Respiratory symptoms associated with low level sulphur dioxide exposure in silicon carbide production workers

Relations between pulmonary symptoms and exposure to respirable dust and sulphur dioxide (SO2) were evaluated for 145 silicon carbide (SiC) production workers with an average of 13.9 (range 3-41) years of experience in this industry. Eight hour time weighted average exposures to SO2 were 1.5 ppm or less with momentary peaks up to 4 ppm. Cumulative SO2 exposure averaged 1.94 (range 0.02-19.5) ppm-years. Low level respirable dust exposures also occurred (0.63 +/- 0.26 mg/m3). After adjusting for age and current smoking status in multiple logistic regression models, highly significant, positive, dose dependent relations were found between cumulative and average exposure to SO2, and symptoms of usual and chronic phlegm, usual and chronic wheeze, and mild exertional dyspnoea. Mild and moderate dyspnoea were also associated with most recent exposure to SO2. Cough was not associated with SO2. No pulmonary symptoms were associated with exposure to respirable dust nor were any symptoms attributable to an interaction between dust and SO2. Cigarette smoking was strongly associated with cough, phlegm, and wheezing, but not dyspnoea. A greater than additive (synergistic) effect between smoking and exposure to SO2 was present for most symptoms. These findings suggest that long term, variable exposure to SO2 at 1.5 ppm or less was associated with significantly raised rates of phlegm, wheezing, and mild dyspnoea in SiC production workers, and that current threshold limits for SO2 may not adequately protect workers in this industry.     

Work related decrement in pulmonary function in silicon carbide production workers

The relation between pulmonary function, cigarette smoking, and exposure to mixed respirable dust containing silicon carbide (SiC), hydrocarbons, and small quantities of quartz, cristobalite, and graphite was evaluated in 156SiC production workers using linear regression models on the difference between measured and predicted FEV1 and FVC. Workers had an average of 16 (range 2-41) years of employment and 9.5 (range 0.6-39.7) mg-year/m3 cumulative respirable dust exposure; average dust exposure while employed was 0.63 (range 0.18-1.42) mg/m3. Occasional, low level (less than or equal to 1.5 ppm) sulphur dioxide (SO2) exposure also occurred. Significant decrements in FEV1 (8.2 ml; p less than 0.03) and FVC (9.4 ml; p less than 0.01) were related to each year of employment for the entire group. Never smokers lost 17.8 ml (p less than 0.02) of FEV1 and 17.0 (p less than 0.05) of FVC a year, whereas corresponding decrements of 9.1 ml (p = 0.12) in FEV1 and 14.4 ml (p less than 0.02) in FVC were found in current smokers. Similar losses in FEV1 and FVC were related to each mg-year/m3 of cumulative dust exposure for 138 workers with complete exposure information; these findings, however, were generally not significant owing to the smaller cohort and greater variability in this exposure measure. Never smokers had large decrements in FEV1 (40.7 ml; p less than 0.02) and FVC (32.9 ml; p = 0.08) per mg-year/m3 of cumulative dust exposure and non-significant decrements were found in current smokers (FEV1: -7.1 ml; FVC: -11.7 ml). A non-significant decrement in lung function was also related to average dust exposure while employed. No changes were associated with SO(2) exposure or and SO(2) dust interaction. These findings suggest that employment in SiC production is associated with an excessive decrement in pulmonary function and that current permissible exposure limits for dusts occurring in this industry may not adequately protect workers from developing chronic pulmonary disease.     

Work related decrement in pulmonary function in silicon carbide production workers.

The relation between pulmonary function, cigarette smoking, and exposure to mixed respirable dust containing silicon carbide (SiC), hydrocarbons, and small quantities of quartz, cristobalite, and graphite was evaluated in 156SiC production workers using linear regression models on the difference between measured and predicted FEV1 and FVC. Workers had an average of 16 (range 2-41) years of employment and 9.5 (range 0.6-39.7) mg-year/m3 cumulative respirable dust exposure; average dust exposure while employed was 0.63 (range 0.18-1.42) mg/m3. Occasional, low level (less than or equal to 1.5 ppm) sulphur dioxide (SO2) exposure also occurred. Significant decrements in FEV1 (8.2 ml; p less than 0.03) and FVC (9.4 ml; p less than 0.01) were related to each year of employment for the entire group. Never smokers lost 17.8 ml (p less than 0.02) of FEV1 and 17.0 (p less than 0.05) of FVC a year, whereas corresponding decrements of 9.1 ml (p = 0.12) in FEV1 and 14.4 ml (p less than 0.02) in FVC were found in current smokers. Similar losses in FEV1 and FVC were related to each mg-year/m3 of cumulative dust exposure for 138 workers with complete exposure information; these findings, however, were generally not significant owing to the smaller cohort and greater variability in this exposure measure. Never smokers had large decrements in FEV1 (40.7 ml; p less than 0.02) and FVC (32.9 ml; p = 0.08) per mg-year/m3 of cumulative dust exposure and non-significant decrements were found in current smokers (FEV1: -7.1 ml; FVC: -11.7 ml). A non-significant decrement in lung function was also related to average dust exposure while employed. No changes were associated with SO(2) exposure or and SO(2) dust interaction. These findings suggest that employment in SiC production is associated with an excessive decrement in pulmonary function and that current permissible exposure limits for dusts occurring in this industry may not adequately protect workers from developing chronic pulmonary disease.     

Symptoms, ventilatory function, and environmental exposures in Portland cement workers.

Data on respiratory symptoms and pulmonary function were obtained for 2736 Portland cement plant workers and 755 controls. Personal dust samples contained a geometric mean concentration of 0.57 mg/m3 for respirable dust and 2.90 mg/m3 for total dust. Cement workers and controls had similar prevalences of symptoms, except that 5.4% of the cement workers had dyspnoea compared with 2.7% of the controls. The mean pulmonary function indices were similar for the two groups. Among cement plant workers, the prevalence of chronic phlegm increased with tenure whereas the prevalence of wheezing increased with both tenure and current dust level. Other symptoms and pulmonary function indices were not significantly related to exposure.     

Symptoms, ventilatory function, and environmental exposures in Portland cement workers

Data on respiratory symptoms and pulmonary function were obtained for 2736 Portland cement plant workers and 755 controls. Personal dust samples contained a geometric mean concentration of 0.57 mg/m3 for respirable dust and 2.90 mg/m3 for total dust. Cement workers and controls had similar prevalences of symptoms, except that 5.4% of the cement workers had dyspnoea compared with 2.7% of the controls. The mean pulmonary function indices were similar for the two groups. Among cement plant workers, the prevalence of chronic phlegm increased with tenure whereas the prevalence of wheezing increased with both tenure and current dust level. Other symptoms and pulmonary function indices were not significantly related to exposure.     

Respirable dust exposure and respiratory health in male Taiwanese steelworkers

The objective of this cross-sectional study was to investigate the prevalence and determinants of respiratory symptoms and lung function and their association with occupational dust exposure in Taiwanese steelworkers. The study was conducted on an integrated-steel company in Taiwan from March 1989 to February 1990. After excluding workers in the coke ovens and ex-smokers, we performed physical examinations on 1,339 male workers in the iron making and steel making factories. Subjects were interviewed regarding respiratory symptoms using a Chinese version of the American Thoracic Society respiratory questionnaire and were examined with respect to their lung function using spirometry. Objective dust exposure was measured using personal air sampling with 277 valid samples. Prevalences of cough frequently, chronic cough, phlegm frequently, chronic phlegm, wheezing occasionally, and breathlessness were 11.4%, 9.3%, 14.6%, 11.9%, 2.6%, and 6.5%, respectively. Duration of employment, smoking, subjective dustiness, and past respiratory illnesses can predict these respiratory symptoms. Average respirable dust exposure significantly decreased the forced vital capacity (FVC) and forced expiratory volume in one second (FEVI.0) in smoking workers. In the non-smokers, an effect of respirable dust exposure on FEVl.0/FVC was shown. Since the main ingredients of dust in such a steelworks usually contained mixtures of oxides and silicates other than silica dust, respirable dust exposure in steelworks might impair lung function, especially among smokers.     

Flock workers' exposures and respiratory symptoms in five plants

BACKGROUND: Sentinel cases of lymphocytic bronchiolitis in flock production and coating operations triggered a five-plant study of airborne respirable dust and fiber exposures and health symptoms. METHODS: Job histories from 219 current workers were linked to a job-exposure matrix derived from personal exposure measurements of respirable dust and fibers. Univariate group comparisons and multivariate modeling tested for relations between indices of cumulative and current exposure, and respiratory and systemic symptom outcomes. RESULTS: Respiratory symptoms and repeated flu-like illnesses were associated with use of compressed air to clear equipment (blow-downs) and with respirable dust exposure (current and cumulative) after controlling for smoking. Blow-downs had an equal or greater effect than smoking status on most symptoms. CONCLUSIONS: Eliminating compressed air cleaning, engineering control of dust exposure, and respirators are needed to limit exposures to particulates. Longitudinal follow up may provide guidance for a dust or fiber level without adverse respiratory health effects.     

Work-related respiratory symptoms and ventilatory disorders among employees of a cement industry in Shiraz, Iran

Although the main hazard in cement processing is dust and respiratory tract disorders are the most important group of occupational diseases in this industry, evidence for associations between exposure to cement dust and either respiratory symptoms or functional impairment has not been conclusive. This study was, therefore, undertaken to more thoroughly examine the effects of occupational exposure to cement dust on the respiratory system. The study population consisted of a group of 88, randomly selected, male workers with current exposure to cement dust and 80 healthy male office workers without present or past history of exposure to dust that served as the referent group. Subjects were interviewed and were given respiratory symptom questionnaires to answer. They also underwent chest X-ray and lung function tests. Additionally, personal dust monitoring for airborne inhalable and respirable dust was carried out at nine different worksites. Moreover, X-ray diffraction (XRD) and X-ray fluorescence (XRF) techniques were performed to determine the silica phases and the SiO2 contents of the dust samples. Levels of exposures to inhalable and respirable cement dust were estimated to be 53.4+/-42.6 and 26+/-14.2 mg/m3, respectively (Mean+/-SD). Statistical analysis of the data revealed that symptoms like regular cough, phlegm, wheezing and shortness of breath were significantly (p<0.05) more prevalent among exposed workers. Similarly, chest radiographs of exposed workers showed various degrees of abnormalities including emphysematous changes, old calcified granulomas, emphysematous changes associated with inflammatory processes, evidence of chronic inflammatory processes, focusal calcification of the lungs and infiltrative changes. However, no significant changes were noted in the radiographs of the referent group. Furthermore, exposed workers compared to their referent counterparts showed significant reductions in the parameters of lung function. In conclusions, our data provide corroborative evidence further substantiating the contention that exposure to cement dust is associated with respiratory symptoms and functional impairments.     

Dose-response relationships between occupational aerosol exposures and cross-shift declines of lung function in poultry workers: recommendations for exposure limits

Numerous articles have been published regarding the adverse respiratory health consequences of working in intensive livestock and poultry housing. Threshold limit exposure guidelines are not currently applied to this environment, but they are essential to implement and monitor effective environmental controls. Previous dose-response research work with swine workers has resulted in exposure limit recommendations of 2.5 mg/m3 total dust, 0.23 mg/m3 respirable dust, 100 EU/m3 endotoxin, and 7 ppm ammonia. No similar recommendations have been reported previously for poultry workers. Therefore, an industry-wide study was conducted to examine dose-response relationships of bioaerosol exposures and worker respiratory health. A total of 257 poultry workers were studied for respiratory symptoms, pulmonary function, and exposure to dust (total and respirable), endotoxin (respirable and total), and ammonia. Details of the sampling plan and environmental assessment are described elsewhere. Relationships between exposures and response were studied by correlation and multiple regressions. Significant dose-response relationships were observed between exposures and pulmonary function decrements over a work shift. Exposure concentrations associated with significant pulmonary function decrements were as follows: 2.4 mg/m3 total dust, 0.16 mg/m3 respirable dust, 614 EU/m3 endotoxin, and 12 ppm ammonia.     

Respiratory disorders and lung function impairment in pyrite miners

A research study was carried out at a pyrite mine in Niccioleta, southern Tuscany, during the period 1980-1983 to investigate the possible effects of gaseous and particulate pollutants on the respiratory function of mine workers. The study was undertaken to fill the gap in recent scientific information in this field and also collect data which could be used for future planning of epidemiological and environmental controls at the mine. For the most exposed underground workers a dust exposure of 1.04 mg/m3 of inhalable dust and 0.60 mg/m3 of respirable dust was found. The average quartz content was less than 1.5% in both types of dust. Median exposures of the most exposed risk group were 6.0 ppm for carbon monoxide (CO), 0.22 ppm for nitrogen dioxide (NO2), 0.09 ppm for sulfur dioxide (SO2). The health effects of gaseous and particulate pollutants were studied by comparing the respiratory symptoms and lung function data of the miners with those of a reference group. A significantly increased prevalence of simple chronic bronchitis was found among underground miners when compared to the reference group. This condition was not associated with functional impairment of obstructive nature. Chest x-rays revealed 14 cases of p type pneumoconiosis.     

Respiratory health of automobile workers exposed to metal-working fluid aerosols: Respiratory symptoms

A total of 1,811 automobile workers at three General Motors facilities were evaluated by questionnaire for possible respiratory effects resulting from airborne exposures to metal-working fluids (MWF): 1,042 currently worked as machinists and were exposed to one of three types of MWF aerosols (straight mineral oils, soluble oil emulsions, or water-based synthetic fluids that contained no oils); 769 assembly workers, without direct exposure, served as an internal reference group (of these, 239 had never worked as machinists). Symptoms of usual cough, usual phlegm, wheezing, chest tightness, and breathlessness, as well as physician-diagnosed asthma, and chronic bronchitis were the primary outcomes examined. Machinists as a whole had higher prevalence of cough, phlegm, wheezing, and breathlessness than that of assembly workers. Adjusting for confounding, phlegm and wheeze were associated with increasing levels of current exposure to straight oils; cough, phlegm, wheeze, chest tightness, and chronic bronchitis were associated with increasing levels of current exposure to synthetics. In models that included both past and current exposure, only current exposures to straight and synthetic fluids were associated with current symptoms. Am. J. Ind. Med. 32:450–459, 1997. © 1997 Wiley-Liss, Inc.     

Wood dust and formaldehyde exposures in the cabinet-making industry

Time-weighted average (TWA) personal total and respirable dust exposures were determined gravimetrically for 48 subjects in 4 cabinet-making plants. TWA personal formaldehyde exposures also were obtained, with the use of 3M 3750 passive monitors. Selective area sampling for formaldehyde was undertaken using two methods. The results obtained with the passive monitors were compared to the standard chromotropic acid impinger method. Considerable variation was noted in the dust exposures. Cabinet-makers exposed to softwoods were found to have a mean exposure of approximately one half of the current applicable ACGIH TWA-TLV, while hard-wood exposure was twice the applicable TWA-TLV. The highest dust exposures were recorded for those workers sanding, the mean total dust being 2.91 mg/m3 (S.E. 0.70) and respirable dust 0.63 mg/m3 (S.E. 0.20). Sanding operations also were found to produce a higher proportion of respirable dust (22%) than other woodworking operations (6%-14%). Workers in assembly areas also were found to have higher dust exposures, likely reflecting the fact that conventional dust collection devices for stationary woodworking equipment are not appropriate for hand held tools and hand sanding. The importance of making respirable dust measurements is discussed. The poor correlation between paired total and respirable dust concentrations indicates that both measurements should be made. Some potential limitations to respirable wood dust sampling using 10 mm nylon cyclones are noted, however. Area dust concentrations were found to be significantly lower than personal exposures, emphasizing the importance of personal sampling data. Formaldehyde vapor exposures were very low, with a mean of 0.06 ppm (S.E. 0.01).     

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 health effects of occupational exposure to charcoal dust in Namibia

Background: Charcoal processing activities can increase the risk of adverse respiratory outcomes.

Objective: To determine dose–response relationships between occupational exposure to charcoal dust, respiratory symptoms and lung function among charcoal-processing workers in Namibia.

Methods: A cross-sectional study was conducted with 307 workers from charcoal factories in Namibia. All respondents completed interviewer-administered questionnaires. Spirometry was performed, ambient and respirable dust levels were assessed in different work sections. Multiple logistic regression analysis estimated the overall effect of charcoal dust exposure on respiratory outcomes, while linear regression estimated the exposure-related effect on lung function. Workers were stratified according to cumulative dust exposure category.

Results: Exposure to respirable charcoal dust levels was above occupational exposure limits in most sectors, with packing and weighing having the highest dust exposure levels (median 27.7 mg/m³, range: 0.2–33.0 for the 8-h time-weighted average). The high cumulative dust exposure category was significantly associated with usual cough (OR: 2.1; 95% CI: 1.1–4.0), usual phlegm (OR: 2.1; 95% CI: 1.1–4.1), episodes of phlegm and cough (OR: 2.8; 95% CI: 1.1–6.1), and shortness of breath. A non-statistically significant lower adjusted mean-predicted % FEV1 was observed (98.1% for male and 95.5% for female) among workers with greater exposure.

Conclusions: Charcoal dust levels exceeded the US OSHA recommended limit of 3.5 mg/m³ for carbon-black-containing material and study participants presented with exposure-related adverse respiratory outcomes in a dose–response manner. Our findings suggest that the Namibian Ministry of Labour introduce stronger enforcement strategies of existing national health and safety regulations within the industry.     

Cumulative exposure to dust causes accelerated decline in lung function in tunnel workers

OBJECTIVES—To examine whether underground construction workers exposed to tunnelling pollutants over a follow up period of 8 years have an increased risk of decline in lung function and respiratory symptoms compared with reference subjects working outside the tunnel atmosphere, and relate the findings to job groups and cumulative exposure to dust and gases.
METHODS—96 Tunnel workers and a reference group of 249 other heavy construction workers were examined in 1991 and re-examined in 1999. Exposure measurements were carried out to estimate personal cumulative exposure to total dust, respirable dust, α-quartz, oil mist, and nitrogen dioxide. The subjects answered a questionnaire on respiratory symptoms and smoking habits, performed spirometry, and had chest radiographs taken. Radiological signs of silicosis were evaluated (International Labour Organisation (ILO) classification). Atopy was determined by a multiple radioallergosorbent test (RAST).
RESULTS—The mean exposure to respirable dust and α-quartz in tunnel workers varied from 1.2-3.6 mg/m³ (respirable dust) and 0.019-0.044 mg/m³ (α-quartz) depending on job task performed. Decrease in forced expiratory volume in 1 second (FEV₁) was associated with cumulative exposure to respirable dust (p<0.001) and α-quartz (p=0.02). The multiple regression model predicted that in a worker 40 years of age, the annual decrease in FEV₁ would be 25 ml in a non-exposed non-smoker, 35 ml in a non-exposed smoker, and 50-63 ml in a non-smoking tunnel worker (depending on job). Compared with the reference group the odds ratio for the occurrence of new respiratory symptoms during the follow up period was increased in the tunnel workers and associated with cumulative exposure to respirable dust.
CONCLUSIONS—Cumulative exposures to respirable dust and α-quartz are the most important risk factors for airflow limitation in underground heavy construction workers, and cumulative exposure to respirable dust is the most important risk factor for respiratory symptoms. The finding of accelerated decline in lung function in tunnel workers suggests that better control of exposures is needed.


     

Work-related symptoms and dose-response relationships for personal exposures and pulmonary function among woodworkers

BACKGROUND: Four sawmills, a wood chipping mill, and five joineries in New South Wales, Australia, were studied for the effects of personal exposure to wood dust, endotoxins. (1-->3)-beta-D-glucans, Gram-negative bacteria, and fungi on lung function among woodworkers. METHODS: Personal inhalable and respirable dust sampling was carried out. The lung function tests of workers were conducted before and after a workshift. RESULTS: The mean percentage cross-shift decrease in lung function was markedly high for woodworkers compared with the controls. Dose-response relationships among personal exposures and percentage cross-shift decrease in lung function and percentage predicted lung function were more pronounced among joinery workers compared with sawmill and chip mill workers. Woodworkers had markedly high prevalence of regular cough, phlegm, and chronic bronchitis compared with controls. Significant associations were found between percentage cross-shift decrease in FVC and regular phlegm and blocked nose among sawmill and chip mill workers. Both joinery workers and sawmill and chip mill workers showed significant relationships between percentage predicted lung function (FVC, FEV1, FEV1/FVC, FEF25-75%) and respiratory symptoms. CONCLUSIONS: Wood dust and biohazards associated with wood dust are potential health hazards and should be controlled.     

An epidemiological study of the respiratory health of workers in the European refractory ceramic fibre industry

OBJECTIVES—To investigate possible relations between respiratory health and past airborne exposure to refractory ceramic fibres (RCFs) and respirable dust in workers at six European factories, studied previously in 1987.
METHODS—The target population comprised all current workers associated with RCF production, plus others who had participated in 1987 "leavers". Information was collected on personal characteristics, chest radiographs, lung function, respiratory symptoms, smoking, and full occupational history. Regression analysis was used to study relations between indices of health of individual workers and of cumulative exposure to airborne dust and fibres, and likely past exposure to asbestos.
RESULTS AND DISCUSSION—774 workers participated (90% of current workers, 37% of leavers). Profusion of small opacities in exposed workers (51% 0/1+; 8% 1/0+) was similar to that among an unexposed control group but higher than in new readings of the 1987 study films (11% 0/1+, 2% 1/0+). The large difference between 1987 and recent films may be, at least in part, a reading artefact associated with film appearance. Small opacities of International Labour Organisation (ILO) category 1/0+ were not associated with exposure. An association of borderline significance overall between 0/1+ opacities and exposure to respirable fibres was found for some exposure periods only, the time related pattern being biologically implausible. Pleural changes were related to age and exposure to asbestos, and findings were consistent with an effect of time since first exposure to RCFs. Among men, forced expired volume in 1 second (FEV₁) and forced vital capacity (FVC) were inversely related to exposure to fibres, in current smokers only. FEV₁/ FVC ratio and transfer factor (TL_CO) were not related to exposures. The estimated restrictive effect was on average mild. Prevalence of respiratory symptoms was low. Chronic bronchitis and its associated symptoms (cough, phlegm) showed some association with recent exposure to respirable fibres. This could be due to an irritant effect of RCFs.


Keywords: respiratory health; ceramic fibres     

Respiratory effects of occupational exposure to tobacco dust

Few investigations of the respiratory effects of occupational exposure to tobacco dust have been carried out and the threshold limit value has not well been established. A cross sectional survey on a sample of 223 male and female workers at a cigar and cigarette factory in Lucca (Tuscany) showed a significantly higher prevalence of wheezing, attacks of shortness of breath with wheezing, dyspnoea, and rhinitis than in a reference population. A trend towards a decrease in forced end expiratory flows according to smoking habit and work duration was evident. Positive skin prick tests were observed in 26% of men and 23% of women and were positively associated with duration of work and negatively with cigarette smoking. Thin interstitial space involvement was observed on chest x ray examination in almost half the female workers with more than 35 years exposure. These findings suggest that prolonged exposure to tobacco dust may have negative health effects and that it is advisable to establish a threshold limit value for tobacco dust different from that of inert dust.     

Respiratory effects of occupational exposure to tobacco dust.

Few investigations of the respiratory effects of occupational exposure to tobacco dust have been carried out and the threshold limit value has not well been established. A cross sectional survey on a sample of 223 male and female workers at a cigar and cigarette factory in Lucca (Tuscany) showed a significantly higher prevalence of wheezing, attacks of shortness of breath with wheezing, dyspnoea, and rhinitis than in a reference population. A trend towards a decrease in forced end expiratory flows according to smoking habit and work duration was evident. Positive skin prick tests were observed in 26% of men and 23% of women and were positively associated with duration of work and negatively with cigarette smoking. Thin interstitial space involvement was observed on chest x ray examination in almost half the female workers with more than 35 years exposure. These findings suggest that prolonged exposure to tobacco dust may have negative health effects and that it is advisable to establish a threshold limit value for tobacco dust different from that of inert dust.     

Dust exposure indices and lung function changes in Longshoremen and Dock workers

A group of Dutch harbor workers involved in loading and unloading bulk products from sea vessels such as coal, cokes, and some other products like alumina, borax, phosphate ore, and vermiculite was studied. Exposures were characterized by personal and environmental monitoring. This information was subsequently used to estimate several dust exposure indices and to study relationships with lung function variables and respiratory symptoms. Average respirable dust exposure levels ranged from 0.3–4.0 mg/m³. Workers involved in unloading products from sea vessels were exposed to the highest dust levels. Supervisors and workers with tasks in the dock had an intermediate to low exposure. Office workers had the lowest exposure to respirable dust. Inhalable dust levels were considerably higher and average exposures ranged from 0.3–80 mg/m³. The ranking of occupational titles by inhalable dust exposure was almost identical to the rank order of respirable dust levels. Workers with higher current and cumulative dust exposures tended to have a lower lung function, and only shortness of breath had a statistically significant relationship with current and cumulative inhalable dust exposure. In general, relationships between lung function and inhalable dust levels tended to be somewhat stronger in terms of statistical significance, because inhalable dust is an estimate of dust deposition in the upper airways and lung function is a measurable parameter of airway obstruction in that region. However, the differences with respirable dust were minimal, and variability in dust exposure levels was extremely large for this population. It was concluded that harbor workers involved in unloading ships containing coal and various kinds of ore can be exposed to high dust levels. Relationships between dust exposure and lung function illustrate that these exposures are a respiratory hazard. Our finding that inhalable dust levels have a somewhat stronger relationship with lung function level than respirable dust levels deserves further attention.