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Registered health problems and demographic profile of integrated textile factory workers in Ethiopia: a cross-sectional study. BMC Public Health 2021; 21:1526. [PMID: 34372825 PMCID: PMC8351335 DOI: 10.1186/s12889-021-11556-4] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/28/2020] [Accepted: 07/27/2021] [Indexed: 11/10/2022] Open
Abstract
Background Textile and garment factories are growing in low and middle-income countries as worldwide demand for inexpensive clothing increases each year. These integrated textile and garment production factories are often built-in areas with few workplaces and environmental regulations, and employees can be regularly exposed to workplace hazards with little regulatory oversight. Consequently, workers’ health may be significantly affected due to long term exposure to hazards. This study describes registered health problems and their association to work-related and personal factors among workers in integrated textile factories in Ethiopia. Methods Institution-based cross-sectional study design was employed for this analysis. A one-year recording of worker’s clinical diagnoses (between March 2016 and February 2017) was gathered from the factory clinics of three integrated textile factories. Clinical diagnosis data was obtained as factory workers visited the clinics if feeling unwell. Sociodemographic characteristics and work-related information were obtained from the factory’s human resource departments. The sociodemographic and clinical diagnosis statuses of 7992 workers were analyzed. The association between the registered diagnoses and workplace factors (work in textile production, garment production and support process) and personal factors (age, sex and educational status) were studied using logistic regression analysis. Results The average employee age and years of service were 40 years and 11 years respectively. 60% of workers were females, comprising of 4778 women. 66% of all workers (5276) had 27,320 clinical diagnoses. In total, this caused 16,993 absent working days due to sick leave. Respiratory diseases (34%) and musculoskeletal disorders (29%) were the most prevalent diagnoses, while bodily injuries were the cause of most work absences. Work department, sex and educational status are variables that were most significantly associated with higher prevalence of disease groups. Conclusions About two-thirds of the integrated textile factory workers were diagnosed with different types of disease. The textile and garment production department workers were affected at a greater rate than the support process workers, indicating that some diseases may be related to workplace exposure. Further study should investigate rare chronic diseases such as cancer, heart diseases, renal diseases and diabetes.
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Kifle M, Gebremariam B, Alemu K, Woldeyohannes SM. Prevalence and Factors Associated with Respiratory Symptoms Among Bahir Dar Textile Industry Workers, Amhara Region, Ethiopia. ENVIRONMENTAL HEALTH INSIGHTS 2020; 14:1178630220965933. [PMID: 33116568 PMCID: PMC7573733 DOI: 10.1177/1178630220965933] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 08/11/2020] [Accepted: 09/21/2020] [Indexed: 06/11/2023]
Abstract
INTRODUCTION The expansions of labor-intensive investments in a developing countries, especially in textile production create a dusty work environment for workers, and those workers are from the low socio-economic group and need special safety concern. OBJECTIVE This study was aimed at assessing the prevalence of respiratory symptoms and associated factors among textile factories workers in Bahir Dar, Amhara region, Ethiopia, 2015. METHODS Institutional based cross-sectional study design was employed among randomly selected 384 textile workers using pre-tested interviewer-administered questionnaire. We stratified workers by their working section in the textile industries. Then the proportional numbers of workers were selected from each working section of the factory by using a random number generator. The identification number of workers from each factory was used for selection. The data were checked, coded, and entered to Epi-info Version 7 and exported to the Statistical Package for Social Science Version 20 for further analysis. Both bivariate and multivariate logistic regressions were used to identify associated factors. Variables having a P ⩽ .2 were fitted to multivariate logistic regression so as to assess the presence and strength of association with the respiratory symptom. Variables having a P < .05 were considered as significant. RESULTS Three hundred eighty-three (99.74%) of the study participants responded completely filling the questionnaire. In this study, the prevalence of cough, phlegm, bronchitis, chronic bronchitis, and chest pain among the respondents were 31 (8.1%), 45 (11.7%), 26 (6.8%), 2 (0.5%), and 21 (5.5%), respectively. Generally, 141 (36.81%) of the respondents have either of the above respiratory symptoms in the textile industry. Working in the spinning section (AOR = 3.26, 95% CI: 1.80, 5.89), being in the grade 11 and 12 level and below (AOR = 2.36, 95% CI: 1.50, 3.70) and personal protective equipment (PPE) utilization (AOR = 4.88 95% CI: 1.54-15.45) were significantly associated with respiratory symptoms in the multivariate analysis. CONCLUSION The prevalence of respiratory symptoms in Bahir Dar Textile workers was relatively high. Working department, educational status, and PPE use were variables significantly associated with respiratory symptoms in this study. Experience sharing across departments, employing educated workers and provision of personal protective equipment are important tasks to be followed to reduce respiratory symptoms in the industry.
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Affiliation(s)
- Manay Kifle
- School of Public Health, College of Health Sciences, Aksum University, Aksum, Ethiopia
| | | | - Kasahun Alemu
- School of Public Health, College of Public Health, University of Gondar, Gondar, Ethiopia
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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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Meo SA, Iqbal M, Usmani AM, Almana AA, Alrashed AH, Al-Regaiey KA. Effect of wearing cotton towel Ihram and plain Ihram on lung function among Hajj Pilgrims. Pak J Med Sci 2019; 35:893-898. [PMID: 31372113 PMCID: PMC6659059 DOI: 10.12669/pjms.35.4.727] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
Objectives: Hajj is the world’s largest gathering to Makkah, Saudi Arabia. Wearing cotton made Ihram is a basic and an essential component of Hajj. The aim of this study was to investigate the lung functions among Hajj pilgrims who were wearing cotton towel ihram (ihram with fibers) compared to those who were wearing plain cotton ihram (ihram without fibers). Methods: Ninety male, non-smoker, Hajj pilgrim volunteers with age ranged 20-60 years were selected. Forty five of them wore cotton towel ihram and 45 wore plain ihram. A day before leaving for Hajj and wearing ihram (6th Dhu-al-Hijjah) lung function base line parameters of Hajj pilgrims were determined. Hajj Pilgrims continuously wear ihram from 7-10th Dhu-al-Hijjah. In the afternoon of 10th Dhu-al-Hijjah, after removal of ihram, all parameters were repeated and at the completion of Hajj when all pilgrims return to their homes at Riyadh, all parameters were recorded again. Results: Before wearing Ihram, anthropometric and lung function baseline parameters were recorded, no significant difference was found between the study population. After wearing Ihram on the 7th Dhu-al-Hijjah and its removal on the 10th Dhu-al-Hijjah significant decline in the lung function test parameters was observed among Hajj pilgrims who were wearing cotton towel ihram. Forced Vital Capacity (FVC) 4.30±1.18 vs. 5.03±1.41 (p=0.01); Forced Expiratory Flow 25% (FEF-25%) 4.39±1.94 vs. 5.69±2.84 (p=0.03); Forced Expiratory Flow-50% (FEF-50%) 2.93±1.65 vs. 4.07±2.08 (p=0.01); Forced Expiratory Flow-75% (FEF-75%) 1.02±0.70 vs. 1.66±0.94 (p=0.002) compared to those who were wearing plain ihram. Conclusions: Lung function test parameters were decreased among the Hajj pilgrims who were wearing cotton towel ihram compared to those who were wearing plain cotton ihram. The pattern of impairment of lung function shows an obstructive peripheral airway lung involvement. It is suggested to conduct further large sample size studies to confirm the present study observations and reach at better conclusions.
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Affiliation(s)
- Sultan Ayoub Meo
- Sultan Ayoub Meo, Department of Physiology, College of Medicine, King Saud University, Riyadh, Saudi Arabia
| | - Muhammad Iqbal
- Muhammad Iqbal, Department of Physiology, College of Medicine, King Saud University, Riyadh, Saudi Arabia
| | - Adnan Mahmood Usmani
- Adnan Mahmood Usmani, University Diabetes Centre, College of Medicine, King Saud University, Riyadh, Saudi Arabia
| | - Abdulrahman Abdulaziz Almana
- Abdulrahman Abdulaziz Almana, Department of Armed Forces Medical Services, King Fahad Armed Forces Hospital, Jeddah, Saudi Arabia
| | - Abdulrahman Hamad Alrashed
- Abdulrahman Hamad Alrashed, Department of Family Medicine, King Faisal Specialist Hospital and Research Centre, Riyadh, Saudi Arabia
| | - Khalid Abdullah Al-Regaiey
- Khalid Abdullah Al-Regaiey, Department of Physiology, College of Medicine, King Saud University, Riyadh, Saudi Arabia
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van der Plaat DA, Vonk JM, Terzikhan N, de Jong K, de Vries M, La Bastide-van Gemert S, van Diemen CC, Lahousse L, Brusselle GG, Nedeljkovic I, Amin N, Kromhout H, Vermeulen RCH, Postma DS, van Duijn CM, Boezen HM. Occupational exposure to gases/fumes and mineral dust affect DNA methylation levels of genes regulating expression. Hum Mol Genet 2019; 28:2477-2485. [PMID: 31152171 PMCID: PMC6643643 DOI: 10.1093/hmg/ddz067] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/01/2018] [Revised: 03/13/2019] [Accepted: 03/23/2019] [Indexed: 12/21/2022] Open
Abstract
Many workers are daily exposed to occupational agents like gases/fumes, mineral dust or biological dust, which could induce adverse health effects. Epigenetic mechanisms, such as DNA methylation, have been suggested to play a role. We therefore aimed to identify differentially methylated regions (DMRs) upon occupational exposures in never-smokers and investigated if these DMRs associated with gene expression levels. To determine the effects of occupational exposures independent of smoking, 903 never-smokers of the LifeLines cohort study were included. We performed three genome-wide methylation analyses (Illumina 450 K), one per occupational exposure being gases/fumes, mineral dust and biological dust, using robust linear regression adjusted for appropriate confounders. DMRs were identified using comb-p in Python. Results were validated in the Rotterdam Study (233 never-smokers) and methylation-expression associations were assessed using Biobank-based Integrative Omics Study data (n = 2802). Of the total 21 significant DMRs, 14 DMRs were associated with gases/fumes and 7 with mineral dust. Three of these DMRs were associated with both exposures (RPLP1 and LINC02169 (2×)) and 11 DMRs were located within transcript start sites of gene expression regulating genes. We replicated two DMRs with gases/fumes (VTRNA2-1 and GNAS) and one with mineral dust (CCDC144NL). In addition, nine gases/fumes DMRs and six mineral dust DMRs significantly associated with gene expression levels. Our data suggest that occupational exposures may induce differential methylation of gene expression regulating genes and thereby may induce adverse health effects. Given the millions of workers that are exposed daily to occupational exposures, further studies on this epigenetic mechanism and health outcomes are warranted.
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Affiliation(s)
- Diana A van der Plaat
- Department of Epidemiology.,Groningen Research Institute for Asthma and COPD (GRIAC), University Medical Center Groningen, University of Groningen, Groningen, The Netherlands
| | - Judith M Vonk
- Department of Epidemiology.,Groningen Research Institute for Asthma and COPD (GRIAC), University Medical Center Groningen, University of Groningen, Groningen, The Netherlands
| | - Natalie Terzikhan
- Department of Epidemiology.,Department of Respiratory Medicine, Ghent University Hospital, Ghent, Belgium
| | - Kim de Jong
- Department of Epidemiology.,Groningen Research Institute for Asthma and COPD (GRIAC), University Medical Center Groningen, University of Groningen, Groningen, The Netherlands
| | - Maaike de Vries
- Department of Epidemiology.,Groningen Research Institute for Asthma and COPD (GRIAC), University Medical Center Groningen, University of Groningen, Groningen, The Netherlands
| | | | - Cleo C van Diemen
- Department of Genetics, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands
| | - Lies Lahousse
- Department of Epidemiology.,Department of Respiratory Medicine, Ghent University Hospital, Ghent, Belgium.,Department of Respiratory Medicine, Erasmus Medical Center, Rotterdam, the Netherlands
| | - Guy G Brusselle
- Department of Epidemiology.,Department of Respiratory Medicine, Ghent University Hospital, Ghent, Belgium.,Department of Respiratory Medicine, Erasmus Medical Center, Rotterdam, the Netherlands
| | - Ivana Nedeljkovic
- Department of Respiratory Medicine, Erasmus Medical Center, Rotterdam, the Netherlands
| | | | | | - Hans Kromhout
- Division Environmental Epidemiology, Institute for Risk Assessment Sciences, Utrecht University, Utrecht, The Netherlands
| | - Roel C H Vermeulen
- Department of Pulmonary Diseases, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands
| | - Dirkje S Postma
- Groningen Research Institute for Asthma and COPD (GRIAC), University Medical Center Groningen, University of Groningen, Groningen, The Netherlands.,Department of Pulmonary Diseases, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands
| | | | - H Marike Boezen
- Department of Epidemiology.,Groningen Research Institute for Asthma and COPD (GRIAC), University Medical Center Groningen, University of Groningen, Groningen, The Netherlands
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Ali NA, Nafees AA, Fatmi Z, Azam SI. Dose-response of Cotton Dust Exposure with Lung Function among Textile Workers: MultiTex Study in Karachi, Pakistan. THE INTERNATIONAL JOURNAL OF OCCUPATIONAL AND ENVIRONMENTAL MEDICINE 2018; 9:120-128. [PMID: 29995017 PMCID: PMC6466974 DOI: 10.15171/ijoem.2018.1191] [Citation(s) in RCA: 20] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 10/26/2017] [Accepted: 01/30/2018] [Indexed: 12/22/2022]
Abstract
BACKGROUND Cotton dust exposure among textile mill workers lead to impaired lung function. However, only few studies have investigated the dose-response relationship between cotton dust and lung function. OBJECTIVE To determine the dose-response relationship between cotton dust exposure and lung function among textile workers. METHODS This cross-sectional survey was conducted from January to March 2016 and included 303 adult male textile workers from spinning and weaving sections of 5 mills in Karachi, Pakistan. We collected data through a translated version of the American Thoracic Society respiratory questionnaire (ATS-DLD-78A) and using spirometry. Mill-level airborne cotton dust was measured over an 8-12-hour shift through UCB-PATS (University of California, Berkeley-Particle, and Temperature Monitoring System). Multiple linear regression was used to determine the association between cotton dust exposure and lung function assessed through the 3 indices: forced expiratory volume in the first second (FEV1), forced vital capacity (FVC), and their ratio (FEV1/FVC). RESULTS The mean age of the workers was 32.5 (SD 10.5) years. The mean spirometry indices expressed in percent predicted values were FEV1 82.6 (SD 14.0); FVC 90.3 (14.7), and FEV1/FVC 94.9 (10.5). The median cotton dust concentration was 0.61 (IQR 0.2 to 1.3) mg/m3. The frequency of respiratory symptoms was 15% for cough, 20% for phlegm, and 20% for wheezing. After adjustment for covariates, every mg/m3 increase in dust concentration was associated with 5.4% decline in FEV1. CONCLUSION This study quantifies the exposure-dependent relationship between cotton dust and lung function; which has implications for regulations and standards in the textile industry in Pakistan and similar cotton-processing countries.
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Affiliation(s)
- Naureen Akber Ali
- School of Nursing and Midwifery, Aga Khan University, Karachi, Pakistan.
| | - Asaad Ahmed Nafees
- Department of Community Health Sciences, Aga Khan University, Karachi, Pakistan
| | - Zafar Fatmi
- Department of Community Health Sciences, Aga Khan University, Karachi, Pakistan
| | - Syed Iqbal Azam
- Department of Community Health Sciences, Aga Khan University, Karachi, Pakistan
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Lo CY, Huang HY, He JR, Huang TT, Heh CC, Sheng TF, Chung KF, Kuo HP, Wang CH. Increased matrix metalloproteinase-9 to tissue inhibitor of metalloproteinase-1 ratio in smokers with airway hyperresponsiveness and accelerated lung function decline. Int J Chron Obstruct Pulmon Dis 2018; 13:1135-1144. [PMID: 29692608 PMCID: PMC5903494 DOI: 10.2147/copd.s161257] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/19/2022] Open
Abstract
Background Airway hyperresponsiveness (AHR) is associated with airway inflammation and a rapid decline in lung function and is a predictor of future risk of COPD among smokers. Alveolar macrophages (AMs) from patients with COPD release a greater amount of matrix metalloproteinase (MMP)-9. We hypothesized that the imbalance between MMP-9 and tissue inhibitor of metalloproteinase-1 (TIMP-1) is related to AHR in smokers. Patients and methods Healthy smokers with AHR (AHR + S) or smokers without AHR (AHR − S; divided according to a methacholine challenge test) and nonsmokers without AHR (AHR − NS) were enrolled. Spirometry was performed during enrollment and repeated after 5 years. Initially, AMs recovered from bronchoalveolar lavage (BAL) fluid were cultured in the presence of p38 mitogen-activated protein kinase (MAPK) inhibitor (SB203580), MAPK kinase (MEK) 1/2 (the MEK of extracellular signal-regulated kinase [ERK] inhibitor, PD98059), or medium alone for 24 h. The release of MMP-9 and TIMP-1 in culture supernatants was measured by enzyme-linked immunosorbent assay. Results A greater reduction in forced expiratory volume in 1 s (FEV1)/forced vital capacity (FVC), FEV1 (as a percentage of the predicted value [%pred]), and maximal mid-expiratory flow (MMEF) was observed among AHR + S in the 5-year period. There was a higher proportion of neutrophils and a lower proportion of AMs in BAL fluid recovered from AHR + S. Compared to AMs from AHR − NS and AHR − S, AMs from nonsmokers with AHR (AHR + NS) released more MMP-9 and less TIMP-1, with an increase in MMP-9/TIMP-1 ratios. The MMP-9/TIMP-1 ratio in smokers was positively correlated with the annual decline in FEV1%pred, FVC%pred, and MMEF%pred. Both SB203580 and PD98059 significantly reduced MMP-9, but not TIMP-1, from AMs of smokers. Conclusion AMs of AHR + NS produce excessive MMP-9 over TIMP-1, which may be a predictor of the development of airway obstruction. Inhibition of p38 MAPK and ERK suppresses the generation of MMP-9 by AMs from smokers.
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Affiliation(s)
- Chun-Yu Lo
- Department of Thoracic Medicine, Chang Gung Medical Foundation, College of Medicine, Chang Gung University, Taipei, Taiwan
| | - Hung-Yu Huang
- Department of Thoracic Medicine, Chang Gung Medical Foundation, College of Medicine, Chang Gung University, Taipei, Taiwan
| | - Jung-Ru He
- Department of Thoracic Medicine, Chang Gung Medical Foundation, College of Medicine, Chang Gung University, Taipei, Taiwan
| | - Tzu-Ting Huang
- Department of Thoracic Medicine, Chang Gung Medical Foundation, College of Medicine, Chang Gung University, Taipei, Taiwan
| | - Chih-Chen Heh
- Department of Thoracic Medicine, Chang Gung Medical Foundation, College of Medicine, Chang Gung University, Taipei, Taiwan
| | - Te-Fang Sheng
- Department of Thoracic Medicine, Chang Gung Medical Foundation, College of Medicine, Chang Gung University, Taipei, Taiwan
| | - Kian Fan Chung
- Airways Disease Section, National Heart and Lung Institute, Imperial College London, London, UK
| | - Han-Pin Kuo
- Department of Thoracic Medicine, Chang Gung Medical Foundation, College of Medicine, Chang Gung University, Taipei, Taiwan
| | - Chun-Hua Wang
- Department of Thoracic Medicine, Chang Gung Medical Foundation, College of Medicine, Chang Gung University, Taipei, Taiwan
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Anyfantis ID, Rachiotis G, Hadjichristodoulou C, Gourgoulianis KI. Respiratory Symptoms and Lung Function among Greek Cotton Industry Workers: A Cross-Sectional Study. THE INTERNATIONAL JOURNAL OF OCCUPATIONAL AND ENVIRONMENTAL MEDICINE 2017; 8:32-38. [PMID: 28051194 PMCID: PMC6679635 DOI: 10.15171/ijoem.2017.888] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 07/01/2016] [Accepted: 09/02/2016] [Indexed: 11/25/2022]
Abstract
Background: Workers in cotton industry are occupationally exposed to various dust-related hazards. The nature of these agents and the respective exposure levels depend on the cotton industry specific sector. These exposures could be associated with respiratory symptoms and changes in lung function parameters. Objective: To evaluate associations between occupational exposure and respiratory function as well as reported symptoms in several groups of workers at different stages of the cotton industry in a vertical approach that covers all the major sectors—from cotton ginning to weaving and fabric production. Methods: A questionnaire on respiratory symptoms and individual as well as workplace characteristics was completed by 256 workers at the cotton industry and 148 office workers (control group). Both groups underwent spirometry. Results: Workers in cotton industry reported a higher prevalence of severe dyspnea (p=0.002) and wheezing (p=0.004) compared to the control group. Also they were found to have a lower predicted FEV1% (p<0.029) and lower FEV1/FVC (p<0.001) values. In addition, a higher prevalence of FEV1% <80% (p<0.001) and FEV1/FVC <70% (p=0.041) were found among textile workers. Similar results were found for non-smoker textile workers compared to non-smoker control group workers. Those working in cotton ginning mills recorded the highest decrease of spirometric values. Duration of employment in cotton industry and smoking use were found to be predictors of lung function decline for cotton industry workers. Conclusion: Occupational exposure to cotton dust was associated with increased prevalence of respiratory symptoms and obstructive pattern in pulmonary function test.
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Affiliation(s)
- Ioannis D Anyfantis
- Department of Respiratory Medicine, University of Thessaly Medical School, Biopolis, Larissa 41110, Greece.
| | - Georgios Rachiotis
- Department of Hygiene and Epidemiology, Faculty of Medicine, University of Thessaly, Larissa 41222, Greece
| | - Cristos Hadjichristodoulou
- Department of Hygiene and Epidemiology, Faculty of Medicine, University of Thessaly, Larissa 41222, Greece
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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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Abstract
Background: Long term occupational exposure to cotton dust is associated with respiratory symptoms and loss of pulmonary function. Aim: This study was conducted to explore respiratory symptoms, pulmonary function tests and chest radiography of workers, and to evaluate the findings of high resolution computed tomographyand its correlation with pulmonary function tests (PFT). Material and Methods: The study was conducted on 100 cotton workers as exposed group and 100 unexposed subjects. Smokers were excluded from the study. All workers were interviewed and examined by the pulmonologist. PFT and chest radiography were conducted for all subjects. HRCT was performed for those with abnormal PFT or chest radiography. Results: A total of 51% and 31% of the cotton textile workers had one or more respiratory symptoms and respiratory signs respectively. 28% of subjects in the exposed group and 5% of subjects in unexposed group had obstructive pattern. Bronchia wall thickening and air trapping were the most frequent chest radiography and HRCT abnormalities respectively. There was a significant correlation between HRCT and the results of PFT. Conclusion: We conclude that long term exposure to cotton dust is associated with obstructive disease that increase with duration of exposure (history of working years), also use of HRCT as a sensitive tool in the assessment of pathologic changes and it's correlation with PFT, confirms the expected pathophysiology of airway obstruction in cotton workers.
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Affiliation(s)
- Fariba Mansouri
- Department of Respiratory, Tehran University of Medical Sciences, Tehran, Iran
| | - Jaber Parsa Pili
- Department of Health, Safety and Environmental Management, Baharloo Hospital, Tehran University of Medical Sciences, Tehran, Iran
| | - Akram Abbasi
- Department of Respiratory, Kermanshah University of Medical Sciences, Kermanshah, Iran
| | - Mina Soltani
- Department of Respiratory, Kermanshah University of Medical Sciences, Kermanshah, Iran
| | - Nazanin Izadi
- Center for Research on Occupational Diseases, Tehran University of Medical Sciences, Tehran, Iran
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12
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Particulate matter, endotoxin, and worker respiratory health on large Californian dairies. J Occup Environ Med 2015; 57:79-87. [PMID: 25563544 DOI: 10.1097/jom.0000000000000304] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
OBJECTIVE To assess respiratory exposures and lung function in a cross-sectional study of California dairy workers. METHODS Exposure of 205 dairy and 45 control (vegetable processing) workers to particulate matter and endotoxin was monitored. Pre- and postshift spirometry and interviews were conducted. RESULTS Geometric mean inhalable and PM2.5 concentrations were 812 and 35.3 μg/m3 versus 481.9 and 19.6 μg/m3, respectively, for dairy and control workers. Endotoxin concentrations were 329 EU/m3 or 1122 pmol/m3 and 13.5 EU/m3 or 110 pmol/m3, respectively, for dairy and control workers. In a mixed-effects model, forced vital capacity decreased across a work shift by 24.5 mL (95% confidence interval, -44.7 to -4.3; P = 0.018) with log10 (total endotoxin) and by 22.0 mL (95% confidence interval, -43.2 to -0.08; P = 0.042) per hour worked. CONCLUSIONS Modern California dairy endotoxin exposures and shift length were associated with a mild acute decrease in forced vital capacity.
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13
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Longitudinal assessment of lung function decline in the occupational setting. Curr Opin Allergy Clin Immunol 2015; 15:145-9. [DOI: 10.1097/aci.0000000000000153] [Citation(s) in RCA: 5] [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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14
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Saha A, Doctor PB, Bhagia LJ, Majumdar PK, Patel BD. A study of respiratory function among the workers engaged in ginning processes. Indian J Occup Environ Med 2015; 18:118-21. [PMID: 25598616 PMCID: PMC4292196 DOI: 10.4103/0019-5278.146908] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
Abstract
Background: Known respiratory health effects of exposure to cotton dust are mainly altered pulmonary function findings and symptom of chest tightness. A number of studies have been carried out all over the world to enumerate and evaluate the health effects of cotton dust exposed workers in different processes. However, such studies carried out in ginning industry especially in Indian context are scanty. Objectives: This study was initiated to explore occupational and morbidity details and respiratory functional status of the exposed workers as well as to investigate across the working shift pulmonary function changes. Materials and Methods: A cross-sectional study was conducted including workers from ginning units where principal exposure is from cotton dust. All the workers of the selected ginning units were subjected to an interview with a predesigned questionnaire to collect occupational and medical history, clinical examination and pulmonary function test. Results: In this present study, no cross-shift significant change in relation to PEFR and FEV1 values is observed. However, chronic effect on lung function is observed in a few subjects and declining trend of values was observed with increasing job duration as well as age of workers and among smokers. Other health problems among these subjects were backache and joint pain. Conclusions: Studies on cotton textile workers have shown both cross-shift and chronic decline of values. In this study on ginning workers, chronic effect only is observed. This difference of observation may be explained by different nature of exposure in case of ginning. This study recommends regular periodic clinical examination, lung function test and monitoring of dust, gram-negative bacteria and endotoxins in such workplaces.
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Affiliation(s)
- Asim Saha
- Department of Occupational Medicine, Regional Occupational Health Centre (Eastern), Kolkata, West Bengal, India
| | - Pankaj B Doctor
- Department of Microbiology, National Institute of Occupational Health, Ahmedabad, Gujarat, India
| | - Lakho J Bhagia
- Department of Industrial Hygiene, National Institute of Occupational Health, Ahmedabad, Gujarat, India
| | - Prabhat K Majumdar
- Department of Occupational Medicine, Regional Occupational Health Centre (Eastern), Kolkata, West Bengal, India
| | - Bhupendra D Patel
- Department of Respiratory Medicine, National Institute of Occupational Health, Ahmedabad, Gujarat, India
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15
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The prevalence of byssinosis among cotton workers in the north of Benin. THE INTERNATIONAL JOURNAL OF OCCUPATIONAL AND ENVIRONMENTAL MEDICINE 2014; 5:194-200. [PMID: 25270009 PMCID: PMC7767605] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Subscribe] [Scholar Register] [Received: 05/16/2014] [Accepted: 09/17/2014] [Indexed: 11/01/2022]
Abstract
BACKGROUND Cotton is the main agricultural export product in Benin. Cotton dust is thus present in the air during the handling and processing of cotton. This dust contains a mixture of substances including ground up plant matter, fibres, bacteria, fungi, soil, pesticides, noncotton matter, and other contaminants. While cotton processing is decreasing in industrialized countries, it is increasing in developing countries. Cotton processing, particularly in the early processes of spinning, can cause byssinosis. OBJECTIVE To determine the respiratory effects of cotton dust exposure among cotton mill workers in Benin. METHODS In a cross-sectional study, 109 workers exposed to cotton dust and 107 unexposed workers were studied. The International Commission on Occupational Health (ICOH) questionnaire was used for data collection on respiratory symptoms. For each worker, crossshift pulmonary function was performed with a dry spirometer. Based on the severity of respiratory symptoms and spirometry byssinosis was defined and classified according to the criteria of Schilling, et al. RESULTS The mean ± SD age of the exposed and unexposed workers was 46.3 ± 7.8 and 37.0 ± 8.3 years, respectively (p<0.001). The mean FEV1 predicted value for the exposed and unexposed workers was 76.3% and 77.3%, respectively. The prevalence of grade 3 byssinosis was 21.1% (95% CI: 13.4-28.9) in exposed workers and 8.4% (95% CI: 3.1-13.7) in unexposed workers (p=0.006). On Mondays, the exposed workers had more respiratory symptoms than unexposed workers; for grade 3 byssinosis, the prevalence was 13.8% in exposed and 4.7% in unexposed workers (p=0.011). CONCLUSION The prevalence of respiratory symptoms and byssinosis among cotton mill workers in Benin is high and needs prompt attention of health care workers and policymakers.
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de Jong K, Boezen HM, Kromhout H, Vermeulen R, Postma DS, Vonk JM. Association of occupational pesticide exposure with accelerated longitudinal decline in lung function. Am J Epidemiol 2014; 179:1323-30. [PMID: 24780843 DOI: 10.1093/aje/kwu053] [Citation(s) in RCA: 38] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
Cross-sectional studies have shown that occupational exposure to vapors, gases, dusts, and fumes (VGDF) and pesticides is associated with a lower level of lung function. These associations seem to be stronger in ever smokers. In the current study, we aimed to assess whether occupational exposure to VGDF and pesticides is associated with longitudinal decline in lung function. We used 12,772 observations from 2,527 participants in the Vlagtwedde-Vlaardingen Study, a general-population-based cohort study that followed subjects for 25 years, from 1965 to the last survey in 1989/1990. Job-specific exposure was estimated with the ALOHA+ job exposure matrix. Associations between exposures and annual changes in forced expiratory volume in 1 second (FEV1) and FEV1 as a percentage of inspiratory vital capacity (FEV1%VC) were assessed with linear mixed-effect models including sex, age, and level of lung function at the first measurement and pack-years of smoking at the last measurement. We tested for interaction between smoking and occupational exposure and assessed associations separately for never smokers and ever smokers. Exposure to VGDF was not associated with accelerated lung function decline after adjustment for co-exposure to pesticides. Exposure to pesticides, both in the last-held job and as a cumulative measure, was associated with accelerated decline in FEV1 and FEV1%VC, especially among ever smokers, where we found an excess change in FEV1 of -6.9 mL/year (95% confidence interval: -10.2, -3.7) associated with high pesticide exposure.
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17
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Gaughan DM, Piacitelli CA, Chen BT, Law BF, Virji MA, Edwards NT, Enright PL, Schwegler-Berry DE, Leonard SS, Wagner GR, Kobzik L, Kales SN, Hughes MD, Christiani DC, Siegel PD, Cox-Ganser JM, Hoover MD. Exposures and cross-shift lung function declines in wildland firefighters. JOURNAL OF OCCUPATIONAL AND ENVIRONMENTAL HYGIENE 2014; 11:591-603. [PMID: 24568319 PMCID: PMC7781241 DOI: 10.1080/15459624.2014.895372] [Citation(s) in RCA: 40] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/04/2023]
Abstract
Respiratory problems are common among wildland firefighters. However, there are few studies directly linking occupational exposures to respiratory effects in this population. Our objective was to characterize wildland fire fighting occupational exposures and assess their associations with cross-shift changes in lung function. We studied 17 members of the Alpine Interagency Hotshot Crew with environmental sampling and pulmonary function testing during a large wildfire. We characterized particles by examining size distribution and mass concentration, and conducting elemental and morphological analyses. We examined associations between cross-shift lung function change and various analytes, including levoglucosan, an indicator of wood smoke from burning biomass. The levoglucosan component of the wildfire aerosol showed a predominantly bimodal size distribution: a coarse particle mode with a mass median aerodynamic diameter about 12 μm and a fine particle mode with a mass median aerodynamic diameter < 0.5 μm. Levoglucosan was found mainly in the respirable fraction and its concentration was higher for fire line construction operations than for mop-up operations. Larger cross-shift declines in forced expiratory volume in one second were associated with exposure to higher concentrations of respirable levoglucosan (p < 0.05). Paired analyses of real-time personal air sampling measurements indicated that higher carbon monoxide (CO) concentrations were correlated with higher particulate concentrations when examined by mean values, but not by individual data points. However, low CO concentrations did not provide reliable assurance of concomitantly low particulate concentrations. We conclude that inhalation of fine smoke particles is associated with acute lung function decline in some wildland firefighters. Based on short-term findings, it appears important to address possible long-term respiratory health issues for wildland firefighters. [Supplementary materials are available for this article. Go to the publisher's online edition of Journal of Occupational and Environmental Hygiene for the following free supplemental resources: a file containing additional information on historical studies of wildland fire exposures, a file containing the daily-exposure-severity questionnaire completed by wildland firefighter participants at the end of each day, and a file containing additional details of the investigation of correlations between carbon monoxide concentrations and other measured exposure factors in the current study.].
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Affiliation(s)
- Denise M Gaughan
- a Department of Preventive Medicine and the Institute for Translational Epidemiology , Icahn School of Medicine at Mount Sinai , New York , New York
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18
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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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19
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Acute pulmonary function change associated with work on large dairies in California. J Occup Environ Med 2013; 55:74-9. [PMID: 23235464 DOI: 10.1097/jom.0b013e318270d6e4] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
OBJECTIVE To study whether dairy workers in California have lower baseline and greater cross-shift decrements in lung function than control employees. METHODS A cross-sectional study of 210 dairy and 47 control workers who completed questionnaires and spirometry before and after the work shift. RESULTS Dairy work was associated with mean baseline differences of -0.132 L (P = 0.07) and -0.131 L (P = 0.13) in forced expiratory volume in 1 second and forced vital capacity, respectively, compared with control employees, adjusting for age, height, smoking status, and days back at work since last day off. Dairy work was associated with a mean cross-shift difference of -65.2 mL (P = 0.02) and -103.1 mL (P < 0.01) in forced expiratory volume in 1 second and forced vital capacity, respectively, adjusting for smoking status and work-shift time. CONCLUSIONS Dairy work in California was associated with mild acute airway obstruction. The unclear long-term effect of dairy work in California merits further investigation.
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20
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Jacobsen GH, Schlünssen V, Schaumburg I, Sigsgaard T. Cross-shift and longitudinal changes in FEV1 among wood dust exposed workers. Occup Environ Med 2012; 70:22-8. [PMID: 23014594 PMCID: PMC3534253 DOI: 10.1136/oemed-2011-100648] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/02/2022]
Abstract
Objectives Acute lung function (LF) changes might predict an accelerated decline in LF. In this study, we investigated the association between cross-shift and longitudinal changes in forced expiratory volume in 1 s (FEV1) among woodworkers in a 6-year follow-up study. Methods 817 woodworkers and 136 controls participated with cross-shift changes of FEV1 at baseline and FEV1 and forced vital capacity at follow-up. Height and weight were measured and questionnaire information on respiratory symptoms, employment and smoking habits was collected. Wood dust exposure was assessed from 3572 personal dust measurements at baseline and follow-up. Cumulative wood dust exposure was assessed by a study-specific job exposure matrix and exposure time. Results The median (range) of inhalable dust at baseline and cumulative wood dust exposure was 1.0 (0.2–9.8) mg/m3 and 3.8 (0–7.1) mg year/m3, respectively. Mean (SD) for %ΔFEV1/workday and ΔFEV1/year was 0.2 (6.0)%, and −29.1 (41.8) ml. Linear regression models adjusting for smoking, age, height and weight change showed no association between cross-shift and annual change in FEV1 among woodworkers or controls. Including different exposure estimates, atopy or cross-shift change dichotomised or as quartiles did not change the results. Conclusions This study among workers exposed to low levels of wood dust does not support an association between acute LF changes and accelerated LF decline.
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Affiliation(s)
- Gitte Højbjerg Jacobsen
- Department of Public Health, Section of Environmental and Occupational Medicine, Aarhus University, Aarhus, Denmark.
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21
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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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Zhang X, Wang Z, Li T. The current status of occupational health in China. Environ Health Prev Med 2010; 15:263-70. [PMID: 21432554 PMCID: PMC2921040 DOI: 10.1007/s12199-010-0145-2] [Citation(s) in RCA: 39] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/19/2010] [Accepted: 03/31/2010] [Indexed: 10/19/2022] Open
Abstract
OBJECTIVE This study aimed to summarize the major health problems among Chinese workers, the strategies and measures for occupational hazards control, the network and organizations of occupational health administration, and the achievements and current challenges of occupational health in China. RESULTS The situation of occupational health was found to be still serious in China. Enterprises with occupational hazards were widely distributed, the exposed population and cases of occupational diseases were numerous, and occupational risks were being transferred from the city to the countryside and from developed areas to developing ones. New emerging problems coexisted with traditional occupational hazards. Besides, a lack of occupational health services for migrant workers could be a major problem for a long time. CONCLUSIONS It is necessary to improve the fields related to occupational health, such as the supervision and administration of small- and medium-scale enterprises, research into key techniques for the prevention and control of occupational hazards, systems for the diagnosis and reporting of occupational diseases, and the training of health professionals.
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Affiliation(s)
- Xueyan Zhang
- National Institute of Occupational Health and Poison Control, Chinese Center for Disease Control and Prevention, Nanwei Road 29th, Xuanwu District, Beijing, 100050 China
| | - Zhongxu Wang
- National Institute of Occupational Health and Poison Control, Chinese Center for Disease Control and Prevention, Nanwei Road 29th, Xuanwu District, Beijing, 100050 China
| | - Tao Li
- National Institute of Occupational Health and Poison Control, Chinese Center for Disease Control and Prevention, Nanwei Road 29th, Xuanwu District, Beijing, 100050 China
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McKay RT, LeMasters GK, Hilbert TJ, Levin LS, Rice CH, Borton EK, Lockey JE. A long term study of pulmonary function among US refractory ceramic fibre workers. Occup Environ Med 2010; 68:89-95. [PMID: 20798015 PMCID: PMC3023862 DOI: 10.1136/oem.2009.048033] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
Background Cross-sectional studies have shown declines in lung function among refractory ceramic fibre (RCF) workers with increasing fibre exposure. This study followed current and former workers (n=1396) for up to 17 years and collected 5243 pulmonary function tests. Methods Cumulative fibre exposure and production years were categorised into exposure levels at five manufacturing locations. Conventional longitudinal models did not adequately partition age-related changes from other time-dependent variables. Therefore, a restricted cubic spline model was developed to account for the non-linear decline with age. Results Cumulative fibre >60 fibre-months/cc showed a significant loss in lung function at the first test. When results were examined longitudinally, cumulative exposure was confounded with age as workers with the highest cumulative exposure were generally older. A longitudinal model adjusted by age groups was implemented to control for this confounding. No consistent longitudinal loss in lung function was observed with RCF exposure. Smoking, initial weight and weight increase were significant factors. Conclusion No consistent decline was observed longitudinally with exposure to RCF, although cross-sectional and longitudinal findings were discordant. Confounding and accelerated lung function declines with ageing and the correlation of multiple time-dependent variables should be considered in order to minimise error and maximise precision. An innovative statistical methodology for these types of data is described.
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Affiliation(s)
- Roy T McKay
- Department of Environmental Health, University of Cincinnati College of Medicine, Cincinnati, OH 45267-0056, USA.
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Boubopoulos NJ, Constandinidis TC, Froudarakis ME, Bouros D. Reduction in cotton dust concentration does not totally eliminate respiratory health hazards: the Greek study. Toxicol Ind Health 2010; 26:701-7. [PMID: 20639277 DOI: 10.1177/0748233710377773] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
A number of epidemiological studies have shown that byssinosis is associated with exposure to high levels of cotton dust. In this first survey, the prevalence of respiratory symptoms in cotton workers under low concentration of cotton dust was investigated. A respiratory questionnaire consisting of 47 questions was given to 443 cotton workers. Their lung function was measured with spirometry. Breathing zone cotton dust concentration was measured by personal samplers and static sampling was used to define the level of the work area concentration. Workers with abnormalities in the pulmonary function parameters, including forced expiratory volume in 1 second (FEV₁), forced vital capacity (FVC) and peak expiratory flow rate (PEFR), were 5.9%. In this group of operatives 7.7% had symptoms compatible with byssinosis, 65.4% of them were smokers, 69.2% of them had symptoms of allergic rhinitis, while 72.2% of them were smokers. Asthma, which appeared after the age of 30, was reported by 57.7%, while 60% of them were smokers. Mean breathing zone cotton dust concentration was 0.16 mg/m³ and the mean work area cotton dust concentration 0.14 mg/m³. Despite the reduction in cotton dust concentration, byssinosis symptoms, allergic rhinitis, asthma and impaired pulmonary function are the most common findings in our cotton workers depending on the duration of exposure, whether they are smokers or not and the nature of the cotton dust.
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Affiliation(s)
- Nectarios J Boubopoulos
- Laboratory of Hygiene and Environmental Protection, Medical School of Alexandroupolis, Democritus University of Thrace, Greece.
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Shi J, Hang JQ, Mehta AJ, Zhang HX, Dai HL, Su L, Eisen EA, Christiani DC. Long-term effects of work cessation on respiratory health of textile workers: a 25-year follow-up study. Am J Respir Crit Care Med 2010; 182:200-6. [PMID: 20339150 DOI: 10.1164/rccm.200903-0329oc] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
RATIONALE The degree to which chronic respiratory health effects caused by exposures to cotton dust and endotoxin is reversible after cessation of textile work is unknown. OBJECTIVES To investigate changes in lung function and respiratory symptoms after cessation of textile work and to determine whether past exposure to cotton dust and endotoxin or smoking history modify the associations. METHODS We performed a prospective cohort study consisting of 447 cotton textile workers exposed to cotton dust and 472 unexposed silk textile workers, with a 25-year follow-up. Spirometry testing and respiratory questionnaires were conducted at 5-year intervals. Generalized estimated equations were used to model the average 5-year change in FEV(1) and odds ratios of respiratory symptom prevalence. MEASUREMENTS AND MAIN RESULTS Years since cessation of textile work was positively associated with 11.3 ml/yr and 5.6 ml/yr gains in 5-year FEV(1) change for cotton and silk workers, respectively. Among male cotton workers, smokers gained more FEV(1) per year after cessation of exposure than did nonsmokers, and the risk of symptoms of chronic bronchitis and byssinosis was larger for smoking than for nonsmoking male cotton workers. CONCLUSIONS Cessation of textile work was significantly associated with improvement in lung function and respiratory symptoms. The positive effect of work cessation was greater for cotton workers than for silk workers. For cotton workers, the improvement in lung function loss after cessation of textile work was greater among smokers, but no differences were observed for silk workers.
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Affiliation(s)
- Jing Shi
- Harvard School of Public Health, 665 Huntington Avenue, Building 1-1407, Boston, MA 02115, USA
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