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Tefera Zele Y, Kumie A, Deressa W, Moen BE, Bråtveit M. Reduced Cross-Shift Lung Function and Respiratory Symptoms among Integrated Textile Factory Workers in Ethiopia. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2020; 17:ijerph17082741. [PMID: 32316175 PMCID: PMC7215879 DOI: 10.3390/ijerph17082741] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 02/17/2020] [Revised: 04/13/2020] [Accepted: 04/14/2020] [Indexed: 01/03/2023]
Abstract
Chronic respiratory symptoms and reduction in lung function has been described as a common health problem among textile workers in low- and middle-income countries. The objective of this study was to measure lung function and respiratory symptoms among workers from an integrated textile factory. A comparative cross-sectional study design with a cross-shift lung function measurement was performed in 306 cotton dust exposed workers from an integrated textile factory and 156 control workers from a water bottling factory. An integrated textile factory typically has four main production departments (spinning, weaving, finishing, and garment) that process raw cotton and manufacture clothes or fabrics. Respiratory symptoms were assessed by adopting the standard American Thoracic Society questionnaire. Descriptive statistics and logistic and linear regression analysis were used. The prevalence of respiratory symptoms was significantly higher among textile workers (54%) than in controls (28%). Chronic cough, chest tightness, and breathlessness were significantly higher among textile workers (23%, 33%, and 37%, respectively) than in the control group (5%, 17% and 6%, respectively). Breathlessness was the most prevalent chronic respiratory symptom with highest adjusted odds ratio 9.4 (95% CI 4.4–20.3). A significantly higher cross-shift lung function reduction was observed among textile workers (123 mL for FEV1 and 129 mL for FVC) compared with the control group (14 mL for FEV1 and 12 mL for FVC). Thus, workers’ respiratory health protection programs should be strengthened in textile factories.
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Affiliation(s)
- Yifokire Tefera Zele
- Department of Preventive Medicine, School of Public Health, College of Health Sciences, Addis Ababa University, P.O. Box 9086 Addis Ababa, Ethiopia; (A.K.); (W.D.)
- Department of Global Public Health and Primary Care, University of Bergen, 5007 Bergen, Norway; (B.E.M.); (M.B.)
- Centre for International Health, Department of Global Public Health and Primary Care, Faculty of Medicine, University of Bergen, Årstadveien 21, 5009 Bergen, Norway
- Correspondence: or ; Tel.: +251-91-375-4082
| | - Abera Kumie
- Department of Preventive Medicine, School of Public Health, College of Health Sciences, Addis Ababa University, P.O. Box 9086 Addis Ababa, Ethiopia; (A.K.); (W.D.)
| | - Wakgari Deressa
- Department of Preventive Medicine, School of Public Health, College of Health Sciences, Addis Ababa University, P.O. Box 9086 Addis Ababa, Ethiopia; (A.K.); (W.D.)
| | - Bente E. Moen
- Department of Global Public Health and Primary Care, University of Bergen, 5007 Bergen, Norway; (B.E.M.); (M.B.)
- Centre for International Health, Department of Global Public Health and Primary Care, Faculty of Medicine, University of Bergen, Årstadveien 21, 5009 Bergen, Norway
| | - Magne Bråtveit
- Department of Global Public Health and Primary Care, University of Bergen, 5007 Bergen, Norway; (B.E.M.); (M.B.)
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Associations Between Bioaerosol Exposures and Lung Function Changes Among Dairy Workers in Colorado. J Occup Environ Med 2020; 62:424-430. [DOI: 10.1097/jom.0000000000001856] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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Zhang Y, Ye B, Zheng H, Zhang W, Han L, Yuan P, Zhang C. Association Between Organic Dust Exposure and Adult-Asthma: A Systematic Review and Meta-Analysis of Case-Control Studies. ALLERGY, ASTHMA & IMMUNOLOGY RESEARCH 2019; 11:818-829. [PMID: 31552717 PMCID: PMC6761076 DOI: 10.4168/aair.2019.11.6.818] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/30/2018] [Revised: 09/10/2018] [Accepted: 09/13/2018] [Indexed: 12/25/2022]
Abstract
Background Exposure to organic dust has been widely investigated as a potential risk factor for asthma with different results. To clarify a potential relationship, we performed the present meta-analysis to integrate the results of studies examining the association of organic dust exposure with asthma. Methods A comprehensive literature search in the electronic databases including EMBASE, PubMed and Cochrane Library databases (up to August 2018) was conducted. The adjusted odds ratios (ORs) with corresponding 95% confidence interval (CI) for organic dust exposure and asthma were retrieved and pooled to generate summary effect estimates in Revman 5.2. Results Database searches retrieved 1,016 records. A total of 17 studies containing 3,619 cases and 6,585 controls were finally included in our meta-analysis. The summary estimates suggested that organic dust exposure was positively associated with asthma (OR, 1.48; 95% CI, 1.26–1.75; P < 0.00001), whether among population-based case-control studies (OR, 1.24; 95% CI, 1.13–1.35; P < 0.00001) or hospital-based case-control studies (OR, 2.79; 95% CI, 1.27–6.12; P = 0.01). Subgroup analysis showed that paper/wood (OR, 1.62; 95% CI, 1.38–1.90; P < 0.00001), flour/grain (OR, 1.48; 95% CI, 1.11–1.97; P = 0.008), and textile dust (OR, 1.50; 95% CI, 1.08–2.09; P = 0.02) exposure were significantly associated with asthma. Conclusions Based on the studies evaluated, our meta-analysis results prompt that organic dust exposure is a risk factor inducing asthma, although precise analysis focus on specific organic dust materials is still warranted.
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Affiliation(s)
- Yan Zhang
- Department of Emergency, Jinan Children's Hospital, Qilu Children's Hospital of Shandong University, Jinan 250022, China.
| | - Bing Ye
- Department of Emergency, Jinan Children's Hospital, Qilu Children's Hospital of Shandong University, Jinan 250022, China
| | - Hongling Zheng
- Department of Emergency, Jinan Children's Hospital, Qilu Children's Hospital of Shandong University, Jinan 250022, China
| | - Wei Zhang
- Department of Emergency, Jinan Children's Hospital, Qilu Children's Hospital of Shandong University, Jinan 250022, China
| | - Lin Han
- Department of Emergency, Jinan Children's Hospital, Qilu Children's Hospital of Shandong University, Jinan 250022, China
| | - Peng Yuan
- Department of Emergency, Jinan Children's Hospital, Qilu Children's Hospital of Shandong University, Jinan 250022, China
| | - Chao Zhang
- Department of Emergency, Jinan Children's Hospital, Qilu Children's Hospital of Shandong University, Jinan 250022, China
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Bolund AC, Miller MR, Sigsgaard T, Schlünssen V. The effect of organic dust exposure on long-term change in lung function: a systematic review and meta-analysis. Occup Environ Med 2017; 74:531-542. [PMID: 28404791 DOI: 10.1136/oemed-2016-103963] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/18/2016] [Revised: 02/19/2017] [Accepted: 03/19/2017] [Indexed: 12/19/2022]
Abstract
Lung function is a predictor of morbidity and mortality, and the chronic nature of lung function decline allows for preventive initiatives. Proinflammatory constituents of organic dust are considered a possible cause of compromised respiratory health. The aim of this systematic review was to reveal the impact of organic dust exposure on long-term change in lung function. The literature search was performed according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) criteria. Predefined criteria concerned study design: longitudinal, ≥1 year follow-up, ≥50 exposed; exposure measures: organic dust, measured or estimated, in different occupational settings; and outcome measures: change in lung function measured by spirometry. Based on these criteria, 1580 potentially relevant publications were narrowed down to 20 included publications. Quality was evaluated and discussed based on six objectively defined criteria. Overall, 14 studies found some type of association between exposure to organic dust and long-term change in lung function. However, the results were inconsistent and no specific work exposure showed more clear associations to change in lung function. Meta-analysis revealed an overall small significant excess loss in forced expiratory volume in the 1st s for exposed compared with controls of 4.92 mL/year (95% CI 0.14 to 9.69). No significant association was seen overall for forced vital capacity. 12 studies revealed a significant exposure-response relation between organic dust and change in lung function. The results were inconsistent across varying study design and different exposure measures and outcomes. We therefore conclude that there is limited evidence of a causal association between general exposure to organic dust and long-term excess decline in lung function.
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Affiliation(s)
- Anneli Cs Bolund
- Section for Environment, Occupation and Health, Department of Public Health and Danish Ramazzini Centre, University of Aarhus, Aarhus, Denmark
| | - Martin R Miller
- Institute of Occupational and Environmental Medicine, University of Birmingham, Birmingham, UK
| | - Torben Sigsgaard
- Section for Environment, Occupation and Health, Department of Public Health and Danish Ramazzini Centre, University of Aarhus, Aarhus, Denmark
| | - Vivi Schlünssen
- Section for Environment, Occupation and Health, Department of Public Health and Danish Ramazzini Centre, University of Aarhus, Aarhus, Denmark.,National Research Centre for the Working Environment, Copenhagen, Denmark
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Risk of Pancreatic Cancer in Female Textile Workers in Shanghai, China, Exposed to Metals, Solvents, Chemicals, and Endotoxin: Follow-Up to a Nested Case-Cohort Study. J Occup Environ Med 2016; 58:195-9. [PMID: 26849264 DOI: 10.1097/jom.0000000000000596] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/23/2023]
Abstract
OBJECTIVE We studied associations between pancreatic cancer and occupational exposures to metals, solvents, chemicals, and endotoxin in a cohort of female textile workers in Shanghai, China. To assess the longer-term influences of these agents on pancreatic cancer we extended follow-up of this previously studied cohort. METHODS We utilized a job exposure matrix to assess occupational exposures for 481 pancreatic cancer cases and a randomly selected sub-cohort of 3191 non-cases. We calculated hazard ratios and 95% confidence intervals using Cox proportional hazards modeling adapted for the case-cohort design. RESULTS We observed a statistically significant trend of increasing hazard ratios associated with solvent exposure, but no associations with any of the remaining occupational exposures, including endotoxin and metals. CONCLUSIONS Our findings of increasing risk of pancreatic cancer with solvent exposures are consistent with published literature.
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Hinson AV, Lokossou VK, Schlünssen V, Agodokpessi G, Sigsgaard T, Fayomi B. Cotton Dust Exposure and Respiratory Disorders among Textile Workers at a Textile Company in the Southern Part of Benin. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2016; 13:E895. [PMID: 27618081 PMCID: PMC5036728 DOI: 10.3390/ijerph13090895] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 12/02/2015] [Revised: 07/21/2016] [Accepted: 09/01/2016] [Indexed: 01/16/2023]
Abstract
The textile industry sector occupies a prominent place in the economy of Benin. It exposes workers to several occupational risks, including exposure to cotton dust. To assess the effect of exposure to cotton dust on the health of workers, this study was initiated and conducted in a Beninese cotton industry company. The objective of the study was to evaluate the respiratory disorders among the textile workers exposed to cotton dust and the cross-sectional study involved 656 subjects exposed to cotton dust and 113 non-exposed subjects. The methods used are mainly based on a survey using a questionnaire of organic dust designed by the International Commission of Occupational Health (ICOH); and on the measures of lung function parameters (FEV₁ and FVC). The main results of the different analyzes revealed that subjects exposed to cotton dust have more respiratory symptoms than unexposed subjects (36.9% vs. 21.2%). The prevalence of chronic cough, expectorations, dyspnoea, asthma and chronic bronchitis are 16.8%, 9.8%, 17.3%, 2.6%, and 5.9% respectively among the exposed versus 2.6%, 0.8%, 16.8%, 0% and 0.8% among the unexposed subjects. The prevalence of byssinosis is 44.01%.The prevalence of symptoms is dependent on the sector of activity and the age of the subject. These results should encourage medical interventions and technical prevention especially since the textile industry occupies an important place in the Benin's economy.
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Affiliation(s)
- Antoine Vikkey Hinson
- Unit of Teaching and Research in Occupational Health and Environment, Faculty of Sciences of the Health, University of Abomey-Calavi, Abomey-Calavi, 01 PO 188 Cotonou, Benin.
| | - Virgil K Lokossou
- Unit of Teaching and Research in Occupational Health and Environment, Faculty of Sciences of the Health, University of Abomey-Calavi, Abomey-Calavi, 01 PO 188 Cotonou, Benin.
| | - Vivi Schlünssen
- Section for Environment, Occupation and Health, Department of Public Health, Aarhus University Denmark, Nordre Ringgade 1, 8000 Aarhus C, Denmark.
| | - Gildas Agodokpessi
- Unité D'enseignement et de Recherche en Pneumo-Phtisiologie, Université d'Abomey-Calavi, Abomey Calavi, 01 PO 321 Cotonou, Benin.
| | - Torben Sigsgaard
- Section for Environment, Occupation and Health, Department of Public Health, Aarhus University Denmark, Nordre Ringgade 1, 8000 Aarhus C, Denmark.
| | - Benjamin Fayomi
- Unit of Teaching and Research in Occupational Health and Environment, Faculty of Sciences of the Health, University of Abomey-Calavi, Abomey-Calavi, 01 PO 188 Cotonou, Benin.
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Abstract
Healthy worker survivor bias may occur in occupational studies due to the tendency for unhealthy individuals to leave work earlier, and consequently accrue less exposure, compared with their healthier counterparts. If occupational data are not analyzed using appropriate methods, this bias can result in attenuation or even reversal of the estimated effects of exposures on health outcomes. Recent advances in computing power, coupled with state-of-the-art statistical methods, have greatly increased the ability of analysts to control healthy worker survivor bias. However, these methods have not been widely adopted by occupational epidemiologists. We update the seminal review by Arrighi and Hertz-Picciotto (Epidemiology.1994; 5: 186-196) of the sources and methods to control healthy worker survivor bias. In our update, we discuss methodologic advances since the publication of that review, notably with a consideration of how directed acyclic graphs can inform the choice of appropriate analytic methods. We summarize and discuss methods for addressing this bias, including recent work applying g-methods to account for employment status as a time-varying covariate affected by prior exposure. In the presence of healthy worker survivor bias, g-methods have advantages for estimating less biased parameters that have direct policy implications and are clearly communicated to decision-makers.
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Andujar P, Dalphin JC. [Occupational chronic obstructive pulmonary diseases. Legal aspects and practical management]. Rev Mal Respir 2015; 33:91-101. [PMID: 26115643 DOI: 10.1016/j.rmr.2015.05.009] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/10/2015] [Accepted: 04/05/2015] [Indexed: 11/16/2022]
Abstract
The existence of occupational chronic obstructive pulmonary diseases (COPD) is now well established. Since 1989, several regulations have been progressively introduced, allowing compensation for some cases of occupational COPD. Following a brief review of the main occupational causes of COPD, the authors describe the present context for compensation in France and the procedures to be followed to ensure that patient's interests are supported.
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Affiliation(s)
- P Andujar
- Inserm, unité 955, 94000 Créteil, France; Service de pneumologie et pathologie professionnelle, CHI de Créteil, 94000 Créteil, France; Faculté de médecine, université Paris-Est Créteil Val-de-Marne, 94000 Créteil, France
| | - J-C Dalphin
- Service de pneumologie, CHU de Besançon, 25030 Besançon, France; UMR CNRS 6249, chrono-environnement, université de Franche-Comté, 25000 Besançon, France.
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10
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Gallagher LG, Li W, Ray RM, Romano ME, Wernli KJ, Gao DL, Thomas DB, Checkoway H. Occupational exposures and risk of stomach and esophageal cancers: update of a cohort of female textile workers in Shanghai, China. Am J Ind Med 2015; 58:267-75. [PMID: 25611949 DOI: 10.1002/ajim.22412] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/06/2014] [Indexed: 12/11/2022]
Abstract
BACKGROUND Associations between stomach and esophageal cancer and exposures to dusts, metals, chemicals, and endotoxin in the workplace are not very well understood, particularly in women. METHODS We followed 267,400 female textile workers in Shanghai, China for cancer incidence from 1989 to 2006. Stomach (n = 1374) and esophageal (n = 190) cancer cases were identified and a comparison subcohort (n = 3187) was randomly selected. Cox proportional hazard modeling was used, adjusting for age and smoking. RESULTS Increasing stomach cancer risk was observed with increasing duration of synthetic fiber dust exposure (p = 0.03), although the magnitude of effect was small (20 + years: HR = 1.2, 95% CI 1.1-1.4). Trends with endotoxin exposure were modestly inversed for esophageal cancer and increased for stomach cancer, but with little deviation from a null association. CONCLUSIONS Our findings demonstrate that long durations of synthetic fiber dust exposure can increase stomach cancer risk in women, but provide limited support for associations with other textile industry exposures.
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Affiliation(s)
- Lisa G. Gallagher
- Department of Environmental and Occupational Health Sciences; University of Washington; Seattle Washington
| | - Wenjin Li
- Public Health Sciences Division; Fred Hutchinson Cancer Research Center; Seattle Washington
| | - Roberta M. Ray
- Public Health Sciences Division; Fred Hutchinson Cancer Research Center; Seattle Washington
| | - Megan E. Romano
- Center for Environmental Health and Technology; Brown University, Providence; Rhode Island
| | | | - Dao L. Gao
- Zhong Shan Hospital Cancer Center; Shanghai China
| | - David B. Thomas
- Public Health Sciences Division; Fred Hutchinson Cancer Research Center; Seattle Washington
- Department of Epidemiology; University of Washington; Seattle Washington
| | - Harvey Checkoway
- Department of Family & Preventive Medicine; University of California San Diego; San Diego California
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Nazurah bt Abdul Wahid NN, Balalla NBP, Koh D. Respiratory symptoms of vendors in an open-air hawker center in brunei darussalam. Front Public Health 2014; 2:167. [PMID: 25325051 PMCID: PMC4183101 DOI: 10.3389/fpubh.2014.00167] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/07/2014] [Accepted: 09/15/2014] [Indexed: 11/22/2022] Open
Abstract
OBJECTIVES We studied respiratory problems among vendors exposed to cooking fumes in an open-air hawker center. Exposure to cooking fumes from either the use of fossil fuels or liquefied petroleum gas (LPG) has been shown to be associated with adverse respiratory health effects. METHODS We conducted a cross-sectional study among 67 food vendors exposed to cooking fumes as well as 18 merchandise sellers at an open-air hawker center in Brunei Darussalam. Past medical and smoking history and exposure to cooking fumes were obtained. The validated American Thoracic Society Questionnaire with a translated Malay version was used to ask for respiratory symptoms. RESULTS Compared to merchandise sellers (n = 18), cooking vendors (n = 67) had a higher self-reported respiratory symptoms (50.7% for those cooking and 33.3% for merchandise sellers). Cough (28.3%) was the main respiratory symptom experienced in cooking vendors and breathlessness (22.2%) among merchandise sellers. Half (50.0%) of cooking vendors who worked for more than 10 years had cough and 27.3% had phlegm. Those cooking with charcoal were two times more likely to have cough than those cooking with LPG. Cooking vendors with a job duration of more than 10 years were thrice more likely to have cough. CONCLUSION Cooking vendors in the open-air hawker center exposed to cooking fumes had more respiratory symptoms compared to non-exposed merchandise sellers. The type of fuel used for cooking and duration of work was associated with increased prevalence of cough.
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Affiliation(s)
| | - N. B. P Balalla
- Occupational Health Division, Ministry of Health, Bandar Seri Begawan, Brunei Darussalam
| | - David Koh
- PAPRSB Institute of Health Sciences, Universiti Brunei Darussalam, Bandar Seri Begawan, Brunei Darussalam
- Saw Swee Hock School of Public Health, National University of Singapore, Singapore
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12
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Across-shift changes of exhaled nitric oxide and spirometric indices among cotton textile workers. Int J Occup Med Environ Health 2014; 27:707-15. [PMID: 25168972 DOI: 10.2478/s13382-014-0306-4] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/10/2014] [Accepted: 06/16/2014] [Indexed: 11/20/2022] Open
Abstract
OBJECTIVES For the purpose of evaluation of exhaled NO as an index of airway inflammation, we assessed changes in fractional exhaled NO (FeNO) across a work shift and its relationship with respiratory complaints. MATERIAL AND METHODS Chronic and work-aggravated respiratory complaints were assessed using a questionnaire in 89 male textile workers. FeNO and spirometry were performed before and after a work shift and all the changes were registered. RESULTS A significant increase in FeNO after a work shift was observed. Post-shift FeNO was significantly higher among the subjects with chronic respiratory complaints. There was an obvious decrease in FVC, and FEV1 after a work shift; however, we couldn't find a significant relationship between changes in respiratory parameters and concentration of inhalable dusts. CONCLUSIONS FeNO increase after a work shift along with pulmonary function decrement and higher post-shift FeNO among subjects with respiratory complaints makes across-shift FeNO a non-invasive test for assessment of airway hyper-responsiveness in textile workers.
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Kahraman H, Sucakli MH, Kilic T, Celik M, Koksal N, Ekerbicer HC. Longitudinal pulmonary functional loss in cotton textile workers: a 5-year follow-up study. Med Sci Monit 2013; 19:1176-82. [PMID: 24346118 PMCID: PMC3871488 DOI: 10.12659/msm.889681] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022] Open
Abstract
BACKGROUND Occupational exposure to cotton dust causes several diseases affecting the lungs, but only limited information is available on effects of long-term exposure. In this study, we aimed to evaluate longitudinal changes in selected parameters of pulmonary function in textile workers. MATERIAL AND METHODS This prospective cohort study began with 196 textile workers in 2006 and was completed in 2011 with 49 workers. We used standardized tests for pulmonary function on participants on the first day of the workweek in June of 2006 and 2011. Environmental samples of cotton dust were gathered with a vertical elutriator. Loss of pulmonary function was assessed based on gender and smoking status. RESULTS The mean number of years participants worked in the textile factory was 7.61 ± 1.83 years, and the mean age was 35.3+5.8 years. The annual FEV1 loss of all workers was 53.2 ml, giving a ratio of annual FEV1 loss to baseline FEV1 of 1.4%. Pulmonary function parameters of all participants in 2011 were significantly lower than those in 2006 (for all, p<0.05). In both surveys, pulmonary function in current smokers was lower, but this difference was not significant (p>0.05). CONCLUSIONS This study provides the first data on pulmonary functional loss in Turkish textile workers and supports the findings of other cohort studies that workers with long-term exposure to cotton dust may lose some pulmonary function. The ratio of annual FEV1 loss to baseline FEV1 appears to be a more accurate and comparable method than annual FEV1 loss for evaluating pulmonary functional loss.
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Affiliation(s)
- Hasan Kahraman
- Department of Chest Disease, Kahramanmaras Sutcu İimam University, Faculty of Medicine, Kahramanmaras, Turkey
| | - Mustafa Haki Sucakli
- Department of Family Medicine, Kahramanmaras Sutcu İimam University, Faculty of Medicine, Kahramanmaras, Turkey
| | - Talat Kilic
- Department of Chest Disease, Inonu University, Faculty of Medicine, Malatya, Turkey
| | - Mustafa Celik
- Department of Family Medicine, Kahramanmaras Sutcu İimam University, Kahramanmaras, Turkey
| | - Nurhan Koksal
- Department of Chest Disease, Ondokuz Mayis University, Faculty of Medicine, Samsun, Turkey
| | - Hasan Cetin Ekerbicer
- Department of Public Health, Sakarya University, Faculty of Medicine, Sakarya, Turkey
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Abstract
PURPOSE OF REVIEW Over 60 million people worldwide work in the textile or clothing industry. Recent studies have recognized the contribution of workplace exposures to chronic lung diseases, in particular chronic obstructive pulmonary disease (COPD). Early studies in textile workers have focused on the relationship between hemp or cotton dust exposure and the development of a syndrome termed byssinosis. The purpose of this review is to evaluate the effect of long-term exposure to organic dust in textile workers on chronic respiratory disease in the broader context of disease classifications, such as reversible or irreversible obstructive lung disease (i.e. asthma or COPD), and restrictive lung disease. RECENT FINDINGS Cessation of exposure to cotton dust leads to improvement in lung function. Recent animal models have suggested a shift in the lung macrophage:dendritic cell population ratio as a potential mechanistic explanation for persistent inflammation in the lung due to repeated cotton dust-related endotoxin exposure. Other types of textile dust, such as silk, may contribute to COPD in textile workers. SUMMARY Textile dust-related obstructive lung disease has characteristics of both asthma and COPD. Significant progress has been made in the understanding of chronic lung disease due to organic dust exposure in textile workers.
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Boskabady MH, Karimiani EG, Vostacolaei HA. Respiratory Symptoms and Pulmonary Function Changes among Carpet Weavers in Iran. INTERNATIONAL JOURNAL OF OCCUPATIONAL AND ENVIRONMENTAL HEALTH 2013; 13:369-75. [DOI: 10.1179/oeh.2007.13.4.369] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/31/2022]
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16
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Applebaum KM, Ray RM, Astrakianakis G, Gao DL, Thomas DB, Christiani DC, LaValley MP, Li W, Checkoway H, Eisen EA. Evidence of a paradoxical relationship between endotoxin and lung cancer after accounting for left truncation in a study of Chinese female textile workers. Occup Environ Med 2013; 70:709-15. [PMID: 23759537 DOI: 10.1136/oemed-2012-101240] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/04/2023]
Abstract
INTRODUCTION Occupational exposure to endotoxin, found in Gram-negative bacteria in organic material, has been associated predominantly with a reduced risk of lung cancer among workers. An inverse exposure-response gradient among women textile workers in Shanghai, China, has been reported previously. In this case-cohort study, we investigated the influence of left truncation, which can itself induce a downward trend, on the observed association. METHODS Subjects were enrolled between 1989 and 1991 and followed until 1998. The data were left-truncated as all subjects were hired before baseline. An analysis was performed with 3038 subcohort members and 602 cases of incident lung cancer. To evaluate left truncation, we compared lung cancer rates in those hired longer ago with those hired more recently among unexposed subjects. Cox proportional hazards modelling was used to estimate incident rate ratios (IRRs) and 95% CIs. RESULTS Among those who were never exposed to workplace endotoxin, we compared lung cancer rates in those hired >35 years before enrolment with workers hired ≤35 years before enrolment and observed a reduced risk in the former group, IRR=0.74, 95% CI (0.51 to 1.07). After accounting for this downward bias from left truncation, the reduced risk associated with endotoxin remained among those hired ≤50 years before enrolment. In contrast, there was suggestion of an increased risk of lung cancer among those hired >50 years ago. CONCLUSIONS After examination of left truncation bias, an inverse dose-response between endotoxin and lung cancer remained for all subjects except those hired longest ago.
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Affiliation(s)
- Katie M Applebaum
- Department of Epidemiology, School of Public Health, Boston University, Boston, Massachusetts, USA
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Gallagher LG, Ray RM, Li W, Psaty BM, Gao DL, Thomas DB, Checkoway H. Occupational exposures and mortality from cardiovascular disease among women textile workers in Shanghai, China. Am J Ind Med 2012; 55:991-9. [PMID: 22968969 DOI: 10.1002/ajim.22113] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/09/2012] [Indexed: 12/13/2022]
Abstract
BACKGROUND Exposure to textile fiber dusts, like particulate air pollution, may be associated with cardiovascular disease (CVD) mortality. Bacterial endotoxin, a potent inflammagen found in cotton dust, may be a specific risk factor. METHODS Female textile workers (N = 267,400) in Shanghai, China were followed for CVD mortality (1989-2000). Factory exposures were approximated by sector classifications based on materials and processes. Quantitative endotoxin and cotton dust measures were available for a subcohort (n = 3,188). Cox proportional hazards modeling was used to estimate hazard ratios (HR) and 95% confidence interval (CI). RESULTS Slightly elevated mortality risk for the cotton sector was seen for ischemic stroke (HR = 1.12, 95% CI: 0.97-1.31) and hemorrhagic stroke (HR = 1.12, 95% CI: 1.02-1.23). Similar hemorrhagic stroke mortality risk was observed in high dust sectors (HR = 1.12, 95% CI: 1.02-1.24). No association was observed for ischemic heart disease. CONCLUSIONS Exposures in textile factories may have contributed to CVD mortality among this cohort. The specific components of these exposures that may be harmful are not clear and should be further investigated.
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Affiliation(s)
- Lisa G Gallagher
- Department of Environmental and Occupational Health Sciences, University of Washington, Seattle, Washington 98195-7234, USA.
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Lai PS, Fresco JM, Pinilla MA, Macias AA, Brown RD, Englert JA, Hofmann O, Lederer JA, Hide W, Christiani DC, Cernadas M, Baron RM. Chronic endotoxin exposure produces airflow obstruction and lung dendritic cell expansion. Am J Respir Cell Mol Biol 2012; 47:209-17. [PMID: 22517795 DOI: 10.1165/rcmb.2011-0447oc] [Citation(s) in RCA: 23] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/24/2022] Open
Abstract
Little is known about the mechanisms of persistent airflow obstruction that result from chronic occupational endotoxin exposure. We sought to analyze the inflammatory response underlying persistent airflow obstruction as a result of chronic occupational endotoxin exposure. We developed a murine model of daily inhaled endotoxin for periods of 5 days to 8 weeks. We analyzed physiologic lung dysfunction, lung histology, bronchoalveolar lavage fluid and total lung homogenate inflammatory cell and cytokine profiles, and pulmonary gene expression profiles. We observed an increase in airway hyperresponsiveness as a result of chronic endotoxin exposure. After 8 weeks, the mice exhibited an increase in bronchoalveolar lavage and lung neutrophils that correlated with an increase in proinflammatory cytokines. Detailed analyses of inflammatory cell subsets revealed an expansion of dendritic cells (DCs), and in particular, proinflammatory DCs, with a reduced percentage of macrophages. Gene expression profiling revealed the up-regulation of a panel of genes that was consistent with DC recruitment, and lung histology revealed an accumulation of DCs in inflammatory aggregates around the airways in 8-week-exposed animals. Repeated, low-dose LPS inhalation, which mirrors occupational exposure, resulted in airway hyperresponsiveness, associated with a failure to resolve the proinflammatory response, an inverted macrophage to DC ratio, and a significant rise in the inflammatory DC population. These findings point to a novel underlying mechanism of airflow obstruction as a result of occupational LPS exposure, and suggest molecular and cellular targets for therapeutic development.
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Affiliation(s)
- Peggy S Lai
- Harvard School of Public Health, Boston, Massachusetts, USA
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Adetona O, Hall DB, Naeher LP. Lung function changes in wildland firefighters working at prescribed burns. Inhal Toxicol 2012; 23:835-41. [PMID: 22035123 DOI: 10.3109/08958378.2011.617790] [Citation(s) in RCA: 26] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
CONTEXT Although decline in lung function across workshift has been observed in wildland firefighters, measurements have been restricted to days when they worked at fires. Consequently, such results could have been confounded by normal circadian variation associated with lung function. OBJECTIVES We investigated the across-shift changes in lung function of wildland firefighters, and the effect of cumulative exposure on lung function during the burn season. MATERIALS AND METHODS We measured forced vital capacity (FVC), forced expiratory volume in 1 second (FEV₁), forced expiratory flow from 25% to 75% of FVC (FEF₂₅₋₇₅), and peak expiratory flow (PEF) of wildland firefighters before and after their workshifts. In all, 501 pre-shift and 488 post-shift measurements were collected over 22 prescribed burn days and 43 non-burn days from 24 non-smoking wildland firefighters during the dormant winter burn seasons of 2003 and 2004. We compared changes in the spirometry measures across the workshift on burn days to those observed on non-burn days. We also assessed the effect of cumulative exposure during the burn season on the spirometry measures. RESULTS There were no significant differences in the across workshift changes on burn days compared to those on non-burn days for all the spirometry measures. However, for a given point in time during the season, each additional day of exposure was estimated to be associated with declines of 24 ml in pre-shift FVC and 24 ml in pre-shift FEV₁ (p <0.01). DISCUSSION AND CONCLUSION Cumulative exposure to woodsmoke was associated with slight decrements in lung function among the wildland firefighters.
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Affiliation(s)
- Olorunfemi Adetona
- Department of Environmental Health Science, The University of Georgia, College of Public Health, Athens, GA, USA
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Beshir S, Mahdy-Abdallah H, Saad-Hussein A. Ventilatory functions in cotton textile workers and the role of some inflammatory cytokines. Toxicol Ind Health 2011; 29:114-20. [DOI: 10.1177/0748233711425071] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Exposure to cotton dust in industrial environments causes inflammation in the airways of the exposed workers. This may manifest as respiratory complaints and changes in the respiratory functions after work shift and in the baseline of their ventilatory functions. The study aimed to investigate the effect of occupational exposure to cotton dust on respiratory symptoms, ventilatory functions and pro-inflammatory cytokine levels (tumor necrosis factor α, interleukin 6 and interleukin 1β). The study was conducted on 63 textile workers and 65 nonexposed subjects. Both groups were matched for age, socioeconomic status and smoking habit. The respirable dust measured in the workplace did not exceed the permissible values of the Egyptian law 1994. The bacterial counts detected were within the occupational exposure limits of the industrial settings. The results revealed that the percentage of respiratory symptoms was higher in textile workers. Respiratory complaints were chronic cough (33.2%), chronic bronchitis (39.7%) and dyspnea (23.8%) in textile workers compared to (6.2%, 6.2% and 1.5%), respectively, in controls. There was a marked reduction in the ventilatory functions (forced vital capacity and forced expiratory volume in 1 s) in the textile workers compared to the controls. The additive effect of smoking on the ventilatory functions was not apparent. The ventilatory functions of the workers were significantly positively correlated with the duration of exposure. The cytokines were insignificantly higher in the textile workers compared to their controls. The textile workers with respiratory complaints showed significant decline in ventilatory functions and elevation in the cytokine levels compared to the nonsymtomatizing workers with significant difference in interleukin 1β and interleukin 6. In conclusion, the results supported the fact that exposure to cotton dust deteriorates ventilatory functions and elevates proinflammatory cytokine levels. Analysis of the release of cytokines can be used to evaluate the immune responses to organic dust-induced airway inflammation.
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Affiliation(s)
- Safia Beshir
- Department of Environmental and Occupational Medicine, National Research Center, Dokki, Cairo, Egypt
| | - Heba Mahdy-Abdallah
- Department of Environmental and Occupational Medicine, National Research Center, Dokki, Cairo, Egypt
| | - Amal Saad-Hussein
- Department of Environmental and Occupational Medicine, National Research Center, Dokki, Cairo, Egypt
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Cui L, Gallagher LG, Ray RM, Li W, Gao D, Zhang Y, Vedal S, Thomas DB, Checkoway H. Unexpected excessive chronic obstructive pulmonary disease mortality among female silk textile workers in Shanghai, China. Occup Environ Med 2011; 68:883-7. [PMID: 21486992 DOI: 10.1136/oem.2010.062034] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
Abstract
OBJECTIVE To investigate chronic obstructive pulmonary disease (COPD) mortality among textile workers. METHODS A total of 267,400 Chinese female textile employees were monitored for COPD mortality from 1989 to 2000. Textile factories in the cohort were classified into 10 industrial sectors. Age-adjusted mortality, standardized mortality ratios (SMRs) and 95% CIs were calculated by sector. In addition, RRs (HRs) adjusted for smoking and age were calculated for exposure to cotton and silk textile work compared with the other sectors in the cohort. RESULTS A majority of textile sectors had lower or similar COPD mortality (age-adjusted SMRs=0.58-1.15) compared with the general female population in the city of Nanjing, China. SMRs for cotton and silk workers were, respectively, 1.02 (95% CI: 0.81 to 1.28) and 2.03 (95% CI: 1.13 to 3.34). Compared with all other textile sectors in the cohort, there was greater COPD mortality among cotton workers (HR=1.40, 95% CI: 1.03 to 1.89) and silk workers (HR=2.54, 95% CI: 1.47 to 4.39). CONCLUSION Elevated COPD mortality among cotton workers is consistent with previous reports of adverse respiratory effects of cotton dust. The higher rate of COPD deaths among silk workers was unexpected.
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Affiliation(s)
- Ling Cui
- Department of Environmental and Occupational Health Sciences, University of Washington, 4225 Roosevelt Way NE, Seattle, WA 98105, USA.
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Innate microbial sensors and their relevance to allergy. J Allergy Clin Immunol 2008; 122:846-58; quiz 858-60. [PMID: 19000576 DOI: 10.1016/j.jaci.2008.10.002] [Citation(s) in RCA: 14] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/24/2008] [Revised: 10/02/2008] [Accepted: 10/02/2008] [Indexed: 01/01/2023]
Abstract
The innate immune system oversees the gateway to immunity with its microbial sensors. Innate microbial sensors are germ line-encoded receptors with genetically predetermined specificities for microbes. The readiness and effectiveness of the innate immune system to provide immediate and appropriate responses at the host-environment interface is dependent on its sensitive and comprehensive microbial detection systems. The purpose of this review is to provide an overview of innate microbial sensors, our growing understanding of their diverse repertoire, and their elegant structural and functional approaches to microbial recognition. Their relevance to allergic disease is also discussed: the potential recognition and uptake of allergens by some of these receptors, inhibited expression of other microbial sensors by allergic immune responses and inflammation, and their upregulation by microbial exposures in early life that may help to protect against the development of allergic immune responses and disease.
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Alison C. P. Elder, Jacob Finkelste. INDUCTION OF ADAPTATION TO INHALED LIPOPOLYSACCHARIDEEIN YOUNG AND OLD RATS AND MIC. Inhal Toxicol 2008. [DOI: 10.1080/089583700196257] [Citation(s) in RCA: 15] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/16/2022]
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Wong EY, Ray RM, Gao DL, Wernli KJ, Li W, Fitzgibbons ED, Camp JE, Astrakianakis G, Heagerty PJ, De Roos AJ, Holt VL, Thomas DB, Checkoway H. Dust and chemical exposures, and miscarriage risk among women textile workers in Shanghai, China. Occup Environ Med 2008; 66:161-8. [PMID: 18805889 DOI: 10.1136/oem.2008.039065] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Abstract
INTRODUCTION To investigate possible associations between miscarriage and occupational exposures in the Shanghai textile industry. METHODS A retrospective cohort study of miscarriages among 1752 women in the Shanghai textile industry was conducted. Reproductive history was self-reported by women and occupational work histories were collected from factory personnel records. Occupational exposures were assigned by linking work history information to an industry-specific job-exposure matrix informed by factory-specific textile process information and industrial hygiene assessments. Estimates of cotton dust and endotoxin exposure were also assigned. Odds ratios (OR) and 95% CI were estimated by multivariate logistic regression, with adjustment for age at pregnancy, educational level, smoking status of the woman and her spouse, use of alcohol, and woman's year of birth. RESULTS An elevation in risk of a spontaneously aborted first pregnancy was associated with exposure to synthetic fibres (OR 1.89, 95% CI 1.20 to 3.00) and mixed synthetic and natural fibres (OR 3.31, 95% CI 1.30 to 8.42). No increased risks were observed for women working with solvents, nor were significant associations observed with quantitative cotton dust or endotoxin exposures. Associations were robust and similar when all pregnancies in a woman's reproductive history were considered. CONCLUSIONS Occupational exposure to synthetic fibres may cause miscarriages, and this possibility should be the subject of further investigation.
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Affiliation(s)
- E Y Wong
- Department of Environmental and Occupational Health Sciences, School of Public Health and Community Medicine, University of Washington, Seattle, WA 98195-7234, USA
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Wernli KJ, Ray RM, Gao DL, Fitzgibbons ED, Camp JE, Astrakianakis G, Seixas N, Li W, De Roos AJ, Feng Z, Thomas DB, Checkoway H. Occupational risk factors for endometrial cancer among textile workers in Shanghai, China. Am J Ind Med 2008; 51:673-9. [PMID: 18626909 DOI: 10.1002/ajim.20614] [Citation(s) in RCA: 14] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
Abstract
OBJECTIVE A case-cohort study was conducted to investigate associations between occupational exposures and endometrial cancer nested within a large cohort of textile workers in Shanghai, China. METHODS The study included 176 incident endometrial cancer cases diagnosed from 1989 to 1998 and a randomly-selected age-stratified reference subcohort (n = 3,061). Study subjects' complete work histories were linked to a job-exposure matrix developed specifically for the textile industry to assess occupational exposures. Hazard ratios (HR) and 95% confidence intervals were calculated using Cox proportional hazards modeling adapted for the case-cohort design, adjusting for age at menarche and a composite variable of gravidity and parity. RESULTS An increased risk of endometrial cancer was detected among women who had worked for > or =10 years in silk production (HR = 3.8, 95% CI 1.2-11.8) and had exposure to silk dust (HR = 1.7, 95% CI 0.9-3.4). Albeit with few exposed women (two cases and eight subcohort women), there was a 7.4-fold increased risk associated with > or =10 years of silica dust exposure (95% CI 1.4-39.7). CONCLUSIONS The findings suggest that some textile industry exposures might play a role in endometrial carcinoma and should be further replicated in other occupational settings.
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Affiliation(s)
- Karen J Wernli
- Program in Epidemiology, Fred Hutchinson Cancer Research Center, Seattle, Washington 9810, USA.
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Abstract
BACKGROUND Occupational risk factors for ovarian cancer have been investigated only to a limited extent. We conducted a case-cohort study to examine associations between occupational exposures and ovarian cancer in the textile industry. METHODS We compared 261 incident ovarian cancer cases diagnosed between 1989 and 1998 with an age-stratified reference subcohort (n = 3199) from a cohort of 267,400 textile workers in Shanghai, China. Occupational exposures were assessed by job-exposure matrices designed for the textile industry, and estimates of quantitative cotton dust and endotoxin. We calculated hazard ratios (HRs) and 95% confidence intervals (CIs) with Cox proportional hazards modeling adapted for the case-cohort design. RESULTS A decreased risk of ovarian cancer was associated with ever having worked in cotton manufacturing production (HR = 0.7; 95% CI = 0.4-1.0). An increased risk was associated with ever having worked in textile finishing (2.1; 0.9-5.0). We found an increasing risk of ovarian cancer associated with cumulative exposure to silica dust (for <10 years exposure, HR = 6.8 [CI = 0.6-76]; for > or =10 years, 5.6 [1.3-23.6]), although these results are based on only 8 exposed subcohort women (0.3%) and 4 cases (1.3%). We also detected inverse risk gradients for cumulative exposures to endotoxin when exposures were lagged by 20 years (in highest quartile, HR = 0.6 [CI = 0.4-1.1]). CONCLUSION Silica dust may increase the risk of ovarian cancer, and cotton dust and endotoxin may reduce risk.
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La bronchopneumopathie chronique obstructive professionnelle : une maladie méconnue. ARCH MAL PROF ENVIRO 2007. [DOI: 10.1016/s1775-8785(07)78222-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
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Ray RM, Gao DL, Li W, Wernli KJ, Astrakianakis G, Seixas NS, Camp JE, Fitzgibbons ED, Feng Z, Thomas DB, Checkoway H. Occupational Exposures and Breast Cancer Among Women Textile Workers in Shanghai. Epidemiology 2007; 18:383-92. [PMID: 17435449 DOI: 10.1097/01.ede.0000259984.40934.ae] [Citation(s) in RCA: 27] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Abstract
BACKGROUND Breast cancer incidence rates have been increasing in China over the past 2 decades. Most studies have focused on reproductive, dietary, and genetic risk factors. Little is known about the contribution of occupational exposures. METHODS We conducted a case-cohort study within a cohort of female textile workers who had participated in a randomized trial of breast self-examination in Shanghai, China. We compared 1709 incident breast cancer cases with an age-stratified reference subcohort (n = 3155 noncases). Cox proportional hazards modeling, adapted for the case-cohort design, was used to estimate hazard ratios for breast cancer in relation to duration of employment in various job processes and duration of exposure to several agents. We also evaluated the associations of cotton dust and endotoxin with breast cancer. RESULTS Cumulative exposures to cotton dust and endotoxin demonstrated strong inverse gradients with breast cancer risk when exposures were lagged by 20 years (trend P-values <0.001). We did not observe consistent associations with exposures to electromagnetic fields, solvents, or other chemicals. CONCLUSION Endotoxin or other components of cotton dust exposures may have reduced risks for breast cancer in this cohort, perhaps acting at early stages of carcinogenesis. Replication of these findings in other occupational settings with similar exposures will be needed to confirm or refute any hypothesis regarding protection against breast cancer.
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Affiliation(s)
- Roberta M Ray
- Program in Epidemiology, Division of Public Health Sciences, Fred Hutchinson Cancer Research Center, Seattle, WA 98109-1024, USA.
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Astrakianakis G, Seixas NS, Ray R, Camp JE, Gao DL, Feng Z, Li W, Wernli KJ, Fitzgibbons ED, Thomas DB, Checkoway H. Lung cancer risk among female textile workers exposed to endotoxin. J Natl Cancer Inst 2007; 99:357-64. [PMID: 17341727 DOI: 10.1093/jnci/djk063] [Citation(s) in RCA: 65] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/07/2023] Open
Abstract
BACKGROUND Reduced risk of lung cancer among workers in the cotton textile industry has been observed since the 1970s. Bacterial endotoxin, a contaminant of raw cotton fiber and cotton dust, has been proposed as a protective agent that may act through the innate and acquired immune systems. We examine the association between endotoxin exposure and lung cancer risk in a cohort of female textile workers. METHODS We conducted a case-cohort study nested within a cohort of 267,400 female textile workers in Shanghai, China. We compared the cumulative exposure histories of 628 case patients diagnosed with incident lung cancer from January 1, 1989, through December 31, 1998, with those of a lung cancer-free reference subcohort of 3184 workers who were frequency matched by 5-year age-groups to all cancer patients in the cohort. Cumulative endotoxin exposure for all participants was based on historic measurements and on additional measurements for this study. Relative risks and 95% confidence intervals (CIs) were estimated by hazard ratios (HRs) from Cox proportional hazards models. We conducted exposure-response trend analyses by use of cumulative exposures with lag times of 0, 5, 10, 15, or 20 years to account for disease latency. All analyses controlled for age and smoking status. All statistical tests were two-sided. RESULTS Cumulative exposure to endotoxin was strongly, statistically significantly, and inversely associated with lung cancer risk. The inverse trend was greatest with a 20-year lag time, for which highest endotoxin exposure was associated with a statistically significantly 40% less risk of lung cancer (HR = 0.60, 95% CI = 0.43 to 0.83; P(trend) across quintiles = .002) than non-exposure. From a reported population rate of lung cancer among women in Shanghai of 19.1 per 100,000 for the year 2000 and the estimated reduction in risk of lung cancer observed for 20 years of endotoxin exposure in this population of workers, the incidence of lung cancer in this cohort was reduced by approximately 7.6 per 100,000 (range = 3.2-10.9 per 100,000). CONCLUSIONS Long-term and high-level exposure to endotoxin, compared with no exposure, appears to be associated with a reduced risk of lung cancer in this cohort.
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Affiliation(s)
- George Astrakianakis
- Departments of Environmental and Occupational Health Sciences, University of Washington, Seattle, WA, USA.
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Zhang H, Hang J, Wang X, Zhou W, Sun B, Dai H, Su L, Christiani DC. TNF polymorphisms modify endotoxin exposure-associated longitudinal lung function decline. Occup Environ Med 2007; 64:409-13. [PMID: 17332138 PMCID: PMC2078509 DOI: 10.1136/oem.2006.029025] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Abstract
OBJECTIVES Endotoxin exposure induces airway inflammation, hyper-responsiveness and higher expression of tumour necrosis factor (TNF). This study was conducted to investigate whether TNF polymorphisms modify the effect of endotoxin exposure on chronic declines in lung function. METHODS Associations between TNF and LTA polymorphisms, endotoxin exposure and lung function were analysed in 263 cotton workers and 230 silk workers as a reference group, who were prospectively followed for 20 years. Multiple linear regression models were used to assess the association, with adjustment for smoking and other covariates. RESULTS Endotoxin exposure was associated with faster lung function decline among genotypes associated with higher TNF expression levels, with estimates of annual FEV1 change in relation to endotoxin exposure of -2.9 ml and -6.8 ml in the G/G and G/A+AA genotypes, respectively, for the TNF polymorphism; and -2.0 ml, -4.0 ml and -3.6 ml in A/A, A/G and G/G genotypes, respectively, for the LTA polymorphism. When joint effects of endotoxin exposure and smoking were considered, the effect modification of TNF and LTA polymorphisms was prominent in never smokers. CONCLUSIONS TNF and LTA polymorphisms may modify the association between occupational endotoxin exposure and longitudinal lung function decline, which was more clearly observed in never smokers.
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Affiliation(s)
- Hongxi Zhang
- Shanghai Putuo District People's Hospital, Shanghai, China
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Oldenburg M, Latza U, Baur X. Exposure-response relationship between endotoxin exposure and lung function impairment in cotton textile workers. Int Arch Occup Environ Health 2006; 80:388-95. [PMID: 17051395 DOI: 10.1007/s00420-006-0145-0] [Citation(s) in RCA: 28] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/20/2005] [Accepted: 09/04/2006] [Indexed: 11/28/2022]
Abstract
OBJECTIVES Preventive workplace regulations are so far not based on an ubiquitously accepted threshold for airborne endotoxin in the bioaerosol. METHODS In a cross-sectional study, 150 employees of a cotton spinning mill underwent lung function testing. Furthermore, in a random subset of 75 textile workers cross-shift lung function test and methacholine challenges were performed. Airborne current endotoxin exposure was classified as "low", "medium", and "high" (<or=100, >100-<or=450, and >450 Endotoxin Units (EU)/m(3), respectively) based on endotoxin activity. RESULTS The exposure-response relationship between current endotoxin exposure and prevalence of an obstructive ventilation pattern was significant (test for linear trend: P = 0.019); the adjusted odds ratio for high endotoxin exposure was 11.22 (95% confidence interval 1.03-121.17). Within individuals, FEV(1)/FVC% was significantly reduced after the shift (paired t test: P = 0.009) but not related to current endotoxin exposure. Twelve workers showed bronchial hyperresponsiveness (8.1% before and 12.2% after the work shift; Fisher's exact test: P = 0.021). CONCLUSION The study among German cotton textile workers suggests an exposure-dependent effect of current endotoxin exposure on lung function impairment with significant effects above 450 EU/m(3).
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Affiliation(s)
- Marcus Oldenburg
- Clinical Occupational Medicine, Institute of Occupational Medicine (ZfA), University of Hamburg, Hamburg, Germany.
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Ameille J, Dalphin J, Descatha A, Pairon J. La bronchopneumopathie chronique obstructive professionnelle : une maladie méconnue. Rev Mal Respir 2006. [DOI: 10.1016/s0761-8425(06)71803-4] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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Astrakianakis G, Seixas N, Camp J, Smith TJ, Bartlett K, Checkoway H. Cotton dust and endotoxin levels in three Shanghai textile factories: a comparison of samplers. JOURNAL OF OCCUPATIONAL AND ENVIRONMENTAL HYGIENE 2006; 3:418-27. [PMID: 16862712 DOI: 10.1080/15459620600793672] [Citation(s) in RCA: 17] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/11/2023]
Abstract
The results of a field survey at three Shanghai textile factories were used to compare the performance of the Chinese dust sampler (CDS) with the standard American sampler, vertical elutriator (VE). Side-by-side samples using a CDS and a VE were collected in seven specific manufacturing processes, with additional area and personal samples collected with a modified Institute of Occupational Medicine (IOM) personal inhalable sampler. Filters were analyzed for mass and endotoxin concentration. The geometric mean (GM) of the samples collected by the CDS was 0.79 mg/m3 (geometric standard deviation [GSD] 1.9) compared with a GM of 0.31 mg/m3 (GSD 1.7) for the VE measurements. The correlation coefficient for the CDS and VE samples was 0.35. The CDS, a high-volume total dust area sampler, collects 2 to 10 times more dust than the VE, a size-selective method, depending on the manufacturing process. In spinning at Factory A, the VE and CDS measured concentrations of 0.15 mg/m3 and 1.62 mg/m3, respectively. Cotton dust concentration measurements collected by the IOM sampler demonstrated that personal exposure concentrations were significantly higher (GM 1.84 mg/m3, GSD 1.6) than fixed-position area samples (GM 0.68 mg/m3, GSD 1.9). The endotoxin concentration based on the VE samples was 366 EU/m3, with the highest levels found in the specific manufacturing process drawing (1871 EU/m3) and the lowest in spinning (43.5 EU/m3). The results of the field comparison were used to convert historic CDS data into comparable exposures and to assign retrospective exposures to subjects included in a case-cohort study of lung cancer among female textile workers in Shanghai.
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Affiliation(s)
- George Astrakianakis
- Department of Environmental and Occupational Health Sciences, University of Washington, Seattle, WA, USA.
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Chang CK, Astrakianakis G, Thomas DB, Seixas NS, Camp JE, Ray RM, Gao DL, Wernli KJ, Li W, Fitzgibbons ED, Vaughan TL, Checkoway H. Risks of biliary tract cancer and occupational exposures among Shanghai women textile workers: a case-cohort study. Am J Ind Med 2006; 49:690-8. [PMID: 16830349 DOI: 10.1002/ajim.20345] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/09/2023]
Abstract
BACKGROUND Biliary tract cancer (BTC) is a relatively rare malignancy worldwide. Little is known about potential etiologic contributions of occupational exposures. METHODS The associations between occupational exposures to textile dusts and chemicals and BTC are investigated in a cohort of 267,400 women textile workers in Shanghai, China. A nested case-cohort analysis of 162 BTC cases diagnosed during 1989-1998 was conducted with a reference subcohort of 3,188 workers. Exposures to workplace dusts and chemicals were reconstructed by linking complete work history data with a job-exposure matrix (JEM). Hazard ratios (HR) and dose-response trends were estimated by Cox proportional hazards modeling modified for case-cohort design. RESULTS An elevated risk of > or = 1-year employment in maintenance jobs (HR 2.92, 95% CI: 1.48, 5.73) with a significant trend by duration is observed. Excess risk was also found for > or = 20 years exposure to metals (HR 2.50, 95% CI: 1.09, 5.72). CONCLUSIONS Long-term exposure to maintenance work and metals in the textile industry may have increased BTC risk in this population.
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Affiliation(s)
- Chin-Kuo Chang
- Department of Epidemiology, School of Public Health and Community Medicine, University of Washington, Seattle, Washington, USA.
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Li W, Ray RM, Gao DL, Fitzgibbons ED, Seixas NS, Camp JE, Wernli KJ, Astrakianakis G, Feng Z, Thomas DB, Checkoway H. Occupational risk factors for pancreatic cancer among female textile workers in Shanghai, China. Occup Environ Med 2006; 63:788-93. [PMID: 16847032 PMCID: PMC2078009 DOI: 10.1136/oem.2005.026229] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
Abstract
OBJECTIVES To investigate whether occupational exposures to dusts and chemicals in the Shanghai textile industry are associated with risk of pancreatic cancer. METHODS A case cohort study nested in a cohort of 267,400 female textile workers in Shanghai, China was conducted among 180 incident pancreatic cancer cases and an age stratified randomly selected comparison subcohort (n = 3188). A complete occupational history of work in the textile industry was obtained for each woman, and was linked to a job exposure matrix developed for the textile industry to estimate exposures to specific dusts and chemicals. Cumulative exposures to cotton dust and endotoxin were reconstructed from historical and contemporaneous measurements. RESULTS After adjusting for smoking status, a trend of decreasing risk of pancreatic cancer was observed for increasing cumulative exposures to cotton dust and endotoxin with a lag of 20 years. The hazard ratios for women cumulatively exposed to >143.4 mg/m3 x years of cotton dust and >3530.6 EU/m3 x years of endotoxin were 0.6 (95% CI 0.3 to 0.9) and 0.5 (95% CI 0.3 to 0.9), respectively, compared to unexposed women. There was little evidence that exposures to other textile dusts and chemicals were associated with risk of pancreatic cancer. CONCLUSIONS Occupational exposure to cotton dust and endotoxin in the textile industry may have reduced risks of pancreatic cancer in this cohort. These associations should be replicated by others before making a firm conclusion of their possible effects on pancreatic cancer.
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Affiliation(s)
- W Li
- Public Health Sciences, Fred Hutchinson Cancer Research Center, Seattle, WA 98109, USA.
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Liebers V, Brüning T, Raulf-Heimsoth M. Occupational endotoxin-exposure and possible health effects on humans. Am J Ind Med 2006; 49:474-91. [PMID: 16586405 DOI: 10.1002/ajim.20310] [Citation(s) in RCA: 96] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
BACKGROUND Endotoxins are commonly found at workplaces where large amounts of bioaerosols are generated. In Germany, especially since the Ordinance on Safety and Health Protection related to work involving biological agents (Biostoff-Verordnung) became effective (1999), threshold limit values are widely discussed. Up to the present, endotoxin values are measured with non-uniform methods and therefore values are of limited benefit for classification of exposure groups. In Germany there is no threshold limit value for endotoxin. METHODS Relevant literature of the last 20 years was selected from Medline and discussed. RESULTS In this review we focused on the impact of endotoxin exposure on human health with special respect to the measurements on workplace and methodological aspects of endotoxin determination. Methods for sampling and endotoxin determination have to be validated, optimized, and standardized first. CONCLUSION The adverse health effects of endotoxins are known, standardization of measurements is a necessary goal and protection measures should be established immediately.
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Affiliation(s)
- Verena Liebers
- Research Institute for Occupational Medicine of the Berufsgenossenschaften (BGFA), Institute of the Ruhr-University Bochum, Bochum, Germany.
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Wernli KJ, Fitzgibbons ED, Ray RM, Gao DL, Li W, Seixas NS, Camp JE, Astrakianakis G, Feng Z, Thomas DB, Checkoway H. Occupational risk factors for esophageal and stomach cancers among female textile workers in Shanghai, China. Am J Epidemiol 2006; 163:717-25. [PMID: 16467414 DOI: 10.1093/aje/kwj091] [Citation(s) in RCA: 30] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/31/2022] Open
Abstract
The authors evaluated associations between occupational exposures in the textile industry and the risks of esophageal cancer and stomach cancer. The authors conducted a case-cohort study nested in a cohort of female textile workers in Shanghai, China. One hundred and two workers with incident esophageal cancer and 646 workers with incident stomach cancer diagnosed between 1989 and 1998 were compared with an age-stratified reference subcohort (n = 3,188). Work histories were ascertained for all study subjects from factory personnel records or interviews. Exposures were reconstructed for chemicals and dusts by linking work history data with a job-exposure matrix developed for the Shanghai textile industry. Hazard ratios and 95 percent confidence intervals were calculated with Cox proportional hazards modeling adapted for the case-cohort design. Risk of esophageal cancer was associated with long-term (> or = 10 years) exposure to silica dust (hazard ratio = 15.8, 95% confidence interval: 3.5, 70.6) and metals (hazard ratio = 3.7, 95% confidence interval: 1.9, 7.1). Cumulative exposure to endotoxin, a contaminant of cotton dust, was inversely related to risks of both esophageal cancer (p-trend = 0.01) and stomach cancer (p-trend < 0.001) when exposures were lagged 20 years. Endotoxin has not been previously reported to be a protective factor for either stomach cancer or esophageal cancer and therefore warrants further study.
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Affiliation(s)
- Karen J Wernli
- Program in Epidemiology, Fred Hutchinson Cancer Research Center, Seattle, WA 98109-1024, USA.
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De Roos AJ, Ray RM, Gao DL, Wernli KJ, Fitzgibbons ED, Ziding F, Astrakianakis G, Thomas DB, Checkoway H. Colorectal cancer incidence among female textile workers in Shanghai, China: a case-cohort analysis of occupational exposures. Cancer Causes Control 2006; 16:1177-88. [PMID: 16215868 DOI: 10.1007/s10552-005-0398-z] [Citation(s) in RCA: 29] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/07/2004] [Accepted: 06/15/2005] [Indexed: 10/25/2022]
Abstract
Previous studies have suggested increased risks of colorectal cancers among textile industry workers, potentially related to synthetic fibers. To investigate risks of colon and rectum cancers in relation to these and other textile industry exposures, we conducted a case-cohort study nested within a cohort study of female employees from the Shanghai Textile Industry Bureau (STIB). Cox proportional hazard regression modeling was used to estimate hazard ratios (HR) for colon and rectum cancers associated with duration of employment (e.g., 0, >0 to <10, 10 to <20 years, > or =20 years) in various jobs classified according to process type and exposures to specific agents. Our findings indicate that certain long term exposures may pose increased risk of colorectal cancers, especially dyes and dye intermediates with colon cancer (> or =20 years exposure versus never, HR=3.9; 95% CI: 1.4-10.6), and maintenance occupation (HR = 2.3; 95% CI: 1.0-5.7) and metals exposure (HR = 2.0; 95% CI: 1.1-3.6) with rectum cancer. A decreased risk of rectum cancer was associated with exposure to natural fibers such as cotton (HR = 0.7; 95% CI: 0.5-0.9), and a trend of decreasing rectum cancer incidence was observed by category of cumulative quantitative cotton dust or endotoxin exposures, when exposures were lagged by 20 years.
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Affiliation(s)
- A J De Roos
- Department of Epidemiology, School of Public Health and Community Medicine, University of Washington, Seattle, WA 98109-1024, USA.
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Jaén Á, Zock JP, Kogevinas M, Ferrer A, Marín A. Occupation, smoking, and chronic obstructive respiratory disorders: a cross sectional study in an industrial area of Catalonia, Spain. Environ Health 2006; 5:2. [PMID: 16476167 PMCID: PMC1388209 DOI: 10.1186/1476-069x-5-2] [Citation(s) in RCA: 36] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/03/2005] [Accepted: 02/14/2006] [Indexed: 05/06/2023]
Abstract
BACKGROUND Few studies have investigated the independent effects of occupational exposures and smoking on chronic bronchitis and airflow obstruction. We assessed the association between lifetime occupational exposures and airflow obstruction in a cross-sectional survey in an urban-industrial area of Catalonia, Spain. METHODS We interviewed 576 subjects of both sexes aged 20-70 years (response rate 80%) randomly selected from census rolls, using the ATS questionnaire. Forced spirometry was performed by 497 subjects according to ATS normative. RESULTS Lifetime occupational exposure to dust, gases or fumes was reported by 52% of the subjects (63% in men, 41% in women). Textile industry was the most frequently reported job in relation to these exposures (39%). Chronic cough, expectoration and wheeze were more prevalent in exposed subjects with odds ratios ranging from 1.7 to 2.0 being highest among never-smokers (2.1 to 4.3). Lung function differences between exposed and unexposed subjects were dependent on duration of exposure, but not on smoking habits. Subjects exposed more than 15 years to dusts, gases or fumes had lower lung function values (FEV1 -80 ml, 95% confidence interval (CI) -186 to 26; MMEF -163 ml, CI -397 to 71; FEV1/FVC ratio -1.7%, CI -3.3 to -0.2) than non-exposed. CONCLUSION Chronic bronchitis symptoms and airflow obstruction are associated with occupational exposures in a population with a high employment in the textile industry. Lung function impairment was related to the duration of occupational exposure, being independent of the effect of smoking.
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Affiliation(s)
- Ángeles Jaén
- Centre d'Estudis Epidemiològics sobre la SIDA de Catalunya (CEESCAT), Crta de Canyet s/n, 08916 Badalona, Spain
- Respiratory and Environmental Health Research Unit, Institut Municipal d'Investigació Mèdica (IMIM), Dr. Aiguader 80, 08003 Barcelona, Spain
| | - Jan Paul Zock
- Respiratory and Environmental Health Research Unit, Institut Municipal d'Investigació Mèdica (IMIM), Dr. Aiguader 80, 08003 Barcelona, Spain
| | - Manolis Kogevinas
- Respiratory and Environmental Health Research Unit, Institut Municipal d'Investigació Mèdica (IMIM), Dr. Aiguader 80, 08003 Barcelona, Spain
| | - Antonio Ferrer
- Hospital de Sabadell. Consorci Hospitalari Parc Taulí, Parc Taulí s/n 08208 Sabadell, Spain
| | - Albert Marín
- Hospital de Sabadell. Consorci Hospitalari Parc Taulí, Parc Taulí s/n 08208 Sabadell, Spain
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Ameille J, Descatha A, Pairon JC, Dalphin JC. Bronchopneumopathies chroniques obstructives professionnelles. ACTA ACUST UNITED AC 2006. [DOI: 10.1016/s1155-1925(05)38960-9] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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Li W, Ray RM, Gao DL, Fitzgibbons ED, Seixas NS, Camp JE, Wernli KJ, Astrakianakis G, Feng Z, Thomas DB, Checkoway H. Occupational risk factors for nasopharyngeal cancer among female textile workers in Shanghai, China. Occup Environ Med 2006; 63:39-44. [PMID: 16361404 PMCID: PMC2078032 DOI: 10.1136/oem.2005.021709] [Citation(s) in RCA: 42] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 07/15/2005] [Indexed: 11/03/2022]
Abstract
AIMS To investigate whether occupational exposure to dusts and chemicals in the Chinese textile industry are associated with risk of nasopharyngeal cancer. METHODS Sixty seven nasopharyngeal carcinoma (NPC) cases identified during 1989-98 and a random sample (n = 3188) of women were included in a case cohort study nested in a cohort of 267,400 women textile workers in Shanghai, China. A complete occupational history of work in the textile industry was obtained for each woman. A job exposure matrix developed by experienced industrial hygienists was used to assess exposures to specific dusts and chemicals. RESULTS Risk of NPC is associated with cumulative exposure to cotton dust. The hazard ratio for women cumulatively exposed to >143.4 mg/m3 x years of cotton dust was 3.6 (95% CI 1.8 to 7.2) compared with unexposed women. Trends of increasing risk were also found with increasing duration of exposure to acids and caustics (p = 0.05), and with years worked in dyeing processes (p = 0.06). Women who worked at least 10 years in dyeing processes had a 3.6-fold excess risk of NPC (95% CI 1.0 to 12.1). CONCLUSIONS Occupational exposure to cotton dust, acids, and caustics, and work in dyeing and printing jobs in the textile industry may have increased risk of NPC in this cohort.
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Affiliation(s)
- W Li
- Program in Epidemiology, Fred Hutchinson Cancer Research Center, Seattle, WA, USA
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Chang CK, Astrakianakis G, Thomas DB, Seixas NS, Ray RM, Gao DL, Wernli KJ, Fitzgibbons ED, Vaughan TL, Checkoway H. Occupational exposures and risks of liver cancer among Shanghai female textile workers--a case-cohort study. Int J Epidemiol 2005; 35:361-9. [PMID: 16373377 DOI: 10.1093/ije/dyi282] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/11/2022] Open
Abstract
BACKGROUND Liver cancer is the fifth most frequent malignancy worldwide. Viral hepatitis B and C, alcohol, and aflatoxin are the major established risk factors. Little is known about the aetiological contributions of occupational exposures, as previous occupational epidemiological studies of liver cancer suggest few agent-specific associations. We investigated associations of occupational exposures to dusts and chemicals in a cohort of female textile workers. METHODS Cancer incidence was determined among 267,400 female textile workers in Shanghai, China, who had been enrolled in an intervention trial of breast self-exam efficacy during 1989-98. Subjects were interviewed at baseline regarding basic demographics, smoking habits, alcohol consumption, and contraceptive practices. A case-cohort study of 360 liver cancer cases and 3,186 age-stratified randomly chosen subcohort subjects was conducted within this cohort. Exposures to workplace dusts and chemicals were reconstructed from complete work history data, historical exposure monitoring data for selected agents, and a specially designed job-exposure matrix for the textile industry. Relative risks and dose-response trends were estimated by Cox proportional hazards modelling, adapted for the case-cohort design. Latency analyses with different lag years were also applied. RESULTS 2,095,904 person-years were contributed by this female cohort. The results of the case-cohort analysis revealed a protective effect of cotton fibre exposure years [adjusted hazards ratio (HR) = 0.64; 95% confidence interval (95% CI) 0.44-0.92] or endotoxin exposure (adjusted HR = 0.60; 95% CI 0.41-0.88) for the fourth quartile with significant trends for 20 year exposure lags. CONCLUSIONS This study suggests that chronic exposure to endotoxin or some other component of cotton dust exposure may have reduced liver cancer risk in this population.
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Affiliation(s)
- Chin-Kuo Chang
- Department of Epidemiology, School of Public Health and Community Medicine, University of Washington, Seattle, WA, USA.
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Hang J, Zhou W, Wang X, Zhang H, Sun B, Dai H, Su L, Christiani DC. Microsomal Epoxide Hydrolase, Endotoxin, and Lung Function Decline in Cotton Textile Workers. Am J Respir Crit Care Med 2005; 171:165-70. [PMID: 15531751 DOI: 10.1164/rccm.200407-888oc] [Citation(s) in RCA: 26] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
Occupational exposure to endotoxin in organic dust may induce lung function decline. Microsomal epoxide hydrolase (mEH) detoxifies reactive oxygen species generated by endotoxin exposure, and polymorphisms of the mEH gene are associated with altered enzyme activity. We investigated the associations between mEH polymorphisms, endotoxin exposure, and lung function decline in a 20-year prospective study of 265 workers exposed to endotoxin and 234 control subjects. mEH Tyr113His and His139Arg polymorphisms were genotyped by the 5' nuclease assay, and data were analyzed using multivariate linear regression models, adjusting for important covariates. Overall, the annual decline rate of FEV1 was 29.47 ml during the 20-year follow-up. Endotoxin exposure was associated with faster lung function decline among genotypes associated with slower enzyme activity: estimates (SE) of annual FEV1 decline rates for endotoxin exposure were -2.33 (2.07), -2.81 (1.66), and -6.73 (2.83) ml for Tyr/Tyr, Tyr/His, and His/His genotype groups, respectively, for the Tyr113His polymorphism; and -1.82 (2.58) and -4.27 (1.33) ml for Arg/Arg + His/Arg and His/His genotypes, respectively, for the His139Arg polymorphism. We conclude that mEH polymorphisms modify the association between occupational endotoxin exposure and longitudinal lung function decline.
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Affiliation(s)
- Jingqing Hang
- Shanghai Putuo Districs People's Hospital, Shanghai, China
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Charbotel B, Hours M, Perdrix A, Anzivino-Viricel L, Bergeret A. Respiratory function among waste incinerator workers. Int Arch Occup Environ Health 2004; 78:65-70. [PMID: 15599755 DOI: 10.1007/s00420-004-0557-7] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/13/2004] [Accepted: 07/13/2004] [Indexed: 11/29/2022]
Abstract
INTRODUCTION Whereas air pollutants have been measured in incinerator working areas, few studies have focused on the effects of these pollutants on the lung function of incinerator workers. In France, a study was performed among workers at two urban incinerators, aimed at identifying a link between exposure to different pollutants in incinerator plants and respiratory lung function impairments. METHODS A follow-up of lung function was carried out on 83 incinerator workers from two incinerator plants, comparing them with a group of 76 non-exposed workers recruited by the same occupational physician. Workers' lung functions were measured during their yearly occupational medical examination, for 3 years. The American Thoracic Society quality criteria were used to control the quality of the flow-volume curves. RESULTS Base-line lung functions were lower among incinerator workers than among non-exposed workers. The few significant differences were indicative of obstructive symptoms. During the first year the differences observed between the two groups were close to the significant threshold value of 5% for FEF(75)/ PV and FEF(25-75)/PV. During the third year significant differences covered three parameters: FEF(50)/PV, FEF(25-75)/PV and FEF(25-75)/FVC. After smoking habits (pack-years), medical history of allergy or lung diseases and the examination centres had been taken into account in a linear regression, the reduction of FEF(75)/PV in the first year and FEF(25-75)/FVC in the third year was linked to exposure in incinerator plants. There was no significant association between exposure and the differences observed in the FEF(25-75)/PV in the first year or in the FEF(50)/PV and the FEF(25-75)/PV in the third year. CONCLUSION This analysis of incinerator workers' lung functions has identified some lung impairments among workers exposed to incinerator air pollutants compared to non-exposed workers, thus indicating possible obstructive disorders among incinerator workers. However, these impairments are moderate and in accordance with the low levels of airborne pollutants identified in a previous study.
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Affiliation(s)
- Barbara Charbotel
- UMRETTE (Transport, Work & Environment Epidemiology Research Unit), INRETS (French National Institute for Transport and Safety Research), University Lyon I, Domaine Universitaire Rockefeller, 69373 Lyon, France.
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Sigsgaard T, Jensen LD, Abell A, Würtz H, Thomsen G. Endotoxins isolated from the air of a Danish paper mill and the relation to change in lung function: an 11-year follow-up. Am J Ind Med 2004; 46:327-32. [PMID: 15376218 DOI: 10.1002/ajim.20068] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
BACKGROUND A decline in lung function has been associated with farming, cotton spinning, and work in the animal feed industry. The aim of the study was to reveal if loss of lung function was associated to work at a paper mill. METHODS Ninety-seven male paper workers (PW), and 55 control workers were examined. Hygiene samples included total dust, endotoxins, and microorganisms. Interview, pulmonary function testing, and skin prick test (SPT) were performed and yearly decline in lung function was calculated. RESULTS The exposure for endotoxin (LPS) ranged from Median (Max-Min) 69 (370-6) EU/m3, in the wet-end of the paper machines to 6 (19-16) in the pulping area. The lung function decline among the controls was comparable to the decrements among the maintenance and repair workers at the paper factory, around 51-54 and 37-38 ml/year among smokers' and non-smokers, respectively. After adjustment for baseline FEV1, the variables associated to an increased loss of FEV1 were age smoking and cough. For FVC we found an inverse relation between exposure and yearly decline. CONCLUSION No increase in loss of lung function is seen among workers exposed to up to 200 EU/m3 of LPS.
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Affiliation(s)
- Torben Sigsgaard
- Institute of Environmental and Occupational Health, University of Aarhus, Aarhus C, Denmark.
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Wang XR, Eisen EA, Zhang HX, Sun BX, Dai HL, Pan LD, Wegman DH, Olenchock SA, Christiani DC. Respiratory symptoms and cotton dust exposure; results of a 15 year follow up observation. Occup Environ Med 2003; 60:935-41. [PMID: 14634185 PMCID: PMC1740446 DOI: 10.1136/oem.60.12.935] [Citation(s) in RCA: 50] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/20/2023]
Abstract
AIMS To determine chronic effects of long term exposure to cotton dust and endotoxin on incidence of respiratory symptoms and the effect of cessation of exposure. METHODS Respiratory health in 429 Chinese cotton textile workers (study group) and 449 silk textile workers (control group) was followed prospectively from 1981 to 1996. Byssinosis, chest tightness, and non-specific respiratory symptoms were assessed by means of identical standardised questionnaires at four time points. Exposures to cotton dust and endotoxin were estimated using area samples collected at each survey. Incidence and persistence of symptoms were examined in relation to cumulative exposure and exposure cessation using generalised estimating equations (GEE). RESULTS Among cotton workers, the cumulative incidence of byssinosis and chest tightness was 24% and 23%, respectively, and was significantly more common in smokers than in non-smokers. A high proportion of symptoms was found to be intermittent, rather than persistent. Among silk workers, no typical byssinosis was identified; the incidence of chest tightness was 10%. Chronic bronchitis, cough, and dyspnoea were more common and persistent in the cotton group than in the silk group. Significantly lower odds ratios for symptoms were observed in cotton workers who left the cotton mills; risk was also related to years since last worked. Multivariate analysis indicated a trend for higher cumulative exposure to endotoxin in relation to a higher risk for byssinosis. CONCLUSION Chronic exposure to cotton dust is related to both work specific and non-specific respiratory symptoms. Byssinosis is more strongly associated with exposure to endotoxin than to dust. Cessation of exposure may improve the respiratory health of cotton textile workers; the improvement appears to increase with time since last exposure.
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Affiliation(s)
- X-R Wang
- Department of Environmental Health (Occupational Health Program), Harvard School of Public Health, Boston, MA 02115, USA
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Ameen M, Ahmad I, Musthapa S, Baig MA, Mishra R, Rahman Q. Differential responses of rat alveolar macrophages to carpet dust in vitro. Hum Exp Toxicol 2003; 22:263-70. [PMID: 12774889 DOI: 10.1191/0960327103ht356oa] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
Epidemiological studies of workers in carpet weaving units in carpet industries have shown a direct relation between the concentration of carpet dust in the air and respiratory symptoms. To predict the health risk of carpet weavers, this preliminary study was conducted to evaluate the toxic potential of different types of workplace dust by using alveolar macrophages (AMs). Several parameters were observed for cytotoxicity such as cell viability, the release of lactate dehydrogenase (LDH) in rat AMs treated with different concentration of carpet dust and haemolytic potential of erythrocytes. In addition, reactive oxygen/nitrogen species-inducing effects of carpet dust were assessed by nitric oxide (NO), reduced glutathione (GSH) release and hydrogen peroxide (H2O2) generation in AMs. Results of cell viability and hemolytic assay showed a direct correlation between increasing the dust concentration with enhancing the toxic effect. Knotted and tufted carpet dust increases the release of LDH, NO, GSH and H2O2 production with increasing dust concentration. Present observations have revealed that dusts collected from tufted carpet weaving units exhibited more toxicity to AMs than knotted carpet dust. These data further suggest that injurious effects of carpet dust to AMs could pave a way to evaluate the toxic potential of the different types of workplace dusts and component(s) involved in it.
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Affiliation(s)
- Mohamed Ameen
- Fibre Toxicology Division, Industrial Toxicology Research Centre, Post Box No. 80, MG Marg, Lucknow-226 001, India
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Abstract
The dust generated during weaving (carpet dust) tibbati, knotted and tuffted carpets in carpet industry was studied for its toxicity in vitro and in vivo. Carpet dust (0.5, 1.0, 2.5 and 5.0 mg/1 x 10(6) cells) caused in vitro cytotoxicity in rat alveolar macrophages (AM) in a concentration-dependent manner. The cytotoxic, inflammatory and oxidative responses were observed in bronchoalveolar lavage fluid (BALF) of rats at 1, 4, 8 and 16 days after exposure. Rats were intratracheally exposed at 5 mg/rat individually to all three types of carpet dust. All types of carpet dusts produced increased AM, lymphocytes (PMN) population in BALF suggesting their inflammatory reactions. Cytotoxic nature of carpet dust was shown by the increased activities of lactate dehydrogenase (LDH) and acid phosphatase (AP) in BALF. Increased AM population and in vitro cytotoxicity due to carpet dusts have shown some correlation with the levels of LDH and AP activities in BALF. The gradual enhanced profile of hydrogen peroxide (H2O2) and nitric oxide (NO) along with depletion of reduced glutathione (GSH) in AM due to these carpet dusts are suggestive of their oxidant nature. The enzyme activities of both glutathione peroxidase (GPx) and glutathione reductase (GR) in AM were marginally reduced in exposed rats. In conclusion, the data suggest the cytotoxic, inflammatory and oxidant nature of carpet dusts. It is extrapolated that health effects on carpet weavers would be associated with the concentration and nature of airborne dust generated during weaving of carpets.
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Affiliation(s)
- M Ameen
- Fibre Toxicology Division, Industrial Toxicology Research Centre, Post Box No. 80, M.G. Marg, Lucknow-226 001, India
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Mastrangelo G, Fedeli U, Fadda E, Milan G, Lange JH. Epidemiologic evidence of cancer risk in textile industry workers: a review and update. Toxicol Ind Health 2002; 18:171-81. [PMID: 12974540 DOI: 10.1191/0748233702th139rr] [Citation(s) in RCA: 57] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Abstract
A meta-analysis of epidemiologic studies for textile industry workers was undertaken in an attempt to evaluate whether the cancer risk varies within the textile industry in relation to the job held or the textile fiber used. We combined studies published up until 1990, when an ad hoc IARC Monograph was issued, and those published after 1990 with the aim of appreciating evidence of reversing trends in cancer risk. Observed and expected cases reported in the original studies were summed up and the totals were divided to obtain a pooled relative risk (PRR) with a 95% confidence interval (CI) estimated with a fixed-effect model. We calculated a chi-square test (chi2) of heterogeneity among studies. When PRR and chi2 were both significant, PRR and CI were calculated with a random-effect model and the source of heterogeneity was investigated. Lung cancer risk was around 0.4 in the first study on cotton workers published in 1936, around 0.7 in subsequent studies, mostly published in the 1970s and 1980s, and around 1.0 in the last studies published in the 1990s. Papers published in the 1970s and 1980s produced consistent risk estimates for lung cancer risk, which was significantly lower than 1.0 in workers exposed to cotton (PRR = 0.77; CI = 0.69-0.86) and wool dust (0.71; 0.50-0.92), as well as in carders and fiber preparers (0.73; 0.54-0.91), weavers (0.71; 0.56-0.85), and spinners and weavers (0.78; 0.66-0.91). Lung cancer PRRs did not significantly deviate from 1.0 in textile workers using synthetic fibers or silk, and in dyers. Increased PRRs were found for sinonasal cancer in workers exposed to cotton dust, and in workers involved in spinning or weaving (4.14; 1.80-6.49). PRR was 1.46 (1.10-1.82) for cancer of the digestive system in textile workers using synthetic fibers or silk, and 1.34 (1.10-1.59) for colorectal cancer in spinners and weavers. The increased bladder cancer PRR in dyers (1.39; 1.07-1.71) is generally attributed to textile dye exposure. In studies published after 1990, there is a general tendency to move toward unity for all the cancer risk estimates, leading to an increasing heterogeneity among studies. Since adjustment for smoking made little difference to the findings, the latter could be attributed to the exposure to textile dusts. The recent findings could be due to a lowering of dust concentration in the workplaces. The reduction of cases of upper respiratory tract cancer parallels with a corresponding increase of lung cancer cases. So, preventive measures have paradoxically increased the lung cancer burden to the textile workers.
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Affiliation(s)
- Giuseppe Mastrangelo
- Department of Environmental Medicine and Public Health, Section of Occupational Medicine, University of Padua, Italy.
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Wang XR, Pan LD, Zhang HX, Sun BX, Dai HL, Christiani DC. Follow-up study of respiratory health of newly-hired female cotton textile workers. Am J Ind Med 2002; 41:111-8. [PMID: 11813216 DOI: 10.1002/ajim.10042] [Citation(s) in RCA: 29] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/02/2023]
Abstract
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.
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Affiliation(s)
- Xiao-Rong Wang
- Department of Environmental Health (Occupational Health Program), Harvard School of Public Health, Boston, MA 02115, USA
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