A study was carried out to determine the health effects of rice husk dust in Malaysian rice millers. The study population consisted of 122 male Malay workers from three rice mills, with 42 controls of similar age, sex, ethnic group, and agricultural work background. Interviews using standardised questionnaires, physical examination, total and differential white cell counts, chest radiographs, and lung function tests were performed on each of the millers and the controls. Environmental dust monitoring was also carried out in the three rice mills. Clinical, haematological, and radiological findings suggest that a distinct clinical syndrome seems to be associated with exposure to rice husk dust. The manifestations of this "rice millers' syndrome" include acute and chronic irritant effects affecting the eyes, skin, and upper respiratory tract; allergic responses such as nasal catarrh, tightness of chest, asthma, and eosinophilia; and radiological opacities in the chest, probably representing early silicosis or extrinsic allergic alveolitis.In many Asian countries rice is a major agricultural crop and forms the staple food of more than one quarter of the world's population. The cultivation of rice (Oryza sp) is usually carried out in irrigated "padi" (fields). After harvesting, the rice is dried and milled and a large amount of dust is thereby generated. Apart from reported cases of occupational asthma' and keratitis nummularis,2 little research has been carried out on the effects of rice husk dust. A study was thus carried out in Malaysia (a major rice growing country) to determine whether there were adverse health effects associated with occupational exposure to rice husk dust. MethodsThe study population consisted of all workers employed at the time of the study (March-May 1983) Each subject and control was interviewed by a physician using a standard questionnaire based on the British Medical Research Council questionnaire on respiratory symptoms. This also contained questions pertaining to symptoms of eye irritation (defined as any complaints of itchiness, grittiness, soreness, lachrymation, redness, or photophobia of the eyes) and pruritus (defined as any complaints of itchiness or irritation of the skin with or without rashes). A full physical examination was also carried out on each subject and control by another physician who was not aware of the dust exposure levels. Blood samples were also collected by finger prick using a triangular surgical needle and analysed for total white and differential count by a trained laboratory technologist. For total white count, 2% aqueous acetic acid solution was used for dilution and counting was carried out using an improved Neubauer chamber. Leishman's stain was used for slide preparation in the differential white count.Standard erect posterior anterior chest radiographs were taken for each subject and control, using conventional exposure of between 60-80 KV without an absorption grid. The focal film distance was fixed at three metres, with centering point betw...
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