Medical and industrial hygiene characterization of the cotton waste utilization industry.

We studied 260 workers in the cotton waste utilization industry and 310 "blue-collar" control workers from nondusty industries in the same geographic area of the United States by respiratory symptom questionnaire and by pre- and postshift spirometry. We excluded 75 cotton workers and 75 control workers from statistical analysis because of prior hazardous occupational exposures. Plant-wide, 8-hour time-weighted average exposures ranged from 0.28 mg/m3 to 7.80 mg/m3. The overall prevalence of symptoms compatible with byssinosis was 5.9% in cotton workers and 4.7% in the controls. Cotton workers with less than 2 years of employment had a significantly greater prevalence of bronchitis than their control counterparts. The cotton workers with 2 years or more of employment had significantly greater prevalences of bronchitis, shift decrement in forced expiratory volume in 1 second (FEV1) of greater than or equal to 10%, and FEV1/FEV1-predicted less than 80%, than their control counterparts. Regression analysis showed that for matched cotton and control workers, the percentage decrement in FEV1 over the shift was significantly greater for cotton workers; and that in all cotton workers, longevity in industry had a negative effect on the before-shift forced vital capacity (FVC). This study suggests that there are both acute and chronic effects of cotton exposure in the cotton waste utilization industry.