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Female Woodworkers' Lungs At Risk, Reports A Major Study In The New Issue Of European Respiratory Journal

When you next buy furniture, spare a thought for the health of those who made it. A prospective six-year study shows that women with occupational exposure to wood dust, even at low levels, have an higher risk of asthma, cough or chronic bronchitis than their non-woodworking counterparts. Curiously, their male colleagues do not seem to be affected. The results will appear in the forthcoming issue of the European Respiratory Journal (ERJ), the peer-reviewed publication of the European Respiratory Society (ERS). They are all the more alarming given the widespread exposure to wood dust in European workplaces, at levels considerably higher than those measured in Denmark. Nearly four million workers, 700,000 of them in the furniture industry alone, are thought to be exposed to wood dust in the European Union. Wood dust is a factor in many respiratory pathologies. For example, cancer of the sinus is now recognised as an occupational disease of woodworkers, and a link has been found between asthma and western red cedar dust, particularly in Canada. Yet the danger posed by wood dust to the respiratory tree is still far from entirely clear. Indeed, no prospective study, to date, had monitored timber industry workers to measure the levels of newly diagnosed respiratory conditions. So Gitte Jacobsen and her team, of the Department of Occupational and Environmental Medicine at Aarhus University in Denmark, decided to investigate. Having demonstrated a decline in lung function among female woodworkers, they decided to clarify and, most importantly, quantify the various symptoms associated with this occupational exposure. Their findings are now presented in the ERJ. Thousands of measurements The six-year study was centred on 54 factories producing wooden furniture in the Danish county of Viborg. Three other factories that did not use wood (two produced refrigerators and one hearing aids) were selected as controls. A total of 1377 woodworkers were monitored for the full six years, and compared to the 297 control subjects from the non-woodworking factories. All of the subjects completed a questionnaire at the time of recruitment and at the end of the study, in which they provided information about their work, smoking history and any allergies or respiratory symptoms (asthma, rhinitis, cough etc). In parallel, Jacobsen and her colleagues conducted objective measurement of the subjects" lung capacity, using functional respiratory testing. Allergy screening was also carried out on a smaller sample by means of blood tests. The participants" exposure to wood dust was determined through thousands of in-situ measurements, designed to make it possible to assess each worker"s personal exposure at the beginning and end of the study. In this way, the team could see how the exposure had changed over time and calculate cumulative exposure. Up to six times the risk of chronic bronchitis A first finding, of importance for the European scope of this original study, was that exposure had declined significantly over the six years of the study, from 0.9 mg/m3 to 0.6 mg/m3. In fact, as the authors of the ERJ article emphasise, levels in Danish factories are much lower than the European average. Indeed, recent research indicates that at least two million European workers are exposed to over 2mg/m3 of wood dust! So the excess risk identified by Jacobsen and her team is even more worrying. Despite the improved working conditions in Danish furniture factories, the figures published in the ERJ provide cause for alarm, particularly as regards female woodworkers. Women with occupational exposure to wood dust are significantly more prone to asthma, cough and chronic bronchitis than control subjects. Since the risk is proportional to the exposure level, the team tried to separate the subjects into lower and higher exposure groups at the outset. The risk of cough or chronic bronchitis was found to be multiplied by 1.6 or 2.3 respectively for the first group, and 3.8 or 6 for the second. Hormonal and mechanical factors The increase in risk is even higher (13 times greater) among women who have left the woodworking industry, which suggests that the onset of respiratory symptoms spurs sufferers to abandon the occupation. Strangely, as the authors point out, none of these links has been found to apply to men. Some possible explanations are suggested. "Women are probably more susceptible to wood dust than men", Jacobsen points out, "because their airways are narrower, there are hormonal factors, and their cough reflex is more sensitive. " Which, she is quick to warn, does not mean men should be complacent. "Men could suffer respiratory consequences from inhaling wood dust at higher exposure levels", she suggests. "In practice, it is not so much a question of getting better medical follow-up for female woodworkers as of making the industry even cleaner", Jacobsen concludes. European Respiratory Journal


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