An epidemiological study of the respiratory health of workers in the European refractory ceramic fibre industry
H A Cowiea, P Wildb, J Becka, G Auburtinc, C Piekarskid, N Massinb, J W Cherriea, J F Hurleya, B G Millera, S Groata, C A Soutara
a Institute of
Occupational Medicine, 8 Roxburgh Place, Edinburgh EH8 9SU, UK, b Institut National de Recherche et de
Sécurité, Vandoeuvre, France, c Institut National de l'Environnement Industriel
et des Risques, Paris, France, d University
of Köln, Köln, Germany
Correspondence to: H Cowie hilary.cowie{at}iomhq.org.uk
Accepted 12 July 2001
OBJECTIVES
To
investigate possible relations between respiratory health and past
airborne exposure to refractory ceramic fibres (RCFs) and respirable
dust in workers at six European factories, studied previously in 1987.
METHODSThe target
population comprised all current workers associated with RCF
production, plus others who had participated in 1987 "leavers".
Information was collected on personal characteristics, chest
radiographs, lung function, respiratory symptoms, smoking, and full
occupational history. Regression analysis was used to study relations
between indices of health of individual workers and of cumulative
exposure to airborne dust and fibres, and likely past exposure to asbestos.
RESULTS AND
DISCUSSION774 workers participated (90% of
current workers, 37% of leavers). Profusion of small opacities in
exposed workers (51% 0/1+; 8% 1/0+) was similar to that among an
unexposed control group but higher than in new readings of the 1987 study films (11% 0/1+, 2% 1/0+). The large difference between 1987 and recent films may be, at least in part, a reading artefact
associated with film appearance. Small opacities of International
Labour Organisation (ILO) category 1/0+ were not associated with
exposure. An association of borderline significance overall between
0/1+ opacities and exposure to respirable fibres was found for some
exposure periods only, the time related pattern being biologically
implausible. Pleural changes were related to age and exposure to
asbestos, and findings were consistent with an effect of time since
first exposure to RCFs. Among men, forced expired volume in 1 second (FEV1) and forced vital capacity
(FVC) were inversely related to exposure to fibres, in current smokers
only. FEV1/ FVC ratio and transfer factor
(TLCO) were not related to exposures. The estimated
restrictive effect was on average mild. Prevalence of respiratory
symptoms was low. Chronic bronchitis and its associated symptoms
(cough, phlegm) showed some association with recent exposure to
respirable fibres. This could be due to an irritant effect of RCFs.
Keywords: respiratory health; ceramic fibres
© 2001 by Occupational and Environmental Medicine
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