The Shanghai Textile Worker study is a competing continuation of R01 OH 02421. This proposal is designed to address unanswered questions regarding the respiratory health of workers chronically exposed to organic dust and endotoxin. Exposure to gram-negative bacterial endotoxin has been described in laboratory studies as producing acute respiratory symptoms and lung function change. To date, no other prospective epidemiologic study has addressed the relative contributions of cotton dust and endotoxin in producing both acute and chronic respiratory effects of workers. Although the study to date has elucidated new aspects of dust and endotoxin-related pulmonary responses, significant questions remain unanswered.
In AIM 1, we will model changes in pulmonary function over 25 years for each subject (stage 1) and the association of these declines with dust and endotoxin (stage II).
In AIM 2, we will examine the long-term effects of removal by retirement from exposure on respiratory health status. Finally, we have added an innovative AIM 3: to assess gene-environment interactions for acute and chronic pulmonary responses to exposure. The study population (a closed cohort) that has been followed since 1981 is unusually well-suited for epidemiologic study due to: low turnover;very low smoking prevalence among women workers;reliable baseline data;a suitable comparison group studied in identical fashion;excellent cooperation among industry officials, union and the collaborative research team;access to subjects who have retired or left the industry in disability;and cost-efficiency. The population includes 447 cotton textile and 472 silk textile workers first surveyed in 1981. Follow-up surveys were conducted in 1986,1992,1996, and 2001 with excellent participation. The proposed study is unique because exposure estimates for both dust and endotoxin over a 25-year period allow assessment of exposure response relationships for both dust and endotoxin for the full study interval. This cohort represents the largest prospective study of a working population exposed to vegetable dust and endotoxin. Results of this work are relevant to disease control in a wide variety of occupational settings, including textiles, grain processing, wood processing, animal confinement, sewage treatment, biotechnology, and clean-up of environmental disasters such as Hurricanes Katrina and Rita.
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