title: Respiratory health effects of fifteen years of improved collective protection in a wheat-processing worker population.
abstract: BACKGROUND
  Occupational exposure to grain dust causes respiratory symptoms and pathologies. To decrease these effects, major changes have occurred in the grain processing industry in the last twenty years. However, there are no data on the effects of these changes on workers' respiratory health.
  
  
  OBJECTIVE
  The aim of this study was to evaluate the respiratory health of grain workers and farmers involved in different steps of the processing industry of wheat, the most frequently used cereal in Europe, fifteen years after major improvements in collective protective equipment due to mechanisation.
  
  
  METHODS
  Information on estimated personal exposure to wheat dust was collected from 87 workers exposed to wheat dust and from 62 controls. Lung function (FEV1, FVC, and PEF), exhaled nitrogen monoxide (FENO) and respiratory symptoms were assessed after the period of highest exposure to wheat during the year. Linear regression models were used to explore the associations between exposure indices and respiratory effects.
  
  
  RESULTS
  Acute symptoms - cough, sneezing, runny nose, scratchy throat - were significantly more frequent in exposed workers than in controls. Increased mean exposure level, increased cumulative exposure and chronic exposure to more than 6 mg.m (-3) of inhaled wheat dust were significantly associated with decreased spirometric parameters, including FEV1 and PEF (40 ml and 123 ml.s (-1) ), FEV1 and FVC (0.4 ml and 0.5 ml per 100 h.mg.m (-3) ), FEV1 and FVC (20 ml and 20 ml per 100 h at >6 mg.m (-3) ). However, no increase in FENO was associated with increased exposure indices.
  
  
  CONCLUSIONS
  The lung functions of wheat-related workers are still affected by their cumulative exposure to wheat dust, despite improvements in the use of collective protective equipment.
authors.affiliation: Service of Occupational Medicine, Institute for Work and Health, University of Lausanne and Geneva, Epalinges-Lausanne, Switzerland.
authors.forename: Victor
authors.initials: V
authors.lastname: Dorribo
authors.affiliation: INRS, Scientific Management, Nancy, France.
authors.forename: Pascal
authors.initials: P
authors.lastname: Wild
authors.affiliation: Service of Occupational Medicine, Institute for Work and Health, University of Lausanne and Geneva, Epalinges-Lausanne, Switzerland.
authors.forename: Jacques A
authors.initials: JA
authors.lastname: Pralong
authors.affiliation: Service of Occupational Medicine, Institute for Work and Health, University of Lausanne and Geneva, Epalinges-Lausanne, Switzerland.
authors.forename: Brigitta
authors.initials: B
authors.lastname: Danuser
authors.affiliation: Service of Parasitology and Mycology, CHU de Besançon, Besançon, France.
authors.forename: Gabriel
authors.initials: G
authors.lastname: Reboux
authors.affiliation: Service of Occupational Medicine, Institute for Work and Health, University of Lausanne and Geneva, Epalinges-Lausanne, Switzerland.
authors.forename: Peggy
authors.initials: P
authors.lastname: Krief
authors.forename: Hélène
authors.initials: H
authors.lastname: Niculita-Hirzel
mesh_terms: D000328:Adult; D004391:Dust / Q000032:analysis* / Q000517:prevention & control; D002523:Edible Grain; D000067565:Farmers; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D016273:Occupational Exposure; D000067393:Personal Protective Equipment / Q000706:statistics & numerical data; D012140:Respiratory Tract Diseases / Q000139:chemically induced / Q000453:epidemiology*; D013557:Switzerland; D014908:Triticum
chemical_list: D004391:Dust