Lung Disease in Chinese Textile Workers

描述（由申请人提供）：上海纺织工人研究是R01 OH 02421的竞争性延续。本提案旨在解决有关长期暴露于有机粉尘和内毒素的工人的呼吸健康的悬而未决的问题。在实验室研究中，暴露于革兰氏阴性细菌内毒素可产生急性呼吸道症状和肺功能改变。迄今为止，还没有其他前瞻性流行病学研究涉及棉尘和内毒素在产生工人急性和慢性呼吸效应中的相对贡献。尽管迄今为止的研究已经阐明了粉尘和内毒素相关的肺部反应的新方面，但仍有一些重要问题没有得到解答。在AIM 1中，我们将模拟每个受试者25年内肺功能的变化（第一阶段）以及这些下降与灰尘和内毒素的关系（第二阶段）。在AIM 2中，我们将研究通过退休清除暴露对呼吸健康状况的长期影响。最后，我们增加了一个创新的AIM 3：评估急性和慢性肺暴露反应的基因-环境相互作用。自1981年以来一直跟踪的研究人群（封闭队列）非常适合流行病学研究，因为：低流动率；女工吸烟率极低；可靠的基线数据；一个合适的对照组以相同的方式进行研究；行业官员、工会和协同研究团队之间的良好合作；接触已退休或因残疾离开行业的受试者；和成本效益。1981年首次调查棉纺织工人447人，丝纺织工人472人。在1986年、1992年、1996年和2001年进行了后续调查，参与情况良好。拟议的研究是独特的，因为在25年期间对灰尘和内毒素的暴露估计允许在整个研究期间评估灰尘和内毒素的暴露反应关系。该队列代表了对暴露于植物粉尘和内毒素的工作人群的最大的前瞻性研究。这项工作的结果与各种职业环境中的疾病控制有关，包括纺织、谷物加工、木材加工、动物禁闭、污水处理、生物技术以及卡特里娜飓风和丽塔飓风等环境灾害的清理。

DESCRIPTION (provided by applicant): The Shanghai Textile Worker study is a competing continuation of R01 OH 02421. 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. 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 of workers. Although the study to date has elucidated new aspects of dust and endotoxin-related pulmonary responses, significant questions remain unanswered. In AIM 1, we will model changes in pulmonary function over 25 years for each subject (stage 1) and the association of these declines with dust and endotoxin (stage II). In AIM 2, we will examine the long-term effects of removal by retirement from exposure on respiratory health status. Finally, we have added an innovative AIM 3: to assess gene-environment interactions for acute and chronic pulmonary responses to exposure. The study population (a closed cohort) that has been followed since 1981 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 447 cotton textile and 472 silk textile workers first surveyed in 1981. Follow-up surveys were conducted in 1986,1992,1996, and 2001 with excellent participation. The proposed study is unique because exposure estimates for both dust and endotoxin over a 25-year period allow assessment of exposure response relationships for both dust and endotoxin for the full study interval. This cohort represents the largest prospective study of a working population exposed to vegetable dust and endotoxin. Results of this work are relevant to disease control in a wide variety of occupational settings, including textiles, grain processing, wood processing, animal confinement, sewage treatment, biotechnology, and clean-up of environmental disasters such as Hurricanes Katrina and Rita.