Occupational Asthma Reference

Fishwick D, Barraclough R, Pickering T, Fletcher A, Lewis R, Niven R, Warburton CJ, Comparison of various airflow measurements in symptomatic textile workers, Occup Med, 2010;60:631-634,

Keywords: cotton, textile, cross-shift FEV1, NSBR, Oasys, PEF

Known Authors

Tony Pickering, Wythenshawe Hospital, Manchester, UK Tony Pickering

David Fishwick, Royal Hallamshire Hospital, Sheffield, UK David Fishwick

Chris Warburton, Liverpool Chris Warburton

Angela Fletcher, North West Lung Centre, Manchester Angela Fletcher

Rob Niven, Wythenshawe Hospital, Manchester Rob Niven

Richard Barraclough, Manchester Richard Barraclough

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To investigate the poorly understood relationship between work-related respiratory symptoms, airway reactivity, across working shift change in forced expiratory volume in 1 s (FEV1) and work-related changes in serial peak expiratory flow (sPEF) measures in a group of textile workers.

Methods Fifty-three workers, 34 exposed to cotton dust and 19 to man-made fibre (MMF), were investigated using a standard respiratory questionnaire, sPEF, across-shift FEV1 measurement and airway responsiveness.

Results Thirty-four workers (64%) were male, and 9 workers (17%) had a >5% across-shift fall in FEV1, and these falls were associated with the presence of work-related symptoms. Seven workers had a positive sPEF chart as judged by the software analysis (OASYS), although there was no relationship between work-related symptoms and sPEF. Six cotton workers (18%) and one MMF worker (5%) had airway hyperreactivity, which was associated strongly with work-related symptoms. Five of the 7 subjects with a positive sPEF had airway hyperreactivity compared with 12 of 46 with a negative sPEF.

Conclusions In this worker group, the presence of work-related respiratory symptoms was best associated with airway hyperresponsiveness and across-shift changes in FEV1. While a positive sPEF chart was associated with increased airway responsiveness, it was not associated with work-related symptoms. sPEF measurements may not be the initial investigation of choice for such workers. As these findings also have relevance to developing evidence-based approaches to health surveillance, further work is needed to better define these relationships in other workers complaining of work-related respiratory symptoms.

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Oasys scores related less well to symptoms than cross-shift changes in FEV1 in this group of textile workers. The disease causing the symptoms was less clear

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