Respiratory and allergic symptoms in wool textile workers

Evaluation of respiratory system in textile-dyeing workers

BACKGROUND

Despite the presence of many textile and dyeing plants in Iran, we couldn't find similar studies in this country. Forthermore, considering progress in the dyeing process and engineering controls, assessment of respiratory system is important for these workers. The present study was performed to evaluate the respiratory system in dyeing workers.

METHODS

In a cross-sectional study, 101 dyeing workers (all dyeing workers in yazd) and 90 workers without respiratory exposures (control group), were evaluated. A questionnaire was filled for each participant included Venables questionnaire and some other questions about age, work experience, personal or familial history of asthma or atopy, acute and chronic respiratory symptoms; Then spirometry was performed before and after the shift work Results: The frequency of acute and chronic respiratory symptoms was significantly higher among dyeing workers than controls. According to the Venables questionnaire, 11.9% of the dyeing workers suffered from asthma. Means of FVC and FEV1 of pre-shift spirometry were lower than control (p< 0.001). Across-shift spirometry showed significant reduction of FVC (p< 0.001), FEV1 (p< 0.001), FEF25-75% (p= 0.05) and FEF25% (p= 0.007) in dyeing workers compared to the control group.

CONCLUSION

Evaluation of dyeing workers' respiratory system in this study showed that despite development in dyeing processes and engineering controls, workers in this job show more prevalent acute and chronic symptoms, and across-shift changes in spirometric parameters were significantly higher in this work group than the control group. Therefore it is necessary to pay attention to the control of respiratory exposures in this job.

Respiratory symptoms and pulmonary functions of workers employed in Turkish textile dyeing factories

Dyes are known to be a causative agent of occupational asthma in workers exposed to them. We have evaluated respiratory symptoms among textile workers. The study population comprised 106 exposed workers and a control (unexposed) group. Data were collected by a questionnaire. PFTs (Pulmonary Function Test) were performed. Among the exposed workers 36.8% defined phlegm. Respiratory symptoms were not significantly different between two groups. The employment duration of the exposed workers with phlegm was longer than those without phlegm (p = 0.027). The mean % predicted of FEF(25-75) of the exposed workers was found to be significantly lower than the control (unexposed) group (p = 0.01). Our study suggests that textile dyeing might cause respiratory symptoms in workers.

Environmental health survey in asbestos cement sheets manufacturing industry

About 673 small-scale asbestos mining and milling facilities and 33 large - scale asbestos manufacturing plants, (17 asbestos-cement product manufacturing plants and 16 other than asbestos-cement product plants) are situated in India. The present study reveals the exposure of commercial asbestos (chrysotile) in the occupational as well as ambient air environment of the asbestos-cement (AC) sheets industry using membrane filter method of Bureau of Indian Standards (BIS). The fibre concentrations in 15 samples collected in the occupational environment at ingredient feeding site, sheet-producing site, fibre godown were 0.079, 0.057 and 0.078 f/cc, respectively and in five samples from surrounding ambient air at factory gate resulted fibre concentration of 0.071 f/cc. All the samples have shown fibre concentration lower than the threshold limit values (TLVs) prescribed by BIS. Morphological analysis of samples, further under phase contrast and polarized microscopy indicates the presence of chrysotile asbestos, which acts as carcinogen as well as co-carcinogen. A clinical examination of exposed subjects reveals that there was no case of clubbing, crepitation, ronchi and dyspnea on exertion; however, obstruction and restriction were 10.9 per cent and 25 per cent in exposed subjects, respectively while in control there were 12 per cent and 28 per cent, respectively. The study revealed that chrysotile asbestos is emitted in the occupational as well as ambient environment that may cause adverse health impact.

Respiratory symptoms in Lancashire textile weavers

OBJECTIVES

To investigate a large population of cotton textile weavers for reported respiratory symptoms relative to occupational factors, smoking, and exposure to dust. Cotton processing is known to produce a respiratory disease known as byssinosis particularly in the early processes of cotton spinning. Relatively little is known about the respiratory health of the cotton weavers who produce cloth from spun cotton. By the time cotton is woven many of the original contaminants have been removed.

METHODS

1295 operatives from a target population of 1428 were given an interviewer led respiratory questionnaire. The presence of upper and lower respiratory tract symptoms were sought and the work relatedness of these symptoms determined by a stem questionnaire design. Also occupational and demographic details were obtained and spirometry and personal dust sampling performed.

RESULTS

Byssinosis was present in only four people (0.3%). Chronic bronchitis had a moderate overall prevalence of about 6% and was related predominantly to smoking. There were several other work related respiratory symptoms (persistent cough 3.9%, chronic production of phlegm 3.6%, chest tightness 4.8%, wheezing 5.4%, and breathlessness 2.3%). All of these were predicted predominantly by smoking (either past or present), with no consistent independent effect of exposure to dust. Work related eye and nasal symptoms were more common (10.4% and 16.9% respectively).

CONCLUSION

Byssinosis is a rare respiratory symptom in cotton weaving. Other work related respiratory symptoms were reported but their presence was predominantly related to smoking with no consistent effects of exposure to dust.

Prevalence and predictors of work related respiratory symptoms in workers exposed to organic dusts

OBJECTIVES

The aims of this study were to document the prevalence of work related upper and lower respiratory tract symptoms in workers exposed to organic dusts and to identify variables predictive of their occurrence.

METHODS

A cross sectional survey with an administered questionnaire (a previously validated adaptation of the Medical Research Council (MRC) respiratory questionnaire) was performed. Symptoms were classified as work related by their periodicity. Demographic data, smoking habits, and occupational histories were recorded. Personal exposures to dust and endotoxin were measured and individual subjects ascribed an exposure value specific to occupation, site and industry. Cox's regression techniques were used to identify variables predictive of work related upper and lower respiratory tract symptoms. Information was stored using Dbase 3 and analysed with SPSS.

RESULTS

1032 Workers (93% of the target population) were studied in nine different industries. The highest prevalences of work related lower respiratory tract symptoms (38.1%), upper respiratory tract symptoms (45.2%), and chronic bronchitis (15.5%) were found among poultry handlers. White workers were significantly more likely to complain of upper and lower respiratory tract symptoms. An individual in the swine confinement industry had a symptom complex compatible with byssinosis. Increasing current personal exposures to dust or endotoxin were found to be predictive of upper and lower respiratory tract symptoms, chronic bronchitis, and byssinosis. In a univariate analysis a relation between current exposures and the organic dust toxic syndrome was found. Present smoking and previously documented respiratory tract illness were significantly predictive of work related lower respiratory tract symptoms. Women were more likely to report work related upper respiratory tract symptoms.

CONCLUSIONS

People exposed to organic dusts may have a high prevalence of work related respiratory tract symptoms which are related to dust exposures and smoking habits. Action should be taken to reduce exposures to dust and endotoxin and stopping smoking should be promoted among workers exposed to organic dusts to reduce morbidity.

Chronic bronchitis in textile workers

BACKGROUND

Exposure to cotton is known to produce a specific occupational disease known as byssinosis. A large population of textile workers was investigated to determine whether such exposure was also associated with chronic bronchitis once other possible aetiological factors had been accounted for.

METHODS

A total of 2991 workers were investigated for the presence of symptoms compatible with chronic bronchitis. An MRC adapted respiratory questionnaire and MRC definition of chronic bronchitis were used for diagnostic labelling. Current and lifetime exposure to dust was estimated by personal and work area sampling, and the use of records of retrospective dust levels previously measured over the preceding 10 years. Airborne endotoxin exposure was measured using a quantitative turbidometric assay. Lung function tests were performed to measure forced expiratory volume in one second (FEV1) and forced vital capacity (FVC). A control group of workers exposed to man-made fibre textiles was identified. The comparative prevalence of chronic bronchitis in the two populations was assessed, allowing for sex, age, smoking habit, and ethnic origin. Two case referent studies were also performed; cases of chronic bronchitis were separately matched with controls from the cotton and control populations to determine the effect of the symptomatic state on lung function.

RESULTS

After controlling for smoking (pack years), workers in a cotton environment were significantly more likely to suffer from chronic bronchitis and this was most marked in workers over 45 years of age (odds ratio 2.51 (CI 1.3 to 4.9); p < 0.01). Regression analysis of all possible influencing parameters showed that cumulative exposure to cotton dust was significantly associated with chronic bronchitis after the effects of age, sex, smoking, and ethnic group were accounted for (p < 0.0005). In the intra-cotton population case control study a diagnosis of chronic bronchitis was associated with a small decrement in lung function compared with controls: percentage predicted FEV1 in cases 81.4% (95% CI 78.3 to 84.6), controls 86.7% (84.9 to 88.5); FVC in cases 89.9% (95% CI 87.0 to 92.9), controls 94.6% (92.8 to 96.4). After controlling for cumulative past exposure and pack years of smoking the effect of the diagnostic state remained significant for both FEV1 (p < 0.01) and FVC (p < 0.05).

CONCLUSIONS

Chronic bronchitis is more prevalent in cotton workers than in those working with man-made fibre and exposure is additive to the effect of smoking. The diagnosis of chronic bronchitis is associated with a small but significant decrement in lung function.

Respiratory health of workers exposed to low levels of chromium in stainless steel production

OBJECTIVES

To determine whether occupational exposure to chromite, trivalent chromium, or hexavalent chromium causes respiratory diseases, an excess of respiratory symptoms, a decrease in pulmonary function, or signs of pneumoconiosis among workers in an integrated chain of stainless steel production.

METHODS

This cross sectional study was carried out in 1993 and the inclusion criterion was a minimum of eight years of employment in the same production department. A self administered questionnaire was collected, and spirometry, measurement of diffusing capacity, chest radiography, and laboratory tests were carried out by a mobile research unit.

RESULTS

There were 221 workers in the exposure groups and 95 in the control group. The average duration of employment was 18 years. No significant differences in the odds ratios (ORs) of the symptoms were found between the exposure and the control groups. In a logistic regression analysis age and smoking significantly explained the occurrence of most of the respiratory symptoms. The smokers in the chromite group had significantly lower forced vital capacity (FVC), forced expiratory volume in one second (FEV1), and diffusing capacity than the corresponding values of the control group. The analysis of variance between study groups, smoking, and exposure time, without modelling for interactions, showed that the chromite group had lower values for FVC, FEV1, and diffusing capacity than the other groups. The occurrence of small opacities was more frequent on the chest radiographs of the workers in the chromite group.

CONCLUSIONS

An average exposure time of 18 years in ferrochromium and stainless steel production and exposure to dusts containing low concentrations of hexavalent or trivalent chromium do not lead to any respiratory changes detectable by lung function tests or radiography nor to any increase in symptoms of respiratory diseases. The lung function values were lower and the occurrence of radiological findings was more frequent among the workers from the chromite mine than among the controls. The difference was partly caused by differences in age and smoking habits, but evidently also partly by higher exposures more than two decades ago or by the fibrous components of the dust.

Wool and grain dusts stimulate TNF secretion by alveolar macrophages in vitro

OBJECTIVE

The aim of the study was to investigate the ability of two organic dusts, wool and grain, and their soluble leachates to stimulate secretion of tumour necrosis factor (TNF) by rat alveolar macrophages with special reference to the role of lipopolysaccharide (LPS).

METHODS

Rat alveolar macrophages were isolated by bronchoalveolar lavage (BAL) and treated in vitro with whole dust, dust leachates, and a standard LPS preparation. TNF production was measured in supernatants with the L929 cell line bioassay.

RESULTS

Both wool and grain dust samples were capable of stimulating TNF release from rat alveolar macrophages in a dose-dependent manner. The standard LPS preparation caused a dose-dependent secretion of TNF. Leachates prepared from the dusts contained LPS and also caused TNF release but leachable LPS could not account for the TNF release and it was clear that non-LPS leachable activity was present in the grain dust and that wool dust particles themselves were capable of causing release of TNF. The role of LPS in wool dust leachates was further investigated by treating peritoneal macrophages from two strains of mice, LPS responders (C3H) and LPS non-responders (C3H/HEJ), with LPS. The non-responder mouse macrophages produced very low concentrations of TNF in response to the wool dust leachates compared with the responders.

CONCLUSIONS

LPS and other unidentified leachable substances present on the surface of grain dust, and to a lesser extent on wool dust, are a trigger for TNF release by lung macrophages. Wool dust particles themselves stimulate TNF. TNF release from macrophages could contribute to enhancement of inflammatory responses and symptoms of bronchitis and breathlessness in workers exposed to organic dusts such as wool and grain.

Ocular and nasal irritation in operatives in Lancashire cotton and synthetic fibre mills

OBJECTIVES

To document the prevalence of work related ocular (eyeWRI) and nasal (noseWRI) irritation in workers in spinning mills of cotton and synthetic textile fibres and to relate the prevalence of symptoms to atopy, byssinotic symptoms, work history, and measured dust concentrations in the personal breathing zone and work area.

METHODS

A cross sectional study of 1048 cotton workers and 404 synthetic fibre workers was performed. A respiratory questionnaire was given to 1452 workers (95% of the total available population). Atopy was judged by skin prick tests to three common allergens. Work area cotton dust sampling (WAdust) was carried out according to EH25 guidelines in nine of the 11 spinning mills included in the study. Personal breathing zone dust concentrations were assessed with the IOM sampler to derive total dust exposure (PTdust) and a concentration calculated after the removal of fly (Pless).

RESULTS

3.7% of all operatives complained of symptoms of byssinosis, 253 (17.5%) complained of eyeWRI and 165 (11%) of noseWRI. These symptoms did not relate to atopy or byssinosis, or correlate univariately with any measure of cotton dust exposure (noseWRI v WAdust r = 0.153, PTdust r = 0.118, eyeWRI v WAdust r = 0.029, PTdust r = 0.052). Both of these symptoms on logistic regression analysis were related to being of white origin (P < 0.001), female sex (P < 0.001), and younger age (P < 0.001). With regression analysis, there was a negative relation between dust concentration and prevalence of symptoms.

CONCLUSION

Work related ocular and nasal irritation are the most common symptoms complained of by cotton textile workers. There was no relation between these symptoms and atopy, byssinosis, or dust concentration. It is likely that they relate to as yet unidentified agents unrelated to concentration of cotton dust.

Oilseed rape and seasonal symptoms: epidemiological and environmental studies

BACKGROUND

There is widespread concern that the cultivation of oilseed rape leads to seasonal epidemics of respiratory symptoms in populations living in the neighbourhood, and it has been suggested that the plant is a potent allergen. A study was therefore undertaken to determine the prevalence of seasonal symptoms in rural populations close to and far from areas of oilseed rape cultivation, and to measure the levels of allergen and other potentially harmful substances released by the crop.

METHODS

Random samples of 1000 adults from the general practice populations of two villages surrounded by oilseed rape fields, and 1000 adults from one village far from such cultivation, were taken. The subjects completed a previously validated questionnaire on respiratory and other symptoms, including questions on symptom seasonality, occupation, and smoking habits. Pollen and fungal spore counts were made around fields of oilseed rape and in the villages. The chemicals released by oilseed rape were measured in the field.

RESULTS

Overall, 86.8% of the subjects completed the questionnaires and the populations of the two samples were generally comparable. Spring and summer exacerbations of symptoms occurred equally in the two areas in approximately 25% of the population. There were small but significant excesses of cough, wheeze, and headaches in spring in the oilseed rape area (2.3% v 1.1%, 6.8% v 4.6%, and 4.8% v 2.8%, respectively), and cough, wheeze, and itchy skin were more prevalent in smokers. Counts of oilseed rape pollen were generally low except adjacent to fields, and counts of fungal spores were mostly higher in the rape than the non-rape areas. Oilseed rape was shown to give off terpenes and these were detected close to fields.

CONCLUSIONS

While it is likely that a proportion of the spring symptoms occurring in people living in close proximity to oilseed rape is caused by the plant, the excess of such symptoms is small. This, together with the low levels of pollen in the area, suggests that allergy to oilseed rape pollen is uncommon. The general prevalence of seasonal symptoms in rural areas is of interest, and a proportion of these cases is likely to be caused by factors other than allergy. Release of chemicals by plants and natural rises in summer ozone levels may be contributors.

Clinical reactions to Aspergillus niger in a biotechnology plant: an eight year follow up

The manufacture of citric acid by fermentation of molasses with Aspergillus niger has previously been described as a cause of occupational asthma in a factory. A longitudinal survey of the workforce of this factory has been carried out from 1984 to 1991. Over this period 160 of the original 278 workers left the workforce, together with 39 of 76 new recruits. Partial enclosure of the process and exhaust ventilation, installed in 1984, was effective in preventing any new cases of occupational asthma over the eight year period, and no new skin sensitisation was detected. Spore counts of A niger averaged about 100 times those in the outside air. Health in the 1984 survey had a striking influence on subsequent retiral; only 11 of the 79 with respiratory symptoms remained in 1991, compared with 90 of the 182 with no symptoms. In conclusion A niger is a weak antigen and simple hygiene measures protect the workforce. Exclusion of recruits with positive skin tests is not necessary if such measures are taken. The survey provided evidence of the selection factors operating within a workforce over this period contributing to retiral of the less healthy.

Inflammation in the lungs of rats after deposition of dust collected from the air of wool mills: the role of epithelial injury and complement activation

In a previous study assessing respiratory symptoms in individuals employed in wool textile mills in the north of England relations between symptoms of chronic bronchitis, breathlessness and wheeze, and rhinitis and current exposure to airborne mass concentration of dust were shown. As preliminary steps in defining the potential hazard associated with dust from the air of wool mills the ability of inspirable dust, collected from the air of wool textile mills, to cause inflammation when injected into the lungs of rats was determined. Dusts were collected from the beginning of wool processing (opening) in one factory and from the middle (combing) and late (backwinding) stages of the process in two other factories. Ability of the dusts to cause inflammation was assessed by instillation into the lungs of rats followed by bronchoalveolar lavage. All the dusts caused some inflammation which peaked on day 1 and did not persist beyond one week. A distinctive aggregation response of mononuclear cells in the lavage, however, had a different time course, peaking at day 7. An attempt was made to determine how the wool mill dusts caused inflammation and experiments showed that the dusts themselves had no inherent chemotactic activity but that they did have a pronounced ability to generate chemotaxins in serum and so could activate complement in lung fluid. In addition, dust collected from ledges in the mills had the ability to injure epithelial cells in vitro which could also contribute to inflammation. A role for endotoxin in the inflammatory activity of the dusts was not discounted and a leachate of the dust had the ability to cause inflammation when injected into the lungs of rats. Wool mill dust is likely to be a complex mixture of materials and these experiments represent a preliminary approach to understanding the biological activity of the whole unfractionated dust and further studies are in progress to define more accurately the toxic material(s) in the dust.