[Abstract] Cross-shift lung function in relation to cotton dust and endotoxin exposure in non-smoking female textile workers: a cross-sectional study

Background: Exposure to inhalable cotton dust particulates and endotoxin have been previously associated with respiratory symptoms and acute changes in lung function. Objectives: This study investigates the cross-shift decline in lung function of female non-smoking textile workers in relation to dust and endotoxin exposure. Methods: We present the subgroup analysis of a previously published study in Nepalese textile workers. 295 workers in four textile sectors (garment, carpet, weaving and recycling) completed a respiratory health questionnaire. A subset of 127 workers performed cross-shift spirometry. Personal exposure to inhalable dust and endotoxin was measured for 32 workers; remaining workers were assigned the geometric mean values of all workers within the same textile sector. Multiple regression analysis were carried out to identify independent predictors of cross-shift decline in lung function. Results: The overall prevalence of persistent cough, persistent phlegm, chest tightness-, wheeze- and breathlessness-ever was 9.2%, 6.1%, 3.1%, 8.5% and 13.9% respectively. A significant cross-shift reduction (p<0.001) in forced expiratory volume in 1s (FEV1) and forced vital capacity (FVC) were measured. Dust and endotoxin exposure did not significantly predict the cross-shift decline in lung function. Conclusions: The cross-shift decline in lung function supports the implementation of measures to improve the working environment in textile sectors. A well-designed study addressing occupational exposures along with the exposures to concomitant domestic and environmental pollutants will help to better understand the respiratory health of textile workers.