Table
4-Comparison
ci
Cases
Problem
Control
Expos
in
ed
and
Groups’
Subjects
,..._A___.,
in
.
Relative
Group
P
Risk
x2
385
684
306
1.38
11.9
0.001
109
250
80
1.28
2.1
NS
P
smokers
621
All nonsmokers
266
All
Total
887
‘Problem
(FEY1),
in
criteria:
and 70%
the
number
control
totaling
size
of
the
difference
tend
further
with
decided
years
to look
each,
residual
an
at
the
analysis
FYC
and
so-called
between
parameter
conveys
concept
or
value,
ality,
volume
unit
Results
of
industry,
we
separately.
is
value
the
For
an
analysis
total
of
of
of
Problem
Groups
Problems
N (%)
24
variance
number
Male
Exposed
Workers
the
the
using
worked
Cases
in
Smokers
(8.70)
the
Exposed
and
*
Problems
N (%)
Total
x2
P (x2)
(9.45)
254
0.09
NS
(8.85)
204
1.15
NS
20-30
40 (16.74)
239
36 (19.78)
182
0.64
NS
30-40
21(27.27)
21(16.80)
125
3.17
NS
NS
8 (26.67)
30
7 (21.21)
33
0.25
Total
114 (14.36)
794
106 (13.28)
798
0.38
‘Problem
(FEV1),
criteria:
and 70%
less than
75%
of predicted.
Respiratory
Long-term
Cotton
the
low
that
dust
the
levels
overall
to
K. Larson,
W. Smith,
M.D.;
P.E.;
Effect
Gin
Martin
L. Barinan,
and Larnj
Nicol,
the Department
of Medicine,
Valley
of Fresno,
and the Department
of Medicine,
California,
San Francisco.
Reprint
requests:
Dr. Barman,
145 Valeria,
fornia 93701
‘From
22S
of years
between
ex-
residuals
showed
FEY,.
With
the
surnum-
was
a significant
control
subjects
For respiratory
to about
60
ml.
workers
reality.
We
difference
in terms
volume,
This
relative
of the
the dif-
decrement
was
to
sub-
control
in this
cotton
disease
and
however,
the
that
persons
explain
category.
in chronic
is an item
are
believe
close
existence
tend
to decrease
terms
occupameas-
but
of
however,
bronchitis
of definite
relatively
among
our control
past,
may
have
be-
In
involved,
signifi-
we
in exposed
the small
of chest
tightness
some
point
in the
exposed
the
the
may
mean
sample
of
dust.
Con-
visited,
figures
exclude
process
individuals
excess
smokers
the
susceptible
also partly
prevalence
who,
at
of
of
cannot,
of
may
to
bers
symptoms
exposed
to
in most
of the plants
byssinosis
prevalence
selection
the number
tions.
This
urable
subjects
byssinotic
workers
nature
of a worker
the
the
symptoms
concern.
num-
significant
in dust-exposed
Leaving
aside
for
further
analysis
the question
of the connections
between
byssinosis,
chronic
bronchitis,
and smoking,
the results
presented
here
provide
grounds
on which
to argue
not
only
for
the
bring,
obvious
benefit
but
for
also
that
cessation
further
of
smoking
improvements
in plant
quality.
(FVC),
of
(0.08)
70%
1 La qualit#{233}du milieu
de travail
dans les industries
qu#{233}b#{233}coisesde filature
et de tissage
du coton,
Division
de
l’hygi#{232}ne industrielle,
Minist#{233}re de
l’environment
du
Qu#{233}bec-Editeur
officiel du Qu#{233}bec,1980
2 Bouhuys
A, Mitchell
CA, Tuttle
RW. On-line
computer
system
for recording
of respiratory
questionnaires
and
MEFV
services.
Biosci,
Comm,
1975;
1:219
3 Bouhuys
A, Beck GJ, Schoenberg
JB. Epidemiology
of environmental
lung disease.
Yale J Biol Med
1979;
52:191
4 Merchant
JA, Kilburn
KR, O’Fallon
WM,
Hamilton
JD,
Lumsden
JC. Byssinosis
and chronic
bronchitis
among
cotton textile
workers.
Ann Intern
Med 1972; 76:423
n adverse
Short-
Exposure*
system
has
been
ever,
Roger
David
vs number
This
translates
into
1.7
percent
of the
of the male
smokers
in our study
population.
summary,
these
results
show
a small
but
sidering
not
controls.
REFERENCES
18
Values
of
(FEV1/FVC)
there
and
means.
cant
excess
of
Quebec
textile
air
24
77
does
and
different
using
FEY1
in residual
worked,
amounted
jects.
FEy1
In
PVC
significantly
in dust-exposed
would
172
and
re-
in
276
of
reof
Control
Workers
Total
ference
FVC
exposed
groups.
exposed
group
longed
FVC
years
21(12.21)
Study
ex-
measured
10-20
40+
of
predicted
not only
between
and
using
The
amount
and
approach
spread
normal
Control
0-10
FEy1
pulmonary
was
conducted
(years)
in textile.
the
measured
tested.3
This
5-Comparison
Years in
Textile
textile
=
time.
against
Table
of
here
the
(P
it also provides
a figure
with
an actual
it is directly
measured
in volume
or units
per
siduals
and
used
of
predicted
but
since
in the
value
the
difference
values
of the
pected
evolution
FVC
and
workers
did
the
significance
of variance
FEy1
vs time
residual
the
the
worked
exposed
Only
in those
years
in textile
toward
80%
residual
of residual
not
control
of years
found
between
was significant.
30 and
40
investigate
function
cases
(FVC),
slopes
were
between
adjusted
less than
80%
of predicted.
of problem
the
and
ber
that
between
A similar
exercise
prisingly
little
change
386
934
Values
of
(FEV1/FVC)
workers
between
0.08).
To
594
P (x2)
showed
discriminate
textile
posed
N
N
industry
Indeed,
Control
Exposed
textile
effectively
M.D.,
F.C.C.P.;
R.R.T.
fects
Medical
Center
University
of
Fresno,
AMERICAN COLLEGE OF CHEST PHYSICIANS
Cali-
our
in
of
Although
information
important
unreasonable.
of
persons
widely
to
ported
effect
of
recognized
knowledge
the
cotton
in
would
from
differences
The
be
the
the
many
the
one
study
the
cotton
tempting
ginning
to
mill
in operation
study
respiratory
textile
has
been
re-
ef-
industry.2
simply
render
How-
respiratory
extrapolate
studies
was
mills
decades.’
about
textile
present
on
in cotton
for
States
dust
dust
only
United
it
cotton
employed
to
this
undertaken
ginning,
approach
to ex-
CHEST, 79: 4, APRIL, 1981 SUPPLEMENT
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plore
in
the
the
respiratory
ginning
effects
industry
of exposure
of
the
to cotton
San
Joaquin
dust
Valley
of
California.
METHODS
Plan
of Study
To investigate
the sustained
respiratory
function,
265 cotton
by questionnaire
and spirometry
ning
as
season.
Also
control
studied
subjects
previously
exposed
effects
of cotton
dust
on
gin workers
were
studied
preceding
the 1978
gin-
by
were
to
questionnaire
201
and
agricultural
cotton
spirometry
workers
never
dust.
To investigate
the short-term
effects
of cotton
dust
on
respiratory
function,
125 cotton
gin workers
were
studied
by spirometry
just before
the
1978
ginning
season
and
again
after
21 to 105 days
(mean,
57 days)
of employment.
To investigate
the prevalence
of byssinosis,
178 cotton
gin
workers
were
studied
by
questionnaire
and
spirometry
before
a workshift
(after
at least
24 hours
of
from work)
and again
after more
than four hours
in the gin, as was a control
group
of 117 agricultural
ers not exposed
to any known
respiratory
hazards.
Study
absence
of work
work-
The
gin workers
were
employed
in cotton
gins in the
San Joaquin
Valley.
All of the gins were
saw gins
and
processed
spindle-picked,
seed
cotton.
Gins
were
selected
to be representative
of the
range
of bale
capacity
and
location.
Workers
from
approximately
one-third
of the gins in the valley
were
studied.
No gin refused
study,
and only four workers
refused
to participate.
Control
subjects
were
selected
from
a large
pool
of
agricultural
workers
in
the
valley
to
meet
the
following
criteria:
(1) no prior
history
of employment
in the cotton
industry,
(2)
no known
exposure
to respiratory
hazards,
and (3)
no medical
examination
required
before
employment.
Control
subjects
were studied
as available.
Only three
potential
control
subjects
refused
to participate.
Comparison of control
and gin worker
characteristics
is shown
in
Table
1.
Technique
Three
model
06031
survey
spirometers
(Warren
E. Collins, mc)
were
used
for all pulmonary
function
measurements.
Each
spirometer
was
calibrated
and
monitored
for
leaks at least weekly.
Each
subject
performed
a minimum
of three
FVCs
in the standing
position.
More
trials
were
performed
when
spirograms
appeared
unsatisfactory.
Spirometry
records
were
identified
only by a random
number.
Calculation
and
knowledge
of
Table
1-Preseason
the
interpretation
subject’s
were
category.
Gin
Workers
Control
Number
done
All
and
Subjects
later
studies
without
were
Control
Gin
Subjects
Workers
201
265
34.8±92*
33.7±.71’
98
96.6
63.7
70.2
Dust
Sampling
Twelve
gins picked
by the Department
of Agriculture
(USDA)
as representative
of the types
of gins found
in
the California
ginning
industry
were
used
for dust
sampling
out of 62 gins participating
in this research
project.5
Vertical
Populations
geographic
formed
indoors
in a quiet
area a short
distance
from
the
gin. The FVC,
FEY,,
FEV,/FVC,
and FEF25-75%
were
derived
from
each
curve
in the
standard
manner.3
Spirometry
was
considered
technically
unsatisfactory
when:
(1) there
were not at least two curves
free of visual
artifacts
and congruent
within
5 percent
of FVC
and FEy,
and (2)
the initial
extrapolated
volume
exceeded
10 percent of the curve
or 400 ml, whichever
was greater.
Predicted
normal
values
were taken
from Knudson
et al.’
The
questionnaire
used
in this
study
was
the
one
recommended
in the Cotton
Dust
Standard
in the Federal
Register,
with
minor
modifications.3
Questionnaires
were
administered
verbally
by only
three
interviewers.
A bilingual
interviewer
was used for all Spanish-speaking
subjects.
The
interviewing
technique
was
standardized
in
English
and Spanish
before
testing.
per-
elutriators
were
used
exclusively
to
collect
dust
samples.
We followed
the sampling
protocol
recommended
by the
Occupational
Safety
and
Health
Administration
(OS HA) and the National
Institute
for Occupational
Safety
and Health
(NIOSH
) .3 The dust study
included
instrument
calibration,
field
analysis.6
to
the
Samples
USDA
oratory
at
sampling,
were
gravimetric
hand-carried
Southwestern
Mesilla
Park,
analysis,
from
Cotton
Ginning
and
the
data
testing
Research
site
Lab-
NM.
Four
vertical
elutriators
were
used
to measure
interior
dust
levels.
Two
were
placed
in the gin stand
area
and
two in the bale press area. This distribution
of instruments
sampled
approximately
95 percent
of typical
worker
exposure
inside
the gin.6 Sampling
varied
from
a minimum
of six hours to 96 hours.
Exclusions
In addition
to those
already
enumerated,
167 subjects
were
studied
but excluded
from
the analysis.
Seventy-five
were cotton
gin workers,
and 92 were control
subjects.
The
reasons
for exclusion
were
determined
at the beginning
of
the project
and
included
the
following:
history
of preexisting
asthma
(13);
history
of previous
mill or gin exposure
in control
subjects
(47);
history
of tuberculosis
(2);
history
of exposure
to other
respiratory
hazards
(5);
and
technically
unsatisfactory
spirographic
results
(100).
Statistical
Analysis
The large
sample
Student’s
t test was
used
to test the
significance
of difference
between
two means.7
The
significance
of difference
in prevalences
was
tested
by the
large sample
test for the difference
between
two population
proportions.7
A P value
greater
than
.05 was considered
not
significant.
RESULTS
Mean
age,
Males,
%
yr
%
Smokers,
Gin
Interior
Average
elutriators
Mean
‘±1
pack-years
13.7 ± 1 45*
SE.
CHEST, 79: 4, APRIL, 1981 SUPPLEMENT
14.2 ± 1.25’
Dust
interior
varied
Levels
dust
from
levels
.38
as measured
mg/me
a mean
dust
level
of 0.74 mg/me
pled.
The
95 percent
confidence
to
1.4
by
vertical
mg/me,
for the 12 gins
limit
for this
INTERNATIONAL CONFERENCE ON BYSSINOSIS
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with
sammean
23S
2-Prevalence
Abnormalities
Table
of
Symptoms
Among
*
Gin
and
Workers
Table
Spirometric
and
4’-Spirometry
in
Control
Preseason
Control
Gin
W orkers
and
Subjects.
Subjects
Gin
Workers
P
Value
5.1
9.8
NS
FEV,,
FEV,/FVC,
%
FEF25-75,
L/sec
cough,
Chronic
%
bronchitis,
%
(9/176)
(27/277)
1.7
(3/182)
3.4
(10/294)
NS
9.6
9.7
NS
(18/187)
9.6
(29/299)
13
(18/187)
(39/299)
%
Dyspnea,
Byssinosis
%
symptoms,
Spirometric
abnormality
No. of abnormalities
Total
No.
*Defined
as any
(%)
one
19 (9.5)
201
or more
FEy1
<80%
dust
level
Therefore,
lies
the
between
workers
Effects
Symptoms
of the following:
of predicted,
FVC
The
equal
among
subjects.
further
of
no
control
severe
by
significant
age
were
ers
values
than
and
ferent
for
FVC,
the
Table
3-Prevalence
Preseason
Gin
Workers
and
4.1
11.6
20.0
Smoking
history
Smokerst
Nonsmokers
‘Defined
dicted,
Includes
24S
0.04
made
to
analyze
to
the
relation
independent
effect
of
of
age.
of spirometric
Short-term
Effects
Mean
25-75%
values
for
in midseason
both
FEY1
in
were
gin
were
Abnormalities’
Subjects
by
worknot
dif-
in
Age
History
the
4.6 (6/132)
12.9 (13/101)
21.9 (7/32)
11.8
5.1
as any or all of the following:
FVC
FEY, <80%
of predicted,
or FEV,/FVC
exsmokers.
P
Value
NS
NS
NS
NS
NS
<80%
of pre<70%.
AMERICAN COLLEGE OF CHEST PHYSICIANS
prevalence
of
analysis
of cotton
gin
abnormalities
same
of Cotton
of
cotton
gin
showed
no
exposure
on
(Table
5).
FVC,
change
FEy,,
were
reached
interval
made
two
measurements
a level
of
statistical
employment
was
eight
weeks.
of
Cotton
Gin
The
Gin
Group
the
vs Age
Abnormalities
on
in
Workers
Cotton
Age
1978-79
between
Exposure
Spirographic
Preseason
the
significance.
gin
of
Prevalence
of
before
and
FEF
different
6).
Two
measurements,
slightly,
and
two
others,
declined
slightly,
but
no
cotton
5-Effect
Table
FEV1/FVC,
significantly
not
measurements
mean
Exposure
Gin
season
began
(Table
and
FEY1,
increased
FEY1/FVC
and
FEF25-75%,
Gin
E xposure,
mo
1-15
>15
18-40 yr
Mean
months
gin exposure
Mean age, yr
Prevalence
of spirographic
abnormalities,
%
7.2
26.2
6.1
(8/131)
33.2
31.6
7.5’
(5/68)
Older than 40 yr
Mean months
gin exposure
Mean age, yr
Prevalence
of spirographic
abnormalities,
%
9.1
68.7
48.1
28.6
(4/14)
‘Difference
Gin Workers
(n=265),
%
the
length
The
duration
prevalence
Table
FVC,
FEY1,
FEF25-75,
=
51.4
17.3’
(9/52)
NS.
6--Comparison
L
L
FEV,/FVC,
11.7
5.5
0.02
±0.1
was
among
was
4).
Spirographic
and
Control
(4/97)
(8/69)
(7/35)
±0.5
4.46
in
detectable
9.9
was
FEV,/FYC
in
for
Control
Sub jects
(n=201),
%
Age, yr
15-30
31-50
>50
re-
was identical
1.5 percent.
and
(Table
Smoking
82.5
normal.
exposure
(Table
history
(Table
gin workers
and
The
prevalence
of more
< 1,500
ml, FEV1/FVC
values
of
1.7
not
was
groups
9.5
percent
of abnormalities
values
NS
4.18±0.1
smoking
FEy,,
groups
by
and
was
between
normal
Mean
two
dust
present
spirograms
on spirometry
subjects
at
predicted
controls.
in
by
found.
(FEy,
<60
percent,
or both)
gin workers
and control
Mean
or
differences
subjects
abnormalities
better
abnormal
0.05
80.8±0.5
ginning
FVC
two
±0.9t
106.8±0.6t
1 SE.
attempt
from
Dyspnea
in the
gin
workers
and
When
prevalence
analyzed
3),
of
106.5
P Value
of
Difference
<70%.
cotton
were
(P=0.27).
prevalence
the
of gin workers
This
difference
frequency
<80%
and
0.93
mg/m3.
studied
were
sub-
bronchitis
significant
with
percent
control
chronic
NS
±1.Of
of predicted
An
Exposure
Gin
in 3.4 percent
control
subjects.
statistically
±
fPereent
NS
or FEV,/FVC
0.51
mg/me
in the gins
of Cotton
of
questionnaire
percent
of
109.1
Gin Workers
(n=265)’
107.4±1.Ot
‘Mean
26 (9.9)
265
jected
to dust
concentrations
exceeding
standard’s
permissible
exposure
1eve1.
Long-term
%
abnormalities
predicted,
2).
Test
FVC,
Symptom
Chronic
ported
Control
Subjects
(n=201)’
Control
Subjects
of
Preseason
L/sec
Midseason
Preseason’
Midseasont’
4.8±.07
5.0±16
NS
4.1 ±.14
NS
4.0±06
%
and
81.2±1.3
83.9±1.4
4.6 ± .3
‘Mean
± 1 SE.
f Measured
before a workshift
ment
in the 1978-79
ginning
work hiatus.
4.4 ± .3
P Value
NS
NS
after at least 2 weeks’ employseason
and after
a 24-hour
CHEST, 79: 4, APRIL, 1981 SUPPLEMENT
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ing
every
The
Monday
pattern
however,
is
scheduled
ones
cal
the
Ficuax
percent
1. Concordance
of
or greater
decrements
Mean
values
workshift
of
for
did
the
FEY,
not
same
workers
percent)
(16.3
cent;
P>
Possible
of
worker
sinosis
13
or
(Fig
the
the
the
means
workshift.
group
(13.7
were
elicited
gin
workers
by
and
9.6
one
gin
Only
response
decrement
to
any
of the
of 5 percent
the
with
workshift.
a decrement
the
=
workshift
gave
questions
on
byssinosis
in
gin
per-
.26).
during
workers
during
to
naire
of
(P
a positive
had
a
greater
response
byssinosis
subjects
greater
in FEy,
only one of 29 gin
before
control
percent
control
giving
questions
cent
and
5
a
or greater
decrements
was
similar
in the
of
in
and
during
from
made
5 percent
workshift
.5).
symptoms
questionnaire
FEF25-75%
significantly
measurements
of
the
of byssinosis
in gin workers.
and
differ
The
prevalence
FEY1
during
percent
symptoms
in FEY,
Conversely,
of 5 perany
No
excess
in
pared
with
of
chronic
cotton
gin
obstructive
group
exposed
to cotton
dust.
by Palmer
et al2 in the
performed
in
surprising
gins
is
when
considered.
the
months
of
year.
ployed
with
try
each
for
ginning
components
the
one
cotton.
that
required
States.
The
majority
develop
the
of
in
The
lack
workshift
total
chronic
correlation
significant
is also
absence
survey
recognized
pattern
of
and
of
of
the
in
years
subjectively
of chest
surprising.
tightness,
its
cough,
is
by
textile
the
remainder
the
objective
ing
a single
FEY,
et
in
Byssinosis
characteristic
or difficulty
CHEST, 79: 4, APRIL, 1981 SUPPLEMENT
of
initial
is
of
al
bysthe
found
their
initial
is
usually
recurrent
in breath-
equal
the
a
with
study
did
pattern
rupted
one.
monstrated
met
percent
in the
a control
this
criterion.
merit.
The
in the
It
first
et
a trend
week
in
the
effect
of
demonstrated
tests
dur-
toward
return
lesser
grades
longer
periods
of
a continual
harmful
than
has recently
with
ozone
al”
of
the
Unfortunately,
that
less
Such
tachyphylaxis
by Follasbee
et
during
the
exposure.
on
indus-
occurrence
first day
FEY,
was
is possible
be
is
the
albo
of
un-
is based
ginning
repeated
the
lack
are
symptoms
There
test
the
There
found
continued
might
workers
for
Merchant
during
not
24
et alz
16.3
met
suggested.
with
week.
exposure.
posure
also
decreasing
week.
despite
least
this
criterion
percent
of
of byssinosis
maximally
on
counterpart
FEY,
gin
Only
explanations
be
employment
work
decrement
at
signfficant.
can
of the
continual
exmore
during
dust
study
Cotton
Palmer
cotton
met
13.7
possible
work
this
The
after
survey.
the
respipulmo-
pulmonary
in
is significant.
cotton
of
in
a 5 percent
138
of
the human
change
in
workshift
their
three
of byssinosis
would
occur
in the
the ginninj
industry.
symptoms
work
is not
to baseline
reeven
of
to
the
dis-
effect
seems
It
from
to no
continual
em-
dust
that
first
gin workers
Furthermore,
exposed
effect
on
decon-
byssinosis
found
the demonstra-
significant.
decreed
percent
in
difference
return
indus-
cotton
cotton
gins
would
of employment,
in
44
cotton
study.
least
statistically
agri(P=
of correlation
deleterious
changes
the
13 per-
symptoms
an objective
It must
be
measured
try.
The
typical
symptom
of respiratory
symptoms
by other
associated
airway
symptoms
by
that
a
in
lack
objective
has
criterion
the
not
a total
workshift
of absence
At
cotton
to four
season
Palmer
industry.
are
in
was
of
(including
same
symptoms
and
the workshift.
the
during
others
obstructive
between
byssinosis
ginning
Standard
FEY,
doubtedly
year
not
to
decrements
not
in
routine
a control
group
of
with
cotton
dust
of cotton
gins
rest on objective
not
were
reported
of cotton
gins
the
exposure
probable
that
a process
of reversal
long
hiatus
between
exposures
in
sinosis
Dust
and
change
each
unlikely
assumption
that
arithmetically
cumulative.
is
small
bys-
a
in breathing
the
The
during
typical
elicited
study,
percent
of
associated
existence
significant
workers
of the
industry
accepted
of
ease.2’8
Equivalent
exposure
quire
40 to 80 consecutive
with
posure
of
the
function.
were
com-
results
were
this
there
not
employment
only
three
months
years
nary
The
was
when
workers
These
pattern
of
Gins
operate
three
20
disease
study
agricultural
and
the
rest
the agricultural
to
to
this
Similar
findings
only other
survey
It is widely
10
of
United
to
industry
of
airway
in
difficulty
to work)
atmosphere
system
must
group
workers
a control
of
ambient
ratory
of 178
present
DIscussIoN
of byssinosis
greater
that
the possible
symptoms
of
survey
were
spurious.
Therefore,
tion
un-
mechani-
by
cluded
in this
this
question-
that
the subjective
in FEY1
during
found
1).
found
Furthermore,
except
or
recognized
between
crease
hours
positive
the
.26).
not
off
or
in
9.6
work.9
industry,
weather
symptoms
back
workers
were
found
in
cultural
workers
function
bysor
day
gin
days
therefore,
be
tightness,
first
of
no
from
ginning
setting.
possible
chest
cent
this
the
adverse
could
in
Mthough
on
to
It is unlikely,
questionnaire
away
in
with
owing
symptoms
cough,
a weekend
employment
continual,
problems.
sinotic
after
of
ex-
an
inter-
been
deexposure.
Second,
recent
interest
has
sibility
that
byssinosis
might
contaminant
of cotton
rather
been
aroused
in the posbe caused
by a bacterial
than
by the cotton
dust
itself.’2”3
should
If
this
hypothesis
be
differences
in prevalence
of byssinosis
ments
of the cotton
industry
could
be
differences
in
A third
is a process
sufficiently
bacterial
possible
substantiated,
in different
accounted
for
segby
contamination.
explanation
for
of
self-selection.
It
large
percentage
of
the
negative
is conceivable
reactors
results
that
eliminates
INTERNATIONAL CONFERENCE ON BYSSINOSIS
Downloaded From: http://journal.publications.chestnet.org/pdfaccess.ashx?url=/data/journals/chest/21212/ on 06/17/2017
a
it-
25S
self
from
employment
statistically
lieve
this
not
eliminated
of
the
so that
demonstrated
to be unlikely,
significant
cotton
no
adverse
differences
industry.
a single
ence
was
case
of
confirmed
opportunity
care
This
a survey
physicians
to
years
have
for
cotton
of
negative
than
might
have
gin
au-
experi440
San
had
an
workers.
SUMMARY
No
in
excess
of
a group
of
with
other
After
an
San
In
cotton
of
eight
cotton
125
of
with
pre-employment
of pulmonary
workers
was
when
employment
workers
The
unusual
gins
to diagnosis
this study
tive
showed
a workshift,
greater
by
of
value
no
pattern
California
decrements
the
of
precludes
in
FEY1.
Cotton
Dust
in
6
7
during
slightly
by symptoms.
No
between
symptoms
posed
apcom-
measurements.
temporal
in
San
no
function
function
mean
detecting
in
in
was
and
as
was
found
this
study
proto
of
gin
12
Relation
Subsequent
relation
their
Lung
in Cotton
Function
to
Status
Textile
and
occupational
been
associated
obstructive
of
subsequent
lung
lung
function
employment
exposure
with
disease.”
in
to
the
We
F.C.C.P.;
M.D.t
cotton
development
investigated
cotton
textile
status
and
of
the
to
We
‘From
the Departments
of Epidemiology
and Public
Health,
and Internal
Medicine,
Yale University
School
of Medicine, New
Haven,
Conn.
tDeceased.
Supported
by National
Institute
for Occupational
Safety
and Health
grant OH-00304
and by Department
of Labor
contract
J-9-M-8-0168.
Reprint
requests:
Dr.
Beck,
Epidemiology
and
Public
Health,
Yale Universffij,
New Haven
06510
26S
AMERICAN COLLEGE OF CHEST PHYSICIANS
B.S., for their
imand James
C. Daley,
SE,
Urquhart
N, Smith
D.
Occupation
dust levels
in California
cotton
gins. Presented
to the American
Society
of Agricultural
Engineers.
Dec
13, 1979,
New
Orleans
Hughes
SE, Smith
D, Urquhart
N. Methodology
for cotton dust sampling.
Am md Hyg Asso J (in press)
Snedecor
GW,
Cochran
WG.
Statistical
methods.
6th
ed. Ames,
Iowa:
Iowa
State
University
Press,
1967
Ayer
HE.
Byssinosis.
CRC
Crit
Rev Environ
Control
1971; 2:207-41
Lee WR. Clinical
diagnosis
of byssinosis.
Thorax
1979;
34:287-89
Merchant
J, Haiprin
GN, Hudson
A, Kilburn
K, McKenzie W, Bermanzohn
P, Hurst
D, Hamilton
J, Germino
V.
Evaluation
before
and
after
exposure:
the pattern
of
physiological
response
to cotton
dust. Ann NY Acad
Sci
1974; 221:38-43
Folinsbee
U,
Bedi
JF, Horvath
SM.
Respiratory
responses
in humans
repeatedly
exposed
to low concentrations
of ozone.
Am Rev Resp
Dis 1980;
121:431-40
Pernis
B, Vigliani
CC, Finulli
M. The role of bacterial
endotoxins
in occupational
diseases
caused
by inhaling
vegetable
dusts.
Br J md Med 1961;
18:120-29
Rylander
R, Lundholm
M. Bacterial
contamination
of
cotton
and cotton
dust and effects
on the lung.
Br J
md Med
1978;
35:204-07
wanted
to
textile
workers
age
determine
65
whether
who
years
died
in the mill.
lung
function
ers,
only
one
lung
function
study
one as well
older
active
Columbia,
(our
as
retired
are
based
function
retired
from
from
lung
in
the
function
cotton
mill
in
bethose
Although
many
studies
have
inin active
cotton
textile
workprevious
in
on
and
lung
or
differed
still active
vestigated
present
textile
workers
mortality.
13
Hughes
fore
Workers*
I. Beck,
Ph.D.;
E. Neil Schachter,
M.D.,
R. Maunder,
M.A.;
and Arend
Bouhuys,
ong-term
dust has
chronic
of
Employment
Mortality
j4
11
be
ACKNOWLEDGMENT:
The authors
wish to thank
Maria
Ferrusca;
Marlene
Chandler,
B.A.;
Dale
Claes,
R.R.T.;
Thelma
Rogers,
B.A.; Steve C. Bathurst,
B.A.; George
Voll,
B.A.; and the many
others
in the industry
whose
cooperation made
this study
possible.
We also thank
Sidney
E.
Gerald
Lucinda
10
found
in
objec-
workers.
The
9
approach
questionnaire
Standard
reactors
8
employment
a simple
The
decre-
These
difsignificance
in byssinosis.
correlation
of byssinosis
M.S.;
and Clarence
C. Leonard,
contribution
to the dust studies,
for the statistical
analysis.
1 Report
of the Departmental
Committee
on Dust in Card
Rooms
in the Cotton
Industry.
London,
1932
2 Palmer
A, Finnegan
W, Herwat
P, Jones
J. Byssinosis
and chronic
respiratory
disease
in U.S. cotton
gins. J
Occup
Med 1978; 20:96-102
3 Occupational
exposure
to cotton
dust.
Part
1910
and
1928.
Federal
Register
43:27350-27462,
Juoe
23, 1978
4 Knudson
RJ, Slatin
RC, Lebowitz
M, Burrows
B. The
maximal
expiratory
flow-volume
curve
normal
standards
of variability
and effects
of aging.
Am Rev Respir
Dis
1976;
113:587-600
5
in
showed
pulmonary
Ph.D.
workers.
ments
than
control
agricultural
workers.
ferences
did not reach
a level
of statistical
and were
lower
than
those
usually
found
cotton
found
compared
agricultural
weeks’
gins,
studies
disease
workers
Yalley
deterioration
gin
gin
Joaquin
Yalley
preciable
airway
cotton
average
Joaquin
pared
obstructive
265
Hughs,
portant
REFEBENCES
the
of pulmonary
failed
to iden-
of more
who
be
behas
segments
two
byssinosis.
by
Yalley
Joaquin
can
We
in other
Furthermore,
thors
with
more
than
38 combined
practice
in the San Joaquin
Yalley
tify
effect
in those
remaining.
since
this
phenomenon
study1)
workers.
on
the
Our
previous
the follow-up
retired
cotton
has
examined
findings
in
the
cross-sectional
study
of
textile
these
workers
same
in
SC.
SuBJEcrs
AND
METHODS
Our original
study
population
of cotton
textile
workers
included
anyone
who had worked
for at least
three
years
before
1955 in one or more of four mills in the Columbia,
SC, area.
Of the initial
692 workers
studied
in 1973,’
we
re-examined
408 in 1979,
and an additional
89 were
determined
to have
died between
the two surveys.
For comparison
with
the textile
workers,
we used
as controls
a
like-aged
population
of nontextile
workers
from
Lebanon,
CHEST, 79: 4, APRIL, 1981 SUPPLEMENT
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