title: Respiratory, allergy and eye problems in bagasse-exposed sugar cane workers in Costa Rica.
abstract: OBJECTIVE
  To evaluate bagasse (sugar cane fibres) and microbiological exposure among sugar cane refinery workers in Costa Rica and its relationships with respiratory, allergy and eye problems.
  
  
  METHODS
  Ventilatory lung function and total serum IgE were measured in 104 sugar cane workers in five departments at one refinery before the harvesting season, and repeated for 77 of the workers at the end of the season. Information on the prevalence of respiratory and other symptoms was collected with a standardised questionnaire. During the harvesting season, inhalable dust, endotoxin and mould levels were measured among 74 randomly selected sugar cane workers across departments.
  
  
  RESULTS
  During the harvesting season, dust levels were relatively high in some departments, while endotoxin and mould levels were around background levels. Workers' ventilatory lung function differed between departments before, but not during the harvesting season or between seasons. During the harvesting season, the prevalence of wheeze and eye problems almost doubled in workers exposed to bagasse and other types of dust, whereas shortness of breath and rhinitis increased only in bagasse-exposed workers. Reporting wheeze and shortness of breath was positively associated with the number of years working at the refinery, suggesting a long-term health effect.
  
  
  CONCLUSIONS
  In this refinery, the differences in workers' ventilatory lung function before the harvesting season are unlikely to be explained by bagasse exposure. However, the increase in reported symptoms (wheeze, shortness of breath, eye problems and rhinitis) over the season is likely due to irritation by dust, in particular bagasse, rather than microbiological agents.
authors.affiliation: Programa Salud y Trabajo en América Central, Central American Institute for Studies on Toxic Substances, Universidad Nacional de Costa Rica, Heredia, Costa Rica.
authors.forename: Mireia
authors.initials: M
authors.lastname: Gascon
authors.forename: Hans
authors.initials: H
authors.lastname: Kromhout
authors.forename: Dick
authors.initials: D
authors.lastname: Heederik
authors.forename: Wijnand
authors.initials: W
authors.lastname: Eduard
authors.forename: Berna
authors.initials: B
authors.lastname: van Wendel de Joode
mesh_terms: D000328:Adult; D000382:Agricultural Workers' Diseases / Q000097:blood / Q000453:epidemiology* / Q000209:etiology; D002482:Cellulose / Q000633:toxicity*; D003364:Costa Rica / Q000453:epidemiology; D004391:Dust / Q000032:analysis; D004731:Endotoxins / Q000009:adverse effects / Q000032:analysis; D004783:Environmental Microbiology; D005128:Eye Diseases / Q000453:epidemiology* / Q000209:etiology; D005260:Female; D005658:Fungi / Q000302:isolation & purification; D006801:Humans; D006967:Hypersensitivity / Q000453:epidemiology* / Q000209:etiology; D007073:Immunoglobulin E / Q000097:blood; D008137:Longitudinal Studies; D008297:Male; D008875:Middle Aged; D016273:Occupational Exposure / Q000009:adverse effects / Q000032:analysis; D015995:Prevalence; D012120:Respiration Disorders / Q000453:epidemiology* / Q000209:etiology; D011795:Surveys and Questionnaires; D055815:Young Adult
chemical_list: D004391:Dust; D004731:Endotoxins; D007073:Immunoglobulin E; D002482:Cellulose; C027433:bagasse