LUNG DISEASE IN CHINESE TEXTILE WORKERS

该提案有两个目标：[1]完成15年的纵向 研究纺织工人在上海，中国，和[2]检查一个天真的 入境时及入境后首三年的纺织工人人口 就业这一提议旨在解决尚未得到解答的问题 关于长期接触有机污染物的工人的呼吸系统健康问题 灰尘和内毒素暴露于革兰氏阴性细菌内毒素已被 在实验室研究中被描述为产生急性呼吸道症状 和肺功能改变。 类似的观察结果没有重现 在实际的工厂设置中。迄今为止，没有其他前瞻性流行病学研究 已经讨论了棉尘和内毒素在 产生急性和慢性呼吸影响。的重要性 内毒素在引起肺部效应中不仅在棉花中是重要的， 纺织工业，而且在许多其他环境中 其中遇到显著水平的空气传播的内毒素。 第一个目标是集中在一个研究人群， 自1981年以来，它非常适合流行病学研究 原因是：更替率低，女工吸烟率很低， 可靠的基线数据，一个合适的对照组，在相同的研究 时尚，行业官员，工会和 合作的。研究团队，接触退休或离职的受试者 残疾人和成本效益的行业。人口包括 447名棉纺织工人和465名丝绸纺织工人首先 1981年调查。 1986年和1992年进行了后续调查， 90%的成功率这项拟议的研究是独一无二的，因为 在15年的时间内，灰尘和内毒素都可以评估 对于全样本，粉尘和内毒素的确定性-响应关系 研究间隔。 为达致是次续期申请的第二个目的，我们建议 扩展研究-超出原始队列并招募400名受试者 未经加工的暴露。我们有丰富的机会接触和测试 志愿者已被雇用，但尚未接触到棉尘， 以确定可能是离开风险标志的早期反应 工作和发展慢性呼吸道疾病。这个机会 存在，因为上海纺织业的就业实践是 独特.我们将招聘2名棉花和200名丝绸新员工， 评估其暴露前的支气管反应性、特应性和基线 呼吸道健康然后，我们将在前3年密切关注他们 就业与症状，肺功能（交叉移位）和 粉尘/内毒素测量。

This proposal has two objectives: [1] to complete a 15-year longitudinal study of textile workers in Shanghai, China, and [2] to examine a naive population of textile workers at entry and during the first three years of employment. This proposal is designed to address unanswered questions regarding the respiratory health of workers chronically exposed to organic dust and endotoxin. Exposure to gram-negative bacterial endotoxin has been described in laboratory studies as producing acute respiratory symptoms and lung function change. Similar observations have not been reproduced in actual mill settings. To date, no other prospective epidemiologic study has addressed the relative contributions of cotton dust and endotoxin in producing both acute and chronic respiratory effects. The importance of endotoxin in causing pulmonary effects is important not only in Inc cotton textile industry, but also in a number multitude of other environments where significant levels of airborne endotoxin are encountered. The first objective is focused on a study population that has been followed since 1981 and is unusually well-suited for epidemiologic study due to: low turnover, very low smoking prevalence among women workers, reliable baseline data, a suitable comparison group studied in identical fashion, excellent cooperation among industry officials, union and the collaborative'. research team, access to subjects who have retired or left the industry in disability, and cost-efficiency. The population includes a closed cohort of 447 cotton textile and 465 silk textile workers first surveyed in 1981. Follow-up surveys were conducted in 1986 and 1992 with 90% success. The proposed study is unique because exposure estimates for both dust and endotoxin over a 15-year period allow assessment of exposure-response relationships for both dust and endotoxin for the full study interval. To address the second objective in this renewal application, we propose to expand the study - beyond the original cohort and recruit 400 subjects naive to mill exposures. We have a rich opportunity to access and test volunteers who have been hired, but not yet exposed to cotton dust in order to determine early responses that may be markers of risk for leaving the job and for developing chronic respiratory disease. This opportunity exists because the Shanghai Textile Industry's employment practices are unique. We will recruit 2()() cotton and 200 silk newly-hired workers, assess their pre-exposure for bronchial responsiveness, atopy and baseline respiratory health. We will then follow them closely for the first 3 years of employment with symptoms, pulmonary function (cross-shift) and dust/endotoxin measurements.