An attempt was made to assess the importance of selective discharge by death or retirement of workers with respiratory symptoms in a flax mill in Northern Ireland.
One hundred and two men who had worked in a flax mill during 1952-62 and who were aged 35 years or more at the time of leaving were followed up. Fourteen of the men had died and 75 were interviewed. The proportion who had dyspnoea on exertion at the time of interview was significantly higher (at P<0·05) in those who had had byssinosis than in those who had not had byssinosis while in the mill, although the proportions with dyspnoea in preparers and nonpreparers did not differ significantly. The proportion who stated that they had left the mill because of exertional dyspnoea of increasing severity was also significantly higher among those who had had byssinosis than among those who had not. Most of the men who had had byssinosis stated that their symptoms had improved after they left the mill, though some thought that work in the mill had permanently affected their chests, and two said that their symptoms had become gradually more severe since discharge. Of the 14 who had died, certificates of the cause of death were traced for 12, in none of which had respiratory disease been entered as a cause of death. In one man who had been a flax preparer, chronic bronchitis had been considered a `significant condition, contributing to the death'.
The study indicates that any estimate of the prevalence of byssinosis based solely on the examination of workers in the mills underestimates the true magnitude of the problem.
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