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ELSHAER NOHA, FODA NERMIN, SHEHATA SAMEH. Respiratory symptoms and pulmonary function impairment among textile industry workers in Alexandria, Egypt. J Public Health Afr 2023; 14:2741. [PMID: 38020280 PMCID: PMC10658460 DOI: 10.4081/jphia.2023.2741] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/14/2023] [Accepted: 09/06/2023] [Indexed: 12/01/2023] Open
Abstract
Occupational exposure to cotton dust is still an important cause of respiratory problems in textile workers particularly in less developed countries like Egypt. Evaluate respiratory symptoms and diseases, and pulmonary function pattern among Egyptian textile workers. Cross sectional comparative study was conducted from December 2019 to September 2020 in a textile factory in Egypt; 364 male workers (184 cotton dust exposed workers, and 180 unexposed workers) were included. Participants were subjected to an interviewing questionnaire, British Medical Research Council questionnaire, anthropometric measurements, pulmonary function tests, and byssinosis grading format. Descriptive and analytic statistics were conducted. Chronic cough, phlegm production, and shortness of breath grade I, II and III were more reported in cotton dust exposed workers than unexposed workers (P#x003C;0.01, P#x003C;0.01, and P=0.02, respectively). Prevalence of chronic bronchitis was significantly higher among cotton dust exposed workers (12%) than unexposed workers (3.9%) (P#x003C;0.01). The mean percent predicted values of lung function indices reflecting large-1irway function (VC, FVC, FEV1, FEV1%, PEFR, and FEF75) were significantly lower in cotton dust exposed workers (P#x003C;0.01). Prevalence of byssinosis was 22.8%. Workers with byssinosis had significantly higher prevalence of respiratory symptoms, chronic bronchitis, cross-shift reduction in PEFR and significant decrease in mean percent predicted values of FVC, FEV1, PEFR, FEF75, and FEF50 than workers without byssinosis. This study revealed a substantial association between cotton dust exposure at work and respiratory symptoms and morbidity. Regular measurement of cross shift change in PEFR is recommended among exposed workers for early diagnosis of byssinosis.
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Affiliation(s)
- NOHA ELSHAER
- Industrial Medicine and Occupational Health, Department of Community Medicine, Faculty of Medicine, Alexandria University, Egypt
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Nafees AA, Muneer MZ, Irfan M, Kadir MM, Semple S, De Matteis S, Burney P, Cullinan P. Byssinosis and lung health among cotton textile workers: baseline findings of the MultiTex trial in Karachi, Pakistan. Occup Environ Med 2023; 80:129-136. [PMID: 36717255 PMCID: PMC9985716 DOI: 10.1136/oemed-2022-108533] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/20/2022] [Accepted: 12/14/2022] [Indexed: 02/01/2023]
Abstract
OBJECTIVES To assess the association of exposure in cotton mills in Karachi with different definitions of byssinosis and lung health. METHODS This cross-sectional survey took place between June 2019 and October 2020 among 2031 workers across 38 spinning and weaving mills in Karachi. Data collection involved questionnaire-based interviews, spirometry and measurements of personal exposure to inhalable dust. Byssinosis was defined using both WHO symptoms-based (work-related chest tightness), and Schilling's criteria (symptoms with decreased forced expiratory volume in 1 s (FEV1). Values of FEV1/forced vital capacity ratio below the lower limit of normality on postbronchodilator test were considered as 'chronic airflow obstruction' (CAO). RESULTS 56% of participants had at least one respiratory symptom, while 43% had shortness of breath (grade 1). Prevalence of byssinosis according to WHO criteria was 3%, it was 4% according to Schilling's criteria, and likewise for CAO. We found low inhalable dust exposures (geometric mean: 610 µg/m3). Cigarette smoking (≥3.5 pack-years), increasing duration of employment in the textile industry and work in the spinning section were important factors found to be associated with several respiratory outcomes. CONCLUSION We found a high prevalence of respiratory symptoms but a low prevalence of byssinosis. Most respiratory outcomes were associated with duration of employment in textile industry. We have discussed the challenges faced in using current, standard guidelines for identifying byssinosis.
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Affiliation(s)
- Asaad Ahmed Nafees
- Department of Community Health Sciences, Aga Khan University, Karachi, Pakistan .,National Heart & Lung Institute, Imperial College London, London, UK
| | - Muhammad Zia Muneer
- Department of Community Health Sciences, Aga Khan University, Karachi, Pakistan
| | - Muhammad Irfan
- Department of Pulmonary and Critical Care Medicine, Aga Khan University, Karachi, Pakistan
| | | | - Sean Semple
- Institute of Social Marketing, University of Stirling, Stirling, UK
| | - Sara De Matteis
- National Heart & Lung Institute, Imperial College London, London, UK.,Department of Medical Sciences and Public Health, University of Cagliari, Cagliari, Italy
| | - Peter Burney
- National Heart & Lung Institute, Imperial College London, London, UK
| | - Paul Cullinan
- National Heart & Lung Institute, Imperial College London, London, UK
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Nafees AA, Matteis SD, Burney P, Cullinan P. Contemporary Prevalence of Byssinosis in Low- and Middle-Income Countries: A Systematic Review. Asia Pac J Public Health 2022; 34:483-492. [DOI: 10.1177/10105395211073051] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
We aimed to identify the contemporary prevalence of byssinosis through a systematic review. We used Medline, Web of Science, Embase, and Global Health databases to identify studies published in any language between 2000 and 2019, reporting primary data on byssinosis among adults. We used the Joanna Briggs Institute checklist to estimate the risk of bias in studies and undertook a qualitative, narrative data analysis. The review considered the prevalence of byssinosis, chest tightness, and airflow obstruction in textile workers in low- and middle-income countries (LMICs). We found 26 relevant studies that included 6930 workers across 12 countries. Most of the studies (n = 19) were from Asia, and 7 from African countries. Twenty-five studies were cross-sectional surveys while 1 was a cohort study. The prevalence of byssinosis was reported by 18 studies, and ranged from 8% to 38%, without any clear associations, at the group level, between the prevalence of byssinosis and durations of workers’ exposures. Prevalence of chest tightness ranged between 4% and 58% and that of airflow obstruction between 10% and 30%. We found a strong correlation ( r = 0.72) between prevalence of byssinosis and cotton dust levels. Our findings indicate that byssinosis remains a significant, contemporary problem in some parts of the textile sector in LMICs.
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Affiliation(s)
- Asaad Ahmed Nafees
- Department of Community Health Sciences, The Aga Khan University, Karachi, Pakistan
- Genomic and Environmental Medicine, National Heart and Lung Institute, Imperial College London, UK
| | - Sara De Matteis
- Genomic and Environmental Medicine, National Heart and Lung Institute, Imperial College London, UK
- Department of Medical Sciences and Public Health, University of Cagliari, Italy
| | - Peter Burney
- Genomic and Environmental Medicine, National Heart and Lung Institute, Imperial College London, UK
| | - Paul Cullinan
- Genomic and Environmental Medicine, National Heart and Lung Institute, Imperial College London, UK
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da Silveira Fleck A, Sadoine ML, Buteau S, Suarthana E, Debia M, Smargiassi A. Environmental and Occupational Short-Term Exposure to Airborne Particles and FEV 1 and FVC in Healthy Adults: A Systematic Review and Meta-Analysis. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph182010571. [PMID: 34682321 PMCID: PMC8536058 DOI: 10.3390/ijerph182010571] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 08/19/2021] [Revised: 10/02/2021] [Accepted: 10/04/2021] [Indexed: 11/29/2022]
Abstract
Background: No study has compared the respiratory effects of environmental and occupational particulate exposure in healthy adults. Methods: We estimated, by a systematic review and meta-analysis, the associations between short term exposures to fine particles (PM2.5 and PM4) and certain parameters of lung function (FEV1 and FVC) in healthy adults. Results: In total, 33 and 14 studies were included in the qualitative synthesis and meta-analyses, respectively. In environmental studies, a 10 µg/m3 increase in PM2.5 was associated with an FEV1 reduction of 7.63 mL (95% CI: −10.62 to −4.63 mL). In occupational studies, an increase of 10 µg/m3 in PM4 was associated with an FEV1 reduction of 0.87 mL (95% CI: −1.36 to −0.37 mL). Similar results were observed with FVC. Conclusions: Both occupational and environmental short-term exposures to fine particles are associated with reductions in FEV1 and FVC in healthy adults.
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Affiliation(s)
- Alan da Silveira Fleck
- Department of Environmental and Occupational Health, School of Public Health, University of Montreal, 2375 Chem. de la Côte-Sainte-Catherine, Montreal, QC H3T 1A8, Canada; (A.d.S.F.); (M.L.S.); (M.D.)
- Centre for Public Health Research (CReSP), 7101 Av du Parc, Montreal, QC H3N 1X9, Canada
| | - Margaux L. Sadoine
- Department of Environmental and Occupational Health, School of Public Health, University of Montreal, 2375 Chem. de la Côte-Sainte-Catherine, Montreal, QC H3T 1A8, Canada; (A.d.S.F.); (M.L.S.); (M.D.)
- Centre for Public Health Research (CReSP), 7101 Av du Parc, Montreal, QC H3N 1X9, Canada
| | - Stéphane Buteau
- Institut National de Sante Publique du Québec (INSPQ), 190 Boul Crémazie E, Montreal, QC H2P 1E2, Canada;
| | - Eva Suarthana
- Research Institute of the McGill University Health Center, 2155 Rue Guy, Montreal, QC H3H 2L9, Canada;
- Centre de Recherche de l’Hôpital du Sacré-Coeur de Montréal (CRHSCM), 5400 Boul Gouin O, Montreal, QC H4J 1C5, Canada
| | - Maximilien Debia
- Department of Environmental and Occupational Health, School of Public Health, University of Montreal, 2375 Chem. de la Côte-Sainte-Catherine, Montreal, QC H3T 1A8, Canada; (A.d.S.F.); (M.L.S.); (M.D.)
- Centre for Public Health Research (CReSP), 7101 Av du Parc, Montreal, QC H3N 1X9, Canada
| | - Audrey Smargiassi
- Department of Environmental and Occupational Health, School of Public Health, University of Montreal, 2375 Chem. de la Côte-Sainte-Catherine, Montreal, QC H3T 1A8, Canada; (A.d.S.F.); (M.L.S.); (M.D.)
- Centre for Public Health Research (CReSP), 7101 Av du Parc, Montreal, QC H3N 1X9, Canada
- Institut National de Sante Publique du Québec (INSPQ), 190 Boul Crémazie E, Montreal, QC H2P 1E2, Canada;
- Correspondence:
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Tefera Y, Schlünssen V, Kumie A, Deressa W, Moen BE, Bråtveit M. Personal inhalable dust and endotoxin exposure among workers in an integrated textile factory. ARCHIVES OF ENVIRONMENTAL & OCCUPATIONAL HEALTH 2020; 75:415-421. [PMID: 32308145 DOI: 10.1080/19338244.2020.1743958] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/11/2023]
Abstract
The aim of this study was to determine personal exposure to inhalable dust and endotoxin levels among workers in an integrated cotton-processing textile factory and exposure variability across the different work sections. Full shift measurements were carried out using inhalable conical samplers with 37 mm glass-fiber filters. Personal inhalable dust was determined gravimetrically, and endotoxin levels were analyzed by kinetic chromogenic Limulus Amebocytes Lysate assay. The geometric means of personal dust and endotoxin concentrations were 0.75 mg·m-3 and 831 EU·m-3, respectively. The highest dust and endotoxin concentrations were observed in carding section (1.34 mg·m-3 and 6,381 EU·m-3, respectively). Altogether, 11% of dust and 89% of endotoxin samples exceeded workplace exposure limits. This study showed a moderate correlation between inhalable dust and endotoxin (r = 0.450, p < 0.001). Our findings indicate that low dust exposure does not guarantee a low exposure to endotoxin.
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Affiliation(s)
- Yifokire Tefera
- Department of Preventive Medicine, School of Public Health, College of Health Sciences, Addis Ababa University, Addis Ababa, Ethiopia
- Department of Global Public Health and Primary Care, University of Bergen, Bergen, Norway
- Centre for International Health, Department of Global Public Health and Primary Care, Faculty of Medicine, University of Bergen, Bergen, Norway
| | - Vivi Schlünssen
- Department of Public Health, Environment, Occupation and Health, Danish Ramazzini Centre, Aarhus University, Aarhus, Denmark
- The National Research Centre for the Working Environment, Copenhagen, Denmark
| | - Abera Kumie
- Department of Preventive Medicine, School of Public Health, College of Health Sciences, Addis Ababa University, Addis Ababa, Ethiopia
| | - Wakgari Deressa
- Department of Preventive Medicine, School of Public Health, College of Health Sciences, Addis Ababa University, Addis Ababa, Ethiopia
| | - Bente E Moen
- Department of Global Public Health and Primary Care, University of Bergen, Bergen, Norway
- Centre for International Health, Department of Global Public Health and Primary Care, Faculty of Medicine, University of Bergen, Bergen, Norway
| | - Magne Bråtveit
- Department of Global Public Health and Primary Care, University of Bergen, Bergen, Norway
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Elser H, Falconi AM, Bass M, Cullen MR. Blue-collar work and women's health: A systematic review of the evidence from 1990 to 2015. SSM Popul Health 2018; 6:195-244. [PMID: 30417066 PMCID: PMC6215057 DOI: 10.1016/j.ssmph.2018.08.002] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/29/2018] [Revised: 08/06/2018] [Accepted: 08/13/2018] [Indexed: 01/09/2023] Open
Abstract
Despite the implications of gender and sex differences for health risks associated with blue-collar work, adverse health outcomes among blue-collar workers has been most frequently studied among men. The present study provides a "state-of-the-field" systematic review of the empiric evidence published on blue-collar women's health. We systematically reviewed literature related to the health of blue-collar women published between January 1, 1990 and December 31, 2015. We limited our review to peer-reviewed studies published in the English language on the health or health behaviors of women who were presently working or had previously worked in a blue-collar job. Studies were eligible for inclusion regardless of the number, age, or geographic region of blue-collar women in the study sample. We retained 177 studies that considered a wide range of health outcomes in study populations from 40 different countries. Overall, these studies suggested inferior health among female blue-collar workers as compared with either blue-collar males or other women. However, we noted several methodological limitations in addition to heterogeneity in study context and design, which inhibited comparison of results across publications. Methodological limitations of the extant literature, alongside the rapidly changing nature of women in the workplace, motivate further study on the health of blue-collar women. Efforts to identify specific mechanisms by which blue-collar work predisposes women to adverse health may be particularly valuable in informing future workplace-based and policy-level interventions.
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Affiliation(s)
- Holly Elser
- School of Public Health, Division of Epidemiology, University of California, Berkeley, 50 University Hall, Berkeley, CA 94720, United States
| | - April M. Falconi
- Stanford Center for Population Health Sciences, Stanford University, 1070 Arastradero Road, Palo Alto, CA 94304, United States
| | - Michelle Bass
- Population Research Librarian, Lane Medical Library & Knowledge Management Center, Stanford University School of Medicine, 300 Pasteur Dr L109, Stanford, CA 94305, United States
| | - Mark R. Cullen
- Stanford Center for Population Health Sciences, Stanford University, 1070 Arastradero Road, Palo Alto, CA 94304, United States
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Adaptation to Occupational Exposure to Moderate Endotoxin Concentrations: A Study in Sewage Treatment Plants in Germany. ADVANCES IN EXPERIMENTAL MEDICINE AND BIOLOGY 2018. [PMID: 30284691 DOI: 10.1007/5584_2018_261] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register]
Abstract
Acute or chronic inhalation of endotoxin may lead to changes of lung function and inflammatory markers in the airways. Adaptation to workplace exposure may be possible. In this study, we investigated the possible difference in inflammatory markers assessed in nasal lavage fluid (NALF) in chronical exposure compared to voluntary subjects exposed acutely to endotoxin. We sought to define the variability of inflammatory markers in NALF and the dose-related changes after moderate exposure in naïve subjects. Endotoxin exposure (4-1039 EU/m3) resulted from routine work during one shift in sewage treatment plants. Subjects were matched to pairs (8 workers escorted by 10 students). Inflammatory markers were investigated before, directly after, and 16 h after the shift end. Additional NALF samples were collected in students without any specific exposure after 3 days. In NALF, total cell count, and interleukin (IL)-8 and IL-1β concentrations were significantly higher in workers than in students at all times pointing to workplace-related long-lasting exposure resulting in adaptation. However, concentration of inflammatory markers without specific exposure in students showed a great variability, covering the whole range of values recorded in the workers. The findings of this study make us to recommend a repeated assessment of inflammatory markers in healthy volunteers before the investigation of exposure-related changes and a sample size adequate for statistical analysis.
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Davidson ME, Schaeffer J, Clark ML, Magzamen S, Brooks EJ, Keefe TJ, Bradford M, Roman-Muniz N, Mehaffy J, Dooley G, Poole JA, Mitloehner FM, Reed S, Schenker MB, Reynolds SJ. Personal exposure of dairy workers to dust, endotoxin, muramic acid, ergosterol, and ammonia on large-scale dairies in the high plains Western United States. JOURNAL OF OCCUPATIONAL AND ENVIRONMENTAL HYGIENE 2018; 15:182-193. [PMID: 29157144 PMCID: PMC8641559 DOI: 10.1080/15459624.2017.1403610] [Citation(s) in RCA: 25] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/07/2023]
Abstract
Dairy workers experience a high degree of bioaerosol exposure, composed of an array of biological and chemical constituents, which have been tied to adverse health effects. A better understanding of the variation in the magnitude and composition of exposures by task is needed to inform worker protection strategies. To characterize the levels and types of exposures, 115 dairy workers grouped into three task categories on nine farms in the high plains Western United States underwent personal monitoring for inhalable dust, endotoxin, 3-hydroxy fatty acids (3-OHFA), muramic acid, ergosterol, and ammonia through one work shift. Eighty-nine percent of dairy workers were exposed to endotoxin at concentrations exceeding the recommended exposure guidelines (adjusted for a long work shift). The proportion of workers with exposures exceeding recommended guidelines was lower for inhalable dust (12%), and ammonia (1%). Ergosterol exposures were only measurable on 28% of samples, primarily among medical workers and feed handlers. Milking parlor workers were exposed to significantly higher inhalable dust, endotoxin, 3-OHFA, ammonia, and muramic acid concentrations compared to workers performing other tasks. Development of large modern dairies has successfully made progress in reducing worker exposures and lung disease prevalence. However, exposure to endotoxin, dust, and ammonia continues to present a significant risk to worker health on North American dairies, especially for workers in milking parlors. This study was among the first to concurrently evaluate occupational exposure to assayable endotoxin (lipid A), 3-hydroxy fatty acids or 3-OHFA (a chemical measure of cell bound and noncell-bound endotoxins), muramic acid, ergosterol, and ammonia among workers on Western U.S. dairies. There remains a need for cost-effective, culturally acceptable intervention strategies integrated in OHS Risk Management and production systems to further optimize worker health and farm productivity.
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Affiliation(s)
- Margaret E Davidson
- a Department of Environmental & Radiological Health Sciences , Colorado State University , Fort Collins , Colorado
- b High Plains Intermountain Center for Agricultural Health and Safety , Colorado State University , Fort Collins , Colorado
- f Edith Cowan University , Perth , Western Australila , Australia
| | - Joshua Schaeffer
- a Department of Environmental & Radiological Health Sciences , Colorado State University , Fort Collins , Colorado
- b High Plains Intermountain Center for Agricultural Health and Safety , Colorado State University , Fort Collins , Colorado
| | - Maggie L Clark
- a Department of Environmental & Radiological Health Sciences , Colorado State University , Fort Collins , Colorado
- b High Plains Intermountain Center for Agricultural Health and Safety , Colorado State University , Fort Collins , Colorado
| | - Sheryl Magzamen
- a Department of Environmental & Radiological Health Sciences , Colorado State University , Fort Collins , Colorado
- b High Plains Intermountain Center for Agricultural Health and Safety , Colorado State University , Fort Collins , Colorado
| | - Elizabeth J Brooks
- a Department of Environmental & Radiological Health Sciences , Colorado State University , Fort Collins , Colorado
- b High Plains Intermountain Center for Agricultural Health and Safety , Colorado State University , Fort Collins , Colorado
| | - Thomas J Keefe
- a Department of Environmental & Radiological Health Sciences , Colorado State University , Fort Collins , Colorado
- b High Plains Intermountain Center for Agricultural Health and Safety , Colorado State University , Fort Collins , Colorado
| | - Mary Bradford
- a Department of Environmental & Radiological Health Sciences , Colorado State University , Fort Collins , Colorado
- b High Plains Intermountain Center for Agricultural Health and Safety , Colorado State University , Fort Collins , Colorado
| | - Noa Roman-Muniz
- a Department of Environmental & Radiological Health Sciences , Colorado State University , Fort Collins , Colorado
- c Department of Animal Science , Colorado State University, Colorado State University , Fort Collins , Colorado
| | - John Mehaffy
- a Department of Environmental & Radiological Health Sciences , Colorado State University , Fort Collins , Colorado
- b High Plains Intermountain Center for Agricultural Health and Safety , Colorado State University , Fort Collins , Colorado
| | - Gregory Dooley
- a Department of Environmental & Radiological Health Sciences , Colorado State University , Fort Collins , Colorado
- b High Plains Intermountain Center for Agricultural Health and Safety , Colorado State University , Fort Collins , Colorado
| | - Jill A Poole
- d University of Nebraska Medical Center , Omaha , Nebraska
| | - Frank M Mitloehner
- e Western Center for Agricultural Health and Safety , UC Davis , Davis , California
| | - Sue Reed
- f Edith Cowan University , Perth , Western Australila , Australia
| | - Marc B Schenker
- e Western Center for Agricultural Health and Safety , UC Davis , Davis , California
| | - Stephen J Reynolds
- a Department of Environmental & Radiological Health Sciences , Colorado State University , Fort Collins , Colorado
- b High Plains Intermountain Center for Agricultural Health and Safety , Colorado State University , Fort Collins , Colorado
- f Edith Cowan University , Perth , Western Australila , Australia
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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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Zielen S, Trischler J, Schubert R. Lipopolysaccharide challenge: immunological effects and safety in humans. Expert Rev Clin Immunol 2015; 11:409-18. [DOI: 10.1586/1744666x.2015.1012158] [Citation(s) in RCA: 33] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/15/2023]
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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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Bioaerosols from a food waste composting plant affect human airway epithelial cell remodeling genes. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2013; 11:337-54. [PMID: 24368426 PMCID: PMC3924447 DOI: 10.3390/ijerph110100337] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 09/11/2013] [Revised: 12/04/2013] [Accepted: 12/13/2013] [Indexed: 02/02/2023]
Abstract
The composting procedure in food waste plants generates airborne bioaerosols that have the potential to damage human airway epithelial cells. Persistent inflammation and repair responses induce airway remodeling and damage to the respiratory system. This study elucidated the expression changes of airway remodeling genes in human lung mucoepidermoid NCI-H292 cells exposed to bioaerosols from a composting plant. Different types of microorganisms were detectable in the composting plant, using the agar culture method. Real-time polymerase chain reaction was used to quantify the level of Aspergillus fumigatus and the profile of remodeling genes. The real-time PCR results indicated that the amount of A. fumigatus in the composting hall was less than 102 conidia. The endotoxins in the field bioaerosols were determined using a limulus amebocyte lysate test. The endotoxin levels depended on the type of particulate matter (PM), with coarse particles (2.5–10 μm) having higher endotoxin levels than did fine particles (0.5–2.5 μm). After exposure to the conditioned medium of field bioaerosol samples, NCI-H292 cells showed increased pro-inflammatory interleukin (IL)-6 release and activated epidermal growth factor receptor (EGFR), transforming growth factor (TGF)-β1 and cyclin-dependent kinase inhibitor 1 (p21WAF1/CIP1) gene expression, but not of matrix metallopeptidase (MMP)-9. Airborne endotoxin levels were higher inside the composting hall than they were in other areas, and they were associated with PM. This suggested that airborne bioaerosols in the composting plant contained endotoxins and microorganisms besides A. fumigatus that cause the inflammatory cytokine secretion and augment the expression of remodeling genes in NCI-H292 cells. It is thus necessary to monitor potentially hazardous materials from bioaerosols in food composting plants, which could affect the health of 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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Carazo Fernández L, Fernández Alvarez R, González-Barcala FJ, Rodríguez Portal JA. Indoor Air Contaminants and Their Impact on Respiratory Pathologies. ACTA ACUST UNITED AC 2013. [DOI: 10.1016/j.arbr.2012.11.004] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/16/2022]
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Carazo Fernández L, Fernández Alvarez R, González-Barcala FJ, Rodríguez Portal JA. Indoor air contaminants and their impact on respiratory pathologies. Arch Bronconeumol 2012; 49:22-7. [PMID: 22704531 DOI: 10.1016/j.arbres.2012.04.005] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/22/2012] [Revised: 04/03/2012] [Accepted: 04/11/2012] [Indexed: 12/13/2022]
Abstract
Humans spend a considerable amount of their time breathing air inside enclosed spaces in which, due to various sources, there may be contaminants that deteriorate the air quality. This is an important risk factor for the health of the general population. This review evaluates the contaminants that are present in the air of indoor air spaces, describing the sources that generate them as well as the physiopathological mechanisms and the diseases that they may cause in the respiratory system.
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Hsia BJ, Pastva AM, Giamberardino CD, Potts-Kant EN, Foster WM, Que LG, Abraham SN, Wright JR, Zaas DW. Increased Nitric Oxide Production Prevents Airway Hyperresponsiveness in Caveolin-1 Deficient Mice Following Endotoxin Exposure. ACTA ACUST UNITED AC 2012; Suppl 1. [PMID: 24273688 PMCID: PMC3836011 DOI: 10.4172/2155-6121.s1-004] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/21/2023]
Abstract
BACKGROUND Caveolin-1, the hallmark protein of caveolae, is highly expressed within the lung in the epithelium, endothelium, and in immune cells. In addition to its classical roles in cholesterol metabolism and endocytosis, caveolin-1 has also been shown to be important in inflammatory signaling pathways. In particular, caveolin-1 is known to associate with the nitric oxide synthase enzymes, downregulating their activity. Endotoxins, which are are composed mainly of lipopolysaccharide (LPS), are found ubiquitously in the environment and can lead to the development of airway inflammation and increased airway hyperresponsiveness (AHR). METHODS We compared the acute responses of wild-type and caveolin-1 deficient mice after LPS aerosol, a well-accepted mode of endotoxin exposure, to investigate the role of caveolin-1 in the development of environmental lung injury. RESULTS Although the caveolin-1 deficient mice had greater lung inflammatory indices compared to wild-type mice, they exhibited reduced AHR following LPS exposure. The uncoupling of inflammation and AHR led us to investigate the role of caveolin-1 in the production of nitric oxide, which is known to act as a bronchodilator. The absence of caveolin-1 resulted in increased nitrite levels in the lavage fluid in both sham and LPS treated mice. Additionally, inducible nitric oxide synthase expression was increased in the lung tissue of caveolin-1 deficient mice following LPS exposure and administration of the potent and specific inhibitor 1400W increased AHR to levels comparable to wild-type mice. CONCLUSIONS We attribute the relative airway hyporesponsiveness in the caveolin-1 deficient mice after LPS exposure to the specific role of caveolin-1 in mediating nitric oxide production.
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Affiliation(s)
- Bethany J Hsia
- Department of Cell Biology, Duke University Medical Center, North Carolina, 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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18
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McElvenny DM, Hurley MA, Lenters V, Heederik D, Wilkinson S, Coggon D. Lung cancer mortality in a cohort of UK cotton workers: an extended follow-up. Br J Cancer 2011; 105:1054-60. [PMID: 21847124 PMCID: PMC3185933 DOI: 10.1038/bjc.2011.312] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/21/2022] Open
Abstract
Background: A recent systematic review and meta-analysis suggested that occupational exposure to endotoxins protects against lung cancer. To explore this hypothesis further, the follow-up of mortality of a cohort of 3551 workers, who were employed in the British cotton industry during 1966–1971, was extended by 23 years. Methods: Subjects had originally been recruited to a survey of respiratory disease, which collected information about occupation and smoking habits. Cumulative exposures to endotoxins were estimated from data on endotoxin levels by work areas in cotton mills. Risks of lung cancer were estimated using survival modelling. Results: During follow-up, 2018 deaths were recorded before the age of 90 years, including 128 deaths from lung cancer. After adjustment for smoking, hazard ratios (95% confidence intervals) for cumulative endotoxin exposures of ⩽30 000, >30 000 and ⩽200 000, >200 000 and ⩽400 000, >400 000 and ⩽600 000 and >600 000 endotoxin units (EU) m−3 years were 1, 0.8 (0.5–1.6), 0.7 (0.4–1.3), 0.6 (0.3–1.0) and 0.5 (0.3–0.9), respectively (P for trend=0.005). Conclusion: Our findings strengthen the evidence that occupational exposure to endotoxins protects against lung cancer, and suggest that the effect depends on cumulative dose and persists after exposure ceases.
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Affiliation(s)
- D M McElvenny
- School of Health, University of Central Lancashire, Preston, Lancashire, PR1 2HE, UK.
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Paudyal P, Semple S, Niven R, Tavernier G, Ayres JG. Exposure to dust and endotoxin in textile processing workers. ACTA ACUST UNITED AC 2010; 55:403-9. [PMID: 21177262 DOI: 10.1093/annhyg/meq084] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
BACKGROUND Inhalation of cotton-based particulate has been associated with respiratory symptoms and overt lung disease related to endotoxin exposure in some studies. This cross-sectional study measures personal exposure to inhalable dust and endotoxin in the textile industry of Nepal. METHODS This study was conducted in four sectors (garment making, carpet making, weaving, and recycling) of the textile industry in Kathmandu, Nepal. Personal exposure to inhalable dust and airborne endotoxin was measured during a full-shift for 114 workers. RESULTS Personal exposure to cotton dust was generally low [geometric mean (GM) 0.81 mg m(-3)) compared to the UK workplace exposure limit (WEL) (2.5 mg m(-3)) but with nearly 18% (n = 20) of the workers sampled exceeding the limit. Exposures were lowest in the weaving and the garment sector (GM = 0.30 mg m(-3)), higher in the carpet sector (GM = 1.16 mg m(-3)), and highest in the recycling sector (GM = 3.36 mg m(-3)). Endotoxin exposures were high with the overall data (GM = 2160 EU m(-3)) being more than 20-fold higher than the Dutch health-based guidance value of 90 EU m(-3). The highest exposures were in the recycling sector (GM = 5110 EU m(-3)) and the weaving sector (GM = 2440 EU m(-3)) with lower levels in the garment sector (GM = 157 EU m(-3)). The highest endotoxin concentrations expressed as endotoxin units per milligram inhalable dust were found in the weaving sector (GM = 165 EU mg(-1)). There was a statistically significant correlation between inhalable dust concentrations and endotoxin concentrations (r = 0.37; P < 0.001) and this was particularly strong in the garment (r = 0.82; P = 0.004) and the carpet sector (r = 0.81; P < 0.001). CONCLUSIONS Inhalable dust exposures measured in the weaving, carpet, and garment sectors were all below the UK WEL for cotton dust. A significant proportion of the measurements from the cotton recycling sector were above the UK WEL suggesting that better hygiene control measures are required. Airborne endotoxin concentrations in all sectors were found to exceed the Dutch health-based guidance limit of 90 EU m(-3) and may be associated with respiratory health effects.
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Affiliation(s)
- Priyamvada Paudyal
- Scottish Centre for Indoor Air, Environmental and Occupational Medicine, University of Aberdeen, Aberdeen, UK
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Shi J, Mehta AJ, Hang JQ, Zhang H, Dai H, Su L, Eisen EA, Christiani DC. Chronic lung function decline in cotton textile workers: roles of historical and recent exposures to endotoxin. ENVIRONMENTAL HEALTH PERSPECTIVES 2010; 118:1620-4. [PMID: 20797932 PMCID: PMC2974703 DOI: 10.1289/ehp.0901178] [Citation(s) in RCA: 26] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 07/08/2009] [Revised: 06/25/2010] [Accepted: 08/25/2010] [Indexed: 05/26/2023]
Abstract
BACKGROUND Long-term occupational exposure to cotton dust that contains endotoxin is associated with chronic respiratory symptoms and excessive decline in forced expiratory volume in 1 sec (FEV1), but the mechanisms of endotoxin-related chronic airflow obstruction remain unclear. OBJECTIVE In the current study, we examined temporal aspects of the exposure-response relationship between airborne endotoxin exposure, longitudinal change in FEV1, and respiratory symptoms in a cohort of Chinese cotton textile workers. METHODS This prospective cohort study followed 447 cotton textile workers from 1981 to 2006. at approximately 5-year intervals. We used a generalized estimating equations approach to model FEV1 level and respiratory symptoms as a function of past exposure (cumulative exposure up to the start of the most recent 5-year survey interval) and cumulative exposure (within the most recent interval) to endotoxins, after adjusting for other covariates. Models were stratified by active versus retired work status and by years employed before the baseline survey (< 5 and > or = 5 years). RESULTS AND CONCLUSIONS Past exposure to endotoxin was associated with reduced FEV1 level among retired cotton workers. Among all cotton workers, past exposure was more strongly associated with reduced FEV1 for those hired < 5 years before baseline than for those who were hired > or = 5 years after baseline. Recent endotoxin exposure was significantly associated with byssinosis, chronic bronchitis, and chronic cough.
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Affiliation(s)
- Jing Shi
- Department of Safety Engineering, China Institute of Industrial Relations, Beijing, China
- Department of Environmental Health (Environmental and Occupational Medicine and Epidemiology Program), Harvard School of Public Health, Boston, Massachusetts, USA
| | - Amar J. Mehta
- Department of Environmental Health (Environmental and Occupational Medicine and Epidemiology Program), Harvard School of Public Health, Boston, Massachusetts, USA
| | - Jing-qing Hang
- Shanghai Putuo District People’s Hospital, Shanghai, China
| | - Hongxi Zhang
- Shanghai Putuo District People’s Hospital, Shanghai, China
| | - Helian Dai
- Shanghai Putuo District People’s Hospital, Shanghai, China
| | - Li Su
- Department of Environmental Health (Environmental and Occupational Medicine and Epidemiology Program), Harvard School of Public Health, Boston, Massachusetts, USA
| | - Ellen A. Eisen
- Department of Environmental Health (Environmental and Occupational Medicine and Epidemiology Program), Harvard School of Public Health, Boston, Massachusetts, USA
- School of Public Health, University of California Berkeley, Berkeley, California, USA
| | - David C. Christiani
- Department of Environmental Health (Environmental and Occupational Medicine and Epidemiology Program), Harvard School of Public Health, Boston, Massachusetts, USA
- Pulmonary and Critical Care Unit, Massachusetts General Hospital, and Department of Medicine, Harvard Medical School, Boston, Massachusetts, USA
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Lenters V, Basinas I, Beane-Freeman L, Boffetta P, Checkoway H, Coggon D, Portengen L, Sim M, Wouters IM, Heederik D, Vermeulen R. Endotoxin exposure and lung cancer risk: a systematic review and meta-analysis of the published literature on agriculture and cotton textile workers. Cancer Causes Control 2009; 21:523-55. [PMID: 20012774 PMCID: PMC2839468 DOI: 10.1007/s10552-009-9483-z] [Citation(s) in RCA: 53] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/28/2009] [Accepted: 11/20/2009] [Indexed: 01/21/2023]
Abstract
Objective To examine the association between exposure to endotoxins and lung cancer risk by conducting a systematic review and meta-analysis of epidemiologic studies of workers in the cotton textile and agricultural industries; industries known for high exposure levels of endotoxins. Methods Risk estimates were extracted from studies published before 2009 that met predefined quality criteria, including 8 cohort, 1 case–cohort, and 2 case–control studies of cotton textile industry workers, and 15 cohort and 2 case–control studies of agricultural workers. Summary risk estimates were calculated using random effects meta-analyses. Potential sources of heterogeneity were explored through subgroup analyses. Results The summary risk of lung cancer was 0.72 (95% CI, 0.57–0.90) for textile workers and 0.62 (0.52–0.75) for agricultural workers. The relative risk of lung cancer was below 1.0 for most subgroups defined according to sex, study design, outcome, smoking adjustment, and geographic area. Two studies provided quantitative estimates of endotoxin exposure and both studies tended to support a dose–dependent protective effect of endotoxins on lung cancer risk. Conclusion Despite several limitations, this meta-analysis based on high-quality studies adds weight to the hypothesis that occupational exposure to endotoxin in cotton textile production and agriculture is protective against lung cancer.
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Affiliation(s)
- Virissa Lenters
- Institute for Risk Assessment Sciences, Division Environmental Epidemiology, Utrecht University, PO Box 80178, 3508 TD, Utrecht, The Netherlands
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Mazan MR, Svatek J, Maranda L, Christiani D, Ghio A, Nadeau J, Hoffman AM. Questionnaire assessment of airway disease symptoms in equine barn personnel. Occup Med (Lond) 2009; 59:220-5. [PMID: 19223434 DOI: 10.1093/occmed/kqp003] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
BACKGROUND People working in cattle, swine and poultry barns have a higher prevalence of respiratory symptoms and decreased lung function. There is scant evidence regarding the respiratory health of humans working in horse barns, although it is well documented that stabled horses have a high prevalence of airway disease. AIMS To determine whether people spending time in horse barns have a higher prevalence of self-reported respiratory symptoms than non-exposed controls. METHODS A cross-sectional questionnaire study was conducted from May 2005 to January 2006 to investigate the prevalence of self-reported respiratory symptoms in 82 barn-exposed subjects and 74 control subjects. Logistic regression and the chi-square test were used to analyse the data. RESULTS There was a significantly higher prevalence of self-reported respiratory symptoms in the barn-exposed group (50%) versus the control group (15%). Exposure to horse barns, smoking and family history of asthma or allergies was independent risk factors for respiratory symptoms. High exposure to the horse barn yielded a higher odds ratio for self-reported respiratory symptoms (8.9). CONCLUSIONS Exposure to the equine barn is a risk factor for respiratory symptoms. Investigation of organic dust exposures, lung function and horse dander allergies in the barn-exposed group will be necessary to determine how best to protect the health of this group.
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Affiliation(s)
- Melissa R Mazan
- Department of Clinical Sciences, Tufts University Cummings School of Veterinary Medicine, 200 Westboro Road, North Grafton, MA 01536, USA.
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Liebers V, Raulf-Heimsoth M, Brüning T. Health effects due to endotoxin inhalation (review). Arch Toxicol 2008; 82:203-10. [DOI: 10.1007/s00204-008-0290-1] [Citation(s) in RCA: 128] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/19/2007] [Accepted: 01/30/2008] [Indexed: 12/16/2022]
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