title: Occupational exposures and mortality from cardiovascular disease among women textile workers in Shanghai, China.
abstract: BACKGROUND
  Exposure to textile fiber dusts, like particulate air pollution, may be associated with cardiovascular disease (CVD) mortality. Bacterial endotoxin, a potent inflammagen found in cotton dust, may be a specific risk factor.
  
  
  METHODS
  Female textile workers (N = 267,400) in Shanghai, China were followed for CVD mortality (1989-2000). Factory exposures were approximated by sector classifications based on materials and processes. Quantitative endotoxin and cotton dust measures were available for a subcohort (n = 3,188). Cox proportional hazards modeling was used to estimate hazard ratios (HR) and 95% confidence interval (CI).
  
  
  RESULTS
  Slightly elevated mortality risk for the cotton sector was seen for ischemic stroke (HR = 1.12, 95% CI: 0.97-1.31) and hemorrhagic stroke (HR = 1.12, 95% CI: 1.02-1.23). Similar hemorrhagic stroke mortality risk was observed in high dust sectors (HR = 1.12, 95% CI: 1.02-1.24). No association was observed for ischemic heart disease.
  
  
  CONCLUSIONS
  Exposures in textile factories may have contributed to CVD mortality among this cohort. The specific components of these exposures that may be harmful are not clear and should be further investigated.
authors.affiliation: Department of Environmental and Occupational Health Sciences, University of Washington, Seattle, Washington 98195-7234, USA. lgallag@u.washington.edu
authors.forename: Lisa G
authors.initials: LG
authors.lastname: Gallagher
authors.forename: Roberta M
authors.initials: RM
authors.lastname: Ray
authors.forename: Wenjin
authors.initials: W
authors.lastname: Li
authors.forename: Bruce M
authors.initials: BM
authors.lastname: Psaty
authors.forename: Dao Li
authors.initials: DL
authors.lastname: Gao
authors.forename: David B
authors.initials: DB
authors.lastname: Thomas
authors.forename: Harvey
authors.initials: H
authors.lastname: Checkoway
mesh_terms: D000328:Adult; D002545:Brain Ischemia / Q000453:epidemiology / Q000401:mortality; D002318:Cardiovascular Diseases / Q000453:epidemiology / Q000401:mortality*; D002681:China / Q000453:epidemiology; D016001:Confidence Intervals; D032561:Cotton Fiber; D004391:Dust; D005260:Female; D006801:Humans; D008875:Middle Aged; D009203:Myocardial Infarction / Q000453:epidemiology / Q000401:mortality; D016273:Occupational Exposure / Q000009:adverse effects / Q000706:statistics & numerical data*; D016272:Occupational Health / Q000706:statistics & numerical data*; D016016:Proportional Hazards Models; D018570:Risk Assessment; D020521:Stroke / Q000453:epidemiology / Q000401:mortality; D013784:Textiles / Q000633:toxicity*; D013997:Time Factors; D016387:Women's Health
chemical_list: D004391:Dust