title: Respiratory effects in workers processing dried tobacco leaves.
abstract: OBJECTIVE
  The aim of this study was to examine the pollution level of the occupational environment and to investigate the effects of occupational exposure to tobacco dust on the respiratory system of tobacco workers. No such study has previously been conducted in Greece, which is one of the main tobacco-producing countries.
  
  
  METHODS
  A total of 1,020 seasonal and permanent tobacco workers (188 men and 832 women) were studied in a factory in Thessaloniki. The study included: 1) completion of a questionnaire (British Medical Research Council 1986), 2) spirometry and 3) rhinomanometry. At the same time, tobacco dust levels in the working environment were measured. As controls, 469 workers (87 men and 382 women) at a Thessaloniki hospital were used. Seventy six workers with nasal symptoms underwent: 1) special nasal provocation test with tobacco dust antigen, 2) skin prick tests, and 3) measurement of total IgE, specific IgE and specific IgG against tobacco protein.
  
  
  RESULTS
  Very high levels of total suspended dust were found in work site air (45.3-54.4 mg/m3). The prevalence of chronic bronchitis was 8.7 % versus 20.6 % in controls. Chronic obstructive pulmonary disease was found in 13 workers (1.3 %) and in 16 controls (3.4 %). FEV1 %pred, FVC %pred and the FEV1/FVC ratio were lower in controls, whereas FEF25-75 % %pred was lower in workers. There were no workers with bronchial asthma or extrinsic allergic alveolitis. Rhinitis was reported by 27.3 % of the workers versus 17.9 % of controls, whereas nasal flows were 563+/-211 versus 645 +/- 321 ml/sec, respectively. According to the results of skin prick tests, six workers were sensitized to dried tobacco leaf dust.
  
  
  CONCLUSIONS
  The results of our study do not support an association between the development of chronic diseases of the lower respiratory system and pollutants associated with the processing of dried tobacco leaves. In contrast, an association between disorders of the upper airways and tobacco dust in work sites is postulated.
authors.affiliation: Laboratory for the Investigation of Environmental Diseases, Pulmonary Clinic, Aristotle's University of Thessaloniki, Thessaloniki, Greece.
authors.forename: D
authors.initials: D
authors.lastname: Chloros
authors.forename: L
authors.initials: L
authors.lastname: Sichletidis
authors.forename: G
authors.initials: G
authors.lastname: Kyriazis
authors.forename: E
authors.initials: E
authors.lastname: Vlachogianni
authors.forename: I
authors.initials: I
authors.lastname: Kottakis
authors.forename: M
authors.initials: M
authors.lastname: Kakoura
mesh_terms: D000328:Adult; D000368:Aged; D000395:Air Pollutants, Occupational / Q000009:adverse effects* / Q000032:analysis; D016902:Air Pollution, Indoor / Q000032:analysis; D001991:Bronchitis / Q000453:epidemiology / Q000209:etiology; D003890:Desiccation; D004391:Dust; D005160:Facility Design and Construction; D005260:Female; D005541:Forced Expiratory Volume; D006115:Greece; D006801:Humans; D007073:Immunoglobulin E / Q000097:blood; D008297:Male; D008875:Middle Aged; D009299:Nasal Provocation Tests; D009784:Occupational Diseases / Q000453:epidemiology* / Q000209:etiology; D009790:Occupations; D018515:Plant Leaves; D012140:Respiratory Tract Diseases / Q000453:epidemiology* / Q000209:etiology; D012221:Rhinitis, Allergic, Perennial / Q000453:epidemiology / Q000209:etiology; D025363:Rhinomanometry; D012882:Skin Tests; D013147:Spirometry; D011795:Surveys and Questionnaires; D014026:Nicotiana / Q000009:adverse effects*
chemical_list: D000395:Air Pollutants, Occupational; D004391:Dust; D007073:Immunoglobulin E