Respiratory and allergic symptoms in wool textile workers.

Abstract

An epidemiological study of 2153 workers in 15 West Yorkshire wool textile mills was conducted to determine relations between respiratory symptoms and exposure to inspirable wool mill dust. A questionnaire designed to elicit all the common respiratory symptoms was developed and tested, and administered to all workers willing to participate (85%). It was translated and administered in Urdu for the 385 workers from Pakistan whose English was not fluent. Symptoms investigated included cough and phlegm, wheezing and chest tightness, breathlessness and its variability, rhinitis, conjunctivitis, chills, nosebleeds, and chest illnesses. Additional questions were asked, where appropriate, about the times of day, days of the week, seasons, and places that the symptoms were worse or better than normal. An environmental survey was carried out at each mill, which included 629 measurements of inspirable dust, enabling estimates to be made of the airborne concentrations ofinspirable dust usually experienced by each member ofthe workforce under current conditions. Overall symptom prevalences were: persistent cough and phlegm, 9%; wheeze, 31%; breathlessness on walking with others on level ground, 10%; persistent rhinitis, 18%; persistent conjunctivitis, 10%; persistent chills, 2%; ten or more nosebleeds a year, 2%; and three or more chest illnesses in past three years, 5%. After allowing for the effects of age, sex, smoking habit, and ethnic group, cough and phlegm, wheeze, breathlessness, rhinitis, conjunctivitis, and nosebleeds were found to be more frequent in those exposed to higher than to lower concentrations of dust. In some experiencing high concentrations (blenders and carpet yarn backwinders) cough and phlegm, wheeze, rhinitis, and conjunctivitis were related to the years worked in such jobs. Relative risks of each symptom in relation to inspirable dust concentrations were calculated by means of a logistic regression analysis. At concentrations of 10 mg/m3, the current United Kingdom standard for nuisance dusts, the risk ofcough and phlegm relative to that ofan unexposed worker was 137, that of wheeze 1 -40, breathlessness 1 48, rhinitis 1-24, and conjunctivitis 1 -70. Since some of these symptoms may be associated with functional impairment of the lungs, further studies of selected workers are being carried out to estimate the functional effects of exposure to dust in wool textile mills.West Yorkshire is the main centre of the British wool textile industry, which employs over 40 000 people in this area alone, in mills ranging in size from one to over a thousand workers. Over 50 years ago Moll described sensitivity to wool as a factor in occupational asthma.' More recent studies in Poland, India, Yugoslavia, and Turkey have identified an association between complaints of respiratory symptoms and dusty working conditions or duration of employment in the wool textile industry.2' Airborne dust has been shown to be a potential respiratory hazard in the United Kingdom

Exposure assessment in occupational epidemiology: measuring present exposures with an example of a study of occupational asthma

“…The use of quantitative measures of exposure has become more common (Love et al 1988;Huy et al 1991;Smid et al 1992;Wegman et al 1992;Gardiner et al 1993;Cullinan et al 1994;Halpin et al 1994), partly because they allow a more elaborate exploration of exposure-response relationships. Often, the use of quantitative intensity measures of exposure leads to the observation of steeper exposure-response gradients and larger relative risk estimates (Blair and Stewart 1992).…”

Respiratory disorders and atopy in cotton, wool, and other textile mill workers in denmark

“…Chest tightness has also been shown to occur in wool mills in Turkey [Ozesmi et al, 19871 and Scotland [Love et al, 19881, but, in contrast to the present and the Scottish survey, byssinosis was found in the Turkish mills. Like Love et al [1988], we found significant association between smoking and dyspnea, as well as between smoking and chronic bronchitis.…”

“…Respiratory symptoms have been shown to be more prevalent in cotton industry workers than in the general population [Beck et al, 19841 and than in silk workers [Christiani et al, 19861. High prevalences have also been demonstrated in the wool industry [Love et al, 1988;Ozesmi et al, 19871, but no reports have demonstrated any increased risk of respiratory diseases in the MMF industry preparing yarn from nylon, rayon, etc.…”

“…Furthermore, it was our intention to evaluate lung function, respiratory, and allergic symptoms throughout the textile industry, to see if there were differences between these industries when investigated with the same method and staff. This was initiated with the finding of respiratory problems including byssinosis in the wool industry that had been reported in the literature [Love et al, 1988; Ozesmi et al, 19871. Finally, it was our intention to search for dose-response relationship between exposure and symptoms within the cotton industry.…”

Assessment of variability of exercise tolerance limited by breathlessness.

“…*Routing instructions, and instructions for excluding subjects disabled by musculoskeletal disease, have not been shown, but are advisable in the use of the questionnaire. From the answers to questions 1-6 and also 7-12 gradings of exercise tolerance at best and at worst respectively can be derived on scales of [1][2][3][4][5][6][7] (note that the logic of the yes/no answers changes through the sequence). The gradings attributed to combinations of answers to the first six questions are shown on the right.…”