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1.  Asbestosis: a study of dose-response relationships in an asbestos textile factory 
ABSTRACT A group of 379 men who had worked at an asbestos textile factory for at least 10 years has been followed up. The prevalence of crepitations, 'possible asbestosis', certified asbestosis, small opacities in the chest radiograph and values of lung function have been related to dust levels. The type of asbestos processed was predominantly chrysotile although a substantial amount of crocidolite had also been used in the past. There was a higher prevalence of crepitations than had been observed previously at the same factory. The presence of crepitations is not a specific effect of asbestos exposure and 'possible asbestosis', a combined judgement of two physicians on whether a man had developed signs which might be attributable to early asbestosis, was preferred. Fifty per cent of men with a diagnosis of possible asbestosis were certified as suffering from asbestosis by the pneumoconiosis Medical Panel within 3-5 yr. The most reliable data relate to men first employed after 1950; 6·6% of men in this group had possible asbestosis after an average length of follow-up of 16 yr and an average exposure to 5 fibre/cm3 where the dust levels were determined by static area samplers. The forced expiratory volume and forced vital capacity declined significantly with exposure, after allowing for age and height, but there was no decline in the total lung capacity. The transfer factor also declined with exposure, but not to a statistically significant extent. The non-smokers and light smokers as a group had less crepitations, asbestosis and small opacities on the chest radiograph than heavier smokers with similar exposure. Combining dust concentrations to form the cumulative dose may not be completely satisfactory, and a family of measures was investigated which allows for elimination of dust from the lungs and includes the cumulative dose as a special case. Because the rate of elimination of dust from the lungs is unknown and cannot be estimated from the data, this approach leads to a wide range of possible interpretations of the data; for example the concentration such that possible asbestosis occurs in no more than 1% of men after 40 years' exposure could be as high as 1·1 fibres/cm3 or may have to be as low as 0·3 fibres/cm3. This range is wide because the data relate to higher dust levels, and a shorter period of follow-up. Until data are available on groups exposed to lower levels it will not be possible to assess the effects of the current standard with any certainty. However, the results of this study show that it is important to continue to reduce dust levels to values as low as possible.
PMCID: PMC1008524  PMID: 465379
2.  UK Naval Dockyards Asbestosis Study: radiological methods in the surveillance of workers exposed to asbestos 
ABSTRACT In a survey of the effects of exposure to asbestos in the UK Naval Dockyards, small- and large-film chest radiographs of 674 men have been examined. These films have been read under survey conditions by two readers using a simple screening classification, and also in a controlled trial by five readers using the full ILO U/C classification. Comparison between the reading methods showed a deficiency, independent of the size of film, of at least 30% in the detection of asbestos-related radiographic abnormalities when the screening classification was used. For adequate diagnostic sensitivity the ILO U/C classification appears to be essential. There was a deficiency of 43% in significant abnormalities observed by a majority of readers in the small films when directly compared with large film readings. This deficiency could be reduced to 7% by using readings of the small films at any level of abnormality by any of the five readers. When the ILO U/C readings were related to the clinical diagnoses, the only abnormality missed was a small pleural plaque. Films with previously agreed coding were inserted at intervals during the reading trial and helped to maintain the consistency of reading. Right oblique views were taken for 1884 men, in addition to the full-sized postero-anterior view, but the contribution provided by this view proved insufficient to justify its use in large surveys. The cost of a survey when small films are used as a screening method is reduced to between one-third and one-half of the cost when large films are used, assuming that the abnormality rate is not more than 5%. However, this cost advantage for small films is likely to be overtaken by the development of automatic large-film units. The radiation dose when small films are used is increased by a factor of about 20, but is within the prescribed safety level. It is concluded that at least three readers should be involved, using the full ILO U/C classification. Small films may be of particular use in a large-scale survey, in which the abnormality rate is expected to be low, and which might otherwise be too expensive. A sensitive reading method and a high standard of film quality are essential factors in the use of this technique.
PMCID: PMC1008405  PMID: 698132
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
4.  Byssinosis: The Acute Effect on Ventilatory Capacity of Dusts in Cotton Ginneries, Cotton, Sisal, and Jute Mills 
Studies of ventilatory capacity change in small groups of employees during a shift in a cotton mill and in three cotton ginneries in Uganda, a sisal factory in Kenya, and a jute mill in England, have demonstrated that an effect is produced by the dust in the cotton mill and in a very dusty ginnery but not in two other less dusty ginneries. No significant effect was detected in the sisal factory or in the jute mill despite much higher dust concentrations than in the cotton mill.
The dust sampling instruments gave the weight in three sizes: Coarse (>2 mm.), medium (7μ to 2 mm.), and fine (<7μ). The samples were analysed for protein, mineral (ash), and cellulose (by difference). The fine and medium sisal and jute dusts contain less protein than cotton dusts. The physiological changes observed in the employees in the cotton mill indicate the need for general dust measurement and control, even when new carding machinery is installed in a new mill.
PMCID: PMC1038126  PMID: 13898707
5.  The Size of Cotton Dust Particles Causing Byssinosis: An Environmental and Physiological Study 
Fourteen subjects of whom 12 were cotton mill blow- or card-room workers were exposed in a plastic tent for periods of three or four hours to airborne mill dust either of unrestricted size distribution (total dust) or containing only particles of less than 7μ(fine dust).
A significant fall in indirect maximum breathing capacity followed exposure to either total or fine dust in most experiments. The response to total dust usually appeared a little larger than to fine but the concentration of fine particles in the unfiltered air was rather higher. The changes in the single-breath nitrogen clearance index and the inspiratory airways resistance were less constant, but the general pattern followed that of the ventilatory capacity.
It is concluded that the fine fraction (under 7μ) of cotton mill dust produces changes in respiratory function and may be alone responsible. The findings suggest a direct action by the dust on the smaller air passages and imply that to be completely effective dust suppression measures in cotton mills should remove fine dust.
PMCID: PMC1038125
6.  Population Studies of Chronic Respiratory Disease: A Comparison of Miners, Foundryworkers, and Others in Staveley, Derbyshire 
Mortality and morbidity statistics suggest that miners and foundryworkers are more prone to bronchitis than other industrial workers but it is not yet certain that this excess is due to occupational factors. The present investigation was designed to compare the prevalence of bronchitis and respiratory disability in a representative sample of miners, foundryworkers, and other industrial groups living in Staveley, Derbyshire, a town of some 18,000 inhabitants, and to study some of the possible aetiological factors. A random sample of 776 men, stratified by age into two groups, 25 to 34 and 55 to 64 years, and by occupation into four groups, non-dusty, miners and ex-miners, foundry and ex-foundryworkers, and other dusty jobs, was used. Respiratory symptoms were recorded on a standardized questionnaire and the ventilatory capacity was assessed by means of the forced expiratory volume (F.E.V.0·75) and recorded as the indirect maximum breathing capacity (M.B.C.).
Miners and ex-miners recorded a higher prevalence of respiratory symptoms and a lower mean M.B.C. than men who had worked only in dust-free occupations. In the older age group the differences were not large and were not statistically significant but in the younger men the difference in the mean M.B.C. was significant. Foundry and ex-foundryworkers with a pure industrial history recorded a similar prevalence of symptoms to the men who had never worked in dusty occupations and their mean M.B.C. was only slightly and insignificantly lower. A higher prevalence of symptoms and a lower mean M.B.C. was, however, recorded by the foundrymen who had also been exposed to other dusts or fumes and the occupational histories suggested that such exposure was more likely than foundry work to account for the findings.
The number of years spent on the coal-getting shift was used to assess the importance of exposure to coal dust. In the elderly miners without pneumoconiosis there was a significant increase in the prevalence of breathlessness, accompanied by a reciprocal fall in the mean M.B.C. with increasing years spent on the coal-getting shift; but in no other group was a consistent trend found.
In both age groups the prevalence of respiratory symptoms was lower and the mean M.B.C. higher in non-smokers than in smokers and ex-smokers. Heavy smokers (those smoking 15g. and over/day) recorded a higher prevalence of symptoms and a lower mean M.B.C. than light smokers, and the values for ex-smokers approximated to those of the non-smokers.
The wives of the elderly men in the sample were studied to try to determine how far the apparently high rates of bronchitis shown by national mortality statistics are attributable to social factors. The findings suggested that the wives of the men who worked in dusty jobs had a somewhat higher prevalence of cough and/or sputum and of chest illness during the past three years than the wives of those who had worked only in dust-free occupations.
PMCID: PMC1037963  PMID: 14401755

Results 1-10 (10)