Relationship of acute obstructive airway change to chronic (fixed) obstruction.

In this report of a 5-yr longitudinal study of workers at six cotton textile mills, exposure and across- shift FEV, changes were evaluated as possible predictors of the annual change in FEV, for yarn manufacturing workers. A total of 611 workers had three repeatable spirometric tests, over at least 3yr, and at least one (average of three) across-shift test, while always working the same shift. The "same shift" criterion controlled for the effect of diurnal variation. Average exposure was determined from measures of lint-free elutriated cotton dust in combination with job histories. This study found a significant association between the acute and chronic effects of cotton dust exposure. Both exposure and across-shift change proved to be significant predictors of annual change, and excess annual declines in FEV, were predicted even for exposures of 200pg/m3 and across-shift drops in FEV, of 200 ml. These results suggest that, to prevent dust-related chronic decline in lung function, current smokers should be excluded from yarn manufacturing work and exposure should be reduced below 200 pgi/m3, to