Airway hyperresponsiveness, prevalence of chronic respiratory symptoms, and lung function in workers exposed to irritants

• Published in: Occupational and environmental medicine (London, England) England), 1994-01, Vol.51 (1), p.3-13
• Main Authors: Kremer, A M, Pal, T M, Boleij, J S, Schouten, J P, Rijcken, B
• Format: Article
• Language: English
• Subjects: Adult; Allergies; Biological and medical sciences; Chemical and industrial products toxicology. Toxic occupational diseases; Cigarette smoking; Forced Expiratory Volume; Fumes; General aspects; Histamine; Histamines; Humans; Industry; Irritants - adverse effects; Lung - physiopathology; Lung Diseases, Obstructive - chemically induced; Lung Diseases, Obstructive - physiopathology; Lungs; Male; Maximal expiratory flow rate; Maximal Midexpiratory Flow Rate; Medical research; Medical sciences; Middle Aged; Mist; Occupational Diseases - chemically induced; Occupational Diseases - physiopathology; Occupational exposure; Polyamides; Polyesters; Prevalence; Prospective Studies; Respiratory function; Respiratory Hypersensitivity - chemically induced; Respiratory symptoms; Smoking; Sulfur dioxide; Time Factors; Toxicology; Vital Capacity; Yarns
• ISSN: 1351-0711; 1470-7926
• DOI: 10.1136/oem.51.1.3

The association between occupational exposure to airway irritants and the prevalence of chronic respiratory symptoms and level of lung function, and whether these associations were modified by airway hyperresponsiveness, smoking, and a history of allergy were studied in 668 workers from synthetic fibre plants. Respiratory symptoms were recorded with a self administered Dutch version of the British Medical Research Council questionnaire, with additional questions on allergy. Airway responsiveness was measured by a 30 second tidal breathing histamine challenge test. On the basis of job titles and working department, the current state of exposure of all workers was characterised as (1) no exposure, reference group; (2) white collar workers; (3) SO2 HCl, SO4(2); (4) polyester vapour; (5) oil mist and vapour; (6) polyamide and polyester vapour; (7) multiple exposure. Workers exposed to airway irritants were not simultaneously exposed to airborne dust. Airway hyperresponsiveness (AHR), defined as a 20% fall in forced expiratory volume in one second (FEV1) at < or = 32 mg/ml histamine, was present in 23% of the subjects. The association between exposure groups and prevalence of symptoms was estimated by means of multiple logistic regression; the association with level of lung function (forced vital capacity (FVC), FEV1, maximum mid-expiratory flow rate (MMEF)) was estimated by means of multiple linear regression. Both methods allow simultaneous adjustment for potential confounding factors. The exposure groups were associated with a higher prevalence of chronic respiratory symptoms. Lower prevalence of symptoms was found for workers exposed to SO2, HCl, and SO4(2-), most likely due to pre-employment selection procedures. Current smoking, AHR, and a history of allergy were significantly associated with a higher prevalence of chronic respiratory symptoms, independent of each other, and independent of irritant exposure. The association between exposure and prevalence of symptoms was greater in smokers than in ex-smokers and non-smokers. This difference was most clearly seen in the polyester vapour and polyamide and polyester vapour group. No modification of the association between exposure groups and prevalence of symptoms by airway hyperresponsiveness could be shown. The exposure groups were not significantly associated with a lower level of lung function. Adjustment for chronic respiratory symptoms did not change the results. There were no indications of a possible