title: Exposure-response relationship between endotoxin exposure and lung function impairment in cotton textile workers.
abstract: OBJECTIVE
  Preventive workplace regulations are so far not based on an ubiquitously accepted threshold for airborne endotoxin in the bioaerosol.
  
  
  METHODS
  In a cross-sectional study, 150 employees of a cotton spinning mill underwent lung function testing. Furthermore, in a random subset of 75 textile workers cross-shift lung function test and methacholine challenges were performed. Airborne current endotoxin exposure was classified as "low", "medium", and "high" (<or=100, >100-<or=450, and >450 Endotoxin Units (EU)/m(3), respectively) based on endotoxin activity.
  
  
  RESULTS
  The exposure-response relationship between current endotoxin exposure and prevalence of an obstructive ventilation pattern was significant (test for linear trend: P = 0.019); the adjusted odds ratio for high endotoxin exposure was 11.22 (95% confidence interval 1.03-121.17). Within individuals, FEV(1)/FVC% was significantly reduced after the shift (paired t test: P = 0.009) but not related to current endotoxin exposure. Twelve workers showed bronchial hyperresponsiveness (8.1% before and 12.2% after the work shift; Fisher's exact test: P = 0.021).
  
  
  CONCLUSIONS
  The study among German cotton textile workers suggests an exposure-dependent effect of current endotoxin exposure on lung function impairment with significant effects above 450 EU/m(3).
authors.affiliation: Clinical Occupational Medicine, Institute of Occupational Medicine (ZfA), University of Hamburg, Hamburg, Germany. marcus.oldenburg@bsg.hamburg.de
authors.forename: Marcus
authors.initials: M
authors.lastname: Oldenburg
authors.forename: Ute
authors.initials: U
authors.lastname: Latza
authors.forename: Xaver
authors.initials: X
authors.lastname: Baur
mesh_terms: D000328:Adult; D032561:Cotton Fiber; D003430:Cross-Sectional Studies; D004731:Endotoxins / Q000032:analysis*; D005260:Female; D005858:Germany; D006801:Humans; D008297:Male; D008875:Middle Aged; D016273:Occupational Exposure; D012129:Respiratory Function Tests; D013783:Textile Industry
chemical_list: D004731:Endotoxins