title: Chronic lung function decline in cotton textile workers: roles of historical and recent exposures to endotoxin.
abstract: BACKGROUND
  Long-term occupational exposure to cotton dust that contains endotoxin is associated with chronic respiratory symptoms and excessive decline in forced expiratory volume in 1 sec (FEV1), but the mechanisms of endotoxin-related chronic airflow obstruction remain unclear.
  
  
  OBJECTIVE
  In the current study, we examined temporal aspects of the exposure-response relationship between airborne endotoxin exposure, longitudinal change in FEV1, and respiratory symptoms in a cohort of Chinese cotton textile workers.
  
  
  METHODS
  This prospective cohort study followed 447 cotton textile workers from 1981 to 2006. at approximately 5-year intervals. We used a generalized estimating equations approach to model FEV1 level and respiratory symptoms as a function of past exposure (cumulative exposure up to the start of the most recent 5-year survey interval) and cumulative exposure (within the most recent interval) to endotoxins, after adjusting for other covariates. Models were stratified by active versus retired work status and by years employed before the baseline survey (< 5 and > or = 5 years).
  
  
  CONCLUSIONS
  Past exposure to endotoxin was associated with reduced FEV1 level among retired cotton workers. Among all cotton workers, past exposure was more strongly associated with reduced FEV1 for those hired < 5 years before baseline than for those who were hired > or = 5 years after baseline. Recent endotoxin exposure was significantly associated with byssinosis, chronic bronchitis, and chronic cough.
authors.affiliation: Department of Safety Engineering, China Institute of Industrial Relations, Beijing, China.
authors.forename: Jing
authors.initials: J
authors.lastname: Shi
authors.forename: Amar J
authors.initials: AJ
authors.lastname: Mehta
authors.forename: Jing-Qing
authors.initials: JQ
authors.lastname: Hang
authors.forename: Hongxi
authors.initials: H
authors.lastname: Zhang
authors.forename: Helian
authors.initials: H
authors.lastname: Dai
authors.forename: Li
authors.initials: L
authors.lastname: Su
authors.forename: Ellen A
authors.initials: EA
authors.lastname: Eisen
authors.forename: David C
authors.initials: DC
authors.lastname: Christiani
mesh_terms: D000328:Adult; D000395:Air Pollutants, Occupational / Q000032:analysis*; D029481:Bronchitis, Chronic / Q000453:epidemiology; D002095:Byssinosis / Q000453:epidemiology; D032561:Cotton Fiber; D003371:Cough / Q000453:epidemiology; D004731:Endotoxins / Q000032:analysis*; D005260:Female; D005541:Forced Expiratory Volume; D006801:Humans; D019570:Inhalation Exposure / Q000032:analysis / Q000706:statistics & numerical data*; D008171:Lung Diseases / Q000453:epidemiology*; D008297:Male; D008875:Middle Aged; D016273:Occupational Exposure / Q000032:analysis / Q000706:statistics & numerical data*; D016017:Odds Ratio; D011446:Prospective Studies; D012129:Respiratory Function Tests
chemical_list: D000395:Air Pollutants, Occupational; D004731:Endotoxins
references.citation: Am Rev Respir Dis. 1991 Sep;144(3 Pt 1):675-83
references.pmid: 1892310
references.citation: Occup Environ Med. 2007 Jun;64(6):409-13
references.pmid: 17332138
references.citation: Am J Physiol Lung Cell Mol Physiol. 2008 Oct;295(4):L708-17
references.pmid: 18689605
references.citation: Epidemiology. 1994 Mar;5(2):189-96
references.pmid: 8172994
references.citation: Ann Occup Hyg. 2008 Jan;52(1):45-54
references.pmid: 18089577
references.citation: Am J Respir Crit Care Med. 1998 Jan;157(1):15-8
references.pmid: 9445272
references.citation: J Environ Qual. 2009 Jul 23;38(5):1919-23
references.pmid: 19643758
references.citation: Epidemiology. 1995 Jul;6(4):387-90
references.pmid: 7548346
references.citation: J Allergy Clin Immunol. 2001 Aug;108(2):157-66
references.pmid: 11496229
references.citation: Am J Ind Med. 1999 May;35(5):481-90
references.pmid: 10212701
references.citation: Crit Rev Microbiol. 1990;17(3):189-208
references.pmid: 1689164
references.citation: Biometrics. 1986 Mar;42(1):121-30
references.pmid: 3719049
references.citation: Am Rev Respir Dis. 1987 Jan;135(1):194-200
references.pmid: 3800146
references.citation: Am J Respir Crit Care Med. 2008 Jan 1;177(1):4-10
references.pmid: 17872490
references.citation: Ann Agric Environ Med. 2008;15(2):251-61
references.pmid: 19118445
references.citation: Am J Respir Crit Care Med. 2005 Jan 15;171(2):165-70
references.pmid: 15531751
references.citation: Arch Environ Health. 2003 Jan;58(1):6-13
references.pmid: 12747513
references.citation: Am Rev Respir Dis. 1989 Oct;140(4):981-6
references.pmid: 2508526
references.citation: Scand J Work Environ Health. 1986 Feb;12(1):40-5
references.pmid: 3961440
references.citation: Occup Environ Med. 2007 Oct;64(10):681-7
references.pmid: 17449560
references.citation: Lancet. 1956 Aug 18;271(6938):319-24; concl
references.pmid: 13358211
references.citation: Eur Respir J. 2005 Nov;26(5):881-6
references.pmid: 16264050
references.citation: Occup Environ Med. 2003 Dec;60(12):935-41
references.pmid: 14634185
references.citation: Int Arch Occup Environ Health. 2007 Feb;80(4):306-12
references.pmid: 16897096
references.citation: Ann Intern Med. 1982 Nov;97(5):645-51
references.pmid: 7137730
references.citation: Prev Med. 1987 Mar;16(2):142-9
references.pmid: 3495793
references.citation: Chest. 1994 Jun;105(6):1713-21
references.pmid: 8205865
references.citation: Am J Ind Med. 2006 Jun;49(6):474-91
references.pmid: 16586405
references.citation: N Engl J Med. 1987 Sep 3;317(10):605-10
references.pmid: 3614274
references.citation: Ann Agric Environ Med. 2007;14(1):129-36
references.pmid: 17655190
references.citation: Chest. 2007 Jan;131(1):245-54
references.pmid: 17218583
references.citation: Am J Respir Crit Care Med. 2001 Mar;163(4):847-53
references.pmid: 11282755
references.citation: J Occup Environ Med. 2007 Aug;49(8):853-61
references.pmid: 17693783
references.citation: Biomed Environ Sci. 1990 Dec;3(4):443-51
references.pmid: 2096849
references.citation: J Occup Med. 1973 Mar;15(3):222-30
references.pmid: 4693165
references.citation: Am Rev Respir Dis. 1978 Dec;118(6 Pt 2):1-120
references.pmid: 742764
references.citation: Inhal Toxicol. 2004 Apr;16(4):217-29
references.pmid: 15204769
references.citation: Arch Environ Health. 1990 Mar-Apr;45(2):95-100
references.pmid: 2334237
references.citation: Am J Ind Med. 1993 Feb;23(2):333-42
references.pmid: 8427261
references.citation: Int J Epidemiol. 1989 Dec;18(4):970-5
references.pmid: 2695476