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Objectives: To investigate a large population of cotton textile weavers for reported respiratory symptoms relative to occupational factors, smoking, and exposure to dust. Cotton processing is known to produce a respiratory disease known as byssinosis particularly in the early processes of cotton spinning. Relatively little is known about the respiratory health of the cotton weavers who produce cloth from spun cotton. By the time cotton is woven many of the original contaminants have been removed., Methods: 1295 operatives from a target population of 1428 were given an interviewer led respiratory questionnaire. The presence of upper and lower respiratory tract symptoms were sought and the work relatedness of these symptoms determined by a stem questionnaire design. Also occupational and demographic details were obtained and spirometry and personal dust sampling performed., Results: Byssinosis was present in only four people (0.3%). Chronic bronchitis had a moderate overall prevalence of about 6% and was related predominantly to smoking. There were several other work related respiratory symptoms (persistent cough 3.9%, chronic production of phlegm 3.6%, chest tightness 4.8%, wheezing 5.4%, and breathlessness 2.3%). All of these were predicted predominantly by smoking (either past or present), with no consistent independent effect of exposure to dust. Work related eye and nasal symptoms were more common (10.4% and 16.9% respectively)., Conclusion: Byssinosis is a rare respiratory symptom in cotton weaving. Other work related respiratory symptoms were reported but their presence was predominantly related to smoking with no consistent effects of exposure to dust.

Objectives: The aims of this study were to document the prevalence of work related upper and lower respiratory tract symptoms in workers exposed to organic dusts and to identify variables predictive of their occurrence., Methods: A cross sectional survey with an administered questionnaire (a previously validated adaptation of the Medical Research Council (MRC) respiratory questionnaire) was performed. Symptoms were classified as work related by their periodicity. Demographic data, smoking habits, and occupational histories were recorded. Personal exposures to dust and endotoxin were measured and individual subjects ascribed an exposure value specific to occupation, site and industry. Cox's regression techniques were used to identify variables predictive of work related upper and lower respiratory tract symptoms. Information was stored using Dbase 3 and analysed with SPSS., Results: 1032 Workers (93% of the target population) were studied in nine different industries. The highest prevalences of work related lower respiratory tract symptoms (38.1%), upper respiratory tract symptoms (45.2%), and chronic bronchitis (15.5%) were found among poultry handlers. White workers were significantly more likely to complain of upper and lower respiratory tract symptoms. An individual in the swine confinement industry had a symptom complex compatible with byssinosis. Increasing current personal exposures to dust or endotoxin were found to be predictive of upper and lower respiratory tract symptoms, chronic bronchitis, and byssinosis. In a univariate analysis a relation between current exposures and the organic dust toxic syndrome was found. Present smoking and previously documented respiratory tract illness were significantly predictive of work related lower respiratory tract symptoms. Women were more likely to report work related upper respiratory tract symptoms., Conclusions: People exposed to organic dusts may have a high prevalence of work related respiratory tract symptoms which are related to dust exposures and smoking habits. Action should be taken to reduce exposures to dust and endotoxin and stopping smoking should be promoted among workers exposed to organic dusts to reduce morbidity.

Objectives: This survey was conducted to investigate current lung function levels in operatives working with cotton and man made fibres. Dust concentrations, smoking history, and occupational details were recorded so that factors influencing lung function could be identified., Methods: A cross sectional study of respiratory symptoms and lung function was made in 1057 textile spinning operatives of white caucasian extraction. This represented 96.9% of the total available working population to be studied. Most (713) worked currently with cotton. The remainder worked with man made fibre. Lung function was assessed by measuring forced expiratory volume in one second (FEV1) and forced vital capacity (FVC). Exposure to cotton dust was measured in the work area and personal breathing zones, and retrospective exposure to cotton dust over a working life was estimated with accurate work history and best available hygiene data., Results: 3.5% of all operatives had byssinosis, 55 (5.3%) chronic bronchitis, 36 (3.5%) work related persistent cough, 55 (5.3%) non-byssinotic work related chest tightness, and 56 (5.3%) work related wheeze. A total of 212 static work area dust samples (range 0.04-3.23 mg/m3) and 213 personal breathing zone samples (range 0.14-24.95 mg/m3) were collected. Percentage of predicted FEV1 was reduced in current smokers (mean 89.5, 95% confidence interval (95% CI) 88-91) in comparison with non-smokers (93.1, 90.5-94.1) and FVC was reduced in operatives currently working with man made fibre (95.3, 93.8-96.9) in comparison with cotton (97.8, 96.6-99.0). Regression analysis identified smoking (P < 0.01), increasing age (P < 0.01), increasing time worked in the waste room (P < 0.01), and male sex (P < 0.05) as being associated with a lower FEV1 and FVC. Current and retrospective cotton dust exposures did not appear as predictor variables in the regression analysis although in a univariate analysis, FEV1 was reduced in those operatives exposed to high dust concentrations assessed by personal and work area sampling., Discussion: This study has documented loss of lung function in association with exposure to cotton dust. Those operatives with work related symptoms had significantly lower FEV1 and FVC than asymptomatic workers. Although lung function seemed to be affected by high dust exposures when operatives were stratified into high and low exposure groups, regression analysis did not identify current dust concentrations as an independent factor influencing loss. Smoking habit was found to explain most of the measured change in FEV1 and FVC. It is likely that smoking and dust exposure interact to cause loss of lung function in cotton textile workers.

A cross-sectional study of work-related symptoms and cotton dust exposure was made in 404 man-made fiber and 1,048 cotton operatives in Lancashire spinning mills; 39 cotton-exposed operatives (3.7%) had symptoms of byssinosis. This was associated on regression analysis with cumulative lifetime cotton dust exposure (p < 0.001), total years spent carding (p < 0.001), and currently working in the carding area (p = 0.0041). Smoking habit did not differ significantly between byssinotic and nonbyssinotic workers. Other work-related symptoms were common: chronic bronchitis (CB) and persistent cough. The prevalence of CB correlated positively with dust exposure (r = 0.59). Cotton dust sampling was performed in the work area (SDPRES) and personal breathing zone (PD1). A retrospective estimate of lifetime cotton dust exposure based on SDPRES correlated best with the prevalence of byssinosis (r = 0.797), although correlations with PD1 (r = 0.709) and SDPRES (r = 0.594) were also significant.

A total of 645 cotton mill operatives were administered a respiratory questionnaire. Of these, 85 (13.2%) complained of one or more work-related respiratory symptoms: 23 (3.6%) had byssinosis and the remaining 62 had symptoms not conforming to byssinosis (nonbyssinotic symptomatics, NBS). All byssinotic, 56 NBS, and 84 matched asymptomatic operatives underwent pulmonary function testing (FEV1 and FVC), skin testing to common allergens, and histamine bronchial challenge. Work area and personal breathing zone cotton dust concentrations were assessed, and a cumulative cotton dust exposure index was calculated for each individual. Byssinotic, NBS, and asymptomatic operatives all had reduced FEV1; observed mean liters (95% CI); predicted mean: byssinosis, 2.36 (2.09 to 2.63), 3.02; NBS, 2.94 (2.71 to 3.17), 3.29; and asymptomatic, 3.12 (2.95 to 3.29), 3.31. Only byssinotic subjects had evidence of impaired FVC: 3.31 (2.97 to 3.65), 3.69. The majority of byssinotic operatives (18 of 23) had bronchial hyperreactivity (BHR) in comparison with 21 of 56 NBS and 14 of 84 asymptomatic operatives. Mean log PD20 (95% CI) values were significantly lower in the byssinotic group -0.72 (-1.42, -0.02) than in NBS 0.57 (0.08, 1.06) and asymptomatic subjects 0.57 (-0.26, 1.39). The distribution of atopy did not differ significantly between groups, and lung function did not differ significantly between atopic and nonatopic subjects. The cumulative cotton dust exposure index was the only dust parameter to be significantly greater in those with BHR (mean mg-yr/m3 [95% CI] 14.13 [13.1 to 15.1]) than those with normal reactivity [5.35 (3.9 to 6.8)].