday workshift there was a significant mean acute decrease in maximum expiratory flow rates at 50% vital capacity (range: 4.1-8.8%) and at 25% VC (range: 7.8-21.8%) except in those exposed to camomile. Acute reductions in forced expiratory volume in one second were considerably smaller and mostly not significant. Mean acute reductions on Wednesday were similar to those on Monday with no significant differences between preshift Monday and Wednesday data. Acute decreases in flow rates at low lung volumes suggest that the bronchoconstrictor effect of the dust acts mostly on smaller airways. Preshift administration of disodium cromoglycate significantly diminished acute reduction in flow rates except in workers processing Indian tea. A comparison of Monday preshift values of ventilatory capacity in tea workers with those in controls indicates that exposure to tea dust may, in some workers, lead to chronic respiratory impairment.     

Respiratory function in coffee workers.

Respiratory function was studied in three groups of workers employed in processing coffee. The prevalence of almost all chronic respiratory symptoms was significantly higher in coffee processors than in control workers. In each group during the Monday work shift there was a significant mean acute decrease in the maximum expiratory flow rate at 50% vital capacity (VC), ranging from 4.0% to 8.7%, and at 25% VC, ranging from 6.0% to 18.5%. Acute reductions in FEV1.0 were considerably lower, ranging from 1.3% to 2.8%. On Thursdays the acute ventilatory function changes were somewhat lower than on Mondays. Acute decreases in flow rates at low lung volumes suggest that the bronchoconstrictor effect of the dust acts mostly on smaller airways. Administration of Intal (disodium cromoglycate) before the shift considerably diminished acute reductions in flow rates. A comparison of Monday pre-shift values of ventilatory capacity in coffee workers with those in controls indicates that exposure to dust in green or roasted coffee processing may lead to persistent loss of pulmonary function.     

Respiratory diseases in wood workers.

A survey was carried out on wood workers and on a group of unexposed, healthy controls. One group of wood workers (group A) were asymptomatic and another (group B) had symptoms either of chronic cough and dyspnoea on exertion (B1) or dyspnoea at work and bronchial hyperreactivity (B2). The control group (group C) was randomly selected from among a population of laboratory workers. No significant differences were found among the groups with respect to the frequency of atopy but the prevalence of a positive skin reaction to wood extracts was significantly higher in the asthmatic subjects. The adjusted FVC and FEV1/FVC% were significantly higher in B1 than in the other groups; the FEV1 was lower in B1 than in B2 and in B2 than in the other groups; TLCO and KCO differed significantly in all four groups. A significant negative correlation was observed between FEV1, MEF50, TLCO and KCO and duration of exposure to wood dusts. The alveolar volumes were not significantly different between the groups and were not correlated with duration of exposure. These results confirm the observation that exposure to wood dust or to some bronchoreactive substances linked with wood working can induce chronic obstructive lung disease (COLD). Some cases of wood dust asthma seem to be related to an immediate allergic reaction, but precipitating antibodies appear to be an index of exposure rather than of disease. The decrease in diffusion capacity can be ascribed to a thickening of the alveolar capillary membranes secondary to an alveolitis like, non-symptomatic, allergic reaction.     

Respiratory disorders in aluminium potroom workers.

Epidemiological studies of aluminum potroom workers have been in progress in Norway since 1986. The occurrence of work-related asthmatic symptoms and their determinants were studied. Work-related asthmatic symptoms and airflow limitation were closely associated with duration of potroom employment. A significant relationship between current fluoride exposure and work-related asthmatic symptoms was observed in a smaller, cross-sectional population where a detailed exposure classification was carried out. A similar association and also a dose-response gradient was found in a longitudinal study of new employees. The existence of occupational asthma in aluminium potroom workers was confirmed by characteristic patterns of repeated peak flow measurements supported by changes in methacholine responsiveness in workers with suspected work-related asthma. Current smoking as a risk factor for work-related asthmatic symptoms was observed both in cross-sectional and in longitudinal investigations. Similarly to current fluoride exposure, a dose-response gradient was demonstrated in the association between work-related asthmatic symptoms and current amount of tobacco smoked. Allergy was not shown to be a determinant of work-related asthmatic symptoms in any part of the investigation. A family history of asthma and previous occupational exposure may have had some influence on the risk of developing symptoms but the findings were inconsistent and probably of minor importance. Methacholine challenge seemed inappropriate for the screening of aluminium potroom workers in order to detect work-related asthmatic symptoms, but was closely correlated to the severity of symptoms.(ABSTRACT TRUNCATED AT 250 WORDS)     

Respiratory morbidity in rubber workers: II. Pulmonary function in curing workers.

Pulmonary function tests were conducted on 121 curing and 189 control workers in 1972; 87% of the 1972 cohort was resurveyed one year later. The curing workers were subdivided into high and low exposure groups on the basis of environmental sampling. Cross-sectionally, in the 1972 cohort, the residual forced vital capacity was significantly decreased (P greater than .01) among the the heavily exposed workers (266 ml). Longitudinally, the mean one-year loss of forced expiratory volume in one second (FEV1.0) (173 ml/yr) in the curing workers with more than ten years of exposure was significantly greater (P less than .01) than in the control groups. Pulmonary function tests before and after a day's work were conducted on 29 curing-room workers. The eight heavily exposed curing workers had a significant decrease (P less than .05) in FEV1.0 of 115 ml. Our findings are sufficient to conclude that heavy exposure to curing fume affects pulmonary function. We recommend reduction of exposure and further longitudinal studies, especially in regard to those most heavily exposed.     

Mortality and disability among cotton mill workers.

The mortality and disability of cotton mill workers were studied in five Finnish cotton mills. The population under study comprised all 1065 women exposed to raw cotton dust who had been hired between 1950 and 1971. The minimum exposure period was five years. For the study on disability, the cohort was followed up until the end of 1981. The follow up period for the mortality analysis was from 1950 to 1985. At the end of 1981 the observed number of prevalent disability pensions for respiratory disease was 15, whereas 3.9 were expected (p less than 0.01) on the basis of the national figures for women. There were 46 musculoskeletal diseases (27.7 expected, p less than 0.01), of which 24 were osteoarthritis (14.5 expected) and 13 rheumatoid arthritis (6.6 expected). The incidence rates of disability pensions were calculated for the period 1969-81. Comparison of incidence rates between cotton mill workers and the Finnish female population showed excessive rates for both respiratory diseases (p less than 0.001) and musculoskeletal diseases (p less than 0.01), with an excess of new cases of rheumatoid arthritis (p less than 0.05). By the end of 1985 the number of person-years was 31,678 and the number of deaths 95. The standardised mortality ratios for the total period of follow up (1950-85) showed no excess for respiratory diseases. Mortality from cardiovascular diseases was also lower than expected. The observed number of tumours was 33, the corresponding expected number 32.0. Thirteen tumours were in the digestive organs (6.6 expected, p<0.05) and three were lung cancers (1.9 expected). Five workers had died from renal disease; the expected number was 1.5 (p<0.05).     

Respiratory illness in agricultural workers

Respiratory diseases have long been recognized in association with work in farming. Overall, only a small proportion of the population is employed in agriculture, so respiratory disease in farmers is not a major public health issue. However, farmers are known to have high morbidity and mortality from certain respiratory diseases, as shown by routinely collected statistics. Despite this, knowledge of the frequency, nature and risk factors for some respiratory disorders in agricultural workers is incomplete. Multiple exposures are common and some exposures can give rise to more than one specific disease. Moreover, the most common respiratory symptoms reported by farm workers (wheeze, dyspnoea and cough) are relatively non-specific and can be associated with several occupational respiratory disorders. This review describes the main occupational respiratory illnesses in farming and summarizes the current literature about epidemiology and prevention. The most important diseases are rhinitis and asthma, which, although common, are not usually fatal. Some non-allergic conditions, e.g. asthma-like syndrome and organic toxic dust syndrome, are not yet fully understood, but appear to be common among farm workers. The most serious respiratory diseases are hypersensitivity pneumonitis and respiratory infections, but these are rare. Most importantly, respiratory diseases are preventable by controlling harmful exposures to organic dust, toxic gases and chemicals on farms through improvements in animal rearing techniques, ventilation of animal accommodation, careful drying and storage of animal feed-stuffs, crops and other products, and use of personal protective equipment.     

Respiratory symptoms in kitchen workers

INTRODUCTION: A possible association between cooking fumes and respiratory diseases other than cancer has not been studied earlier. METHODS: All employees at 67 selected kitchens were asked to answer a personal questionnaire regarding the presence of dyspnea, serious dyspnea, cough, and respiratory symptoms in connection with work. The study group consisted of 139 women and 100 men. RESULTS: The prevalence of dyspnea (RR = 4.1 (2.7-6.3)), serious dyspnea (RR = 2.9 (1.5-5.7)), and symptoms in connection with work (RR = 4.3 (2.7-6.7)) were statistically significantly higher for the female kitchen workers compared to the controls. For the men only dyspnea (RR = 1.8 (1.4-2.3)) and symptoms in connection with work (RR = 2.1 (1.6-2.7)) showed an increased prevalence. An analysis of possible predictors for respiratory symptoms in connection with work gave an odds ratio of 3.2 (P = 0.000) for "working in a restaurant kitchen." CONCLUSIONS: The results of the study indicate a relationship between working in kitchens and respiratory symptoms.     

Respiratory cancers in furniture workers

In a 19 year follow up study of 8141 furniture workers nasal adenocarcinoma was 63 X 4 times more common than expected. The findings also indicate an excess risk of adenocarcinoma of the maxillary sinus. No increase in risk was found for laryngeal cancer, lung cancer, or sinonasal cancers other than adenocarcinoma.