EPIDEMIOLOGIC-STUDY OF CLINICAL AND PHYSIOLOGIC PARAMETERS IN GRAIN HANDLERS OF NORTHERN UNITED-STATES

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Abstract
Respiratory parameters between 310 grain handlers and 237 city workers of comparable age, height, weight and smoking habits were compared to study the effects of grain dust exposure. Both populations resided and worked in the same USA geographic area. Information was obtained by questionnaire, interview and examination. Pulmonary function tests included FEV1 (forced expiratory vol in 1 s), FVC (forced vital capacity) FEF25-75, .ovrhdot.Vmax50 [maximal expiratory flow at 50% vital capacity], .ovrhdot.Vmax75(.ovrhdot.Vmax at 75% vital capacity], CV [closing volume], .DELTA.N2/L [alveolar plateau phase III slope] and DLCO [lung diffusing capacity for CO]. The prevalence of acute work-related and chronic respiratory symptoms, auscuitatory ronchi and airways obstruction (FEV1/FVC < 0.7) were significantly higher (P < 0.05) in grain handlers than in control subjects. All lung functions mean values except CV, .DELTA.N2/L and DLCO were significantly lower in grain workers than in control subjects. The effects of smoking and grain handling on symptom prevalence and lung functions adjusted for age and height, analyzed by logistic regression model, were highly significant (P values of 0.00001-0.5) and independent. The odds of having chronic bronchitis or wheezing at work were, respectively, increased 4.4-fold and 4.8-fold by grain handling and by 2.9-fold and 1.9-fold by smoking. Grain handling increased the odds of having airways obstruction 2.6-fold and smoking increased it 2.7-fold. Grain handlers have a higher prevalence of chronic bronchitis and other respiratory symptoms than do comparable workers who do not handle grain. The effect of grain dust exposure on symptom prevalence is usually greater than that of smoking. Grain handling has an adverse effect on lung function that is of the same or smaller magnitude than smoking. Smoking and grain handling effects were additive but not synergistic.

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