OBJECTIVES--To follow up a group of newly employed workers in a cotton mill, and to report changes in symptoms over time. METHODS--A group of 110 mill workers at a cotton mill in Shijiazhuang, China, was investigated by questionnaire, skin testing, and spirometric measurements of airway responsiveness through forced expiratory volume in one second (FEV1). The workers were examined before starting work, at 10 weeks, and at one year. RESULTS--Decreases in FEV1 over shifts were small at 10 weeks and one year, and slightly higher among people with skin reactions to cotton dust extracts. Airway responsiveness, defined as the average decrease in FEV1 after 1.25 mg methacholine was increased at 10 weeks. It remained about the same after one year, except in the workers positive for the skin test, in whom it was further increased. Subjective symptoms of chest tightness and cough with phlegm increased progressively at 10 weeks and one year; nasal irritation remained unchanged and dry cough decreased between 10 weeks and one year. CONCLUSION--The results suggest that the airway inflammation caused by cotton dust increases with increasing exposure time and that the changes are more notable in workers with reactivity to cotton dust extract.
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