Is it important to do pre-contract and follow-up spirometries for cotton textile employees?

I am a pulmonary specialist newly hired in a large textile cotton dust industry in Honduras. I need information (Eg. papers) on the importance of pre-contract and follow up spirometries among this employees, in order to protect them and save money with an early detection program.

Occupational Asthma, Specialist, 4/7/2007, 5/28/2007,

I am not an expert in cotton workers, but have experience of respiratory surveillance. Cotton can cause several different lung diseases including occupational asthma, byssinosis, allergic alveolitis (often from humidifiers) and COPD. Surveillance is best done with a combination of respiratory questionnaires and spirometry. Picking out individuals with rapid FEV1 decline is difficult and important, it depends on the quality control of your lung function testing as to how large a change in FEV1 is required to exceed measurement error. In general changes up to 500 ml are seen in workers without obvious disease. It is important to keep the measurements over time, perhaps annually, as the longer period over which the measurements are made the greater the precision in picking out rapid decliners. The paper by Eva Hnizdo is the best, but hard work Hnizdo E, Yu L, Freyder L, Attfield M, Lefante J, Glindmeyer HW, The precision of longitudinal lung function measurements: monitoring and interpretation, Occup Environ Med, 2005;62:695-701, Hnizdo E, Esterhuizen TM, Occupational Asthma As Identified By The Surveillance Of Work-Related And Occupational Respiratory Diseases Programme In South Africa, Clin Exp Allergy, 2001;31:32-39,

5/28/2007