Byssinosis: a follow-up study of cotton ginnery workers in the Sudan

A follow-up study of lung function tests and dust measurements was undertaken in ginnery workers employed in five ginning factories. Respiratory symptoms and respiratory function tests (FEV1 and FVC) were first recorded in 1967 on a total of 382 workers (323 permanently employed ginnery workers, 35 seasonal farfara workers, and 24 fire brigade men as controls). In 1969 after a six-month break from ginning before the start of the season, a follow-up study of lung function tests was undertaken on 96% of the same workers (306 ginnery workers, 35 farfara, and 24 fire brigade men). Because of the lapse of two years a new adjustment for age and height was made so as to compare the FEV1 measured in the follow-up study. The fire brigade men showed an expected fall in FEV1 during the two-year period, whereas the ginnery workers showed a rise presumably because they had had no dust exposure during the previous six months. The differences between the degree of change in these groups were statistically significant. In 1967 only the fine dust (less than 7 mum) was measured, while in 1969 the concentration of fine and medium dust, that is, less fly was measured. The factories were divided into three groups according to dust concentration. Comparison between the three factory groups and farfara shows a positive association between the level of dust concentration less fly and the prevalence of cough and phlegm. Since age did not appear to be a significant factor in the prevalence of byssinosis, comparisons between permanent workers in these three groups of factories and farfara workers taken separately were made without age standardization. The overall differences were statistically significant. There was a marked trend showing a positive association between prevalence of byssinosis and level of cotton dust concentration in the factories. The correlation between dust levels and the prevalence of byssinosis was nearly perfect when the time factor was included.