title: A longitudinal observation of early pulmonary responses to cotton dust.
abstract: OBJECTIVE
  To examine early adverse pulmonary effects of exposure to cotton dust, and to identify potential risk factors, including atopy for pulmonary responses to cotton dust.
  
  
  METHODS
  Spirometry, methacholine challenge testing, and questionnaire; performed among 101 non-smoking newly hired textile workers at baseline (prior to starting work), and at 3, 12, and 18 months after starting work. Concentrations of airborne cotton dust in various work areas were measured at each follow up survey using vertical elutriators.
  
  
  RESULTS
  The incidence of non-specific respiratory symptoms was 8% at three months, then diminished afterwards. Substantial acute cross shift drops in FEV(1) at each follow up survey, and longitudinal declines in FVC and FEV(1) after 12 months of exposure were observed. Airway responsiveness to methacholine increased with follow up time, and was more pronounced among atopics. Increasing airway responsiveness was strongly correlated with cross shift drops in FEV(1). In addition, one or more respiratory symptoms at three months was significantly, and pre-existing atopy marginally significantly, associated with cross shift drops in FEV(1) after adjusting for other covariates and confounders.
  
  
  CONCLUSIONS
  Results suggest that non-specific respiratory symptoms, decreasing lung function, and increasing airway responsiveness are early pulmonary responses to cotton dust. In addition, the occurrence of respiratory symptoms and increasing airway responsiveness, as well as atopy, may be important predictors for acute changes in lung function among cotton textile workers.
authors.affiliation: Department of Environmental Health (Occupational Health Program), Harvard School of Public Health, Boston, Massachusetts, USA.
authors.forename: X-R
authors.initials: XR
authors.lastname: Wang
authors.forename: L-D
authors.initials: LD
authors.lastname: Pan
authors.forename: H-X
authors.initials: HX
authors.lastname: Zhang
authors.forename: B-X
authors.initials: BX
authors.lastname: Sun
authors.forename: H-L
authors.initials: HL
authors.lastname: Dai
authors.forename: D C
authors.initials: DC
authors.lastname: Christiani
mesh_terms: D000293:Adolescent; D000328:Adult; D016085:Bronchoconstrictor Agents; D002095:Byssinosis / Q000097:blood / Q000209:etiology / Q000503:physiopathology*; D015331:Cohort Studies; D032561:Cotton Fiber; D004391:Dust; D005500:Follow-Up Studies; D005541:Forced Expiratory Volume / Q000502:physiology; D006801:Humans; D007073:Immunoglobulin E / Q000097:blood; D008137:Longitudinal Studies; D016210:Methacholine Chloride; D016273:Occupational Exposure / Q000009:adverse effects; D012130:Respiratory Hypersensitivity / Q000150:complications; D012307:Risk Factors; D014797:Vital Capacity / Q000502:physiology
chemical_list: D016085:Bronchoconstrictor Agents; D004391:Dust; D016210:Methacholine Chloride; D007073:Immunoglobulin E