title: Follow-up study of respiratory health of newly-hired female cotton textile workers.
abstract: BACKGROUND
  Numerous studies have investigated adverse effects of exposure to cotton dust on respiratory health, but very limited longitudinal data are available with regard to the early pulmonary response to cotton dust. Moreover, the adverse effects of occupational exposure to cotton dust have been difficult to separate from the confounding effects of smoking. This setting provided a unique opportunity to evaluate early respiratory effects in newly hired and non-smoking female textile workers.
  
  
  METHODS
  To identify early pulmonary responses to cotton dust exposure and associated gram-negative bacterial endotoxin, respiratory symptoms and pulmonary function in 225 newly-hired textile workers were assessed at work initiation, and at three and twelve months later.
  
  
  RESULTS
  All the workers were females and nonsmokers, with an average age of 18 years. Symptom incidence at three months was 3.6% for usual cough with phlegm, and 6.7% for usual dry cough. Lung function changes were detectable at one year: FEV1 declined by 70 ml and FVC by 124 ml over the year, and workers reporting respiratory symptoms at three months showed a significantly greater cross-shift drop in FEV1 (- 2.3%) than those without the symptoms (- 0.7%).
  
  
  CONCLUSIONS
  These results suggest that the occurrence of respiratory symptoms represents the earliest response to cotton dust exposure, followed by lung function changes. Early respiratory symptoms may be a risk factor for subsequent loss of pulmonary function in cotton textile workers.
authors.affiliation: Department of Environmental Health (Occupational Health Program), Harvard School of Public Health, Boston, MA 02115, USA.
authors.forename: Xiao-Rong
authors.initials: XR
authors.lastname: Wang
authors.forename: Lei-Da
authors.initials: LD
authors.lastname: Pan
authors.forename: Hong-Xi
authors.initials: HX
authors.lastname: Zhang
authors.forename: Bi-Xiong
authors.initials: BX
authors.lastname: Sun
authors.forename: He-lian
authors.initials: HL
authors.lastname: Dai
authors.forename: David C
authors.initials: DC
authors.lastname: Christiani
mesh_terms: D000293:Adolescent; D000328:Adult; D002681:China; D015331:Cohort Studies; D004391:Dust / Q000009:adverse effects*; D004731:Endotoxins / Q000009:adverse effects; D004784:Environmental Monitoring; D005260:Female; D005500:Follow-Up Studies; D005541:Forced Expiratory Volume; D003368:Gossypium / Q000009:adverse effects*; D006801:Humans; D009784:Occupational Diseases / Q000209:etiology* / Q000503:physiopathology; D016273:Occupational Exposure / Q000009:adverse effects*; D012120:Respiration Disorders / Q000209:etiology* / Q000503:physiopathology; D013783:Textile Industry
chemical_list: D004391:Dust; D004731:Endotoxins