Lung Disease in Chinese Textile Workers

中国纺织工人的肺部疾病

• 批准号: 9927534
• 负责人: David C Christiani
• 金额: $ 59.47万
• 依托单位: HARVARD SCHOOL OF PUBLIC HEALTH
• 依托单位国家: 美国
• 财政年份: 2018
• 资助国家: 美国
• 起止时间: 2018-09-01 至 2021-08-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/9927534
• 关键词: Lung; Disease; Chinese; Textile; Workers

ABSTRACT At least 5 million workers in the United States from several sectors are potentially exposed to airborne endotoxin. Acute endotoxin exposure produces features of dynamic airflow obstruction. However, the health effects of long-term exposure remain unclear. A few studies of chronic endotoxin exposure have identified an accelerated decline in forced expiratory volume at 1 second (FEV1), a hallmark of chronic obstructive pulmonary disease (COPD). Even studies of chronic exposure, though, tend to span less than a decade, and little is known about the trajectory of lung disease after exposure cessation, the mechanisms underlying disease severity, and the extra-pulmonary effects of chronic exposure. The goal of this competing continuation is to complete a 36-year longitudinal study of a stable, closed cohort of 919 textile workers living in the same geographical region of Shanghai, China. This unique cohort comprises cotton workers exposed to high levels of workplace endotoxin with matched control silk workers exposed to non-detectable levels of endotoxin, both with a high proportion of lifetime non-smokers. Since 1981, they have been evaluated for dust and endotoxin exposure and respiratory outcomes. All workers are now retired, but 74.2% of those still alive participated in the 30-year survey, with comparable follow-up participation expected at 35 years. The previous continuation cycle of this study enabled us to describe the persistent deleterious effects of workplace endotoxin even after worker retirement. Adverse respiratory effects include impaired lung function recovery with accelerated FEV1 decline, increased airway narrowing, and increased lung mass and lung density on chest computed tomography (CT), which likely represents persistent lung inflammation. These findings raise new questions: whether persistent inflammation plays a role in disease progression, whether disease is reversible after exposure cessation, and whether long-term endotoxin exposure leads to extra-pulmonary disease. Our overarching hypothesis is that prior cumulative workplace endotoxin exposure leads to persistent lung disease after exposure cessation due to systemic, lung parenchymal, and airway inflammation, and also results in extra-pulmonary health effects. This revised proposal has expanded its scope in response to critiques to evaluate a dense panel of inflammatory biomarkers, as well as consideration of air pollution and other variables important to study generalizability. Our research results are essential to devising effective preventive programs. The NORA sectors addressed in this proposal include: agriculture, manufacturing, healthcare, services, and construction. The cross-sector programs addressed are respiratory disease and global collaborations.

抽象的 美国至少有 500 万来自多个行业的工人可能接触空气传播的病毒 内毒素。急性内毒素暴露会产生动态气流阻塞的特征。然而，健康 长期接触的影响仍不清楚。一些关于慢性内毒素暴露的研究已经确定了 第一秒用力呼气量 (FEV1) 加速下降，这是慢性阻塞性肺疾病的标志 肺部疾病（慢性阻塞性肺病）。然而，即使是对长期暴露的研究也往往持续不到十年的时间，并且 对于停止接触后肺部疾病的发展轨迹、其潜在机制知之甚少 疾病的严重程度以及长期接触的肺外影响。这一竞争性延续的目标 的目标是完成一项为期 36 年的纵向研究，对象是居住在同一地区的 919 名纺织工人，是一个稳定、封闭的队列。 中国上海的地理区域。这个独特的群体由接触高浓度的棉花工人组成 工作场所内毒素与暴露于不可检测水平内毒素的匹配对照丝绸工人的比较 终生不吸烟的人比例很高。自 1981 年以来，对它们进行了灰尘和内毒素评估 暴露和呼吸系统结果。现在所有工人都已退休，但 74.2% 的健在工人参加了 30 年的调查，预计 35 年会有类似的后续参与。上一篇继续 这项研究的周期使我们能够描述工作场所内毒素的持续有害影响，即使在 工人退休。不良呼吸系统影响包括肺功能恢复受损以及 FEV1 加速 胸部计算结果下降，气道狭窄增加，肺质量和肺密度增加 断层扫描 (CT)，可能代表持续性肺部炎症。这些发现提出了新的问题： 持续性炎症是否在疾病进展中发挥作用，术后疾病是否可逆 停止接触内毒素，以及长期接触内毒素是否会导致肺外疾病。我们的 总体假设是，先前累积的工作场所内毒素暴露会导致持续性肺部疾病 由于全身、肺实质和气道炎症而停止接触后，也会导致 肺外健康影响。为了回应批评，该修订后的提案扩大了其范围 评估一组密集的炎症生物标志物，并考虑空气污染和其他因素 对研究普遍性很重要的变量。我们的研究成果对于制定有效的预防措施至关重要 程序。本提案涉及的 NORA 部门包括：农业、制造业、医疗保健、 服务业、建筑业。涉及的跨部门计划包括呼吸系统疾病和全球 合作。