title: Study of the respiratory health of employees in seven European plants that manufacture ceramic fibres.
abstract: OBJECTIVE
  To study the relation between occupational exposure to ceramic fibres during manufacture and respiratory health.
  
  
  METHODS
  The respiratory health of 628 current employees in the manufacture of ceramic fibres in seven European plants in three countries was studied with a respiratory questionnaire, lung function tests, and chest radiography. Simultaneous plant hygiene surveys measured subjects' current exposure to airborne ceramic fibres from personal samples with optical microscopy fibre counts. The measured exposures were combined with occupational histories to derive estimates of each subject's cumulative exposure to respirable fibres. Symptoms were related to current and cumulative exposure to ceramic fibres and lung function and findings from chest radiographs were related to cumulative exposure.
  
  
  RESULTS
  The mean duration of employment was 10.2 years and mean (range) cumulative exposure was 3.84 (0-22.94) (f.ml-1.y). Eye and skin symptoms were frequent in all plants and increased significantly, as did breathlessness and wheeze, with increasing current exposure. Dry cough and stuffy nose were less common in the least exposed group but did not increase with increasing exposure. After adjustment for the effects of age, sex, height, smoking, and past occupational exposures to respiratory hazards, there was a significant decrease in both forced expiratory volume in one second (FEV1) and forced midexpiratory flow related to cumulative exposure in current smokers (P < 0.05) and in FEV1 in ex-smokers (P < 0.05). Small opacities were found in 13% of the chest radiographs; their prevalence was not related to cumulative exposure to ceramic fibres.
  
  
  CONCLUSIONS
  It is concluded that exposure to ceramic fibres is associated with irritant symptoms similar to those seen in other exposures to man made mineral fibres (MMMFs) and that cumulative exposure to respirable ceramic fibres may cause airways obstruction by promoting the effects of cigarette smoke.
authors.affiliation: Occupational Health Unit, Royal Shrewsbury Hospital.
authors.forename: W N
authors.initials: WN
authors.lastname: Trethowan
authors.forename: P S
authors.initials: PS
authors.lastname: Burge
authors.forename: C E
authors.initials: CE
authors.lastname: Rossiter
authors.forename: J M
authors.initials: JM
authors.lastname: Harrington
authors.forename: I A
authors.initials: IA
authors.lastname: Calvert
mesh_terms: D000328:Adult; D000395:Air Pollutants, Occupational / Q000009:adverse effects*; D002516:Ceramics / Q000009:adverse effects*; D005060:Europe; D005260:Female; D005541:Forced Expiratory Volume; D006306:Health Surveys; D006801:Humans; D016015:Logistic Models; D008168:Lung / Q000503:physiopathology; D008297:Male; D008448:Maximal Expiratory Flow Rate; D009784:Occupational Diseases / Q000209:etiology* / Q000503:physiopathology; D012120:Respiration Disorders / Q000209:etiology* / Q000503:physiopathology; D012907:Smoking / Q000009:adverse effects / Q000503:physiopathology
chemical_list: D000395:Air Pollutants, Occupational