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Gender differences in lung function recovery after cessation of occupational endotoxin exposure: a complex story
  1. Dick Heederik,
  2. Lidwien A M Smit
  1. IRAS Division Environmental Epidemiology, University of Utrecht, Utrecht, The Netherlands
  1. Correspondence to Dr Dick Heederik, IRAS Division Environmental Epidemiology, University of Utrecht, Utrecht, PO Box 80178, 3508 TD, The Netherlands; d.heederik{at}

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In the 30-year follow-up of the Shanghai Textile Worker Study, Lai et al1 show that individuals with high occupational endotoxin exposure have a more limited lung function recovery after retirement than those with lower organic dust exposures. The results also suggest that lung function improves less in men than in women. These results are of interest for several reasons: they tell us about the underlying mechanisms of endotoxin-related health effects, they give information about the prognosis of formerly diseased workers, and gender differences have not been studied extensively in the work environment.

Endotoxin exposure in the studied population was the result of occupational cotton dust exposure. Cotton workers were compared with silk workers, who had a very low endotoxin exposure. Studies of cotton workers, livestock farmers and animal feed workers have shown an accelerated decline in lung function related to endotoxin exposure level.2–4 Because most studies are cross-sectional and follow-up duration is limited in most longitudinal studies, few have the ability to …

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  • Competing interests None declared.

  • Provenance and peer review Commissioned; internally peer reviewed.

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