Lung Disease in Chinese Textile Workers

描述(申请人提供)：这一竞争延续的目标是完成一项为期30年的纵向研究，对上海棉纺织工人的稳定人口，中国。自1981年以来，该队列一直被评估棉尘和内毒素暴露以及对肺部的影响。这项独特的研究仍然是迄今为止对纺织工人进行的持续时间最长、规模最大的前瞻性队列研究，参与率异常高(80%)，而且非吸烟者占很大比例。到目前为止，这项研究已经使我们能够报告与粉尘和内毒素相关的肺部影响，包括对停止接触的影响和一些与内毒素暴露相关的候选基因的作用的新见解。然而，科学上的不确定性依然存在。具体地说，50多年来，关于肺气肿或慢性支气管炎是所观察到的呼吸道阻塞的基础，争议一直存在。之前对少量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，以及用于量化个体存在的肺气肿和呼吸道疾病程度的经过验证的自动化技术的出现，这项提议代表着将这一创新技术应用于这一独特的、具有良好特征的棉花和丝绸纺织工人群体的不同寻常的机会。我们建议将这项研究的随访时间延长到30年，这样我们就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所涉及的生物过程。我们的第一个目标是评估长期接触棉尘和内毒素与呼吸健康状况之间的关系，以及评估解除退休工人暴露的效果；第二个目标是对研究队列志愿者进行胸部HRCT检查，包括暴露和未暴露于粉尘/内毒素以及有/没有呼吸系统疾病，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呼吸道疾病发展的其他候选基因多态。我们的经验丰富的研究人员小组使用全面和创新的方法继续研究这一独特的队列，将有助于我们确定有机粉尘和内毒素暴露导致的与职业相关的呼吸道疾病发生的关键生物学基础。这项研究涉及NIOSH校外方案组合中跨部门健康结果部分的呼吸系统疾病。 公共卫生相关性：这项竞争性延续的目标是完成一项对棉纺织工人稳定人群进行的为期30年的纵向研究，目标是确定接触蔬菜粉尘的工人呼吸道疾病的确切性质和相关的细菌内毒素。我们还将评估脱离接触后肺功能的潜在改善，以及这些人群中职业性呼吸道疾病的易感因素。

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. PUBLIC HEALTH RELEVANCE: The goal of this competing continuation is to complete a 30-year longitudinal study of a stable population of cotton textile workers with the goals of determining the precise nature of the airways disease in workers exposed to vegetable dust and the associated bacterial endotoxins. We will also assess potential improvement in lung function after removal from exposure, as well as susceptibility factors for occupational airways disease among this population.