Skip to main content
SpringerLink
Log in

Exposure–response relationship between endotoxin exposure and lung function impairment in cotton textile workers

  • Original Article
  • Published:
International Archives of Occupational and Environmental Health Aims and scope Submit manuscript

Abstract

Objectives

Preventive workplace regulations are so far not based on an ubiquitously accepted threshold for airborne endotoxin in the bioaerosol.

Methods

In a cross-sectional study, 150 employees of a cotton spinning mill underwent lung function testing. Furthermore, in a random subset of 75 textile workers cross-shift lung function test and methacholine challenges were performed. Airborne current endotoxin exposure was classified as “low”, “medium”, and “high” (≤100, >100–≤450, and >450 Endotoxin Units (EU)/m3, respectively) based on endotoxin activity.

Results

The exposure–response relationship between current endotoxin exposure and prevalence of an obstructive ventilation pattern was significant (test for linear trend: P = 0.019); the adjusted odds ratio for high endotoxin exposure was 11.22 (95% confidence interval 1.03–121.17). Within individuals, FEV1/FVC% was significantly reduced after the shift (paired t test: P = 0.009) but not related to current endotoxin exposure. Twelve workers showed bronchial hyperresponsiveness (8.1% before and 12.2% after the work shift; Fisher’s exact test: P = 0.021).

Conclusion

The study among German cotton textile workers suggests an exposure-dependent effect of current endotoxin exposure on lung function impairment with significant effects above 450 EU/m3.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Fig. 1

Similar content being viewed by others

References

  • American Thoracic Society: Standardization of spirometry (1995) Am J Respir Crit Care Med 152:1107–1136

    Google Scholar 

  • Baur X, Huber H, Degens PO, Allmers H, Ammon J (1998) Relation between occupational asthma case history, bronchial methacholine challenge, and specific challenge test in patients with suspected occupational asthma. Am J Ind Med 33:114–122

    Article  PubMed  CAS  Google Scholar 

  • BIA Arbeitsmappe (1997) Verfahren zur Bestimmung der Endotoxinkonzentration in der Luft am Arbeitsplatz (Procedures for the determination of airborne endotoxin exposure in the workplace.) In: Berufsgenossenschaftliches Institut für Arbeitssicherheit (BIA) des Hauptverbands der gewerblichen Berufsgenossenschaften e. V. (ed) Messung von Gefahrstoffen, Bielefeld: Erich Schmidt Verlag GmbH & Co, vol 19, pp 1–7

  • Brändli O, Schindler C, Künzli N, Keller R, Perruchoud AP (1996) Lung function in healthy never smoking adults: reference values and lower limits of normal of a Swiss population. Thorax 51:277–283

    Article  PubMed  Google Scholar 

  • Brändli O, Schindler C, Leuenberger P H, Baur X, Degens P, Künzli N (2000) Estimated equations for 5th percentiles of lung function variables. Thorax 55:173–174

    Article  PubMed  Google Scholar 

  • Castellan RM, Olenchock SA, Hankinson JL, Millner PD, Cocke JB, Bragg CK, Perkins HH, Jacobs RR (1984) Acute bronchoconstriction induced by cotton dust: dose-related responses to endotoxin and other factors. Ann Int Med 101:157–163

    PubMed  CAS  Google Scholar 

  • Castellan RM, Olenchock SA, Kathleen B, Kinsley BS, Hankinson JL (1987) Inhaled endotoxin and decreased spirometric values—an exposure–response relation for cotton dust. N Engl J Med 317:605–610

    Article  PubMed  CAS  Google Scholar 

  • Christiani DC, Ye TT, Wegman DH, Eisen EA, Dai HL, Lu PL (1994) Pulmonary function among cotton textile workers. A study of variability in symptom reporting, across-shift drop in FEV1, and longitudinal change. Chest 105:1713–1721

    PubMed  CAS  Google Scholar 

  • Christiani DC, Ye TT, Zhang S (1999) Cotton dust and endotoxin exposure and long-term decline in lung function: results of a longitudinal study. Am J Ind Med 35:321–331

    Article  PubMed  CAS  Google Scholar 

  • Christiani DC, Wang XR, Pan LD, Zhang HX, Sun BX, Dai H, Eisen AE, Wegman DH, Olenchock SA (2001) Longitudinal changes in pulmonary function and respiratory symptoms in cotton textile workers. Am J Respir Crit Care Med 163:847–853

    PubMed  CAS  Google Scholar 

  • Donham KJ (1989) Relationships of air quality and productivity in intensive swine housing. Agri Pract 10:15–26

    Google Scholar 

  • Donham KJ, Zavala DC, Merchant JA (1984) Respiratory symptoms and lung function among workers in swine confinement buildings: a cross-sectional epidemiologic study. Arch Environ Health 39:96–101

    PubMed  CAS  Google Scholar 

  • Donham KJ, Cumro D, Reynolds SJ, Merchant JA (2000) Dose–response relationships between occupational aerosol exposures and cross-shift declines of lung function in poultry workers: recommendations for exposure limits. J Occup Environ Med 42:260–269

    Article  PubMed  CAS  Google Scholar 

  • Dutkiewicz J, Krysinska-Traczyk E, Skorska C, Cholewa G, Sitkowska J (2002) Exposure to airborne microorganisms and endotoxin in a potato processing plant. Ann Agric Environ Med 9(2):225–235

    PubMed  CAS  Google Scholar 

  • Gereda J E, Leung DY, Thatayatikom A (2000) Relation between house-dust endotoxin exposure, type 1 T-cell development, and allergen sensitisation in infants at high risk of asthma. Lancet 355:1680–1683

    Article  PubMed  CAS  Google Scholar 

  • Hang J, Zhou W, Wang X, Zhang H, Sun B, Dai H, Su L, Christiani DC (2005) Microsomal epoxide hydrolase, endotoxin, and lung function decline in cotton textile workers. Am J Respir Crit Care Med 15:165–170

    Google Scholar 

  • Hankinson JL, Viola JO (1983) Dynamic BPTS correction factors for spirometric data. J Appl Physiol 44:1354–1360

    Google Scholar 

  • Jacobs RR, Chun D (2004) Inter-laboratory analysis of endotoxin in cotton dust samples. Am J Ind Med 46:333–337

    Article  PubMed  CAS  Google Scholar 

  • Kennedy SM, Christiani DC, Eisen EA, Wegman DH, Greaves IA, Olenchock SA, Ye TT, Lu PL (1987) Cotton dust and endotoxin exposure–response relationships in cotton textile workers. Am Rev Respir Dis 135:194–200

    PubMed  CAS  Google Scholar 

  • Lane SR, Nicholls PJ, Sewell RD (2004) The measurement and health impact of endotoxin contamination in organic dusts from multiple sources: focus on the cotton industry. Inhal Toxico 16(4):217–229

    Article  CAS  Google Scholar 

  • Latza U, Oldenburg M, Baur X (2005) Endotoxin exposure and respiratory symptoms in the cotton textile industry. Arch Environ Health 59(10):519–525

    Article  Google Scholar 

  • Milton DK, Amsel J, Reed CE, Enright PL (1995) Cross-sectional follow-up of a flulike respiratory illness among fiberglass manufactoring employees—endotoxin exposure associated with two distinct sequelae. Am J Ind Med 28(4):469–488

    PubMed  CAS  Google Scholar 

  • Olenchock SA, May JJ, Pratt DS, Piacitelli LA, Parker JE (1990) Presence of endotoxins in different agricultural environments. Am J Ind Med 18(3):279–284

    PubMed  CAS  Google Scholar 

  • Radon K, Danuser B, Iversen M, Monso E, Weber C, Hartung J, Donham K, Palmgren U, Nowak D (2002) Air contaminants in different European farming environments. Ann Agric Environ Med 9(1):41–48

    PubMed  CAS  Google Scholar 

  • Rylander R (1997) Evaluation of the risks of endotoxin exposures. Int J Occup Environ Health 3(1):32–37

    Google Scholar 

  • Rylander R, Haglind P (1982) Airborne endotoxin in industries processing vegetable fibers. Am Ind Hyg Assoc 43:811–812

    CAS  Google Scholar 

  • Rylander R, Haglind P, Lundholm M (1985) Endotoxin in cotton dust and respiratory function decrement among cotton workers in an experimental cardroom. Am Rev Respir Dis 131:209–215

    PubMed  CAS  Google Scholar 

  • Rylander R, Essle N, Donham J (1990) Bronchial hyperreactivity among pig and dairy farmers. Am J Ind Med 17:66–69

    PubMed  CAS  Google Scholar 

  • Schwartz DA, Thorne PS, Yalga SJ, Burmeister LF, Olenchock SA, Watt JL, Quinn TJ (1995) The role of endotoxine in grain dust-induced lung disease. Am J Respir Crit Care Med 152:603–608

    PubMed  CAS  Google Scholar 

  • Sigsgaard T, Malmros P, Nersting L, Petersen C (1994) Respiratory disorders and atopy in Danish refuse workers. Am J Respir Crit Care Med 149:1407–1412

    PubMed  CAS  Google Scholar 

  • Simpson JCG, Niven R, Pickering CAC, Oldham LA, Fletcher AM, Francis HC (1999) Comparative personal exposures to organic dust and endotoxin. Ann Occup Hyg 43:107–115

    PubMed  CAS  Google Scholar 

  • Thefeld W, Stolzenberg H, Bellach B-M (1999) Bundes-Gesundheitssurvey: response, Zusammensetzung der Teilnehmer und Non-Responder-Analyse. (German National Health Interview and Examination Survey: composition of participants, and analysis of non-respondents). Gesundheitswesen 2:57–61

    Google Scholar 

  • Torres CJ, Alberto FJ, Castro E, Vaz M, Barros H, Agostinho MJ (2004) One-week variation of cotton dust and endotoxin levels in a cotton mill. Relation with the daily variation of the expiratory flow rates. Acta Med Port 17(2):149–156

    Google Scholar 

  • Wang XR, Pan LD, Zhang HX, Sun BX, Dai HL, Christiani DC (2002) Follow-up study of respiratory health of newly-hired female cotton textile workers. Am J Ind Med 41(2):111–118

    Article  PubMed  Google Scholar 

  • Wang XR, Pan LD, Zhang HX, Sun BX, Dai HL, Christiani DC (2003) A longitudinal observation of early pulmonary responses to cotton dust. Occup Environ Med 60:115–121

    Article  PubMed  Google Scholar 

  • Wouters IM, Douwes G, Doekes G, Thorne PS, Brunekreef B, Heederik D J (2000) Increased levels of markers of microbial exposure in homes with indoor storage of organic household waste. Appl Environ Microbiol 66:627–631

    Article  PubMed  CAS  Google Scholar 

  • Zock JP, Hollander A, Heederik D, Douwes J (1998) Acute lung function changes and low endotoxin exposures in the potato processing industry. Am J Ind Med 33:384–391

    Article  PubMed  CAS  Google Scholar 

Download references

Acknowledgement and research support

The authors wish to thank the volunteers and the management of the investigated cotton spinning mill. We also thank the physicians and medical assistance of the ZfA, Hamburg, and the BGFA, Bochum, for the performance of lung function testing and Pari in Starnberg for making three Pari-Provocation-Test II systems available to our cross-shift survey. The authors also express their gratitude to the BIA in Sankt Augustin for the performance of numerous measurements of airborne dust samples. Especially, we thank Dr. Kraus from the Institution for statutory accident insurance in the textile and clothing industry as initiator of this investigation for his enthusiastic engagement. The study was funded by a grant of the central federation of the institution for statutory accident insurance for the industrial sector (Hauptverband der gewerblichen Berufsgenossenschaften) in Germany.

Author information

Authors and Affiliations

  1. Clinical Occupational Medicine, Institute of Occupational Medicine (ZfA), University of Hamburg, Hamburg, Germany

    Marcus Oldenburg, Ute Latza & Xaver Baur

  2. Hamburg State Department for Social Affairs, Family, Health and Consumer Protection, Seewartenstrasse 10, 20459, Hamburg, Germany

    Marcus Oldenburg, Ute Latza & Xaver Baur

Authors
  1. Marcus Oldenburg
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Ute Latza
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Xaver Baur
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Marcus Oldenburg.

Rights and permissions

Reprints and permissions

About this article

Cite this article

Oldenburg, M., Latza, U. & Baur, X. Exposure–response relationship between endotoxin exposure and lung function impairment in cotton textile workers. Int Arch Occup Environ Health 80, 388–395 (2007). https://doi.org/10.1007/s00420-006-0145-0

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s00420-006-0145-0

Keywords

Search

Navigation