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The authors studied respiratory symptoms and lung function among welders at welding workshops, and among nonwelders, in Hamadan, Iran. They used a questionnaire to record demographic data, smoking habits, and respiratory symptoms. The authors measured pulmonary functions with subjects standing upright. They collected metal fume samples from the respiratory zone of workers and analyzed the samples by atomic absorption spectroscopy. The concentrations of iron and manganese were higher than threshold limit values. The prevalence of asthma and clinical symptoms was higher in welders than nonwelders. Also, bronchitis was more common among welders (17.45%) than among nonwelders (2.56%). The average respiratory function values of welders were lower than those of nonwelders, with a significant difference between the means (p < 0.001 for all terms). The results of this study also strongly suggest a synergistic relationship between the effects of smoking and welding exposure.

During the spring of 1995, schoolchildren aged 7-13 y who lived in a rural area in Israel were studied. These children lived in two communities: in one community, the population was exposed to pollution from a cement factory and quarries; the population of the second community was not exposed to pollution from these sources. The children from participating schools performed forced vital capacity, forced expiratory volume in 1 s, peak expiratory flow, forced expiratory flow at 50%, and forced expiratory flow at 25%. Parents completed an American Thoracic Society-National Heart and Lung Institute health questionnaire, which included information about respiratory symptoms and diseases of the children and information about background variables. A trend of higher prevalence of most respiratory symptoms occurred in 638 children who were growing up in the community that bordered the industrial zone, compared with 338 children from the unexposed community. Cough without cold, sputum without cold, and cough accompanied by sputum were the most prevalent symptoms. Asthma diagnosed by a physician was reported more frequently for children who lived near the polluting sources. No consistent trend of reduced pulmonary function tests was observed among children who lived in the polluted community; however, peak expiratory flow was significantly lower among these children. Odds ratio values, calculated from logistic regressions in which we controlled for respiratory problems among parents, mothers who smoked, crowding index, education of mothers, and residential heating, were 3.6 (p value for model = .244) for cough without cold, 4.0 (p value for model = .333) for asthma, and 2.2 (p value for model = .753) for asthma and/or bronchitis in the polluted area, compared with 1.0 in the low-pollution community. Total suspended particulate matter and levels of airborne particles less than 10 microns, measured in the community bordering the industrial zone, very often violated the relevant 24-h Israeli standards of 200 microg/m3 and 150 microg/m3, respectively.

In this study, the association between daily morbidity and respirable particulate pollution (i.e., particles with a mass median aerodynamic diameter of < or = 10 microns [PM10]) was evaluated in the general population of Anchorage, Alaska. Using insurance claims data for state employees and their dependents who lived in Anchorage, Alaska, the authors determined the number of medical visits for asthma, bronchitis, and upper respiratory infections. The number of visits were related to the level of particulate pollution in ambient air measured at air-monitoring sites. This study was conducted during a 3-y period, which included several weeks of higher-level particulate pollution that resulted from a volcanic eruption (i.e., August 1992). The particulate pollution was measured by the Anderson head sampler (24-h accumulation). The medical visits of the population at risk were also tallied daily. To help confirm whether PM10 exposure was a risk factor in the exacerbation of asthma, we used a regression analysis to regress daily asthma visits on PM10 pollution levels, controlling for seasonal variability. A significant positive association between morbidity and PM10 pollution was observed. The strongest association was with concurrent-day PM10 levels. The relative risk of morbidity was higher with respect to PM10 pollution during warmer days.

Seventh-day Adventist nonsmokers, who, subsequent to 1966, had resided within 8 km (5 miles) of their 1977 residence (N = 3,914), completed the National Heart and Lung Institute (NHLI) respiratory symptoms questionnaire in 1977 and again in 1987. For each participant, cumulative ambient concentrations of total suspended particulates (TSP), ozone, and sulfur dioxide (SO2) in excess of several cutoff levels were estimated by month and by interpolating ambient concentrations from state air-monitoring stations to their residential and workplace zip codes for the month. Statistically significant relationships between ambient concentrations of TSP and ozone, but not SO2, were found with several respiratory disease outcomes. Multivariate analyses adjusted for past and passive smoking and occupational exposures. Results are discussed within the context of standards setting for TSP and ozone.

Respiratory questionnaires and pulmonary function tests were administered to sixty-five men exposed to dust in the processing are from three rubber tire manufacturing plants. Similar tests were done on 189 "control" workers. Compared with the controls, the processing workers had a higher prevalence of chronic productive cough. Overall, the processing group showed a decrease in the ratio of FEV to FVC. The processing workers with more than ten years of exposure showed a significant decrease in the ratio of FEV1.0/FVC, the FEV1.0, the residual FEV1.0, and the flow rates at 50% and 25% of the forced vital capacity. None of the pulmonary function effects could be solely explained on the basis of smoking, age, ethnic, or socioeconomic factors: all were related to the length of exposure. Based on these results we conclude that exposure in the processing area produces pulmonary disease.

The effect of smoking on respiratory illness was investigated at a naval recruit camp. All recruits entering training during an 11-month period, beginning in February 1971, were included in the study. Questionnaires in regard to smoking habits were administered on arrival and during the last week of training. Facts of illness were obtained from each recruit's health record during the last week of training and abstracted onto electronic accounting machine (EAM) cards. Data on a sample of 1,100 men, who had complete records, were analyzed. Two thirds of the men were smokers on arrival. Heavy smokers had a longer history of smoking. The majority of recruits decreased smoking during training. Significantly more heavy smokers than light smokers or nonsmokers had symptoms of chronic respiratory involvement. No statistically significant increases in respiratory illness were observed in smokers.

A total of 416 men, retiring during the period 1945 to 1972 from six plants engaged mainly in the manufacture of fibrous glass insulation, were studied to see how their mortality experience compared with that of white men in the entire United States living in comparable age and time intervals. The mean follow-up period from first exposure was about 30 years. Overall mortality was low and there was no evidence of an excess in respiratory cancer mortality. No mesotheliomas were noted. For 115 men retiring from the same six plants during the period 1945 to 1972 due to a disability the distribution of disabilities by cause was compared with an expected distribution based on the experience of the Social Security Administration. This comparison showed no evidence of any unusual health hazards among fibrous glass workers, except a possible excess in chronic bronchitis.

One hundred twenty-one men who were exposed to tire-curing fumes responded to respiratory symptom questionnaires. Results were compared with questionnaires of 189 nonexposed workers who were employed by the same three tire manufacturing plants. The curing workers had a higher prevalence of chronic bronchitis than the controls. Of the curing workers with more than ten years of experience to fumes, 25% met the criteria for the epidemiological diagnosis of chronic obstructive pulmonary disease. Increased respiratory morbidity in the curing workers was related to both intensity and length of exposure to fumes. Because cigarette smoking and other variables cannot explain the difference between the curing and control groups, we attribute the greater prevalence of respiratory morbidity to exposure to curing fumes. These findings warrant further longitudinal studies and reduction of exposure, especially for workers on the manual automobile tire presses, which is the high-exposure group.

The chronic pulmonary effects of exposure to volcanic ash were investigated by conducting a cross-sectional epidemiological study of 2,006 women between 30 and 59 yr of age who lived in three areas subjected to different levels of airborne ash. In the three areas prevalences of chronic bronchitis and other respiratory symptoms were so low that volcanic ash did not seem to be a major cause of respiratory disease. In the highly exposed area, however, 9.9% of the women experienced symptoms of one or more respiratory diseases, while 6.4% of the women in the medium- and 5.4% of the women in the low-exposure area had these symptoms. Prevalences of each disease and symptom increased as total suspended particulate level increased, suggestive of an association of mild respiratory symptoms with volcanic ash.

A re-designed and simplified respiratory disease questionnaire was self-completed by 245 coke oven workers who previously were interviewed using the Standardized Medical Research Council/National Heart and Lung Institute form. The self-completion survey yielded significantly greater numbers of positive responses to various questions; nearly twice as many men were classified as having chronic bronchitis based on responses to the self-administered questionnaire. The severity of symptoms correlated with various factors such as the worker's smoking history; family history of lung disease, and job history. We suggest that, when compared with an interview using the British Medical Research Council/National Heart and Lung Institute respiratory disease questionnaire, a simplified, self-completion form may serve as a less expensive, more sensitive, and equally uniform and selective epidemiological tool. Self-completion forms deserve the attention and study previously afforded the interview process.