Eugenija Zuskin

Acute airway responses to hair-spray preparations.

Abstract Acute exposures (20 seconds) to hair-spray preparations A, B and C caused significant decreases of maximum expiratory flow rates at low lung volumes in healthy men and women. Peak expiratory flow rates were reduced slightly after hair spray A only. The decreases were more pronounced on partial than on maximal expiratory flow-volume curves. On the partial curves, flow at mid-vital capacity decreased on the average 22 per cent immediately after exposure to spray A (16 subjects), 21 per cent after spray B (16 subjects), 29 per cent after spray C (nine subjects) and 4 per cent after placebo spray. These changes suggest that hair sprays cause acute, reversible narrowing of small airways. The chemical nature of the active ingredient (or ingredients) in hair sprays is not known; their mode of action may involve histamine release from lung tissue or a direct effect on airway smooth muscle, or both. Controlled inhalation studies in man should be required as part of the toxicologic evaluation of consumer p...

Respiratory function in tea workers

Respiratory function was studied in five groups of tea workers employed in processing different types of tea. The prevalence of almost all chronic respiratory symptoms was significantly higher in workers processing dog-rose, sage, and gruzyan tea than in control workers. During the Monday workshift there was a significant mean acute decrease in maximum expiratory flow rates at 50% vital capacity (range: 4.1-8.8%) and at 25% VC (range: 7.8-21.8%) except in those exposed to camomile. Acute reductions in forced expiratory volume in one second were considerably smaller and mostly not significant. Mean acute reductions on Wednesday were similar to those on Monday with no significant differences between preshift Monday and Wednesday data. Acute decreases in flow rates at low lung volumes suggest that the bronchoconstrictor effect of the dust acts mostly on smaller airways. Preshift administration of disodium cromoglycate significantly diminished acute reduction in flow rates except in workers processing Indian tea. A comparison of Monday preshift values of ventilatory capacity in tea workers with those in controls indicates that exposure to tea dust may, in some workers, lead to chronic respiratory impairment.

Respiratory findings in spice factory workers.

The respiratory consequences of working in the spice industry were studied in 92 female spice factory workers (mean age, 36 yr; mean exposure, 12 yr). A control group of 104 female workers employed in a nondusty industry was also studied. The prevalence of chronic respiratory symptoms was significantly higher in the exposed than in the control group. In particular, the prevalence of dyspnea (57.6%), chronic cough (22.8%), chronic phlegm and chronic bronchitis (19.6%), nasal catarrh (37.0%), and sinusitis (22.2%) was high when compared to controls (p less than .01). Among spice factory workers, a high prevalence of acute symptoms during the workshift was recorded. Acute reductions in lung function were statistically significant over the workshift for forced vital capacity (FVC), -2.0%; forced expiratory volume in one second (FEV1.0), -3.0%; and for maximum expiratory flow rates at 50% (FEF50), -8.3% and at 25% (FEF25), -15.2% measured on maximum expiratory flow-volume (MEFV) curves. No difference was found in across-shift ventilatory function in workers with or without chronic respiratory symptoms, except for FEF25 (with symptoms, 16.7%; without symptoms, 9.6%). Preshift administration of 40 mg of disodium cromoglycate (DSC) inhaled 15 min before the workshift significantly diminished acute reductions in FEF50 and FEF25 in exposed workers. Monday preshift FEF50 and FEF25 in exposed workers were significantly lower than in control workers (p less than .01), which suggests an early irreversible component to this illness.

Respiratory function in coffee workers.

Respiratory function was studied in three groups of workers employed in processing coffee. The prevalence of almost all chronic respiratory symptoms was significantly higher in coffee processors than in control workers. In each group during the Monday work shift there was a significant mean acute decrease in the maximum expiratory flow rate at 50% vital capacity (VC), ranging from 4.0% to 8.7%, and at 25% VC, ranging from 6.0% to 18.5%. Acute reductions in FEV1.0 were considerably lower, ranging from 1.3% to 2.8%. On Thursdays the acute ventilatory function changes were somewhat lower than on Mondays. Acute decreases in flow rates at low lung volumes suggest that the bronchoconstrictor effect of the dust acts mostly on smaller airways. Administration of Intal (disodium cromoglycate) before the shift considerably diminished acute reductions in flow rates. A comparison of Monday pre-shift values of ventilatory capacity in coffee workers with those in controls indicates that exposure to dust in green or roasted coffee processing may lead to persistent loss of pulmonary function.

Respiratory symptoms and lung function in hemp workers.

Respiratory symptoms and abnormalities of lung function were studied in 84 female and 27 male hemp workers employed in two textile mills (A and B) processing soft hemp (C sativa). In mill A 46 women and 27 men were investigated and 38 female workers were studied in mill B. Forty nine women and 30 men from a non-dusty industry served as controls. A significantly higher prevalence of almost all chronic respiratory symptoms was found in female hemp workers when compared to control workers. Among the men these differences were significant for nasal catarrh and sinusitis. A high prevalence of byssinosis was found among female hemp workers in both mills (group A, 47.8%; group B, 57.9%) as well as in the male workers (66.7%). Statistically significant across shift reductions in lung function were found for all ventilatory capacity measurements in female and male hemp workers varying from 7.1% for forced expiratory volume in one second (FEV1) to 15.1% for flow rates at 50% vital capacity (FEF50). Measured Monday baseline values before the work shift were significantly lower than expected for hemp workers, being particularly reduced for FEF25 and FEF50. The data suggest that occupational exposure to hemp dust is a significant risk factor for the development of acute and chronic lung disease in workers employed in this textile industry.

Respiratory Findings in Workers Employed in the Brick-manufacturing Industry

We studied 233 male workers employed in two brick-manufacturing plants and 149 matched control workers. The mean age of the brick workers was 35 years, with a mean duration of employment in this industry of 16 years. The prevalence of chronic respiratory symptoms as well as acute symptoms during the work shift were recorded. Lung function was measured on Monday during the work shift by recording maximum expiratory flow-volume (MEFV) curves, from which the forced vital capacity (FVC), the one-second forced expiratory volume (FEV1) and flow rates at 50% and the last 75% of the FVC (FEF50, FEF75) were measured. The results of periodic chest roentgenograms were reviewed. There was a significantly higher prevalence of chronic cough (31.8%), chronic phlegm (26.2%), and chest tightness (24.0%) in exposed workers, compared with control workers (20.1%; 18.1%; 0%) (P < 0.05). This increased symptom frequency was also documented among nonsmokers studied by age and by length of employment, suggesting a work-related effect. Among work shift-related symptoms, high prevalences were noted for upper respiratory tract symptoms (e.g., dry throat, eye irritation, throat irritation). The measured FVC and FEV1 were significantly lower than predicted for brick workers and suggested a restrictive pattern. The mean FVC (as a percent of predicted) was 78.1% and FEV1 was 88.1%. The FEF50 and FEF25 were not significantly decreased. A multiple regression analysis with age, exposure, and smoking as predictors and lung function parameters as response variables showed a significant effect between exposure and FVC. Significant chest roentgenographic abnormalities were not documented. These findings of a restrictive lung function pattern in brick workers with normal chest roentgenograms may suggest early interstitial disease. Additionally, a bronchitic component, as suggested by the respiratory symptoms, may also be present.

Byssinosis in carding and spinning workers. Prevalence in the cotton textile industry.

Symptoms of byssinosis were found in 25% of 59 carders and in 12% of 99 spinners employed in two air-conditioned cotton textile mills. In carders as well as spinners, forced expiratory volume (FEV1.0) and flow rates on maximum expiratory flow-volume (MEFV) curves decreased during work on Monday, and to a lesser extent on Wednesday. The prevalence of byssinosis in these mills is higher than would be expected according to previous data, on the basis of the relatively low dust concentrations in the carding and spinning areas. If these prevalence rates are valid for the US cotton textile industry in general, about 8,000 carders and 9,000 spinners have byssinosis (all grades). This estimate excludes retired workers.

Respiratory function in greenhouse workers

SummaryRespiratory findings were studied in a group of 135 female and 32 male workers employed in greenhouses. In addition 51 women and 30 men were studied as a control group. Exposed women had significantly higher prevalences of chronic cough, dyspnea, chest tightness, and rhinitis (P < 0.01) than the controls. Among the men, only rhinitis was more prevalent in greenhouse workers (P < 0.01) than in controls. Smokers had higher prevalences of all chronic respiratory symptoms than nonsmokers, but the differences were statistically significant only for chronic cough and rhinitis in women and for chronic phlegm in men. There was a high prevalence of acute symptoms during work. A large number of greenhouse workers complained of skin reactions to plants and pesticides (women: 37.8%; men: 34.4%). Workers had significantly lower mean ventilatory capacity measurements (except in the case of forced vital capacity) when compared to standard predicted values. Smokers and nonsmokers had similar values of lung function expressed as percentages of the predicted values. Greenhouse workers exposed for more than 10 years had a significanty lower FEF25, measured as a percentage of the predicted value, than workers exposed for less than 10 years. Our data indicate that occupational exposure to greenhouses may be associated with the development of acute and chronic respiratory symptoms and impairment of ventilatory capacity.

Respiratory function and immunological status in cocoa and flour processing workers

Respiratory function and immunological status were studied in 40 cocoa and 53 flour processing workers employed as packers in a confectionery industry and in 65 unexposed control workers in the same industry. A high prevalence of chronic respiratory symptoms was recorded in exposed workers, varying from 5.0% to 30.0% in cocoa workers and from 5.7% to 28.3% in flour workers. Occupational asthma was diagnosed in 2 (5%) of the cocoa workers and in 3 (5.7%) of the flour workers. None of the control workers suffered from occupational asthma. The prevalence of almost all chronic respiratory symptoms was significantly greater in cocoa and flour workers than in control workers. There was also a high prevalence of acute symptoms that developed during the work shift, being highest for cough (cocoa: 57.5%; flour: 50.9%) and eye irritation (cocoa: 50.0%; flour: 54.7%). Significant across-shift reductions of ventilatory capacity were recorded in exposed workers, being largest for flow rates at 50% and the last 25% of the vital capacity on maximum expiratory flow-volume (MEFV) curves (FEF50, FEF75). The prevalence of positive skin tests for cocoa (60.2%) was significantly higher than the prevalence of positive skin tests for flour (25.8%) among the 93 exposed workers (p < 0.05). Control workers had significantly lower prevalences of positive skin tests to cocoa (4.6%) and flour (12.3%) than exposed workers (p < 0.01). Increased total serum IgE levels were found in 17.5% of cocoa and in 18.7% of flour workers; none of the control workers had increased IgE levels. Bronchoprovocation testing demonstrated significant decreases in lung function following inhalation of cocoa dust extract and flour dust in workers with respiratory symptoms and large across-shift reductions in lung function. Dust concentrations in the working environment were higher than those recommended by Croatian standards. These data suggest that workers employed in the processing of cocoa and flour may be at a high risk for the development of allergic sensitization and respiratory impairment.

Byssinosis and airway responses due to exposure to textile dust

SummaryIn epidemiological studies of byssinosis, comparisons of the effects of different vegetable dusts on lung function indicate that hemp and flax are the most potent, followed by cotton, jute, and sisal. Comparison of the preshift lung function data in hemp, flax, and cotton workers with expected normal values demonstrated a considerably decreased one-second forced expiratory volume (FEV1.0) and an increased residual volume (RV), while the average values of diffusing capacity (DLCO) and total lung capacity (TLC) differed less than 10% from the predicted values. - In an experimental study with hemp dust extract in healthy volunteers, prechallenge administration of an antihistamine drug and of ascorbic acid significantly diminished acute reductions in flow rates on partial expiratory flow volume (PEFV) curves. In textile workers, propranolol significantly increased acute reductions in flow rates on maximum expiratory flow volume (MEFV) curves, indicating that the autonomic nervous system is important in determining the lung’s response to textile dust inhalation. Disodium cromoglycate (DSCG) proved to have more protective effect in those with larger (>20%) acute reductions in flow rates than in those with smaller reductions.ZusammenfassungVergleiche in epidemiologischen Studien über Byssinose, über Auswirkungen verschiedener vegetabilischer Staube auf die Lungenfunktion ergeben, daß Hanf und Flachs am aggressivsten sind, danach Baumwolle, Jute und Sisal. Vergleiche zwischen effektiven Lungenfunktionswerten bei Hanf-, Flachs- und Baumwollarbeitern und Sollwerten zeigten ein deutlich niedrigeres forciertes Exspirationsvolumen für 1 sec (FEV1.0) und ein höheres Residualvolumen (RV), während sich die Durchschnittswerte der Diffusionskapazität (DLCO) und der totalen Kapazität (TLC) weniger als 1% von den Sollwerten unterschieden.In einer experimentellen Studie mit Hanfstaubextrakten bei gesunden Freiwilligen haben vorher verabfolgte Antihistaminika und Ascorbinsäure die akute Reduktion maximaler Flows in PEFV Kurven deutlich verringert. Bei Textilarbeitern bewirkte Propranolol deutlich verminderte maximale Flows in MEFV Kurven. Dies weist auf die Bedeutung des autonomen Nervensystems bei der Bestimmung der Lungenreaktion bei Textilstaub-Inhalation hin. Intal (DSCG) zeigte eine bessere Schutzwirkung in Fällen mit höheren (>20%) akuten Reduktionen der maximalen Flows als in jenen mit niedrigeren Reduktionen.