Abstract：
To assess the association of exposure in cotton mills in Karachi with different definitions of byssinosis and lung health.
This cross-sectional survey took place between June 2019 and October 2020 among 2031 workers across 38 spinning and weaving mills in Karachi. Data collection involved questionnaire-based interviews, spirometry and measurements of personal exposure to inhalable dust. Byssinosis was defined using both WHO symptoms-based (work-related chest tightness), and Schilling\'s criteria (symptoms with decreased forced expiratory volume in 1 s (FEV1). Values of FEV1/forced vital capacity ratio below the lower limit of normality on postbronchodilator test were considered as \'chronic airflow obstruction\' (CAO).
56% of participants had at least one respiratory symptom, while 43% had shortness of breath (grade 1). Prevalence of byssinosis according to WHO criteria was 3%, it was 4% according to Schilling\'s criteria, and likewise for CAO. We found low inhalable dust exposures (geometric mean: 610 µg/m3). Cigarette smoking (≥3.5 pack-years), increasing duration of employment in the textile industry and work in the spinning section were important factors found to be associated with several respiratory outcomes.
We found a high prevalence of respiratory symptoms but a low prevalence of byssinosis. Most respiratory outcomes were associated with duration of employment in textile industry. We have discussed the challenges faced in using current, standard guidelines for identifying byssinosis.
This cross-sectional survey took place between June 2019 and October 2020 among 2031 workers across 38 spinning and weaving mills in Karachi. Data collection involved questionnaire-based interviews, spirometry and measurements of personal exposure to inhalable dust. Byssinosis was defined using both WHO symptoms-based (work-related chest tightness), and Schilling\'s criteria (symptoms with decreased forced expiratory volume in 1 s (FEV1). Values of FEV1/forced vital capacity ratio below the lower limit of normality on postbronchodilator test were considered as \'chronic airflow obstruction\' (CAO).
56% of participants had at least one respiratory symptom, while 43% had shortness of breath (grade 1). Prevalence of byssinosis according to WHO criteria was 3%, it was 4% according to Schilling\'s criteria, and likewise for CAO. We found low inhalable dust exposures (geometric mean: 610 µg/m3). Cigarette smoking (≥3.5 pack-years), increasing duration of employment in the textile industry and work in the spinning section were important factors found to be associated with several respiratory outcomes.
We found a high prevalence of respiratory symptoms but a low prevalence of byssinosis. Most respiratory outcomes were associated with duration of employment in textile industry. We have discussed the challenges faced in using current, standard guidelines for identifying byssinosis.
摘要：
目的：评估卡拉奇棉纺厂暴露与不同定义的byssinosis和肺部健康的关系。
方法：这项横断面调查于2019年6月至2020年10月期间对卡拉奇38家纺纱厂的2031名工人进行了调查。数据收集涉及基于问卷的访谈，肺活量测定和个人暴露于可吸入粉尘的测量。根据WHO症状（与工作相关的胸闷）定义了Byssinosis，和Schilling的标准（症状在1s内用力呼气量减少（FEV1）。FEV1/强制肺活量比值低于支气管扩张剂后试验正常值的下限被认为是“慢性气流阻塞”（CAO）。
结果：56%的参与者至少有一种呼吸道症状，43%有呼吸急促(一级)。根据WHO标准，byssinosis的患病率为3％，根据席林的标准是4%,对CAO也是如此。我们发现低的可吸入粉尘暴露量（几何平均值：610µg/m3）。吸烟（≥3.5包年），纺织业就业时间的增加和纺纱部门的工作时间是发现与几种呼吸结局相关的重要因素。
结论：我们发现呼吸道症状的患病率较高，但吸虫病的患病率较低。大多数呼吸结果与纺织业的就业时间有关。我们已经讨论了使用电流所面临的挑战，用于识别byssinosis的标准指南。
方法：这项横断面调查于2019年6月至2020年10月期间对卡拉奇38家纺纱厂的2031名工人进行了调查。
结果：56%的参与者至少有一种呼吸道症状，
结论：我们发现呼吸道症状的患病率较高，但吸虫病的患病率较低。
