For many years there has been much argument whether workers in the dusty trades are prone to chronic bronchitis. In 1966 the Medical Research Council issued a report of a Select Committee which concluded that occupationally induced bronchitis did not play a significant part in the aetiology of airways obstruction in dust-exposed men. Since then epidemiological studies have demonstrated that the prolonged inhalation of dust leads to an increase in prevalence of cough and sputum. Furthermore, new physiological techniques have demonstrated a slight decrement in ventilatory capacity as a result of industrial bronchitis, and which is related to lifetime dust exposure. Unlike bronchitis induced by cigarette smoke, the predominant effect of industrial bronchitis is on large rather than small airways and the condition is not accompanied by emphysema.
The relationship between crystalline silica and lung cancer has been the subject of many recent publications, conferences, and regulatory considerations. An influential, international body has determined that there was sufficient evidence to conclude that quartz and cristobalite are carcinogenic in humans. The present authors believe that the results of these studies are inconsistent and, when positive, only weakly positive. Other, methodologically strong, negative studies have not been considered, and several studies viewed as providing evidence supporting the carcinogenicity of silica have significant methodological weaknesses. Silica is not directly genotoxic and is a pulmonary carcinogen only in the rat, a species that seems to be inappropriate for assessing particulate carcinogenesis in humans. Data on humans demonstrate a lack of association between lung cancer and exposure to crystalline silica. Exposure-response relationships have generally not been found. Studies in which silicotic patients were not identified from compensation registries and in which enumeration was complete did not support a causal association between silicosis and lung cancer, which further argues against the carcinogenicity of crystalline silica.
A cross-sectional study of 788 male employees of an aluminum production company examined the relationship of radiographic abnormalities to smoking and dust exposure from the mining and refining of bauxite to alumina. Among the aluminas produced were low temperature range transitional forms. The present analyses were limited to nonsmokers and current smokers. Two National Institute of Occupational Safety and Health (NIOSH)-certified "B" readers interpreted the radiographs. The predominant radiographic abnormalities noted were scanty, small, irregular opacities in the lower zones of profusion 0/1 to 1/1. Rounded opacities were rare. Among nonsmokers with low dust exposures, the prevalence of opacities greater than or equal to 1/0 showed no trend with increasing age and duration of exposure, suggesting no relationship between age and prevalence of opacities of Category 1 or more in this cohort (p greater than 0.10). Nonsmokers who had accumulated higher dust exposures showed a trend of increasing prevalence of opacities with increasing duration, suggesting an effect of occupational exposure at higher cumulative exposure levels (p less than 0.05). In most exposure categories, smokers exceeded nonsmokers in their prevalence of opacities greater than or equal to 1/0; the overall prevalence among smokers being 12 and 11% according to Readers A and B, respectively, compared with 4% in nonsmokers (p less than 0.01). In conclusion, 7 to 8% of aluminum workers in this cohort had radiographic findings of scanty, small, irregular opacities, the prevalence of which was increased among smokers (p less than 0.01). There was a moderate increase in the prevalence of opacities with increasing tenure in nonsmokers with high cumulative exposures (p less than 0.05).
. Lung volumes and flow rates in black and white subjects. It has been known for some time that the vital capacity and forced expiratory volume in one second of black subjects are about 12% lower than those of whites of the same age and height. In the present study, total lung capacity and residual volume were also shown to be decreased by about the same percentage. Expiratory flow rates were similarly decreased, but when the difference in lung size was evened out by matching black and white subjects of the same total lung capacity, no significant differences in flow rates were observed.
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