Lung function, airway reactivity, and atopy in newly hired female cotton textile workers

To assess changes in lung function and airway reactivity resulting from exposure to cotton dust, and the role of atopic status in these changes, the authors observed a group of 225 newly hired Chinese textile workers for 1 yr. All workers were female, lifelong nonsmokers, and none of them had been exposed previously to cotton or other occupational dust. Atopic status was determined at baseline. Spirometry, response to methacholine challenge, and total serum immunoglobulin E level were examined at baseline and again after subjects began work in the cotton mills. Obvious cross-shift drops in forced expiratory volume in 1 sec (FEV1.0), and declines in forced vital capacity and FEV1.0 over 1 yr, were observed. Atopic workers had a significantly greater acute drop in FEV1.0 than did nonatopic workers. Both atopic and nonatopic workers had slightly increased airway reactivity at 1 yr, compared with baseline values. The results suggest that exposure to cotton dust is responsible for acute and longitudinal declines in lung function, as well as for slightly increased airway reactivity. Atopy may interact with cotton dust to accentuate the acute lung function response.