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Biomedical subjects

E N Schachter

Publications and source records attributed to E N Schachter.

At least 19 recordsLinked to original sources

Respiratory symptoms and lung function in wool textile workers.

Our study investigated a group of 216 wool textile workers (158 women and 58 men). Respiratory symptoms were assessed by questionnaire in wool textile workers and in 130 not exposed (control) workers. Ventilatory capacity was measured in wool workers by recording maximum expiratory flow-volume (MEFV) curves on Monday before and after the work shift. Forced vital capacity (FVC), 1-second forced expiratory volume (FEV1), and flow rates at 50% and the last 25% of the vital capacity (FEF50, FEF25) were measured on the MEFV curves. Analysis of the data demonstrated a significantly higher prevalence of all chronic respiratory symptoms in wool workers than in controls, being the highest in wool workers for nasal catarrh (M: 63.8%; F: 44.9%) and for sinusitis (M: 62.1%; F: 43.0%). A high prevalence of acute symptoms, associated with the work shift, was also noted in wool workers. Exposure to wool dust caused significant across-shift reductions of ventilatory capacity varying from 1.4% for FEV1 to 9.1% for FEF50. Textile workers exposed to wool for > 10 years in the workplace had similar across-shift reductions of ventilatory capacity tests as those with shorter exposures. In a large number of these wool workers, FEF50 and FEF25 were below 70% of predicted normal values. Smokers had acute and chronic lung function changes similar to those of nonsmokers, indicating that smoking did not account for all the respiratory effects seen in wool processing workers. Our data suggest that dust exposures in wool textile mills may be associated with the development of chronic respiratory symptoms and impaired lung function.

Adult

Immunological reactions and respiratory function in wool textile workers.

Immunological status and respiratory function were studied in a group of 64 wool textile workers (52 women and 12 men). A group of 46 workers not exposed to wool dust served as a control for the respiratory symptoms and immunologic testing. Skin testing was performed with different wool allergens (domestic and Australian) as well as with common allergens. Ventilatory capacity was measured in wool workers on Mondays before and after the work shift. The prevalence of positive skin tests to all allergens was higher in wool than in control workers, although the difference was statistically significant only for washed domestic wool (wool workers: 42.2%; control workers: 19.6%; p < 0.05). Increased serum IgE levels were more frequent in wool (26.6%) than in control workers (3.1%) (p < 0.01). In wool textile workers there was a high prevalence of acute and chronic respiratory symptoms. Significant across-shift reductions in ventilatory capacity tests, as well as abnormal baseline lung function, were recorded in wool textile workers. Individual data demonstrated that many of the wool workers had FEF25 lower than 70% of predicted. In general, the prevalence of symptoms and the lung function abnormalities did not correlate with the results of specific (wool) skin tests. Our data indicate that exposure to wool dust in some workers may be associated with the development of acute and chronic respiratory symptoms and impairment of lung function. Immunologic abnormalities, although frequent in this group, do not appear to be associated with the severity of these changes.

Adult

Follow-up study of respiratory function in hemp workers.

A 3-year follow-up study was performed on 38 women and 28 men from the originally studied textile workers employed in a soft hemp processing mill. Acute and chronic respiratory symptoms and ventilatory capacity were recorded during the cross-sectional and the follow-up studies. Maximum expiratory flow-volume (MEFV) curves were obtained on these workers, and forced vital capacity (FVC), 1-second forced expiratory volume (FEV1) and flow rates at 50% and at 25% of the VC (FEF50, FEF25) were measured. High prevalences of acute and chronic respiratory symptoms persisted at the follow-up study. In particular, high prevalences of byssinosis were documented at both studies (women: 47.4% and 47.4%; men: 64.3% and 67.9%, respectively). Statistically significant mean across-shift reductions were recorded for all ventilatory capacity tests at the initial study. A large mean annual decline was calculated for FEV1 in women and for all ventilatory capacity parameters in men; these declines were greater for workers with symptoms of byssinosis than for those without. The accelerated decline in FEV1 noted in the women workers, who were predominantly nonsmokers, suggests an independent hemp effect. Exposures in the work environment were measured with Hexhlet filters and revealed very high dust concentrations (mean total: 21.4 mg/m3, 22.4 mg/m3; respirable: 8.4 mg/m3, 9.9 mg/m3) at both initial and follow-up studies. These levels are much higher than those found in mills processing organic materials in North America. Our data demonstrate that work in the hemp industry, particularly in small poorly regulated mills, continues to have deleterious effects on respiratory function.

Adult

Respiratory symptoms and lung function in bus drivers and mechanics.

Acute and chronic respiratory symptoms as well as ventilatory capacity were studied in 116 bus drivers and 119 mechanics. Bus drivers and mechanics demonstrated a significantly higher prevalence of most chronic respiratory symptoms when compared to control workers. In particular, lower airway symptoms of chest tightness and dyspnea and upper airway symptoms of nasal catarrh were significantly more prevalent among drivers and mechanics than among controls. Bus drivers and mechanics who were smokers had significantly higher prevalences of respiratory symptoms than nonsmoking bus drivers. Bus drivers and mechanics employed for more than 10 years also exhibited higher frequencies of respiratory symptoms than those exposed for 10 years or less. Many of the workers complained of acute symptoms during the work shift. The ventilatory capacity data demonstrated lower values for all parameters, particularly FEF25, compared to control worker values as well as to predicted normal values, for bus drivers and mechanics who were smokers. Our data indicate that long-term employment in the transport industry of bus drivers and mechanics, particularly in combination with smoking, may be associated with the development of chronic respiratory symptoms and lung function impairment.

Acute Disease

Immunological and respiratory reactions in workers exposed to organic dusts.

The relationship of skin reactivity and serum immunoglobulin E (IgE) levels to the prevalence of chronic respiratory symptoms and to ventilatory capacity is examined in workers exposed to different organic aerosols. The results from group of control workers similarly tested are also presented. Workers exposed to occupational allergens had positive skin tests more frequently than did controls, except for soy bean workers. Workers with positive skin tests to occupational allergens had a higher prevalence of almost all symptoms than those with negative skin tests although the differences did not always reach statistical significance. Workers with positive skin reactions in general had significantly higher serum IgE levels than did workers with negative skin reactions. There were across-shift reductions of ventilatory capacity in all groups of exposed workers, varying for forced vital capacity from 1.7% to 13.3%, for forced expiratory volume from 0.4%-21.9%, for maximum flow rates at 50% from 1.5% to 16.1% and for maximum flow rates at the last 25% of control vital capacity from 0% to 24.9%. There was, however, no correlation between acute and chronic lung function changes and skin reactivity or IgE values. Our data suggest that although exposure to organic aerosols may be associated with frequent immunologic reactions, these findings do not predict objective respiratory impairment.

Adult

Respiratory symptoms and immunological status in poultry food processing workers.

A group of 57 female workers employed in the processing of poultry food and 51 nonexposed control workers were studied to determine the possible relation between respiratory and immunological findings in poultry food workers. The prevalences of all chronic respiratory symptoms were significantly higher in exposed than in control workers (P < 0.01) except for occupational asthma. The highest prevalence of chronic respiratory symptoms in exposed workers was found for chronic cough (49.1%), followed by dyspnea (43.9%), rhinitis (38.6%), chronic phlegm (31.6%), and chronic bronchitis (26.3%). Occupational asthma was found in 5.3% of exposed workers. Exposed workers with a positive skin prick test to poultry food extract demonstrated higher prevalences of all chronic respiratory symptoms than those with negative skin tests, although the difference was statistically significant only for rhinitis (P < 0.05). The most frequent skin reactions were found for poultry food extract (exposed: 66.7%; control: 25.5%; P < 0.05). An increased IgE serum level was found in 19 (33.3%) of the exposed and in four (7.8%) of the control workers (P < 0.01). Three exposed workers with occupational asthma demonstrated an increased serum IgE level. Our data confirm previous results indicating that occupational exposure to poultry food dust may be associated with the development of chronic respiratory symptoms and immunological changes in exposed workers.

Adult

Respiratory function and immunological reactions in sisal workers.

A cross-sectional study of respiratory function was performed in 50 sisal textile workers in 1972. Twenty of the 50 sisal workers still employed in the sisal mill were reexamined 19 years later. At the time of the initial study there were higher prevalences of all chronic respiratory symptoms in sisal compared with control workers. By the time of the follow-up study a significant increase had occurred in almost all chronic respiratory symptoms among the 20 sisal workers. At the time of the initial study there were similar and statistically significant across-shift reductions of forced vital capacity (FVC) and the 1-s forced expiratory volume (FEV1) on Monday and the following Thursday of the work week. Across-shift reductions in FVC and FEV1 in the 20 sisal workers at the follow-up study were larger than at the first measurement. Two sisal workers out of 20 (10.0%) had a positive skin test reaction to an extract sisal; both related symptoms of occupational asthma. In two sisal workers (10.0%) increased IgE was measured; one of these had symptoms of occupational asthma. Our data suggest that exposure to sisal dust in the textile industry may, in some workers, cause the development of respiratory difficulties. Immunological testing may be of value in identifying such workers at risk for occupational asthma.

Adolescent

Respiratory function and immunological reactions in jute workers.

A prospective study of respiratory function was performed in a group of 70 jute and 40 control workers. At the initial study there were consistently higher prevalences of all chronic respiratory symptoms in jute workers compared to control workers; however, the differences were statistically significant only for dyspnea (P < 0.05). At the follow-up study 19 out of the original 70 jute workers were examined 19 years later. There was a significant increase in the prevalence of almost all chronic respiratory symptoms among these workers. Similar across-shift reductions of forced vital capacity (FVC) and the 1-s forced expiratory volume (FEV1) were recorded on Monday and the following Thursday at the initial study. In the 19 jute workers followed prospectively there were similar across-shift reductions of FVC and FEV1 at the first and the follow-up study, the reduction being slightly larger for FEV1 than for FVC. Only one jute worker (5.3%) and two control workers (5.7%) responded to skin testing with specific textile extracts. Two workers developed symptoms of occupational asthma. One of these workers had a positive response to skin testing with jute extract. Our data suggest that exposure to jute dust may cause the development of chronic respiratory symptoms in some workers.

Adolescent

Respiratory symptoms and ventilatory function in confectionery workers.

Respiratory symptoms and ventilatory capacity were studied in a group of 288 workers (259 women and 29 men) employed in a confectionery plant. A group of workers (96 women and 31 men) not exposed to confectionery manufacture were also studied as controls. The prevalence of chronic respiratory symptoms was higher in exposed than in control workers, being greatest for confectionery workers exposed to the dust of flour, talc, and starch and the vapours of alcohol. Chronic bronchitis was reported by 7% of the women and 21% of the men, and chest tightness was reported by 27% of women and 66% of men. There was a high prevalence of acute irritative symptoms during the workshift in all groups of confectionery workers, especially for cough, dyspnoea, burning and dryness of the throat, and eye irritation. For all groups of confectionery workers there were statistically significant across shift reductions in ventilatory capacity, being most pronounced for maximum flow rate at 50% of the control vital capacity (FEF50; range 4.6-13.0%) and at 25% of the control vital capacity (FEF25; range 4.7-22.3%). Preshift values of FEF50 and FEF25 were significantly lower than predicted values. The data suggest that some workers employed in confectionery plants may develop acute and chronic respiratory symptoms associated with changes in lung function.

Adolescent

Immunologic findings in confectionary workers.

BACKGROUND: Food allergies are frequent in the general population. There are however, few studies of immunologic responses among workers in the confectionary industry. OBJECTIVE: To assess immunologic and clinical findings of workers in a confectionary plant. METHODS: Immunologic (skin tests and serum IgE) and respiratory findings (symptoms and lung function) were studied in a group of 71 confectionary workers (mean age: 35 years and mean exposure: 11 years). RESULTS: Skin prick testing with food extracts used in the manufacturing of candies and pastries demonstrated that the most frequent positive skin reaction occurred with extracts of cacao (31%), followed by reactions to chocolate (9%), cocoa (6%), hazelnut (6%), and sugar (2%). Increased serum IgE levels were found in 13.0% and increased IgM serum levels in 52.1% of these confectionary workers. The prevalence of asthma (26.1%) and dyspnea (26.1%) in workers with positive skin tests was significantly higher than in workers with negative skin tests (asthma: 2.0%, P = .004; dyspnea: 4.1%, P = .001). There was a high prevalence of acute respiratory symptoms during the work shift, but no significant association with immunologic tests was found. Similarly, both skin test positive and skin test negative workers exhibited significant across shift changes in lung function; however, no significant differences in baseline lung function or across-shift changes were noted between skin test positive and negative workers. Pre-shift administration of disodium cromoglycate (DSCG) significantly diminished across-shift reductions in FEF50 and FEF25 for both skin test positive and skin test negative workers. CONCLUSIONS: These data suggest that exposure to environmental factors in confectionary plants is associated with frequent respiratory symptoms of an irritative nature. Specific skin testing may be useful in characterizing confectionary workers at risk for the development of occupational asthma.

Adult

Immunological and respiratory changes in animal food processing workers.

A group of 35 men employed in the processing of animal food was studied to assess the relation between respiratory findings and immunological status. The most frequent positive skin prick reactions to occupational allergens were to fish flour (82.9%), followed by carotene (77.1%), corn (65.7%), four-leaf clover (62.9%), sunflower (54.3%), chicken meat (31.4%), soy (28.6%), and yeast (22.7%). Increased total IgE serum levels were found in 14/35 (40.0%) animal food workers compared to 1/39 (2.6%) in a healthy population (p less than 0.01). A significantly higher prevalence of chronic respiratory symptoms was found among the exposed workers compared to control workers. There was however, no significant difference in the prevalence of chronic respiratory symptoms between animal food workers with positive and negative skin tests to house dust or to fish flour or among those with increased or normal IgE (except for dyspnea). The frequency of acute symptoms associated with the work shift was high among the animal food workers but similar by immunological status. There were significant mean across-shift reductions for all ventilatory capacity tests, being particularly pronounced for FEF25. Workers with positive skin tests to fish flour antigen had significantly larger across-shift reductions in FEF25 than workers with negative skin reactions. An aqueous extract of animal food dust caused a dose-related contractile response of isolated guinea pig tracheal muscle in vitro. Our data suggest that, in addition to any immunological response animal food dust may produce in vivo, it probably also causes direct irritant or pharmacological reactions on the airways as suggested by our in vitro data.

Adult

Immunological status and respiratory findings in furriers.

We studied 42 women occupationally exposed in the fur manufacturing industry (mean age: 34 years, mean duration of exposure: 11 years). The highest prevalence of positive immediate skin reactions to antigen of animal hair was found for marten (10%), followed by fox and lamb (7%), mink (5%), and Chinese lamb, domestic fox, and Chinese calf (2%). Precipitating antibodies were demonstrated for lamb (17%), astrakhan (14%), mink, domestic fox and skunk (12%), Chinese lamb (10%), and Chinese calf (7%). Increased total IgE was found in 9.5% of subjects. Chronic symptoms were consistently more prevalent among workers with positive skin tests and positive precipitins than among workers with negative tests. A high prevalence of acute symptoms during the work shift was found among furriers. The prevalence of these symptoms was higher among workers with positive precipitating antibodies than among those with negative studies but not for workers with positive skin tests. Mean acute reductions in ventilatory capacity over the work shift were recorded for most ventilatory parameters. In general, greater drops in respiratory parameters occurred in individuals with positive precipitins (e.g., FEV1: -6.5% vs. -2.8%; positive vs. negative precipitins) but not in those with positive skin tests. Our study suggests that workers in the fur manufacturing industry develop acute and chronic respiratory problems often associated with specific indicators of atopy.

Acute Disease

Immunological findings and respiratory function in cotton textile workers.

Immunological parameters were studied in a group of 24 cotton textile workers. These were volunteers from a cohort of 106 (83 women and 23 men) previously studied textile workers. A group of 30 employees from a bottle packing plant served as a control for the immunologic studies. The subgroup of volunteers undergoing immunologic testing did not differ from the original cohort of textile workers in age, sex, smoking history, or prevalence of most chronic respiratory symptoms, nor were there any significant differences in baseline lung function or across-shift changes. The 24 cotton worker volunteers underwent skin testing with extracts of cotton dust and cotton seed. Eight of these 24 (33.3%) had positive tests, and 5 of the 8 had elevated serum immunoglobulin E (IgE) levels. Only one of the 8 skin-test-positive workers had symptoms of byssinosis. Only 1 of 30 control workers' skin tested with cotton extract reacted, and none had an increased serum IgE level (P less than 0.01). Both baseline lung function and across-shift changes did not differ between workers with positive and negative skin test reactions or between workers with normal and elevated IgE levels. Additionally, we studied the response in vitro of nonsensitized guinea pig trachea to cotton bract extract and demonstrated a dose-dependent contractile response. These data suggest that while immunological findings are frequent in textile workers, they correlate poorly with respiratory symptoms and function and may not be the basis for the airway obstruction seen in this disease.

Adult

Immunological findings in hemp workers.

Immunological status and its relation to respiratory findings were studied in 42 female textile workers occupationally exposed to hemp dust and in 49 female control workers. Skin prick tests with hemp or flax dust extracts from different parts of the mill in hemp workers demonstrated the following frequencies of positive tests to antigens: a mixture of hemp and flax extracts (64%), followed by flax extracts (48%), hemp from combing machines (41%), hemp from carding machines (38%), hemp from spinning and weaving machines (33%), and hemp from softening machines (20%). The prevalence of positive skin tests to hemp or flax allergens in control workers was consistently lower, ranging from 21 to 5%. Increased total serum IgE was recorded in 35.7% of hemp workers compared to only 5.0% of control workers (P < 0.05). Hemp workers with positive skin tests had significantly higher prevalences of chronic respiratory symptoms than those with negative skin tests. There were, however, no differences for acute symptoms between workers with positive and negative skin tests. Across-shift changes and baseline lung function were not different when compared by immunologic status. We showed additionally that a water-soluble extract of hemp dust causes a dose-related contraction of nonsensitized guinea pig tracheal smooth muscle when studied in vitro. Our results suggest that frequent immunologic abnormalities can be documented in hemp workers but, with the exception of chronic respiratory symptoms, in general, these do not correlate with respiratory findings.

Adult

Respiratory symptoms and ventilatory capacity in swine confinement workers.

A group of 59 workers (41 men and 18 women) employed in swine confinement areas was studied to assess the presence of acute and chronic respiratory symptoms and the prevalence of abnormalities in ventilatory function. A control group of 46 (31 men and 15 women) unexposed workers was studied for the prevalence of chronic respiratory symptoms. For both male and female swine confinement workers complaints of chronic cough, dyspnoea, and chest tightness were significantly more frequent than among control workers. Male workers also complained more of chronic phlegm. Male swine confinement workers who were smokers had significantly higher prevalences of chronic cough, chronic phlegm, and chronic bronchitis than male non-smoking swine confinement workers. The frequency of acute symptoms associated with the workshift was high among the swine confinement workers with more than half of the workers complaining of cough and dyspnoea associated with work. Significant acute across shift reductions in lung function occurred in swine confinement workers, being largest for FEF25. All Monday preshift ventilatory capacity measurements in male confinement workers were significantly lower than predicted values; FVC and FEV1 were found to be lower than predicted values for women. The data indicate that exposure in swine confinement buildings is associated with the development of acute and chronic respiratory symptoms and impairment of lung function. Smoking appears to aggravate these changes.

Acute Disease

Immunological and respiratory changes in soy bean workers.

Immunological and respiratory findings were studied in a group of 19 male soybean workers. Twenty control workers also participated in the immunological studies. All soybean workers had positive immediate skin reactions to soybean extract, as did 19/20 control workers. Similarly, 18/19 soy workers reacted to soy antigen prepared after separation from oil, but only 3/19 to soy lecithin antigen and 1 to soy oil antigen. A majority of soy workers (13/19) reacted to house dust. Only 3/19 soy workers had increased levels of soy-specific IgE. The prevalence of chronic respiratory symptoms was higher in exposed than in control workers, being significantly different for dyspnea (P less than 0.01). Workers with increased specific serum IgE or positive skin tests to house dust did not have any more symptoms than workers with negative tests. Ventilatory function was significantly worse in soybean workers than expected. Nevertheless, workers with positive skin or serological tests to house dust had across-shift changes similar to those with negative tests. These data suggest that skin and airway responses to soybean components (particularly the non-lipid ones) are very frequent among soybean workers. In the current study specific (soy) and non-specific (house dust) skin tests and immunoglobulins did not allow us to identify the workers at risk of developing symptoms or lung function abnormalities. This suggests that in addition to any atopic mechanisms, the irritant effect of soy dust may play a role in this occupational airway disease.

Adult

Immunological and respiratory findings in swine farmers.

The prevalence of respiratory symptoms and ventilatory capacity abnormalities in relation to immunological status was studied in 32 swine farmers and in 39 controls. A large number of swine farmers reacted to swine confinement building antigens (swine hair, 34%, swine confinement agents, 28%) but also to other extracts such as animal food (78%) and corn flour (37%). Control workers also reacted to these antigens in similar frequencies. Increased serum IgE levels were found in 3 swine farmers (9.4%) and all 3 had positive skin tests to at least one of the swine antigens. Among control workers one (2.6%) had an increased serum IgE level; this worker exhibited a positive skin reaction to swine food antigen. Swine farmers with positive skin reactions had across-shift reductions of FEF50 and FEF25 significantly larger than those with negative skin tests (P less than 0.01). Preshift measured ventilatory capacity data (FEV1, FEF50, FEF25) in swine farmers with positive skin tests were significantly lower (compared to predicted) than in those with negative skin tests. Additionally, we showed that a water-soluble swine confinement building antigen causes a dose-related contraction of nonsensitized guinea pig trachea smooth muscle studied in vitro. Our data indicate significant differences in lung function between swine workers with positive and negative skin tests. We suggest that skin testing may be helpful in identifying workers at risk for developing lung disease.

Adult

A ten-year follow-up study of cotton textile workers.

A follow-up study of respiratory function in cotton textile workers was performed 10 yr after the original cross-sectional study (1975 to 1985). There were 35 nonsmoking female and 31 smoking male textile workers restudied from the original group of 116. The majority of those lost to follow-up had left the industry. The prevalence of byssinosis among the female workers at the time of follow-up was 15/35 (42.9%) compared with 8/35 (22.9%) at the time of the initial study (p = 0.063). For men the byssinosis prevalence at follow-up was 16/31 (51.6%) compared with 8/31 (22.9%) at the time of the initial study (p = 0.03). Similarly, the prevalence of almost all other respiratory symptoms was significantly higher at the follow-up than at the time of the initial study. Significant across-shift decrements in FEV1 and FVC were documented at both surveys. The mean annual decline in ventilatory capacity was greater than expected for both female (FVC: -0.036 +/- 0.005 L/yr; FEV1: -0.059 +/- 0.009 L/yr) and male workers (FVC: -0.059 +/- 0.008 L/yr; FEV1: -0.068 +/- 0.006 L/yr) (Mean +/- SE). The mean total airborne dust concentration measured at the time of the follow-up study was 3.95 mg/m3 with an average respirable dust concentration of 0.97 mg/m3. We conclude that continued exposure to high dust concentrations in the cotton textile industry is associated with an increasing prevalence of respiratory symptoms and progressive impairment of lung function. The increase in respiratory impairment was seen both in smokers and nonsmokers.

Dust