Lung Disease in Chinese Textile Workers

中国纺织工人的肺部疾病

• 批准号: 9927534
• 负责人: David C Christiani
• 金额: $ 59.47万
• 依托单位: HARVARD SCHOOL OF PUBLIC HEALTH
• 依托单位国家: 美国
• 财政年份: 2018
• 资助国家: 美国
• 起止时间: 2018-09-01 至 2021-08-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/9927534
• 关键词: Lung; Disease; Chinese; Textile; Workers

ABSTRACT At least 5 million workers in the United States from several sectors are potentially exposed to airborne endotoxin. Acute endotoxin exposure produces features of dynamic airflow obstruction. However, the health effects of long-term exposure remain unclear. A few studies of chronic endotoxin exposure have identified an accelerated decline in forced expiratory volume at 1 second (FEV1), a hallmark of chronic obstructive pulmonary disease (COPD). Even studies of chronic exposure, though, tend to span less than a decade, and little is known about the trajectory of lung disease after exposure cessation, the mechanisms underlying disease severity, and the extra-pulmonary effects of chronic exposure. The goal of this competing continuation is to complete a 36-year longitudinal study of a stable, closed cohort of 919 textile workers living in the same geographical region of Shanghai, China. This unique cohort comprises cotton workers exposed to high levels of workplace endotoxin with matched control silk workers exposed to non-detectable levels of endotoxin, both with a high proportion of lifetime non-smokers. Since 1981, they have been evaluated for dust and endotoxin exposure and respiratory outcomes. All workers are now retired, but 74.2% of those still alive participated in the 30-year survey, with comparable follow-up participation expected at 35 years. The previous continuation cycle of this study enabled us to describe the persistent deleterious effects of workplace endotoxin even after worker retirement. Adverse respiratory effects include impaired lung function recovery with accelerated FEV1 decline, increased airway narrowing, and increased lung mass and lung density on chest computed tomography (CT), which likely represents persistent lung inflammation. These findings raise new questions: whether persistent inflammation plays a role in disease progression, whether disease is reversible after exposure cessation, and whether long-term endotoxin exposure leads to extra-pulmonary disease. Our overarching hypothesis is that prior cumulative workplace endotoxin exposure leads to persistent lung disease after exposure cessation due to systemic, lung parenchymal, and airway inflammation, and also results in extra-pulmonary health effects. This revised proposal has expanded its scope in response to critiques to evaluate a dense panel of inflammatory biomarkers, as well as consideration of air pollution and other variables important to study generalizability. Our research results are essential to devising effective preventive programs. The NORA sectors addressed in this proposal include: agriculture, manufacturing, healthcare, services, and construction. The cross-sector programs addressed are respiratory disease and global collaborations.

摘要 美国多个行业的至少500万工人可能接触到空气传播 内毒素。急性内毒素暴露会产生动态气流阻塞的特征。然而，健康 长期暴露的影响仍不清楚。一些关于慢性内毒素暴露的研究发现了一种 1秒用力呼气量(FEV1)加速下降，这是慢性阻塞症的标志 肺部疾病(COPD)。然而，即使是对慢性接触的研究，往往跨度也不到十年。 人们对停止接触后肺部疾病的发展轨迹、发病机制知之甚少。 疾病的严重性，以及慢性暴露的肺外影响。这一竞争延续的目标是 是为了完成一项长达36年的纵向研究，研究对象是919名居住在同一地区的稳定、封闭的纺织工人 上海地理区中国。这一独特的群体包括接触高水平辐射的棉花工人。 与接触无法检测到的内毒素水平的匹配对照组丝绸工人的工作场所内毒素，两者 终生不吸烟的人比例很高。自1981年以来，他们一直接受灰尘和内毒素的评估 暴露和呼吸结果。所有工人现在都退休了，但仍活着的人中有74.2%参与了 这项调查为期30年，预计可比的后续参与时间为35年。上一篇续集 这项研究的循环使我们能够描述工作场所内毒素的持续有害影响，即使在 工人退休。不利的呼吸影响包括肺功能恢复受损，FEV1加速 减少，增加呼吸道狭窄，增加肺质量和肺密度在胸部计算 体层摄影(CT)，这可能代表持续性肺部炎症。这些发现提出了新的问题： 持续性炎症是否在疾病进展中起作用，疾病在 停止接触，以及长期接触内毒素是否会导致肺外疾病。我们的 最重要的假设是，先前累积的工作场所内毒素暴露会导致持续性肺部疾病 暴露停止后，由于全身、肺实质和呼吸道炎症，还会导致 肺外健康影响。这项修订后的提案扩大了其范围，以回应对 评估致密的炎性生物标志物小组，以及考虑空气污染和其他因素 变量对研究概括性很重要。我们的研究结果对于制定有效的预防措施至关重要。 程序。该提案涉及的Nora部门包括：农业、制造业、医疗、 服务业和建筑业。涉及的跨部门方案是呼吸系统疾病和全球 合作。