Lung Disease in Chinese Textile Workers

描述（由申请人提供）：该竞争性延续的目标是完成对中国上海棉纺织工人稳定人群的30年纵向研究。自1981年以来，已对该队列进行了棉尘和内毒素暴露以及肺部效应的评价。这项独特的研究仍然是迄今为止对纺织工人进行的时间最长、规模最大的前瞻性队列研究，参与率异常高（> 80%），而且有很大比例的非吸烟者。迄今为止，这项研究使我们能够报告粉尘和内毒素相关的肺部效应，包括对暴露停止的影响和与内毒素暴露相关的一些候选基因的作用的新见解。然而，科学上的不确定性仍然存在。具体来说，五十多年来，关于肺气肿或慢性支气管炎是否是所观察到的气道阻塞的基础的争议一直存在。此前对少数死亡工人的尸检研究一直相互矛盾。自2002年以来，随着改进的高分辨率计算机断层扫描（HRCT）的出现，以及经验证的自动化技术来量化个体中存在的肺气肿和气道疾病的程度，该提案代表了将这种创新技术应用于这一独特且特征良好的棉花和丝绸纺织工人群体的不寻常机会。我们建议在我们的研究中延长随访至30年采样，以便我们可以在体内探索几种数据密集型策略，以阐明粉尘和内毒素相关肺部疾病的生物学过程。我们的第一个目的是评估呼吸系统健康状况与长期暴露于棉尘和内毒素之间的关系，以及评估退休工人去除暴露的影响;我们的第二个目的是对研究队列志愿者进行胸部HRCT，包括暴露和未暴露于粉尘/内毒素以及有/无呼吸系统疾病，以确定观察到的肺损伤的结构基础。最后，在第三个目标中，我们将测试可能调节粉尘和内毒素相关气道疾病发展的其他候选基因多态性。由我们经验丰富的研究人员团队使用全面和创新的方法对这一独特队列进行持续研究，将有助于我们确定有机粉尘和内毒素暴露导致职业相关气道疾病发展的关键生物学基础。这项研究涉及NIOSH校外项目组合中健康结果跨部门部分的呼吸系统疾病。

DESCRIPTION (provided by applicant): The goal of this competing continuation is to complete a 30-year longitudinal study of a stable population of cotton textile workers in Shanghai, China. This cohort has been evaluated for cotton dust and endotoxin exposure as well as pulmonary effects since 1981. This unique study remains the longest and largest prospective cohort study of textile workers to date, with an unusually high (> 80%) participation rate and a large proportion of non-smokers. To date, this study has enabled us to report dust and endotoxin-related pulmonary effects, including new insights on the effect of exposure cessation and the role of some candidate genes related to endotoxin exposure. However, scientific uncertainties remain. Specifically, for over five decades, controversy continues as to whether emphysema or chronic bronchitis is the basis of the observed airway obstruction. Prior autopsy studies on small numbers of deceased workers have been conflicting. With the advent of improved high resolution computed tomography (HRCT) since 2002, as well as validated automated techniques to quantify the degree of emphysema and airways disease present in an individual, this proposal represents an unusual opportunity to apply this innovative technology to this unique and well characterized cohort of cotton and silk textile workers. We propose to extend follow-up in our study to a 30 year sampling so that we may explore in vivo several data-intensive strategies to elucidate the biological processes involved in dust and endotoxin-related lung disease. Our first aim is to assess the relationship between respiratory health status and long term exposure to cotton dust and endotoxin, as well as evaluate the effect of removal of exposure in retired workers; our second aim is to perform HRCT of the chest in study cohort volunteers, both exposed and unexposed to dust/endotoxin and with/without respiratory disease to identify the structural basis for the observed lung impairment. Finally, in the third aim we will test additional candidate gene polymorphisms that may modulate the development of dust and endotoxin-related airways disease. Continued study of this unique cohort by our experienced group of investigators using a comprehensive and innovative approach will help us identify key biological basis underlying the development of occupationally-related airways disease from organic dust and endotoxin exposure. The study addresses respiratory disease in the health outcome cross-sectors portion of the NIOSH extramural program portfolio.