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Cotton dust exposure has been implicated in causing diseases like byssinosis and obstructive airway diseases like COPD and asthma. Long-term exposure to cotton dust causing interstitial lung disease and pulmonary fibrosis has been sparsely reported in the literature. Here, we report a case of an individual with long-term cotton dust exposure who presented with typical symptoms of interstitial lung disease and was managed conservatively.

Objective: To determine the prevalence of cotton dust-related allergic asthma and associated factors among textile workers in Nam Dinh province, Vietnam. Methods: A cross-sectional study was performed with 1082 workers in two textile garment companies using the asthma diagnostic criteria of the GINA (Global Initiative for Asthma) 2016 guidelines. Results: Among study participants, 11.9% had suspected asthma symptoms, 7.4% were diagnosed with asthma, and 4.3% (3.6% in men and 4.5% in women) were diagnosed with cotton dust-related allergic asthma. Overweight, seniority more than 10 years, history of asthma, allergic rhinitis, family history of allergy, and exposure to cotton dust from more than one hour per day in the working environment were found to be important predictors of cotton dust-related allergic asthma among textile workers. Conclusions: Textile workers in two companies in Nam Dinh, Vietnam had a high prevalence of dust-related allergic asthma compared to estimates from the general population. There is a need to design appropriate measures of prevention, screening, and care for dust-related asthma in the textile industry. Further evaluation with better exposure assessment is necessary.

Background Endotoxin, a contaminant of cotton dust, is an experimental model for parkinsonism (PS). Methods We investigated associations between exposures to endotoxin, solvents, magnetic fields, and night shift work, and neurologist-determined PS among Shanghai women textile workers, including 537 retired cotton factory workers ages ≥50 years and an age-matched reference group of 286 retired textile workers not exposed to cotton dust. Repeat exams were conducted 2.5 years after enrollment among 467 cotton workers and 229 reference workers. Results We identified 39 prevalent PS cases and 784 non-cases. No consistent or statistically significant associations were observed for endotoxin, solvents, magnetic fields, or shift work with PS risk, severity, or progression. Conclusions Despite the null findings, additional studies of endotoxin exposure and risk of PS in other well-characterized occupational cohorts are warranted in view of toxicological evidence that endotoxin is a pathogenic agent and its widespread occurrence in multiple industries worldwide.

Background: Cotton dust exposure among textile mill workers lead to impaired lung function. However, only few studies have investigated the dose-response relationship between cotton dust and lung function. Objective: To determine the dose-response relationship between cotton dust exposure and lung function among textile workers. Methods: This cross-sectional survey was conducted from January to March 2016 and included 303 adult male textile workers from spinning and weaving sections of 5 mills in Karachi, Pakistan. We collected data through a translated version of the American Thoracic Society respiratory questionnaire (ATS-DLD-78A) and using spirometry. Mill-level airborne cotton dust was measured over an 8–12-hour shift through UCB-PATS (University of California, Berkeley- Particle, and Temperature Monitoring System). Multiple linear regression was used to determine the association between cotton dust exposure and lung function assessed through the 3 indices: forced expiratory volume in the first second (FEV 1 ), forced vital capacity (FVC), and their ratio (FEV 1 /FVC). Results: The mean age of the workers was 32.5 (SD 10.5) years. The mean spirometry indices expressed in percent predicted values were FEV 1 82.6 (SD 14.0); FVC 90.3 (14.7), and FEV 1 /FVC 94.9 (10.5). The median cotton dust concentration was 0.61 (IQR 0.2 to 1.3) mg/m 3 . The frequency of respiratory symptoms was 15% for cough, 20% for phlegm, and 20% for wheezing. After adjustment for covariates, every mg/m 3 increase in dust concentration was associated with 5.4% decline in FEV 1 . Conclusion: This study quantifies the exposure-dependent relationship between cotton dust and lung function; which has implications for regulations and standards in the textile industry in Pakistan and similar cotton-processing countries.

Background Cotton dust induced respiratory disorders are dramatically increased over the globe, especially the problem is serious in developing countries. Respiratory symptoms, such as cough, phlegm, wheezing, shortness of breath, chest tightness, chronic bronchitis, and byssinosis are common among workers exposed to cotton dust. However, in Ethiopia, the magnitude of the problem is not well known and information is limited about the risk factors. Therefore, this study was aimed to assess the prevalence of respiratory symptoms and associated factors. Methods A Comparative cross-sectional study design was employed. A total of 413 (276 exposed and 137 unexposed) participants were included in the study. Stratified and simple random sampling techniques were used to select exposed and unexposed groups to cotton dust respectively. Multivariable binary logistic regression analyses was performed to identify variables associated with respiratory symptoms and adjusted odds ratio (AOR) was used to determine the strength of associations. Significance level was obtained at 95% confidence interval (CI) and p-value ≤0.05. Results The prevalence of self-reported respiratory symptoms was 47.8% (95% CI: 41.3, 53.7%) and 15.3% (95% CI: 9.6, 22.3%) among exposed and control groups respectively. Sex (AOR = 2.1, 95% CI: 1.29, 3.45), service year (AOR = 2.38, 95% CI: 1.19, 4.71) and ventilation (AOR = 2.4, 95% CI: 1.17, 4.91) were factors significantly associated with respiratory symptoms. Furthermore, working department such as; ginning (AOR = 5.1, 95% CI: 2.13, 12.16), spinning (AOR = 4.96, 95% CI: 2.18, 11.29), weaving (AOR = 5.9, 95% CI: 2.46, 14.27) and blowing working departments (AOR = 5.14, 95% CI: 1.4, 18.94) were significantly associated with respiratory disorders. Conclusions The prevalence of self-reported respiratory symptoms was higher among workers exposed to cotton dust than unexposed workers. Sex, service year, working department and work unit ventilation were predictor variables for respiratory symptoms. Thus, reducing exposure to dust, adequate ventilation and improving the hygiene of working departments are needed to reduce respiratory symptoms.

Background: Cotton industry workers are exposed to various hazards in the different departments of textile factories. The major health problems associated with cotton dust are respiratory problems, byssinosis, bronchitis and asthma. Objective: To study the effect of cotton dust exposure on pulmonary function and respiratory symptoms. Settings and Design: This cross-sectional observational study was conducted at cotton mill in the Ahmedabad city. Materials and Methods: One hundred cotton mill workers of the weaving and spinning area participated in this study while 100 age- and gender-matched male subjects living in the residential area served as the control group. A questionnaire was used to inquire about respiratory symptoms and spirometry was done in both the groups. Statistical Analysis Used: Student's t-test was used to find the difference between spirometric parameters, and Chi-square test was used to find the difference between respiratory symptoms. Results: Respiratory symptoms were statistically significantly more common in the cotton mill workers compared to control group. Cotton mill workers group also showed significant (P < 0.0001) decrease in forced expiratory volume in 1 s (FEV1), ratio of FEV1 and forced vital capacity (FVC) and peak expiratory flow rate, and no significant difference of FVC between groups. There was an association of duration of exposure and symptoms with spirometric abnormality. Conclusion: Cotton mill workers showed a significant decrease in spirometric parameters and increase in respiratory symptoms. As the duration of exposure and symptoms increased, spirometric abnormality increased.

Background: Textile industry is the only industry to have employed women workers since long time. There are many respiratory problems develop in the women workers. Aims and Objective: The aim of this study was to assess the effects of exposure of cotton dust on the pulmonary function in the spinning mill female workers. Method: We enrolled 35 female (age=18 to 50 years) workers in study group who were regularly working in spinning mill and duration of exposure to cotton dust was noted. Inclusion criteria were clinically healthy, non-smokers, without chronic respiratory disease, systemic illness. Tobacco users were excluded. Control group consist 35 female (age=18 to 50 years) who were never in exposure of cotton wool. This study was conducted after obtaining ethical clearance and consent. MEDSPIROR-COMPUTERISED SPIROMETER was used to find out pulmonary function tests which were FVC, FEV1, FEV1/FVC and PEFR, which helped in evaluating pulmonary functions. Statistical Analysis: Unpaired students ‘t’ test was applied to compare the PFT parameters in study group and control group . The data was expressed as mean + standard deviation. Results: Greater declines were seen in forced vital capacity, forced expiratory volume in first second. This reduction was significant in FEV1/FVC which is indicator of early obstructive pattern in the exposed group. As duration of exposure increases FVC reduces and showed restrictive pattern. Conclusion: According to our study, cotton textile workers developed respiratory problems which reflects as reduces pulmonary function.

Background: Byssinosis is still health problems associated with exposure to cotton dust. High risk of health problems in Environmental Health Risk Assessment i s expressed as a Risk Quotenit (RQ) .Work activities, the use of personal protective equipment, and psychological disorder may also affect the incidence of byssinosis. Methods: This was an observational research with cross sectional design. The population in this research are all employees of PT.Grandtex.Eighty workers from morning shifts only were randomly selected. Each worker was examined of the FEV1 and FVC. Questionnaires structured was another tools for collecting data.Total dust measured in the wor king environments and ambient air. Results: The results by Chi-Square test showed significant relation between the Risk Quotenit (RQ) with byssinosis (p-value 0.043; PR 1,8 (95%CI : 0 . 95 - 3 .5 2 ),have a significant relationship between work activities with byssinosis (p-value 0.035; PR 2.2 (95%CI : 0.86 - 5.85 )have a significant relationship between the use of personal protective equipment with byssinosis (p-value 0.001; PR 2.9 (95%CI : 1 .2 1 - 6.81 ) and have a significant relationship between psychological disorders with byssinosis (p-value 0.023; PR 1,7 (95%CI : 1. 28 -2. 14 ) Conclusion: The number of worker with positive Byssinosis symptoms and abnormal lung function 15 people(18.75%) , positive Byssinosis symptoms and normal lung function 35people(43.75%) Keywords : Byssinosis, cotton dust, risk assessment

Purpose of reviewThis review will discuss methodologies and applicability of key inflammatory models of respiratory disease in proof of concept or proof of efficacy clinical studies. In close relationship with these models, induced sputum and inflammatory cell counts will be addressed for phenotype-directed drug development. Additionally, important regulatory aspects regarding noninvestigational medicinal products used in bronchial challenges or clinical inflammatory models of respiratory disease will be highlighted.Recent findingsThe recognition of an ever increasing number of phenotypes and endotypes within conditions such as asthma and chronic obstructive pulmonary disease urges phenotyping of study populations already in early clinical phases of drug development. Apart from the choice of a relevant disease model, recent studies show that especially targeted therapies need to be tested in well defined disease subsets for adequate efficacy assessment. Noninvasive biomarkers, especially sputum inflammatory cell counts, aid phenotyping and are useful outcome measures for novel, targeted therapies.SummaryDisease phenotyping becomes increasingly important for efficient and cost-effective drug development and subsequent disease management. Inflammatory models of respiratory disease combined with sputum biomarkers are important tools in this approach.

Background Byssinosis is the most common disease affecting the cotton textile workers; symptom complexes like mill fever, weaver's cough, mattress-maker‘s cough, also occur in textile workers. 1Cotton workers are at risk for occupational lung disease, including byssinosis and chronic bronchitis3. The present study was done to compare the effect of short term exposure and long term exposure to cotton dust in cotton mill workers and suggest precautions them to prevent this. Objective To compare the effect of short term and long term exposure to cotton dust on pulmonary function tests in cotton mill workers. Method In this study, one group of fifty workers exposed for short term duration and other sixty four, for long term duration exposure were examined for PFTs of age 25–50 years. PFTs were carried out using spirometer. Results or observations The present study found that there is statistically significant difference in PFTs between the short term exposed group and long term exposure group of 25–50 years age. Discussion & conclusion The results of the present study helped us to understand and compare the shortterm and long term exposure group better and suggest workers to take precautions to avoid more subtle effects that can occur.

The textile industry sector occupies a prominent place in the economy of Benin. It exposes workers to several occupational risks, including exposure to cotton dust. To assess the effect of exposure to cotton dust on the health of workers, this study was initiated and conducted in a Beninese cotton industry company. The objective of the study was to evaluate the respiratory disorders among the textile workers exposed to cotton dust and the cross-sectional study involved 656 subjects exposed to cotton dust and 113 non-exposed subjects. The methods used are mainly based on a survey using a questionnaire of organic dust designed by the International Commission of Occupational Health (ICOH); and on the measures of lung function parameters (FEV₁ and FVC). The main results of the different analyzes revealed that subjects exposed to cotton dust have more respiratory symptoms than unexposed subjects (36.9% vs. 21.2%). The prevalence of chronic cough, expectorations, dyspnoea, asthma and chronic bronchitis are 16.8%, 9.8%, 17.3%, 2.6%, and 5.9% respectively among the exposed versus 2.6%, 0.8%, 16.8%, 0% and 0.8% among the unexposed subjects. The prevalence of byssinosis is 44.01%.The prevalence of symptoms is dependent on the sector of activity and the age of the subject. These results should encourage medical interventions and technical prevention especially since the textile industry occupies an important place in the Benin's economy.

Objective To investigate chronic obstructive pulmonary disease (COPD) mortality among textile workers. Methods A total of 267 400 Chinese female textile employees were monitored for COPD mortality from 1989 to 2000. Textile factories in the cohort were classified into 10 industrial sectors. Age-adjusted mortality, standardized mortality ratios (SMRs) and 95% CIs were calculated by sector. In addition, RRs (HRs) adjusted for smoking and age were calculated for exposure to cotton and silk textile work compared with the other sectors in the cohort. Results A majority of textile sectors had lower or similar COPD mortality (age-adjusted SMRs=0.58–1.15) compared with the general female population in the city of Nanjing, China. SMRs for cotton and silk workers were, respectively, 1.02 (95% CI: 0.81 to 1.28) and 2.03 (95% CI: 1.13 to 3.34). Compared with all other textile sectors in the cohort, there was greater COPD mortality among cotton workers (HR=1.40, 95% CI: 1.03 to 1.89) and silk workers (HR=2.54, 95% CI: 1.47 to 4.39). Conclusion Elevated COPD mortality among cotton workers is consistent with previous reports of adverse respiratory effects of cotton dust. The higher rate of COPD deaths among silk workers was unexpected.

PURPOSE OF REVIEW Although, in the industrialized world, there is a significant decline in the prevalence of cotton dust lung diseases, studies show an increasing incidence in the developing world. With rapid industrialization of the developing world, cotton dust-induced lung diseases are poised to become a global health problem. Discovery of other vegetable dusts causing similar conditions and appreciation of a wider variety of clinical features also make this an opportune time to review this topic. RECENT FINDINGS In addition to chronic exposure-related byssinosis and less common forms of acute byssinosis, recent reports describe the rare occurrence of cotton dust-induced pulmonary fibrosis. New data also relate long-term cotton dust exposure to symptoms and physiologic changes of chronic obstructive pulmonary disease. There have also been new developments relating the pathogenesis of cotton dust airway disease to endotoxin lipopolysaccharide found in cotton dust and bract extracts. SUMMARY Establishment of an association between prolonged exposure to cotton and other vegetable dusts and symptoms of chronic obstructive pulmonary disease widens the clinical implication of cotton dust exposure. In addition, accumulating knowledge of endotoxins will bring about promising new developments reshaping industrial safety standards and measures to prevent cotton dust exposure.

Background: While the prevalence of byssinosis is decreasing in industrialized countries and persists at high levels in developing countries, this prevalence is remaining constant in Turkey. Objective: In order to determine the effects of past cotton dust exposure on the respiratory tract, a total of 223 persons working in a cotton mill were included in this study. Methods: A questionnaire was used to inquire about respiratory symptoms. Participants underwent several spirometric measurements, which were performed on the 1st, 3rd and 5th day of the working week. Cotton dust measurements were performed in different divisions of the factory. Results: The most common respiratory symptom was chest tightness (20.3%). The prevalence of byssinosis was 14.2% in cotton-processing workers. Among these cases, 28.6% had symptoms on the 1st day of the week, and 71.4% had symptoms on all days of the week. An acute effect was seen in 53.6% of the workers with byssinosis. Mean respirable dust levels were between 0.095 and 0.413 mg/m3. Conclusions: In spite of technological improvements, respirable dust concentrations are still above the permissible limits, and thus the risk of byssinosis remains. Workers in the cotton industry where obsolete technology is used and standardized protection measures are not applied should be followed for byssinosis.

Background: Occupational health has been included in National Health Policy, with a mission of providing safe healthy environment for the cotton textile workers by Government of India. With large population being agriculture dependent, the cotton textiles sector is the second largest provider of employment in India. Workers of these cotton and related industries are exposed to cotton dust in mills during carding, blowing, spinning and weaving of cotton fibers. Smoking is another causative factor for aggravating these respiratory symptoms in workers as most of them are habitual to smoking due to work load. Following studies was initiated with an objective to evaluate the interaction between cotton dust exposure and smoking on the lung function of these subjectsMethods: Five hundred (500) male weavers, from Varanasi, the state of Uttar Pradesh, North India working in various spinning outlets, were approached for this study with work duration of 10-15years. These subjects selected were in the age group of 28-41 years with no chronic medical history and lung ailments. Some of the workers had smoking history varying from 5-18 years. After segregating them in various groups (G1-G4), lung functions were monitored by evaluating the peak expiratory flow rate (PEFR) in workers of all the groups in lit/min.Results: As lung functions were evaluated in terms of PEFR as main parameter. The results of the present study indicate significantly low values of PEFR (lit/min) in cotton spinning workers (G-3) as compared to normal healthy individuals (G-1), which got further impaired due to prevalence of smoking in subjects of cotton spinners (G-4). The level of significance (p

A 59-year-old man presented with severe paroxysms of cough associated with dyspnea. His CT scan showed diffuse bilateral ground glass opacifications. His bronchoalveolar lavage fluid was consistent with pulmonary alveolar proteinosis. Transbronchial biopsy, microbiological studies, and cytology did not identify any alternative diagnosis. The patient had a history of working as a textile loom technician for thirty-one years and had significant exposure to cotton dust. He responded well to whole lung lavage with improvement of symptoms, gas exchange, and CT scan. This patient represents the third reported case of pulmonary alveolar proteinosis associated with cotton dust exposure. We suggest that cellulose might be useful in animal models of pulmonary alveolar proteinosis.

Exposure to endotoxin (LPS) can cause chronic respiratory disease, with symptoms that are more pronounced after exposure-free periods. The aim of this study was to evaluate LPS-response modulating proteins in nasal lavage and plasma as biomarkers for exposure to airborne endotoxin. We applied nasal lavage, lung function and exposure measurements in a small group (n = 11) of cotton workers during 6 weeks of observation (after 2 weeks free from exposure) and ten external controls. Lipopolysaccharide binding protein (LBP) and bactericidal/permeability increasing protein (BPI) were measured in nasal lavage fluid (NALF) along with classic markers such as differential cell counts, Interleukin-8 (IL-8) and albumin, to evaluate their use as markers in endotoxin exposure. In all control subjects and cotton workers LBP and BPI were readily detectable in NALF, although a high intra- and intervariability was noted. At the exposure levels in this study (cotton dust, geometric mean (GM) = 1.10 mg m(-3); endotoxin, GM = 2869 EU m(-3)), plasma BPI and BPI and LBP in NALF were significantly (Plt; 0.05) different from external controls. In addition, within the group of cotton workers, during the measurement period a significant increase was noted in BPI, albumin and BPI/LBP ratio in NALF (Plt; 0.05), while a significant decrease in total cell numbers was noted. However, none of the markers in NALF was correlated to the different exposure indices used, based on personal endotoxin or dust exposure measurements. The data show that LBP and BPI are present in nasal lavage fluid and that these markers as well as their ratio increase during airborne endotoxin exposure in cotton workers.

Objectives - To study the prevalence of byssinosis and other respiratory abnormalities in workers exposed to cotton dust in Guangzhou in two factories that processed purely cotton. Methods - All the 1320 workers exposed were included. The controls were 1306 workers with no history of occupational dust exposure. Total dust and inhalable dust were measured by Chinese total dust sampler and American vertical elutriator respectively. A World Health Organisation questionnaire was used. Forced vital capacity (FVC) and forced expiratory volume in one second (FEV 1) were measured by a Vitalograph spirometer. Results - The median inhalable dust concentrations ranged from 0.41 to 1.51 mg/m 3 and median total dust concentrations from 3.04 to 12.32 mg/m. The prevalence of respiratory abnormalities in the cotton workers were (a) typical Monday symptoms 9.0%; (b) FEV 1 fall by ≥ 5% after a shift 16.8%; (c) FEV 1 fall by ≥ 10% after a shift 4.2%; (d) FEV'q < 80% predicted 6.1%; (e) FEV 1/FVC < 75% 4.0%; (f) cough or phlegm 18.2%; (g) chronic bronchitis 10-9%; and (h) byssinosis, defined by (a) plus (b) 1.7%. With the exception of (d), most of the prevalences increased with increasing age, duration of exposure, and cumulative inhalable dust exposure. No increasing trends of respiratory abnormalities were found for current total dust, inhalable dust, and cumulative total dust concentrations. Compared with controls, after adjustment for sex and smoking, with the exception of (d), all the pooled relative risks of respiratory abnormalities were raised for cotton exposure. Conclusions - It is concluded that cumulative inhalable cotton is likely to be the cause of byssinotic symptoms, acute lung function decrements, cough, or phlegm, and chronic bronchitis., published_or_final_version

Respiratory diseases occur in some textile mill workers who are exposed to cotton dust for long periods. Research has shown that endotoxins are present in cotton dust. Correlations between endotoxin content of cotton dust and pulmonary function of human volunteers exposed to the dust have been found. It has been shown that short-duration, high-temperature treatments of cotton can reduce the amount of endotoxin present in cotton dust. This report describes development and evaluation of a device to provide rapid, high-temperature treatment of cotton as it comes out of a gin. The device is based partially on the principle of the belt dryer, which employs a conveyor belt to transport cotton, and uses hot air for drying. The device recirculates heated air that can be controlled at temperatures up to 260° C (500° F). Regulating belt speed controls exposure time of the cotton batt flowing through the device. The device’s ability to regulate air temperature and duration of exposure allowed large-scale pseudo-duplication of experimental procedures used previously in destroying endotoxin in cotton. The device performed very well in a three-day test, successfully treating 179 kg (394 lb) of cotton lint for examinations of endotoxin content, guinea pig pulmonary response, cotton quality, and textile processing performance. Related research on the cotton and dust from this work showed that endotoxin content was reduced about the amount expected, guinea pig responses to dust were partially ameliorated, but cotton quality and processing performance were reduced.

The most well-known disease caused by cotton dust is byssinosis though it is also associated with chronic obstructive airways disease, and very rarely, interstitial lung disease. Obliterative bronchiolitis has never been reported in this setting. We report a 63-year-old, nonsmoker male, who presented with complaints of cough and exertional dyspnoea for 10 years. He had worked in textile industry for 35 years and symptoms had persisted even after quitting. Examination revealed prolonged expiration with expiratory wheeze, and pulmonary function tests revealed severe airflow limitation with air trapping and impaired diffusion capacity. Arterial blood gas analysis showed type I respiratory failure. A high resolution computed tomogram of the chest showed bilateral centrilobular nodules with tree-in-bud pattern and areas of air trapping. A diagnosis of obliterative bronchiolitis induced by cotton dust exposure was established on the basis of the occupational history and the characteristic radiological signs.

We performed a cross-sectional study of 705 textile workers in two cotton mills and one silk mill in Shanghai, People′s Republic of China, to assess small airway function among cotton textile workers and to compare the FEV 1 to the FEF 25-75 in detecting airflow obstruction in these workers. All workers had at least 2 years of work experience. Environmental sampling was performed with vertical elutriators and revealed that in the cotton mills mean elutriated dust levels were 1.07 ± 0.23 mg/m 3 in mill 1 and 1.01 mg/m 3 ± 2.4 mg/m 3 in mill 2. Mean endotoxin levels were 332 ± 83 ng/m 3 in mill 1 and 101 ± 46 ng/m 3 in mill 2. No differences were found in preshift FEV 1 or FEF 25-75 between cotton and silk workers. Cotton workers had significantly greater declines than silk workers in FEV 1 across a workshift, but not in FEF 25-75 . These acute changes in FEV 1 were noted in both byssinotic and nonbyssinotic workers. Although cotton dust may affect both large and small airways, spirometric measures of small airway function (e.g., FEF 25-75 ) add little to the FEV 1 and FVC in detecting airflow limitation in cotton dust-exposed workers.

Introduction: Workers in the cotton processing industries risk developing obstructive respiratory conditions due to prolonged exposure to cotton dust. We noted a tenfold increase in asthma among workers in a Textile Manufacturing Company. We determined the prevalence of respiratory obstructive conditions among workers in various sections. Methods: We conducted a cross sectional analytic study. Workers were randomly sampled and data was collected using interviewer-administered questionnaires. Respiratory function was assessed using spirometry and chest auscultation. A walk through survey was conducted and a checklist was used to capture hazards and control measures in the work place. Results: A total of 194 workers participated. The prevalence of severe respiratory obstruction was 27.8%. It was 50.0% among the blowers, 35.3% in waste recovery, 32.5% in carders, 15.0% in spinners and 7.5% among weavers. The mean years of exposure between the affected and the nonaffected were significantly different (T =2.20; p< 0.05). Working in the blowing department was significantly associated with developing respiratory obstruction (OR=3.53; 95% CI= 1.61- 7.79) but working in the weaving department was significantly protective (OR 0.16; CI 0.04-0.59).Working in a department for less than 10 years was protective (OR =0.94; 95% CI= 0.48- 1.85), but not significant. Conclusion: Obstructive respiratory conditions are common among textile workers, with those in blowing and waste recovery sections being the most affected. We recommended worker rotation every six months, regular spirometric screening employment of a medical officer.

Item does not contain fulltext OBJECTIVES: The prevalence of allergies has increased in all parts of the world. The present study was conducted to determine the prevalence of sensitivity to common aeroallergens, pollen, thresher dust and cotton dust, in Pakistan. STUDY-DESIGN: Retrospective cohort study. METHOD: Record of 65067 who attended the Allergy Centre, National Institute of Health, Islamabad, Pakistan from January 2007 to August 2008 was retrieved. Subjects that were skin prick test (SPT) negative and those that were SPT positive to aeroallergens were extracted and subcategorized on the basis of the 8 provinces of Pakistan, including, Islamabad Capital Territory, Punjab, Baluchistan, Sindh, Northern Areas, Kashmir, North Western Frontier Province (NWFP) and Federally Administered Tribal Areas (FATA). Monthly analysis of prevalence of allergies was also determined. RESULTS: Of the total, 68.6% were SPT positive. The highest number of affected individuals was from the Punjab region (41%). The highest number of cases of all aeroallergens was reported in the month of August (3532, 13.7%). Significant high correlations were observed between mixed pollen, thresher dust and raw cotton and allergic rhinitis, asthma, uriticaria and allergic conjunctivitis. There was no significant correlation between allergen sensitivity and atopic edema. CONCLUSION: A high prevalence of sensitivity to aeroallergens is observed in the Punjab Province of Pakistan. 01 mei 2011

Exposure to cotton dust is known to cause both acute and chronic respiratory illness. A specific pattern of symptoms called byssinosis is well described to occur among workers in the cotton processing (e.g., yarn preparation) industry. Recent studies have implicated Gram-negative bacterial endotoxin as one of the agents responsible for acute, and possibly chronic, respiratory illness. Laboratory experiments using a model cardroom have found poor correlations between airborne dust and associated endotoxin. This study reports the results of vertical elutriated dust and endotoxin levels in 11 work areas of 2 cotton textile mills in 1986 in Shanghai, China. The overall correlation between dust and endotoxin was strong, rs = 0.66 and 0.79 (p < 0.0001) for mills 1 and 2, respectively. The dust-endotoxin correlation was relatively poor in early yarn preparation in the workshops and improved in the later preparation areas. Our findings suggest that in these mill settings, dust and endotoxin levels may be well correlated in most work areas. Therefore, dust may be a useful index for monitoring populations employed in the cotton textile industry throughout the world. Additional field studies need to be performed which consider the various determinants of dust and endotoxin levels.

BackgroundLong-term occupational exposure to cotton dust that contains endotoxin is associated with chronic respiratory symptoms and excessive decline in forced expiratory volume in 1 sec (FEV1), but the mechanisms of endotoxin-related chronic airflow obstruction remain unclear.ObjectiveIn the current study, we examined temporal aspects of the exposure-response relationship between airborne endotoxin exposure, longitudinal change in FEV1, and respiratory symptoms in a cohort of Chinese cotton textile workers.MethodsThis prospective cohort study followed 447 cotton textile workers from 1981 to 2006. at approximately 5-year intervals. We used a generalized estimating equations approach to model FEV1 level and respiratory symptoms as a function of past exposure (cumulative exposure up to the start of the most recent 5-year survey interval) and cumulative exposure (within the most recent interval) to endotoxins, after adjusting for other covariates. Models were stratified by active versus retired work status and by years employed before the baseline survey (< 5 and > or = 5 years).Results and conclusionsPast exposure to endotoxin was associated with reduced FEV1 level among retired cotton workers. Among all cotton workers, past exposure was more strongly associated with reduced FEV1 for those hired < 5 years before baseline than for those who were hired > or = 5 years after baseline. Recent endotoxin exposure was significantly associated with byssinosis, chronic bronchitis, and chronic cough.

Secondary pulmonary alveolar proteinosis (PAP) is rare but may occur in association with malignancy, certain infections, and exposure to inorganic or organic dust and some toxic fumes. This case report describes the second recorded case of PAP due to exposure to cotton dust. A 24-year-old man developed PAP after working as a spinner for eight years without respiratory protection. He was admitted as an emergency patient with very severe dyspnea for four months and cough for several years. Chest X-ray showed bilateral diffuse alveolar consolidation. He died 16 days later, and a diagnosis of acute pulmonary alveolar proteinosis was made at autopsy. The histopathology demonstrated alveoli and respiratory bronchioles filled with characteristic periodic acid Schiff-positive material, which also revealed birefringent bodies of cotton dust under polarized light. Secondary PAP can be fatal and present with acute respiratory failure. The occupational history and characteristic pathology can alert clinicians to the diagnosis.

The word byssinosis is derived from the Greek word ?vcjaos, meaning fine linen. Originally the word was used in a wider, more general sense, whereas to-day it indicates a specific industrial entity. Byssinosis is a respiratory disease affecting workers inhaling dust in cotton mills. The condi tion has been known to exist for many years, and was first recorded by Greenhow in a report to the Privy Council of London in 1861. The cotton trade has been the Cinderella of occupational hazards and it is only recently that research into the causes of byssinosis has been undertaken. In 1930 the Industrial Health Research Board published a study of sickness among operatives in Lancashire cotton mills, and in 1932 the Home Office issued the Report of the Departmental Com mittee on Dust in Card Rooms in the Cotton Industry. This report collected the existing information about conditions in the mills, types of machinery in use, and the nature of the cotton dust, and included an account of the clinical examination and radiological findings in a group of workers suffering from the disease. The post-mortem findings in a few cases where death had occurred were also described. In 1936 Prausnitz published an account of investigations on respiratory dust disease in opera tives in the cotton industry. The mass of informa tion from these two reports gives the most recent and authoritative knowledge on byssinosis, and forms the structure on which further investigations can be based. Foreign literature on the subject is scanty and does not contribute any additional knowledge. Zipperlen (1935) reported on an investigation of patients suffering from asthma in W?rttemburg, where there is a textile industry. His report contained the following statement: 4 A few words should be said concerning industry. In spite of all protective appliances cotton dust cannot be excluded, and we have actually observed

Research during recent years has made clear that pulmonary disease and certain general symptoms caused by organic dusts are far more common than previously suspected. To the traditional environments of cotton dust and moldy hay has been added a series of environments, such as swine confinement buildings, sewage treatment stations and industrial fermentation plants. It has been suggested that, rather than linking clinical disease with a specific environment (farmer's lung, byssinosis, etc), symptoms should be related to the relevant pulmonary cellular reactions, particularly inflammation. In so doing, a more homogenous picture of the various clinical entities has emerged. It is now understood that symptoms once considered to be unique to one particular environment, such as chest tightness in cotton mills, are also present in other organic dust environments. New models for organic dust-induced disease have been established using the criteria developed for disease among workers in cotton mills and swine confinements buildings. This has led to uniform methods for diagnosis, description of symptomatology and understanding of pathogenesis. Employing this experience on an international basis, provides an important background for dealing with new problems in this important area of occupational health and is a prerequisite for the establishment of treatment and prevention programs.

Endotoxins present on cotton and released during carding have been implicated as a cause of byssinosis, a lung dysfunction found in some textile mill workers. The endotoxin content of cotton lints and dusts is frequently determined by the Limulus amoebocyte lysate (LAL) test. Although this test is a very effective measure of endotoxin in drugs and parenteral solutions, it is subject to interferences and false positives from other components in a more complex matrix such as cotton dust. To obviate these problems, we are investigating the quantitation of endotoxins by determining the 3- hydroxymyristic acid content of the sample. This fatty acid is reported to be unique to the lipid A portion of lipopolysaccharides from gram-negative bacteria and has been reported as a marker for endotoxin by others. A major source of error in deter mining endotoxins in cotton lints and dusts appears to lie with the extraction procedures used to remove the endotoxin from the cellulosic matrix. This is true for both chemical and LAL assays. To eliminate this time-consuming and error-producing step, we are investigating the direct hydrolysis of the endotoxin while still on the cellulosic matrix. The amount of 3-hydroxymyristic acid is determined by HPLC of the phenacyl ester and related to endotoxin content using a calibration curve prepared from E. agglom erans, generally the predominant bacterial species on cotton fiber. Endotoxin values for direct hydrolysis are from 10 to 40 times greater than those obtained for aqueous or phenol-water extracts of the same lints or dusts, implying that endotoxin from both intact and lysed bacteria may be quantitated. Reproducibility is improved over that obtained for extracts of cotton lints and dusts.

The mortality of 3458 cotton industry workers originally enrolled in a study of respiratory symptoms in the period 1968-1970 was followed to the end of 1984. Both the total mortality and the mortality from respiratory disease were less than expected, and they both decreased as length of service increased. However, for the subjects who initially reported byssinotic symptoms, the mortality from respiratory disease was slightly raised overall, and it increased with length of service. These patterns of mortality indicate a survivor effect (ie, a tendency for those with respiratory weakness to leave the industry), together with a long-term effect reflected in respiratory mortality on the health of those workers susceptible to the effects of cotton dust. The mortality from lung cancer was lower than expected, and it decreased with length of service. This finding is consistent with other observations that exposure to cotton dust may reduce the risk of lung cancer.

The characteristics of the effects of exposure to cotton dust were adequately described more than 50 years ago. Symptoms of airway irritation, cough with or without phlegm, and Monday morning chest tightness are typical. The symptoms caused by exposure to cotton dust are similar to those induced by other organic dusts. A common pathology is acute or chronic inflammation, and bacterial endotoxins seem to be the causative agents for the acute and some chronic reactions.

One hundred and sixty-nine and 175 cotton textile workers (CTWs) were enrolled in the first (1991) and second (1996) surveys to investigate the prevalence of byssinosis. The synergistic effect of smoking on cotton dust exposure was also evaluated. Although the difference in prevalence of abnormal pulmonary function between the first (38.5%) and second study (38.9%) was not statistically significant, smokers had significantly higher frequency than nonsmokers in both surveys. A significant trend existed between the cotton dust levels and the frequency of abnormal lung function. The significant trend was also noted in both smokers and nonsmokers. The frequency of respiratory symptoms and the prevalence of severe byssinosis in the second survey (14.9% and 12.6%, respectively) were significantly lower than that in the first survey (39.7% and 21.9%, respectively). The reduction of symptoms was due to remodeling of this old cotton mill. The prevalences of respiratory symptoms and byssinosis in smokers being significantly higher than in nonsmokers only found in the first survey, but not found in the second survey. These results indicate that smoking potentiates the effect of cotton dust exposure on respiratory symptoms and byssinosis. The second study reveals high prevalence of byssinosis still existed in Taiwanese cotton mill, although the prevalence was declining. Smoking was found to show an additive effect on cotton dust exposure. Anti-smoking campaign, occupational health program to reduce the dust exposure, and periodical medical examination are measures to prevent from byssinosis.

Trade unions have often been criticized for their failure to address occupational health issues. This article explores their response to byssinosis-a chronic respiratory disease caused by exposure to cotton dust that was rife in the Lancashire cotton industry in the early nineteenth and twentieth centuries. Using the archives of the cardroom and spinning unions, it is demonstrated that trade union efforts to combat byssinosis began before the First World War and were sustained for over 70 years. During that period, byssinosis became a recognized medical condition and a compensatable disease, due in no small measure to the trade unions campaigning tirelessly for better dust control, compensation for all affected workers, and more medical research.

The literature on the history of industrial diseases is scanty, especially for byssinosis – a chronic respiratory illness caused by exposure to cotton dust that was prevalent in Lancashire cotton mills from the early nineteenth century. This article uses government, legal, medical, and trade union records to explore the development of state compensation for byssinosis. This began in 1941, but not until the early 1970s did compensation extend to all affected workers. Even then, dissatisfaction with state benefits for byssinosis ensured a steady stream of common law actions after 1975. Most of these were settled, highlighting the failure of government and industry to control dust and safeguard workers' health. Government aversion to increasing costs in a declining industry was a major factor in the development of an inequitable compensation system, which shifted many of the costs of industrial disease onto cotton workers.

Background: The health of the individuals will largely depend upon the work environment. In many of the cotton and textile industries, workers are largely exposed to dust. In the light of rapid economic growth and individual progress, it becomes imperative that safety and health at the workplaces will have to be given due importance. Objective: To study the effect of cotton dust on the lung function test of cotton spinning mill workers Methods: The study was conducted on 50 controls and experimental group in Karimnagar town. The ventilating parameters considered for analysing the pulmonary function test (PFT) were Forced Vital Capacity (FVC), Forced Expiratory Volume in 1 sec (FEV1 ), Percentage of Forced Volume in 1 sec (FEV1/FVC %), Maximum Mixed Expiratory Flow Rates for 25-75% (FEF 25-75%), Peak Expiratory Flow Rate (PEFR) and Maximum Voluntary Ventilation (MW). Results: All studied parameters if PFT show significant decrease in experimental group as compared to control group. This shows that the cotton dust has adverse effect on the health of the cotton spinning mill workers. Conclusion: The continued exposure to cotton dust cause progressive impairment of lung functions and adversely affect the parameters such as FVC, FEV1, FEF 25-75%, PEFR and MW and causes restrictive and obstructive pattern of lung function impairment, which is also associated to the duration of exposure.

To evaluate chronic loss of lung function in cotton dust-exposed workers, a 5-yr follow-up study was performed in Shanghai, China from 1981 to 1986. Workers at a nearby silk thread manufacturing mill were used as a control population. There were 384 cotton textile workers restudied from an original group of 446, and 403 silk workers restudied from the original 468. The presence of byssinosis among retested cotton workers at the time of first survey was 7.3%. The prevalence of byssinosis was 9.7% at the initial survey among those lost to follow-up. No byssinosis was found among control subjects. The mean annual decline in FEV1 was 39.5 ml among cotton workers and 30.6 ml for silk workers (p < 0.05). The greatest annual decrements were found among smoking cotton workers, but nonsmoking cotton workers also lost lung function at a faster rate than silk nonsmokers (annual loss = 33.3 ml versus 24.4 ml, respectively). Autoregressive modeling revealed that after adjustments for age, sex, height, and smoking, cotton dust exposure was significantly associated with decline in FEV1. Moreover, across-shift drop of 5% or more at the time of first survey was predictive of 5-yr decline in FEV1. Cotton workers who had an acute response (5% or greater drop in FEV1 at the time of first survey) suffered a 57.0 ml/yr FEV1 drop compared with a 35.1-ml drop among cotton workers with less acute response at baseline (p < 0.01). Silk workers with or without 5% across-shift drops had similar annual rates of decline (-33.8 ml and -36.1 ml, respectively).(ABSTRACT TRUNCATED AT 250 WORDS)

Studies of cotton textile workers have found an association between atopy and drop in FEV1 over a workshift. We studied the response of previously nonexposed volunteers with and without a history of mild atopy to a 5-h exposure to 1 mg/m3 of respirable cotton dust in a model cardroom. All participants were nonsmokers, had no history of asthma, and had normal spirometry. Twenty atopic subjects gave a personal history of mild respiratory allergy to pollen, dusts, or animals that had been confirmed by a physician. Thirty-two nonatopic subjects had no history of allergy. Spirometry and a methacholine challenge test were performed 1 to 2 days prior to exposure. Spirometry was repeated immediately before exposure to cotton dust; spirometry and a methacholine challenge were performed immediately after exposure. Atopic subjects showed a significantly higher mean serum IgE level to Phadiatop, a screening test to common inhalant allergens, than did nonatopic subjects (mean percent binding, 32.1 versus 1.5; p0.001). Atopic subjects had a significantly greater mean fall in FEV1 during exposure (8.3% versus 4.9%, p0.05). The difference in FEV1 decline between atopic and nonatopic subjects was similar in magnitude to that reported for workshift FEV1 declines between textile workers with and without mild atopy. Atopic subjects had significantly higher baseline methacholine responsiveness than did nonatopic subjects (26% versus 0% reaching a PD20, p0.0005). After cotton dust exposure, there was a significant increase in airway reactivity in both groups (68% versus 20% reaching a PD20, p0.0005). For all subjects combined baseline responsiveness was significantly related to the change in FEV1 after exposure.(ABSTRACT TRUNCATED AT 250 WORDS)

Gram-negative bacteria and their endotoxins have been shown to cause profound changes in the structure and function of mammalian lungs. Airborne exposures in humans have resulted in bronchoconstriction and symptoms of chest tightness and dyspnea. Cotton dust is often heavily contaminated and endotoxin has been postulated to be the agent in cotton dust which is responsible for the byssinosis syndrome. Previous studies of cotton dust have revealed variable amounts of contamination by bacterial endotoxin, with the variability determined in large part by botanical and climatic characteristics. We report here the results of an environmental study conducted in a cotton mill located in the tropics of Central America using locally grown cotton. Results indicate that airborne endotoxin was present in all yarn preparation and weaving areas and ranged from a low of 18 EU/in 3 in weaving to a high of 3138 EU/in 3 in opening areas. Airborne levels and the amount of endotoxin per nanogram of dust were not higher than values obtained in temperate climates.

Here is a feast for lovers of the eponymous and the obscure, and for any physician who has just received a report from a consultant advising that his or her patient has a classical case of Griesinger's syndrome. Magalini, Magalini, and de Francisci have compiled and alphabetized 2700 syndromes, providing them with synonyms, symptoms, signs, etiology, prognosis, and short bibliographies. The abecedarian arrangement of the syndromes stretches from Aagenaes' all the way to Zuelzer-Ogden (the latter, unfortunately, now labeled obsolete). How many readers know what Zoon's syndrome is or the difference between Rosenthal-Kloepfer, Rosenthal's (C.), and Rosenthal's (R.L.) syndromes? Some appellations are more descriptive than eponyms. For instance, Monday fever is what happens in patients with byssinosis when returning to work on Monday morning in a place with a high concentration of industrial cotton dust. If you can't identify mongolian blue spots, you should get this book and look them

Acute spirometric responses to inhaled cotton dust were examined in a population of 226 healthy, non-asthmatic adults whose atopic status had been evaluated by skin prick tests to 10 common environmental allergens. Exposure to cotton dust occurred in model cardrooms where elutriated dust levels were carefully controlled (1.02 mg/m3). Atopy, defined as positive prick tests to at least two allergens, was observed in 26% of subjects. Significant forced expiratory volume in one second (FEV1) decrements occurred after exposure to cotton dust independent of atopic status (p less than 0.001). The mean FEV1 decline in atopic subjects, however, was significantly greater than in non-atopic subjects (p less than 0.05). Degree of atopy, as measured by number of positive skin tests, also exhibited a significant association with cotton induced decrements in FEV1 (p less than 0.05). These data suggest that atopy may be an important determinant of the magnitude of the acute pulmonary response to cotton dust. This may reflect the non-specific airways hyperresponsiveness that has been described in non-asthmatic, atopic individuals.

A guinea pig animal model of byssinosis has been described that demonstrates both acute and chronic effects of cotton dust inhalation (Ellakkani et al., 1984, 1987). During the latter study in which guinea pigs were exposed to 21 mg/m3 cotton dust 5 d/wk, 6 h/d for 52 wk, blood samples were taken from animals (20 exposed, 20 sham-exposed) prior to exposure and monthly during the exposure period. Sera were evaluated for quantities of the major protein fractions, and for IgG antibodies to cotton dust components. At the completion of the study, blood was evaluated for total and differential leukocytes. At 6 mo of exposure, each of the five protein fractions was significantly different from the corresponding fraction in the control animals. Antibodies reactive with an aqueous cotton dust extract (ACDE) were prominent by 2 mo of exposure and the titer was increased with continued exposure. The extract was composed of 2.6% protein, 12.8% reducing sugar, and 4.1% nucleic acid, with the remainder being largely simply sugars and inorganic material. A fraction of the antibodies showed reactivity with gram-negative bacteria and specifically with Enterobacter agglomerans, the most prevalent gram-negative microorganism in the dust. Minimal antibody response was detected using lipopolysaccharide from this microorganism or gram-positive bacteria. These results indicate that exposure of guinea pigs to cotton dust resulted in hematologic changes and in specific antibody formation. The presence of antibodies in each of the animals suggests their possible use as an indicator of cotton dust exposure.

The literature on the chemical composition of cotton dust and its relation to byssinosis has been reviewed. It appears that the component of cotton dust that is a major cause of byssinosis may be an aminopolysaccharide. Recommendations are made for further studies that might point the way to reducing or eliminating the byssinosis problem.

Workers in the "non-textile" cotton industry breathe a dust which is similar to the dust in the cotton spinning and weaving or "textile" industry. This exposure prompts the question of byssinosis prevalence and other respiratory disease in the non-textile cotton industry. NIOSH has completed a cross-sectional medical and environmental study evaluating the prevalence of byssinosis in five segments of the non-textile cotton industry. A total of 92 non-textile cotton facilities were evaluated, including cotton gins, cotton classing offices, cottonseed oil mills, cotton compress-warehouses, and waste utilization plants. This paper presents the results of the measurements of cotton dust levels and particle size distributions in these segments. Average elutriated dust concentrations for individual plants ranged from 101 to 2050 micrograms per cubic meter of air (micrograms/m3) in 35 cotton gins, 81 to 376 micrograms/m3 in 13 classing offices, 502 to 2041 micrograms/m3 in 18 cottonseed oil mills, 39 to 831 micrograms/m3 in 13 compress-warehouses, and 237 to 3968 micrograms/m3 in 13 waste utilization facilities. Results tend to be lower than those reported in the literature for non-textile operations.