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1.  Respiratory symptoms and lung function in hemp workers. 
Respiratory symptoms and abnormalities of lung function were studied in 84 female and 27 male hemp workers employed in two textile mills (A and B) processing soft hemp (C sativa). In mill A 46 women and 27 men were investigated and 38 female workers were studied in mill B. Forty nine women and 30 men from a non-dusty industry served as controls. A significantly higher prevalence of almost all chronic respiratory symptoms was found in female hemp workers when compared to control workers. Among the men these differences were significant for nasal catarrh and sinusitis. A high prevalence of byssinosis was found among female hemp workers in both mills (group A, 47.8%; group B, 57.9%) as well as in the male workers (66.7%). Statistically significant across shift reductions in lung function were found for all ventilatory capacity measurements in female and male hemp workers varying from 7.1% for forced expiratory volume in one second (FEV1) to 15.1% for flow rates at 50% vital capacity (FEF50). Measured Monday baseline values before the work shift were significantly lower than expected for hemp workers, being particularly reduced for FEF25 and FEF50. The data suggest that occupational exposure to hemp dust is a significant risk factor for the development of acute and chronic lung disease in workers employed in this textile industry.
PMCID: PMC1035249  PMID: 2207034
2.  Effects of different vegetable dust exposures1 
Valić, F., and Žuškin, E. (1972).Brit. J. industr. Med.,29, 293-297. Effects of different vegetable dust exposures. In order to establish the rank of biological activity of vegetable dusts, five groups of non-smoking female workers exposed to similar concentrations of hemp, flax, cotton, sisal, and jute airborne dust, respectively, were compared as to the prevalence of byssinosis, chronic respiratory symptoms, and one-second expiratory volume changes over the Monday shift. The groups were selected in such a way as to differ in the distribution of age and length of exposure to the respective dust as little as possible.
The prevalence of byssinosis in hemp and flax workers was approximately equal (44% and 43% respectively), in cotton workers it was considerably lower (27%), while no byssinosis was caused by either sisal or jute dust. The highest prevalence of other chronic respiratory symptoms was recorded in hemp workers (39%), followed by flax (36%) and cotton workers (27%), while in sisal (13%) and jute workers (13%) it was the lowest.
Significant mean FEV1·0 reductions over the shift were recorded in all the groups of textile workers with the largest reductions in hemp workers (19%) followed by flax (11%), cotton (8%), sisal (7%), and jute workers (5%). The application of orciprenaline before the shift diminished the mean acute FEV1·0 falls over the work shift in all the groups studied.
PMCID: PMC1009427  PMID: 5044600
3.  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.
PMCID: PMC1009241  PMID: 6691940
4.  Respiratory mechanics and dust exposure in byssinosis 
Journal of Clinical Investigation  1970;49(1):106-118.
Acute exposures to hemp dust, in healthy subjects as well as hemp workers with byssinosis, resulted in two different responses. Men with symptoms (chest tightness, coughing, and wheezing) after exposure showed decreases of forced expiratory volumes (FEV1.0), flow rates on maximum expiratory flow-volume (MEFV) curves, and of vital capacity (VC), while airway conductance (Gaw: TGV ratio) did not decrease significantly (“flow rate response”). Men without symptoms after exposure showed no changes of VC, FEV1.0, and MEFV curves, but had a significantly decreased airway conductance (“conductance response”). The flow rate response is attributed to a pharmacological bronchoconstrictor effect of hemp dust on small airways, the conductance response to a mechanical or reflex effect of hemp dust on large airways. Both responses were abolished by a bronchodilator drug. The type of response reflects a difference between individuals and is not related to age, smoking habits, or prior exposure history. Men with normal control function data had either a flow rate or a conductance response. All men with abnormal control data had a flow rate response.
Long-term hemp dust exposure causes irreversible obstructive lung disease, in particular among men who respond to acute dust exposure with symptoms and flow rate decreases. The detection of this response, with FEV1.0 measurements and MEFV curves, is essential in the study of byssinosis. Decreases of airway conductance after dust exposure have no consistent relation to the development of clinical symptoms. The relative value of measurements of maximum expiratory flow rates and of airway conductance in other lung diseases needs to be reassessed.
PMCID: PMC322449  PMID: 5409799
5.  Byssinosis, Chronic Bronchitis, and Ventilatory Capacities in Workers Exposed to Soft Hemp Dust 
A study was made of 93 women and 13 men employed in the spinning department of a factory in Yugoslavia processing soft hemp (Cannabis sativa). There were seven occupational groups, with average concentrations of total airborne hemp dust ranging from 2·9 mg./m.3 to more than 19·5 mg./m.3. Thirtyeight women and 11 men, employed in other departments of the factory with average total dust concentrations below 1·0 mg./m.3, were studied as controls.
In the spinning department 40·6% of the workers had byssinosis and 15·1% had chronic bronchitis (defined as persistent cough and phlegm on most days for as much as three months each year during the last two years). None of the controls suffered from either disease.
After adjustment for age, sitting height, and sex, the F.E.V.0·75 and F.V.C. measured at the beginning of the shift were used to assess the long-term effects of hemp dust on the ventilatory function of the lung. The age-adjusted ratio F.E.V.0·75/F.V.C. was also used. A comparison between the control group and the seven exposed groups showed no meaningful association between ventilatory function and present levels of dust exposure, but byssinotics with chronic bronchitis had a mean age-adjusted F.E.V.0·75/F.V.C. ratio significantly lower than that of workers with neither disease (P<0·05).
Acute effects of hemp dust, measured by the change in F.E.V.0·75 and F.V.C. during the shift, were considerable. There were marked reductions in the mean F.E.V.0·75 and F.V.C. during the shift in all the occupational groups exposed to high concentrations of dust. Byssinotics with chronic bronchitis had a significantly greater mean decrease in F.E.V.0·75 during the shift than the byssinotics without chronic bronchitis, and the workers with neither disease (P<0·02).
There is no doubt that the dust of Cannabis sativa hemp can cause byssinosis and at least temporary impairment of ventilatory function, varying in severity according to the level of dust exposure and the presence of respiratory disease.
PMCID: PMC1008770  PMID: 5663421
6.  STUDY OF RESPIRATORY SYMPTOMS AND VENTILATORY CAPACITIES AMONG ROPE WORKERS 
In a rope works handling manila, sisal, and St. Helena hemps, the prevalence of respiratory symptoms and the change in forced expiratory volume (F.E.V.1·0) during the work shift were studied in a group of 41 women and 41 men who represented 93% of the population at risk.
Dust concentrations, measured with a modified Hexhlet, ranged from 0·11 to 4·51 mg./m.3 for total dust and 0·02 to 1·46 mg./m.3 for fine dust. The highest concentrations were found in the preparing rooms, in which the workers, all of whom were women, showed on the average a fall in ventilatory capacity during the shift. The workers in the rope walk, all of whom were men, showed a rise in ventilatory capacity during the shift. The difference between the men and women was statistically significant (p < 0·05). No worker gave a characteristic history of byssinosis, although nine women complained of chest tightness associated with their work.
Undue breathlessness on exertion and persistent cough and phlegm were also more common among the women, but they were on the average 18 years older than the men. When the ventilatory capacities and the prevalence of respiratory symptoms of women rope workers were compared with those of a group of women employed elsewhere in the dockyard, the only significant difference was that the rope workers had more chest tightness associated with their work (p < 0·02).
Exposure of volunteers to St. Helena hemp, which is apparently the most likely of the hard hemps to give rise to respiratory symptoms, caused only a slight fall in ventilatory capacity and a small rise in airways resistance.
A sample of St. Helena hemp assayed on guinea-pig ileum had only a relatively small degree of contractor activity. The evidence suggests that the dusts of hard hemps do not cause byssinosis under the conditions in this factory. However, the irritant nature of the dust indicates the need to prevent total dust levels exceeding about 2 mg./m.3.
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PMCID: PMC1008297
7.  Respiratory response in simultaneous exposure to flax and hemp dust 
Žuškin, E., and Valíc, F. (1973).British Journal of Industrial Medicine,30, 375-380. Respiratory response in simultaneous exposure to flax and hemp dust. The effect of exposure to high concentrations of mixtures of hemp and flax dust was studied in 124 workers in two textile mills (mill A: 65-70% hemp and the rest flax, mean dust concentration 13·9 mg/m3; and mill B: about 35% hemp and the rest flax, mean dust concentration 15·8 mg/m3). A high prevalence of byssinosis was found in both mills (80% in mill B; 46·8% in mill A) after a mean exposure of no more than 13 years. In both mills, byssinotics had a higher prevalence of all chronic respiratory symptoms than non-byssinotics. This difference was more pronounced in mill A. Forty-eight percent of byssinotic women and 43% of byssinotic men had byssinosis of grade 2 or 3. Significant mean acute reductions in FEV1·0 and ˙Vmax 50% VC on Monday were recorded in subjects with and without byssinosis with a significantly larger mean reduction in byssinotics (FEV1·0, P < 0·01; ˙Vmax 50% VC, P < 0·05). ˙Vmax 50% VC proved to be a more sensitive test for detecting acute effects of vegetable dust than FEV1·0. The acute respiratory response of the subjects exposed to similar concentrations of flax and mixtures of two different proportions of flax and hemp dust was found to be equal.
PMCID: PMC1069478  PMID: 4753721
8.  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.
PMCID: PMC1008526  PMID: 111700
9.  Lung function in Lancashire cotton and man made fibre spinning mill operatives. 
OBJECTIVES--This survey was conducted to investigate current lung function levels in operatives working with cotton and man made fibres. Dust concentrations, smoking history, and occupational details were recorded so that factors influencing lung function could be identified. METHODS--A cross sectional study of respiratory symptoms and lung function was made in 1057 textile spinning operatives of white caucasian extraction. This represented 96.9% of the total available working population to be studied. Most (713) worked currently with cotton. The remainder worked with man made fibre. Lung function was assessed by measuring forced expiratory volume in one second (FEV1) and forced vital capacity (FVC). Exposure to cotton dust was measured in the work area and personal breathing zones, and retrospective exposure to cotton dust over a working life was estimated with accurate work history and best available hygiene data. RESULTS--3.5% of all operatives had byssinosis, 55 (5.3%) chronic bronchitis, 36 (3.5%) work related persistent cough, 55 (5.3%) non-byssinotic work related chest tightness, and 56 (5.3%) work related wheeze. A total of 212 static work area dust samples (range 0.04-3.23 mg/m3) and 213 personal breathing zone samples (range 0.14-24.95 mg/m3) were collected. Percentage of predicted FEV1 was reduced in current smokers (mean 89.5, 95% confidence interval (95% CI) 88-91) in comparison with non-smokers (93.1, 90.5-94.1) and FVC was reduced in operatives currently working with man made fibre (95.3, 93.8-96.9) in comparison with cotton (97.8, 96.6-99.0). Regression analysis identified smoking (P < 0.01), increasing age (P < 0.01), increasing time worked in the waste room (P < 0.01), and male sex (P < 0.05) as being associated with a lower FEV1 and FVC. Current and retrospective cotton dust exposures did not appear as predictor variables in the regression analysis although in a univariate analysis, FEV1 was reduced in those operatives exposed to high dust concentrations assessed by personal and work area sampling. DISCUSSION--This study has documented loss of lung function in association with exposure to cotton dust. Those operatives with work related symptoms had significantly lower FEV1 and FVC than asymptomatic workers. Although lung function seemed to be affected by high dust exposures when operatives were stratified into high and low exposure groups, regression analysis did not identify current dust concentrations as an independent factor influencing loss. Smoking habit was found to explain most of the measured change in FEV1 and FVC. It is likely that smoking and dust exposure interact to cause loss of lung function in cotton textile workers.
PMCID: PMC1128403  PMID: 8563857
10.  A study of the acute and chronic changes in ventilatory capacity of workers in Lancashire cotton mills 
Berry, G., McKerrow, C. B., Molyneux, M. K. B., Rossiter, C. E., and Tombleson, J. B. L. (1973).Brit. J. industr. Med.,30, 25-36. A study of the acute and chronic changes in ventilatory capacity of workers in Lancashire cotton mills. A prospective study of workers in 14 cotton and two man-made fibre spinning mills in Lancashire was carried out over a three-year period. A questionnaire on respiratory symptoms was completed at the start of the survey and again two years later. Up to six measurements of ventilatory capacity were made at six-monthly intervals. From these measurements the rate at which the forced expiratory volume (FEV1) was declining (annual decline in FEV) was evaluated for 595 subjects. Six of the mills were visited on Mondays and in 199 operatives the ventilatory capacity was measured at both the beginning and end of the shift to evaluate its acute fall during work (Monday fall in FEV).
The mean annual decline in FEV for cotton workers was 54 ml/year and it was only 32 ml/year for workers in the man-made fibre mills but this lower value was attributable almost entirely to one of the two mills. For the jobs near the carding engines the annual decline was 22 ml/year higher than for speed-frame tenters. The annual decline for cigarette smokers was 19 ml/year greater than for non- and ex-smokers. The annual decline in FEV was not found to be related to symptoms of byssinosis or bronchitis, nor to present dust levels, bioactivity of the dust or air pollution, although the expected effect attributable to byssinosis turned out to be less than that which the survey was designed to detect.
The mean Monday fall in FEV was higher in cotton mills than in man-made fibre mills among those without symptoms of byssinosis and was correlated with present dust levels. For those with symptoms of byssinosis an increased Monday fall was found only in those processing coarse cotton.
For those subjects who completed the respiratory questionnaire on two occasions the chronic and acute changes in FEV were examined in relation to the change in symptoms of byssinosis. No association was found for annual decline in FEV but the Monday fall in FEV was greater for those who developed byssinosis during the survey than for those who remained free of symptoms, and was less for those who lost their symptoms than for those who retained them.
PMCID: PMC1009474  PMID: 4685297
11.  Interaction of atopy and exposure to cotton dust in the bronchoconstrictor response. 
A survey of 255 workers in four cottonseed crushing mills included a respiratory health questionnaire, allergy skin testing, and measurements of lung function over the Monday working shift. Atopy was defined as having two or more positive weal reactions to common inhalant antigens. Categories of exposure to dust were based on the stage of milling, and one category contained workers with continuous exposure to cotton dust derived from linters, the cotton fibres adherent to cottonseed. Atopy and exposure to dust were found to have significant interaction: large mean declines in FEV1 and FEF 25-75 occurred only in the workers exposed to linter dust who were also atopic. Skin-testing surveys in cotton textile mills have concentrated on specific cotton antigen reactivity and its first-order relations to symptoms. Our results indicate a need to identify atopic workers, and to search for interactions between atopy and other variables that may influence acute changes in expiratory flow rates.
PMCID: PMC1008681  PMID: 7426464
12.  The characteristics of respiratory ill health of wool textile workers. 
The relations of lung function and chest radiographic appearances with exposure to inspirable dust were examined in 634 workers in five wool textile mills in west Yorkshire, randomly selected to represent fully the range of current exposures to wool mill dust. Most of these workers could be categorised into three large sex and ethnic groups; European men, Asian men, and Asian women. Exposures to inspirable dust had been measured at a previous survey and time spent in current job, and in the industry were used as surrogates for lifetime cumulative exposures. Chest radiographs were interpreted on the International Labour Office (ILO) scale by three medically qualified readers, and the results combined. Profusions of small opacities of 0/1 on the ILO scale, or greater, were present in only 6% of the population, and were not positively associated with current exposure to wool mill dust, or duration of exposure. In general, statistically significant relations between exposure and lung function indices were not found, with the exception of an inverse relation between the forced expiratory volume/forced vital capacity ratio and dust concentration in European women. A suggestive but not statistically significant inverse relation between FVC and current dust concentration was seen in Asian men. Substantial differences were found between mills in mean values of lung function variables after adjustment for other factors but these were not apparently related to the differences in dust concentrations between these mills. Dyeworkers and wool scourers (mostly European men in relatively dust free jobs) on average experienced an FEV1 251 ml lower than other workers when age, height, smoking habits, and occupational factors had been taken into account. Twenty four per cent of the workforce responded to intracutaneous application of one or more common allergens (weal diameter at least 4 mm), only 12 (7.9%) of these responding to wool extracts. Atopic subjects did not appear to have an increased susceptibility to the effects of inspirable wool dust on lung function. These studies suggest that exposure to wool mill dust may cause functional impairment in some workers but there is little indication from these data of frequent or severe dust related functional deficits. More detailed estimates of cumulative dust exposure by reconstruction of exposure histories might clarify associations between exposure to dust and lung function. These chest radiographic findings provide no evidence that exposure to wool mill dust is related to lung fibrosis.
PMCID: PMC1035359  PMID: 2025586
13.  Byssinosis in Guangzhou, China. 
OBJECTIVES--To study the prevalence of byssinosis and other respiratory abnormalities in workers exposed to cotton dust in Guangzhou in two factories that processed purely cotton. METHODS--All the 1320 workers exposed were included. The controls were 1306 workers with no history of occupational dust exposure. Total dust and inhalable dust were measured by Chinese total dust sampler and American vertical elutriator respectively. A World Health Organisation questionnaire was used. Forced vital capacity (FVC) and forced expiratory volume in one second (FEV1) were measured by a Vitalograph spirometer. RESULTS--The median inhalable dust concentrations ranged from 0.41 to 1.51 mg/m3 and median total dust concentrations from 3.04 to 12.32 mg/m3. The prevalence of respiratory abnormalities in the cotton workers were (a) typical Monday symptoms 9.0%; (b) FEV1 fall by > or = 5% after a shift 16.8%; (c) FEV1 fall by > or = 10% after a shift 4.2%; (d) FEV1 < 80% predicted 6.1%; (e) FEV1/FVC < 75% 4.0%; (f) cough or phlegm 18.2%; (g) chronic bronchitis 10.9%; and (h) byssinosis, defined by (a) plus (b) 1.7%. With the exception of (d), most of the prevalences increased with increasing age, duration of exposure, and cumulative inhalable dust exposure. No increasing trends of respiratory abnormalities were found for current total dust, inhalable dust, and cumulative total dust concentrations. Compared with controls, after adjustment for sex and smoking, with the exception of (d), all the pooled relative risks of respiratory abnormalities were raised for cotton exposure. CONCLUSION--It is concluded that cumulative inhalable cotton is likely to be the cause of byssinotic symptoms, acute lung function decrements, cough, or phlegm, and chronic bronchitis.
PMCID: PMC1128206  PMID: 7795743
14.  A study of rope workers exposed to hemp and flax 
Smith, G. F., Coles, G. V., Schilling, R. S. F., and Walford, Joan (1969).Brit. J. industr. Med.,26, 109-114. A study of rope workers exposed to hemp and flax. Respiratory symptoms and ventilatory capacities were studied in 54 men and 22 women exposed to the mixed dusts of hemp and flax in an English rope factory. The preparers and most of the spinners were exposed on average to concentrations of 1·7 mg./m.3 total dust and 0·5 mg./m.3 fine dust. Those employed on subsequent processes had lower exposures at concentrations of 0·5 mg./m.3 total dust and 0·1 mg./m.3 fine dust.
Six men, all in the high exposure group, had symptoms of byssinosis. After adjustment for age and standing height there was no statistically significant difference in the forced expiratory volume (F.E.V.1·0) between those in high dust concentrations and those in low concentrations; neither was there a significant difference between the ventilatory capacities of men with and without byssinosis.
This study shows that byssinosis is an occupational hazard confined to male workers in this factory. It does not appear to be a very serious problem and will diminish with the increasing use of synthetic materials instead of natural fibres.
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PMCID: PMC1008903  PMID: 5780101
15.  Respiratory symptoms and ventilatory capacity in swine confinement workers. 
A group of 59 workers (41 men and 18 women) employed in swine confinement areas was studied to assess the presence of acute and chronic respiratory symptoms and the prevalence of abnormalities in ventilatory function. A control group of 46 (31 men and 15 women) unexposed workers was studied for the prevalence of chronic respiratory symptoms. For both male and female swine confinement workers complaints of chronic cough, dyspnoea, and chest tightness were significantly more frequent than among control workers. Male workers also complained more of chronic phlegm. Male swine confinement workers who were smokers had significantly higher prevalences of chronic cough, chronic phlegm, and chronic bronchitis than male non-smoking swine confinement workers. The frequency of acute symptoms associated with the workshift was high among the swine confinement workers with more than half of the workers complaining of cough and dyspnoea associated with work. Significant acute across shift reductions in lung function occurred in swine confinement workers, being largest for FEF25. All Monday preshift ventilatory capacity measurements in male confinement workers were significantly lower than predicted values; FVC and FEV1 were found to be lower than predicted values for women. The data indicate that exposure in swine confinement buildings is associated with the development of acute and chronic respiratory symptoms and impairment of lung function. Smoking appears to aggravate these changes.
PMCID: PMC1012126  PMID: 1606030
16.  Pharmacological prevention of acute ventilatory capacity reduction in flax dust exposure 
Valić, F., and Žuškin, E. (1973).British Journal of Industrial Medicine,30, 381-384. Pharmacological prevention of acute ventilatory capacity reduction in flax dust exposure. The protective effect of the preshift application of a bronchodilator (orciprenaline), an antihistamine drug (diadril), and ascorbic acid on flax-induced acute bronchoconstriction was studied in 13 byssinotic and 7 non-byssinotic female workers exposed to airborne fibres of biologically retted flax. Orciprenaline was applied by inhalation, while diadril and ascorbic acid were given orally. All the three drugs exerted a significant preventive effect, diminishing the acute fall of ventilatory capacity during the shift. The fall in forced expiratory volume (FEV1·0) was reduced by 50% and the fall in maximal flow rate at 50% vital capacity (V̇max 50% VC) by over 65%.
PMCID: PMC1069479  PMID: 4148157
17.  CHANGES IN VENTILATORY CAPACITY IN A GROUP OF FLAX WORKERS IN NORTHERN IRELAND 
One-second forced expiratory volume (F.E.V.1·0) and forced vital capacity (F.V.C.) were measured before starting work in five flax hacklers with symptoms of grade II byssinosis and in five matched controls. Similar measurements were taken in each group at the end of the day shift.
A significant (P < 0·05) decline in F.E.V.1·0 was observed in the hacklers during the day on Monday, Tuesday, Wednesday, and Friday. The F.V.C. also declined significantly in the hacklers on Monday, Tuesday, and Wednesday. In the control group, ventilatory function tended to decline during the day, but this was significant only for F.E.V.1·0 on Monday. The reason for this is discussed.
Variations in the dust concentrations in the mill and in outdoor air pollution are shown to be unlikely to have affected the findings.
Morning values of F.E.V.1·0 and of F.V.C. were consistently lower in the byssinotic group than in the matched controls, suggesting that the inhalation of flax dust causes not only daily variations in lung function but longer-term impairment of ventilatory capacity as well. Additional evidence is given for this conclusion from two other studies.
PMCID: PMC1008258  PMID: 14278799
18.  Dust exposure, respiratory symptoms, and longitudinal decline of lung function in young coal miners. 
OBJECTIVES: To study the role of dust exposure on incidence of respiratory symptoms and decline of lung function in young coal miners. METHODS: The loss of lung function (forced vital capacity (FVC), forced expiratory volume in one second (FEV1), forced expiratory flow (MEF), carbon monoxide transfer factor (TLCO)) with time and the incidence of respiratory symptoms in 909 Sardinian coal miners (followed up between 1983 and 1993 with seven separate surveys) has been compared with the past and current individual exposures to respirable mixed coal dust. Multiple linear and logistic regression models were used simultaneously controlling for age, smoking, past occupational exposures, and other relevant covariates. RESULTS: According to the relatively low dust exposures experienced during the follow up few abnormal chest x ray films were detected. In the cross sectional analysis of initial data, significant associations between individual cumulative exposure to dust, decrements in FEV1 and MEFs, and increasing prevalence of respiratory symptoms were detected after allowing for the covariates included in the model. The yearly decline of FVC, FEV1, and single breath carbon monoxide transfer factor (TLCO/VA) was still significantly related to the individual exposure to dust experienced during the follow up, even after allowing for age, smoking, initial cumulative exposure to dust, and initial level of each functional variable. In logistic models, dust exposure was a significant predictor of the onset of respiratory symptoms besides age and smoking. CONCLUSIONS: The results show that even moderate exposures to mixed coal dust, as in our study, significantly affect lung function and incidence of symptoms of underground miners. Although the frequency of chest x ray examination might be fixed at every three or four years, yearly measurements of lung function (spirometry, MEFs, and TLCO) are recommended for evaluation of the respiratory risk from the coal mine environment to assess the need for further preventive interventions.
PMCID: PMC1128473  PMID: 8673178
19.  Pulmonary function, respiratory symptoms, and dust exposures among workers engaged in early manufacturing processes of tea: a cohort study 
BMC Public Health  2012;12:121.
Background
To evaluate pulmonary function and respiratory symptoms in workers engaged in the early manufacturing processes of tea and to identify the associated factors, we conducted a study in a tea production area in Taiwan.
Methods
We recruited tea workers who engaged in the early manufacturing process in the Mountain Ali area in Taiwan and a comparison group of local office workers who were matched for age, gender, and smoking habits. We performed questionnaire interviews, pulmonary function tests, skin prick tests, and measurement of specific IgE for tea on the participants and assessed tea dust exposures in the tea factories.
Results
The 91 participating tea workers had higher prevalence of respiratory symptoms than the comparison group (32 participants). Among tea workers, ball-rolling workers had the highest prevalence of symptoms and the highest exposures of inhalable dusts. At baseline, tea workers had similar pulmonary functions as the comparison group, but compared to the other tea workers ball-rolling workers had a lower ratio of the 1-second forced expiratory volume to forced vital capacity (FEV1/FVC) and a lower maximal mid-expiratory flow rate expressed as% of the predicted value--MMF (%pred). A total of 58 tea workers participated in the on-site investigation and the cross-shift lung function measurements. We found ball-rolling yielded the highest inhalable dust level, panning yielded the highest respirable dust level, and withering yielded the lowest levels of both dusts. Ball-rolling also yielded the highest coarse fraction (defined as inhalable dusts minus respirable dusts), which represented exposures from nose to tracheobronchial tract. During the shift, we observed significant declines in pulmonary function, especially in ball-rolling workers. Multiple regressions showed that age, height, work tasks, coarse fraction, and number of months working in tea manufacturing each year were independent predictors of certain pulmonary function parameters in tea workers.
Conclusions
Tea workers engaged in early manufacturing processes of tea have higher prevalence of respiratory symptoms and pulmonary function impairment, which might be related to tea dust exposures, especially the coarse fraction.
doi:10.1186/1471-2458-12-121
PMCID: PMC3312852  PMID: 22325044
Tea; Occupational exposure; Pulmonary function tests; Signs and symptoms; Respiratory
20.  Respiratory symptoms and ventilatory function in confectionery workers. 
Respiratory symptoms and ventilatory capacity were studied in a group of 288 workers (259 women and 29 men) employed in a confectionery plant. A group of workers (96 women and 31 men) not exposed to confectionery manufacture were also studied as controls. The prevalence of chronic respiratory symptoms was higher in exposed than in control workers, being greatest for confectionery workers exposed to the dust of flour, talc, and starch and the vapours of alcohol. Chronic bronchitis was reported by 7% of the women and 21% of the men, and chest tightness was reported by 27% of women and 66% of men. There was a high prevalence of acute irritative symptoms during the workshift in all groups of confectionery workers, especially for cough, dyspnoea, burning and dryness of the throat, and eye irritation. For all groups of confectionery workers there were statistically significant across shift reductions in ventilatory capacity, being most pronounced for maximum flow rate at 50% of the control vital capacity (FEF50; range 4.6-13.0%) and at 25% of the control vital capacity (FEF25; range 4.7-22.3%). Preshift values of FEF50 and FEF25 were significantly lower than predicted values. The data suggest that some workers employed in confectionery plants may develop acute and chronic respiratory symptoms associated with changes in lung function.
PMCID: PMC1128010  PMID: 8044240
21.  Dust exposure and impairment of lung function at a small iron foundry in a rapidly developing country 
OBJECTIVES—A cross sectional prospective study was carried out among iron foundry workers (exposed) and soft drink bottling and supply company workers (unexposed) to assess their occupational exposure to ambient respiratory dust in their work environment and its effect on their lung function profile.
PARTICIPANTS—Lung function was measured in 81 exposed and 113 unexposed workers. Personal respirable dust concentrations were measured for all the exposed and the unexposed workers. Information on respiratory signs and symptoms was also collected from the participants.
RESULTS—Among the exposed workers, midexpiratory flow (FEF25-75), forced expiratory volume in 1 second (FEV1), peak expiratory flow (PEF), FEV1/FVC, and FEV1/VC ratios were significantly lower whereas the vital capacity (VC) and forced vital capacity (FVC) were non-significantly higher. Job at the iron foundry was a significant predictor of lung function. Exposure to high concentration of respirable dust at the iron foundry was also a significant predictor. Workers working in high exposure areas (general works, furnace, continuous casting areas, and fabrication workshop) had lower lung function values than workers in medium and low exposure areas. Smoking did not enhance the effects of exposure to dust on lung function.
CONCLUSIONS—Exposure to respirable dust was higher among the iron foundry workers; and among these, general, furnace, rolling mill, and fabrication workers had higher exposures to dust than did workers in continuous casting, the mechanical workshop, and the bottling plant. Job type and exposure to dust were significant predictors of lung function. Implementation of industrial hygiene and proper and efficient use of personal protection equipment while at work could help to protect the respiratory health of industrial workers.


Keywords: lung function; dust exposure; foundry; smoking; personal protection
doi:10.1136/oem.58.10.656
PMCID: PMC1740042  PMID: 11555687
22.  Lung function measurements over 21 days shiftwork in steelworkers from a strandcasting department. 
On the assumption that short term changes in lung function may reflect the potential for a long term decline the evolution of lung function indices in 25 steelworkers from a strandcasting department and in 11 comparable steelworkers not exposed to dust was investigated over an almost uninterrupted 21 day working period and over three different workshifts. The mean total dust level in the strandcasting department, assessed by personal sampling, was 11.8 mg/m3. All subjects were examined at the beginning, in the middle, and at the end of their first (day 1) morning shift (0600 to 1400), their last (day 14) afternoon shift (1400 to 2200), and their last (day 21) night shift (2200 to 0600). Indices measured were vital capacity (VC), forced expiratory volume in one second (FEV1) and in three seconds (FEV3), forced expiratory flow over the middle half of the forced vital capacity (FEF25-75), peak expiratory flow rate (PEFR), the slope of the N2 plateau (delta N2) and the closing volume (CV) of the single breath oxygen test. Differences in indices between initial values (0600 on day 1) and final values (0500 on day 21) were not significant in the control group (except delta N2 which became lower); in the casting group there were significant (p less than 0.05) decreases in FEF25-75 and FEV3, but these decreases were not significantly greater than in the control group. Lung function changes were not significant in either group over the morning shift. During the afternoon there were significant decreases in spirometric indices in the casting group, with no significant decreases in the control group, but the interactions between exposure and time were generally not significant. During the night shift, however, the decreases in FEV1 and FEF25-75 observed in the strandcasting group were significantly more pronounced than in the control group. The single breath test, which many subjects failed to perform correctly on each occasion, showed no significant changes in closing volumes, and an "improvement" of delta N2 over the morning and the night shift in the control but not the exposed subjects needs to be interpreted with caution. The more pronounced decrease in spirometric indices, suggestive of slight airways obstruction, found over the night shift in the strandcasting workers is attributed to their working environment.
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PMCID: PMC1007542  PMID: 4041389
23.  Preprocessing cotton to prevent byssinosis 
Merchant, J. A., Lumsden, J. C., Kilburn, K. H., Germino, V. H., Hamilton, J. D., Lynn, W. S., Byrd, H., and Baucom, D. (1973).British Journal of Industrial Medicine,30, 237-247. Preprocessing cotton to prevent byssinosis. A fundamental approach of cleaning or deactivating cotton prior to manufacturing has long been advocated to prevent byssinosis, but no trial had been conducted to test the feasibility of such an approach. In the study described, it was possible to be directed by both biological observations and the results of manufacturing trials.
An exposure chamber was built in a cotton textile mill which had been previously studied as part of a large cross-sectional survey. The chamber was provided with an independent air conditioning system and a carding machine which served as a dust generator. Sixteen subjects, who had shown reductions in expiratory flow rate with exposure to cotton dust, were chosen to form a panel for exposure to raw cottons and cottons which had been preprocessed by heating, washing, and steaming. Indicators of effects were symptoms of chest tightness and/or dyspnoea, change in FEV1·0, and fine dust levels over 6 hours of exposure.
Exposure of the panel to no cotton dust resulted in no change in FEV1·0 and served as the control for subsequent trials. Exposure to strict middling cotton resulted in a byssinosis symptom prevalence of 22%, a significant decrement in FEV1·0 of 2·9%, and a fine dust level of 0·26 mg/m3. Exposure to strict low middling cotton resulted in a byssinosis symptom prevalence of 79%, a decrement in FEV1·0 of 8·5%, and a fine dust level of 0·89 mg/m3. Oven heating strict low middling cotton resulted in a byssinosis symptom prevalence of 56% and a relatively greater drop in FEV1·0 of 8·3% for 0·48 mg/m3 of fine dust. Washing the strict low grade cotton eliminated detectable biological effects with a symptom prevalence of 8%, an increase of 1·4% in FEV1·, and a dust level of 0·16 mg/m3, but the cotton proved to be difficult to process. As an alternative method, strict low middling cotton was steamed initially in large dyeing vats, on a conveyor, in an autoclave, and in a modified yarn dyeing apparatus or `pipe' steamer. Of these methods, autoclaving cotton was the most successful, reducing symptom prevalence to 8%, the drop in FEV1·0 to 0·4%, and the dust level to 0·23 mg/m3. Development of a high capacity cotton steamer based on the small `pipe' steaming model resulted in a symptom prevalence of 8%, a decrement in FEV1·0 of 0·8%, and a mean dust level of 0·27 mg/m3. Regressions calculated from raw and high capacity steaming trials indicate that at low dust levels steamed cotton dust was roughly one half as biologically active as raw cotton dust.
PMCID: PMC1009518  PMID: 4723787
24.  RESPIRATORY FUNCTION AND SYMPTOMS IN ROPE MAKERS 
This paper gives the results of a small environmental, symptomatic, and respiratory function study of byssinosis in a rope factory. An attempt was made to relate the changes in ventilatory function during the working day to the differing dust concentrations within the factory. The tests used included the forced expiratory volume, the forced vital capacity, and, in half the subjects, other derivatives of the forced expiratory spirogram. The inspiratory airways resistance was measured by the interrupter technique.
Measurements were made at the beginning and end of a working shift on either a Monday or a Tuesday in 44 subjects, of whom 22 were in a relatively dusty part of the factory and 14, involved in making wire rope, were exposed to very little dust.
None of the subjects had symptoms of byssinosis, but significant falls were found in the F.E.V.1·0, F.V.C., and other derivatives of the forced expiratory spirogram in those in the dusty parts of the factory. There was some evidence that the peak flow rate, the maximal mid-expiratory flow, and similar indices might be a little more sensitive as measures of the acute changes in ventilatory capacity during the day than the F.E.V.1·0 and F.V.C. There were no significant changes in the airways resistance by the interrupter technique but the results were rather variable.
The fall in ventilatory capacity during the day was not greater in those with symptoms of chronic cough and sputum than in those without, nor did it seem to be related to smoking, but the number of subjects studied was small.
PMCID: PMC1008298
25.  Long-term Effects of Work Cessation on Respiratory Health of Textile Workers 
Rationale: The degree to which chronic respiratory health effects caused by exposures to cotton dust and endotoxin is reversible after cessation of textile work is unknown.
Objectives: To investigate changes in lung function and respiratory symptoms after cessation of textile work and to determine whether past exposure to cotton dust and endotoxin or smoking history modify the associations.
Methods: We performed a prospective cohort study consisting of 447 cotton textile workers exposed to cotton dust and 472 unexposed silk textile workers, with a 25-year follow-up. Spirometry testing and respiratory questionnaires were conducted at 5-year intervals. Generalized estimated equations were used to model the average 5-year change in FEV1 and odds ratios of respiratory symptom prevalence.
Measurements and Main Results: Years since cessation of textile work was positively associated with 11.3 ml/yr and 5.6 ml/yr gains in 5-year FEV1 change for cotton and silk workers, respectively. Among male cotton workers, smokers gained more FEV1 per year after cessation of exposure than did nonsmokers, and the risk of symptoms of chronic bronchitis and byssinosis was larger for smoking than for nonsmoking male cotton workers.
Conclusions: Cessation of textile work was significantly associated with improvement in lung function and respiratory symptoms. The positive effect of work cessation was greater for cotton workers than for silk workers. For cotton workers, the improvement in lung function loss after cessation of textile work was greater among smokers, but no differences were observed for silk workers.
doi:10.1164/rccm.200903-0329OC
PMCID: PMC2913234  PMID: 20339150
respiratory disease; environmental health; cotton textile workers; endotoxin exposure; occupational health

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