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Respiratory Morbidity Among Processing and Mill Workers A Cross-Sectional Survey in Three Tire-Manufacturing Plants Patricia ]. Sparks, M.D., M.P.H.; Thomas ]. Smith, Ph.D.; Lawrence J. Fin*, M.D., D.P.H.; Robert D. Treitman, M5.; and Donna L. Spiafatman, 8.A. Three hundred tevenry workers In three Urt-manuftctwinf plana wan studied to determine the praanei of rtspiretory mart)tally among workers with relatively low currant txooturt to ratpinOia dust (range, 0.0* to 0.70 mg/m`). Workars m tha processing, milling, an* laa dusty anas of tftt plana wart divided Into thru group* an tha basis of thatr currant and past txposurt to raspuobfa dust. Significantly mora aya Irritation (p<.Ot) was found among woman In dia mH/ing areas. Woman in tit* milling arms who war* currant apanrtt smokers had significantly (pc.QS) more chronic bronchitis trad loom or producthi* ob/aettva cough than all other currant agaratta smokers. Tha moan forced expiratory voiuma In I s fftVx), whan corrected far age andhetpst, deemed srgmftcandy (pk.OI) with IncrtdStng dotation of ctgaratta smoking. The moan Fvl and tha forced vital capacity (FVC), whan corrected far age, height and cigarette making, ware tha lowaat In the group with tha Iowan dun treasure and highan In tha group with moderate dun txpoaut* (tha milting are**). Tha measurement of tha difference In flow at SOM of FVC on air and on a haHurmoxygm mixture is e senstthra ten for small-airway obstruction In the hbomory. In the field, however, tha helium-oxygen how dlfPwenca Old not vary with duration of cigarette smoking m expected, end there was no significant variation by txpoourt category. Several previous Madias have kata conducted ot rat* piratory morbidity aitarag ruOOtr workers1-*, and most have dwelt with exposure ao ratpirapia particulates. Tha proeeaemg araa wham preen ruMar and chamicait am weighed, muted and addad to lanPtery mixers was in tha past quits dusty. In a craassscdanal ituty by Fina tt ai,1 $5 procerefcsg workers from dues nipfctr plants war* com pared with 119 connois from tha uma plants. bracestint workors bad sipiifleandy dscrened lung function whan from uw Occupattand Healui Ptwsrww. Hxrvwd ScamI et Puss* Hutin. MS Handnaun **., laataa.MA OJI IS. Or. Sparse * naw Madica Oirecter. Ivrllngix* ledutcriss, r O. tx 31307, Grsemkera, HC 37*19. Dr. Pint Is saw widi tha Scftwea el Pubda HultS. university et Mlctusaa. Am Arear. MM*. compared with centrals. Workers in tha mill araa where tha output from lanbury mixan is millad also are txoostd to respirable particulates, mostly fumas of various composi tion.4-4 Tbasa workers ware not included in our rimer respiratory morbidity soidiee. Sinca savaral of tha Uj. rubber manufacturers and tht United Rubber Workars Union initiated joint iponsorditp of this research proprem in 1970, conditions have improved In tht prccasainf and mill anas of many rubber plants *e bad previously surveyed. Tha present study was under taken so dewnnin* tfve currant prevalanca of respiratory morbidity among workers in the procesuni and milling areas of dire* rubber piano. Methods and Pracadura Ail of tha 214 mala worksrs fexposed) In the processing and mdl areas of three brewnsnufacaning plants who nad been amplayed at Mast six months ware chosen for surrey. One hundred flfor-ftv* workers In the warehouse, n re building, and laboratory treat of the three punts who hut bean employed aa leaet six month* ware chosen as the comparison group. Wa saltctad tha companson workers to match in apa the procaaiing and milling workers. The expoeure to reaelredte parttcutasm of the comparison group wet knows from previous sardiai to be vary low.4-* Twanqrmint (10ft) sraceeawg and mill workers ware not surveyed because 20 workars were it), four refused, and hvo wore on vacation. Similarly, 31 (13*) of comparison work ars ware not surveyed. An additional 11 mill and practising workers and aipit workers in the companion group were eliminated from the analysts bacausa of Incomplete data collection. Quaationraka - A standardized Questionnaire was ad- miniawrad to each xibiect by on* of four trained inter viewers. The quetdontuire wis a modified version of the Sntips Medical Research Council Questionnaire,4 and consisted of ouesdons concerning previous occupation, medical history, acute and chronic respiratory symptoms, md a doodad smoking history. Obreetive cough was also ascertained and recorded as dry, loot*, ot producuv*. Chronic bronchitis was defined at t daily coupt 'or at least three months per year far more than two more years. 630 Raspiettsiy Morbidity in Tire-Mamitaturing Fltno/Sparks et ai DU* 0934631 DU 036951 JKBsam^A VoL 30 So. 24 CASE RECORDS OF THE MASSACHUSETTS GENERAL HOSPITAL Da. Mail: Or. Greene. are then any radiographic hallmarks of broachocentnc granuiocnatoeu* Dr. Giuxt: The radiographic fading and clinical background of the patients that UebowlS originally designated u having broochocencric granulomatosis were variable. When the dinical situation end radiolo gic finding* art 'uggesuve of ABPA, wuh tnucotd im paction, thickened bronchial wails, and coaiescent le sions, the diagnosis of bronchocenme granulomatosis may be considered, but 1 don't mow any way to make that diagnosis on che basis of radiologic findings. Akatqkscai. OUONQStt Brvndmantnc grtmitmient. Bronchiectasis, with mucoid impactioo. (Asthma). tssu iasn-. isansiA ttymirkmmhw omumi . Am W N 0*. 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IS. fflOT a. Bhrh. UUOTL AJhOT M. m. tt< I4.ni .. IVMILLIMETER LANTEXH JUDES rOR THE CASE UCORM 1 Hi min ifiRiJtwiW 111 wii i*~i- *------- --'-a-*'. ----------------<----------- r'"1" . -- or idimw Mtarial ia aN^Ma w racana U-raa liatara dMa. with Ideadftif lignli, of ** paraaau a-ny Rta*. ......... .. |tiiiRirtmum nlr^~~n-------------------- ------ ------------------** l~,i* `",h* JJ^MI p narmt Thaaa tMm, which Ulunrtn dw carrnt awaa ia ch Jtmtai, an naiM wwhiy taaa tha Da^rtmaat of Paihalagy and any ha macaah hr ch mhtenher. Enh ytn tppraajawatr W> alidaa an aa a aath ahaatnbtr. SciaM of dw iaenaaad caaa at pruwrum of tha maKciai aad laailla^ haa haaa airaaaary niaa cha coat to U30 par year. Appdcadm la aw hr tha curmi tuhacnpnoa *aar. which ha^u on Mardi I, 19B. nay ha nhntiwd ftoan Mca. Bccy V. MeSmtr, Otfhnant atFhdudegy, Miauhwm Oaaarai Hoapcai, Bonoa, MaOTdaMia 02U4 (ictcpooaa (417! 724-M7). d0 093*632 DU 036952