As part of a 1992 survey of both environmental and occupational determinants of health, 973 non-smoking women aged 20-40 years who were employed in three comparable modern Chinese cotton textile mills were given a questionnaire that included questions on standard respiratory history and symptoms. All women had some potential exposure to cotton dust; mean employment was 8.7 years. Comparisons were made between those with lowest or no current exposure (job classification in administration, quality control, and testing, n = 112) and those in the more heavily exposed classifications (yarn production areas, n = 861). Association of symptoms with job was tested by logistic regression, adjusting for age, passive smoking at home, and the use of home coal burning stoves. Odds ratios for prevalence of current frequent symptoms in those working in production jobs, after adjustment for home exposure to passive tobacco smoke and coal heating, were frequent cough 2.23 (95% confidence interval (95% CI) 1.05-4.75), frequent phlegm 3.24 (1.54-6.84), shortness of breath 4.54 (1.40-14.72), and wheeze 2.96 (1.16-7.55). Nine cases with grade I byssinosis (chest tightness or shortness of breath on return to work after two days off) were found; all were in production jobs. In these non-smoking women textile workers, chronic respiratory symptoms were associated with job category after correction for domestic indoor air quality. These data support evidence for an increased prevalence of respiratory disease in populations exposed to cotton dust.
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