title: Pulmonary function abnormality and respiratory tract irritation symptoms in epichlorohydrin-exposed workers in Taiwan.
abstract: BACKGROUND
  Epichlorohydrin (ECH) is a strong irritant of the eyes, respiratory tract, and skin. The aims of this study were to examine the dose-response relationship between observed abnormal pulmonary function tests and respiratory tract irritation symptoms among epichlorohydrin-exposed workers in Taiwan.
  
  
  METHODS
  A total of 167 workers were randomly selected from a resin synthesis factory. Sixty-six air samples were taken to determine ECH concentration in the workplace. Demographic data, work history, smoking status, and respiratory tract irritation symptoms were gathered by a standard self-administered questionnaire. Pulmonary function tests were also performed.
  
  
  RESULTS
  There were 13 of 41 (31.7%) abnormal mean mid-expiratory flow (MMEF) among the high-ECH-exposed workers, 11 of 38 (29%) among the low-ECH-exposed workers, and 4 of 59 (6.8%) among non-ECH-exposed workers. There was a significant linear trend between ECH exposure and the prevalence of small airway abnormalities (P = 0.007) after adjusting for other factors. There was also a significant dose-response relationship of respiratory tract irritation symptoms (cough, phlegm, chest tightness, and dyspnea) among the ECH-exposed workers.
  
  
  CONCLUSIONS
  This study suggests that obstructive lung abnormalities and small airway lung damage are associated with ECH exposure. The study also suggests that exposure to very low concentrations (<0.2 ppm) causes significant higher prevalence of respiratory tract irritation symptoms. Causal inferences from the findings cannot be made from this cross-sectional study and further longitudinal studies are needed to better clarify the nature of the observed associations.
authors.affiliation: Department of Public Health, Chang Gung Medical College, Tao Yuan, Taiwan, Republic of China. luo5485@mail.cgu.edu.tw
authors.forename: Jiin-Chyuan
authors.initials: JC
authors.lastname: Luo
authors.forename: Hsen-Wen
authors.initials: HW
authors.lastname: Kuo
authors.forename: Tsun-Jen
authors.initials: TJ
authors.lastname: Cheng
authors.forename: Ming J W
authors.initials: MJ
authors.lastname: Chang
mesh_terms: D000328:Adult; D000704:Analysis of Variance; D015331:Cohort Studies; D004811:Epichlorohydrin / Q000009:adverse effects*; D005260:Female; D006801:Humans; D007509:Irritants / Q000009:adverse effects*; D008297:Male; D009784:Occupational Diseases / Q000139:chemically induced* / Q000453:epidemiology; D016273:Occupational Exposure / Q000009:adverse effects*; D012120:Respiration Disorders / Q000139:chemically induced*; D012129:Respiratory Function Tests; D012140:Respiratory Tract Diseases / Q000139:chemically induced* / Q000453:epidemiology; D013624:Taiwan
chemical_list: D007509:Irritants; D004811:Epichlorohydrin