Occupational hazards and health cost of women cotton pickers in Pakistani Punjab.

BACKGROUND: Farm workers and female cotton pickers are exposed to residual impacts of pesticide use in cotton production, in addition to dust, ultraviolet radiation, etc. Cotton picking causes various health hazards among cotton pickers with varied health cost. A soil bacterium known as Bacillus thuringiensis (Bt) is incorporated in cotton seed through genetic modification and it has resistance against certain bollworms of cotton. So it is considered that Bt cotton fields have less pesticide exposure compared to non-Bt cotton fields. This study was designed to examine and compare the impacts and health cost of cotton picking among female cotton pickers working in Bt and non-Bt cotton fields. METHODS: The study used the data collected from Vehari district of Pakistani Punjab. Health hazards and associated health cost of the respondents involved in Bt cotton picking were compared with those who harvested non-Bt cotton. Comparative use of the personal protective measures among those respondents was also examined. Health cost function and its determinants were analyzed using ordinary least square method. RESULTS: Findings of the study showed that 61 % cotton pickers from Bt cotton households reported one or more health effects of pesticide during picking season whereas this percentage for non-Bt cotton households was 66 %. Health impacts included skin problems, headache, cough, flu/fever, eye irritation and sleeplessness, however, percentage of these health impacts was comparatively higher among non-Bt cotton households. Health cost from exposure to pesticide use in cotton was US$ 5.74 and 2.91 per season for non-Bt cotton and Bt cotton households, respectively. Education, picking in Bt cotton fields and preventive measures were significantly related with health cost. CONCLUSION: Cotton pickers working in Bt cotton fields are found to have less occupational health hazards compared to those working in non-Bt cotton fields. Thus generating awareness among cotton pickers for adopting precautionary measures during harvesting and the use of Bt cotton seed can result in a decline in the ill-effects of cotton picking.

Indomethacin activates peroxisome proliferator-activated receptor γ to improve insulin resistance in cotton pellet granuloma model.

Inflammation is involved in the development of insulin resistance and diabetes. However, the effectiveness of anti-inflammatory drugs in diabetic therapy remains obscure. In the present study, the possible mechanisms of indomethacin, one of the nonsteroidal anti-inflammatory drugs, in the improvement of insulin resistance were investigated. Indomethacin treatment significantly decreased cotton pellet implantation induced white blood cell count elevation and immune cells infiltration in epididymal white adipose tissue. Also, cotton pellet implantation induced impaired glucose utilization and insulin resistance were improved by indomethacin. The decrement in phosphoinsulin receptor and phospho-Akt levels induced by cotton pellet implantation was improved by indomethacin as well. Moreover, indomethacin decreased cyclooxygenase-2 (COX-2) and inducible nitric oxide synthase (iNOS) expression in epididymal white adipose tissue with a marked reduction of prostaglandin 2 (PGE2) and nitrite/nitrate (NOx) levels in cotton pellet-implanted mice. Furthermore, pretreatment of peroxisome proliferator-activated receptor γ (PPARγ) antagonist, GW9662 not only reversed indomethacin-modified COX-2 and iNOS levels but also reversed indomethacin-improved insulin sensitivity determined by homeostasis model assessment-insulin resistance (HOMA-IR). Taken together, indomethacin might elevate the expression of PPARγ to decrease serum NOx and PGE2 to result in the improvement of insulin resistance.

Transgenic Cotton: From Biotransformation Methods to Agricultural Application.

Transgenic cotton is among the first transgenic plants commercially adopted around the world. Since it was first introduced into the field in the middle of the 1990s, transgenic cotton has been quickly adopted by cotton farmers in many developed and developing countries. Transgenic cotton has offered many important environmental, social, and economic benefits, including reduced usage of pesticides, indirect increase of yield, minimizing environmental pollution, and reducing labor and cost. Agrobacterium-mediated genetic transformation method is the major method for obtaining transgenic cotton. However, pollen tube pathway-mediated method is also used, particularly by scientists in China, to breed commercial transgenic cotton. Although transgenic cotton plants with disease resistance, abiotic stress tolerance, and improved fiber quality have been developed in the past decades, insect-resistant and herbicide-tolerant cottons are the two dominant cottons in transgenic cotton market.

Paget's disease of bone in Lancashire and arsenic pesticide in cotton mill wastewater: a speculative hypothesis.

A 1974 survey of Paget's disease of bone in 31 UK towns identified a cluster of six Lancashire former cotton mill towns with the highest prevalence rates of the disease and noted a link with the cotton industry. The two highest-prevalence towns are situated on estuaries and are jointly the smallest of the six by the size of their former cotton industry. The two lowest-prevalence towns of the six are highest above sea level and jointly the largest by the size of their former cotton industry. This pattern suggests a waterborne agent. A 1993 repeat survey of 10 of the 31 towns identified a general decline in prevalence, greatest in the three cotton towns included from the six in the earlier survey, further suggesting a link to the cotton industry. Cotton mills and bleach/dyeworks produced a large volume of wastewater that was commonly discharged into adjacent waterways. Wastewater contained process chemicals and imported organisms and pesticides carried in cotton bales. The process chemicals and imported organisms could be discounted as a probable factor in Paget's disease; however, pesticides could not be discounted. Lancashire cotton came predominantly from the American cotton belt. From 1917 to 1945, calcium arsenate pesticide was used intensively to combat the boll weevil and was imported to Lancashire in cotton bales. The calcium arsenate era is consistent with the high-prevalence findings in 1974 and the decline in 1993, allowing for time lags. Geochemical arsenate is widespread in the environment and may account for geographic variations in Paget's prevalence, although data are inadequate for correlation studies. Noncytotoxic doses of arsenic affect all the steroid receptors and some signal transduction pathways, which may lead to dysfunctional osteoclast signaling and differentiation. Human cells are more susceptible than animal cells to arsenic, based on studies of nonbone cells. It is speculative that arsenic may be a factor in the abnormal variation in prevalence rates in Lancashire. It is not a general theory of Paget's disease.

Smoking and cotton dust effects in cotton textile workers: an analysis of the shape of the maximum expiratory flow volume curve.

Cotton textile workers have an increased prevalence of both obstructive and restrictive lung function patterns when compared to control subjects. Similar abnormal lung function patterns may occur with other respiratory diseases, notably those associated with cigarette smoking. The shape of the maximum expiratory flow volume (MEFV) curve has been used to characterize patterns of lung function abnormality. We defined a new functional parameter (angle beta) related to the shape of the MEFV curve in order better to characterize the respiratory effects of cotton dust exposure. In this study, 477 cotton textile workers, both current smokers and never smokers 45 years and older, were compared to 932 similarly aged control subjects from three communities: Lebanon and Ansonia, CT, and Winnsboro, SC. Smokers, regardless of their occupational exposure of sex, have smaller values of beta than do nonsmokers. Cotton textile workers who have more abnormal lung function than do controls, cannot be distinguished from controls by beta. We suggest that such functional differences between cotton and smoking effects may reflect injury to different portions of the bronchial tree.

Cotton dust concentrations and particle size distributions associated with genotypes.

The problem of byssinosis has plagued cotton textile mills for hundreds of years, and it is still a problem today. With the regulations on airborne raw cotton dust set by OSHA and the ACGIH, research regarding the measurement of cotton dust in lint fiber is a necessity. A procedure known as the mass concentration particle size distribution (MCPSD) technique, developed at Texas A&M University, was used to measure the characteristics of cotton dust as affected by harvesting method and genotype. Cotton genotypes from three harvest seasons were analyzed by using a Coulter Counter, Model TAII, to obtain the mass concentrations and particle size distributions of dust present in the lint fiber. The genotypes were subjected to both hand harvesting and conventional spindle harvesting for comparison purposes. Results from the dust concentration analyses of particles less than 100 micron, 16 micron, and 8 micron in diameter, respectively, are presented. Also, a proposed procedure to obtain large quantities of "cotton dust" from gin trash material is discussed.

Exposure of cotton workers in an experimental cardroom with reference to airborne endotoxins.

Workers from cotton mills were exposed to cotton dust during carding in an experimental cardroom. Cotton from different geographical locations with varying amounts of endotoxin were used. Exposure levels ranged from 0.6 to 3.6 mg dust/m3 (from a vertical elutriator) and from 0.1 to 8.0 micrograms/m3 of endotoxin. No relationship was found between the decrease in FEV1 over the workshift and the amount of airborne dust. Airborne endotoxin correlated with the decrease in FEV1 and the increase in blood neutrophils. The FEV1 decrease was more pronounced among smokers. The data suggest that the amount of airborne endotoxin determines the risk for development of the acute symptoms in the byssinosis syndrome.

Immunologic responses to inhaled cotton dust.

Byssinosis, a respiratory disease of workers on cotton, flax, and soft hemp, is classically characterized as shortness of breath, cough, and chest tightness on Mondays or the first day of return to work after a time off. Exposure to these vegetable dusts can also result in other respiratory diseases, and the term cotton dust-induced respiratory disease (CDIRD) is introduced. Although clinically characterized for more than a century, the underlying pathogenesis of CDIRD remains obscure. An allergic pathogenesis has been proposed. This article reviews previous and current research findings supporting this mechanism and raises the possibility that, in some individuals, CDIRD may be due to pre-existing or occupationally induced mold allergy.

Pulmonary reactions to organic dust exposures: development of an animal model.

Acute inhalation of organic dusts such as cotton, hay, silage, grain, animal confinement, or compost dust can result in illness characterized by fever, pulmonary inflammation, chest tightness, and airway obstruction. These agricultural materials are complex mixtures of plant, bacterial, and fungal products. Elucidation of the time course of disease onset, the mechanisms of disease progression, and the identity of etiologic agents is essential for effective prevention and treatment. Toward this end, animal models for acute organic dust-induced reactions have been developed and characterized. Information concerning the applicability of various animal models to humans and progress toward elucidation of causative agents and mechanisms of action is presented.

Evaluation of mechanical prototype machines for continuous separation of respirable cotton dust fractions.

The original cotton particulates analyzer used stationary screens to separate aerodynamically the coarse and fine dust fractions from small samples of cotton. By replacing stationary with rotary screens that were continuously cleaned, larger supplies of respirable dust were obtained without interruption. A ginned and a waste cotton were used to test two methods of separation: a rotating 38-micron screen and a tandem rotating 710- or 38- micron screen and cyclone. The fine dust fractions from both systems were captured on filters and examined gravimetrically, by Coulter counter, and scanning electron microscope. The dust passing 38 micron stationary or rotary screens contained particles of 15 micron maximum diameter whereas dust from the 710-gmm rotary screen and tandem cyclone exhibited particles of 10 micron maximum diameter and lint fragments. Dust fractions with particles less than 10 micron diameter and free of lint were obtained with a 38-micron rotary screen and tandem cyclone.

Biologic activity of purified cotton bract extracts in man and guinea pig.

Purified aqueous extracts of cotton bract induce acute airway constriction in healthy volunteers never before exposed to cotton bract. The response is similar to that of textile workers who inhale cotton dust. Approximately 60% of volunteers respond to bract extract with significant decreases in lung function, and these volunteers show an increased number of lymphocytes present in their lungs. Following inhalation of bract, the percent of polymorphonuclear leukocytes increases. Macrophages obtained by bronchoalveolar lavage from volunteers pre-challenged with bract extract release increased amounts of chemotactic factor and superoxide anion. Efforts to detect release of histamine and leukotrienes in volunteers following challenge with bract show no increase in urinary histamine and no significant release of leukotrienes in lung lavage fluid. Purified extracts exhibit chemotactic activity in vitro. They also contract guinea pig ileal longitudinal muscle in vitro. This preparation contains mast cells but no basophils, and the H-1 blocker, mepyramine blocks the contraction. Purified bract extracts contain no histamine or endotoxin but other contractors of smooth muscle may be present. The purified extract exhibits spectral, fluorescent, and radioimmune assay properties similar to a leukotriene B-like component. Cotton bract appears to have direct as well as cell-mediated activities.

Vegetable dust and airway disease: inflammatory mechanisms.

Exposure to cotton or grain dust causes an obstructive bronchitis in certain subjects, mechanisms of which are poorly understood. A difficulty encountered in discerning mechanisms of this airway disease is the lack of knowledge of the active components of these dusts. Clinical features suggest common but not exact mechanisms of the airway disease associated with these vegetable dusts. Human and animal studies show evidence of acellular and cellular inflammatory mechanisms of the bronchoconstriction and inflammation associated with these disorders. Potential cellular sources include alveolar macrophages, polymorphonuclear leukocytes, mast cells, basophils, eosinophils and lymphocytes. Acellular origins include the complement and humoral antibody systems, both of which have been implicated, although their pathogenic role in grain or cotton dust disorders is uncertain. In this review we critically address potential inflammatory mechanisms of airway alterations resulting from cotton or grain dust exposure. General mechanisms of bronchoconstriction are first presented, then specific studies dealing with either of the two dusts are discussed. We believe this area of research may be fruitful in dissecting mechanisms of bronchoconstriction and airway inflammation, especially as more human studies are undertaken.

A longitudinal study of pulmonary function in cotton gin workers in the San Joaquin Valley.

In a previous study we found no significant effects of acute exposure to the cotton gin environment on FEV1 in San Joaquin Valley gin workers compared with concurrent control subjects, nor was there an excess of obstructive lung disease among the same gin workers. The present study looked at the mean annual decline in FEV1, FEV1/FVC, and FEF25-75% in San Joaquin Valley cotton gin workers vs concurrent control subjects over four years. The FEV1 of gin workers completing all four years of the study declined 27.3 ml vs 35.5 ml in control subjects (p = 0.37); FEV1/FVC declined 0.21 percent in gin workers and 0.23 percent in control subjects (p = 0.86); FEF25-75% declined 0.058 L/s in gin workers and 0.066 L/s in control subjects (p = 0.68). Also, the mean annual rate of change of FEV1 was less among the gin workers who did not complete all four years than the gin workers completing all four years. The presence of "byssinosis" symptoms did not significantly influence the results. This prospective, longitudinal study failed to find any detrimental effect of the cotton gin environment on the rate of decline of FEV1, FEV1/FVC, and FEF25-75%. This result was independent of "byssinosis" symptoms and the effect of "dropouts."

Airway reactivity and cotton bract-induced bronchial obstruction.

Most seemingly healthy persons challenged with an aerosol of cotton bract extract develop some degree of bronchospasm. The role of nonspecific reactivity of the airways in this reaction to cotton bract extract is undefined. We examined the relationship between airway responses to cotton bract extract and to methacholine, as well as between airway responses to cotton bract extract and to a bronchodilator. Twenty-two healthy subjects were screened for sensitivity to inhaled cotton bract extract. Pulmonary function was measured using partial expiratory flow-volume curves on which flow at 60 percent of the control vital capacity below total lung capacity was measured (MEF40%[P]) following ten minutes of inhalation of cotton bract extract. In the group screened, 12 were found to be responders to the extract, with drops in MEF40%(P) of 20 percent or more, and ten were found to be nonresponders. On separate days, we measured the responses of our subjects' airways to inhaled metaproterenol and methacholine. The mean threshold dose for methacholine in the responding group was 26.8 mg/ml, as compared to 55.6 mg/ml for the nonresponders (t = 2.52; p less than 0.05). Furthermore, the mean percent increase in MEF40%(P) following inhalation of metaproterenol was 41 percent in responders and 24 percent in nonresponders (t = 2.19; p less than 0.05). We conclude that some responders to cotton bract extract exhibit greater reactivity of the airways than nonresponders.

Use of disposable products in surgical practice.

Disposable products today are an important part of the multibillion dollar health devices industry. A few heavy-usage and low-usage examples of disposable products used by surgeons are chosen to demonstrate that in a 1,000-bed hospital, economy is rarely, if ever, a reason for converting from reusables to disposables. The actual reasons are more closely related to individual preference, availability, convenience, dependability, safely, and, in some cases, manufacturer's promotion. In a 24-hospital study of surgical apparel, it was found that only caps, masks, shoe covers, and other small items approached partly in cost between disposable and reusable items, where as the per-use cost of reusable larger items such as gowns and drapes was still much lower than that of their disposable counterparts. However, each hospital must make its own decisions based on all factors, not on economy alone.

Possible foreign body granuloma of the retina associated with intravenous cocaine addiction.

A 27-year-old man who was a heroin addict had light flashes in front of the right eye and a hemicentral scotoma immediately after intravenous cocaine. The initial ophthalmoscopic appearance was of a white foreign body lying over the papillomacular bundle of the retina in the right eye. This ophthalmoscopic finding was consistent with intraocular talc, cornstarch, or lactose, common diluting agents that are present in intravenous injections of heroin, cocaine, or methylphenidate hydrochloride, and are known to cause systemic embolic phenomena in chronic drug abusers. This glistening crystal on the surface of the retina changed and evolved into a noninfectious but inflammatory organization of retinal granuloma, in which the foreign body crystal could still be visualized at the apex of the lesion. The anterior and posterior segments of the eye remained free of inflammatory signs throughout the course of the organization of the retinal granuloma.

MR characteristics of muslin-induced optic neuropathy: report of two cases and review of the literature.

Muslin-induced optic neuropathy is a rarely reported but important cause of delayed visual loss after repair of intracranial aneurysms. Most of the previously reported cases were published before the introduction of MR imaging. We describe the clinical features and MR appearance of two cases of delayed visual loss due to "muslinoma," and compare them with the 21 cases reported in the literature.

Foreign-body granuloma as a complication of wrapping and coating an intracranial aneurysm. Case report.

A rare case is presented in which a foreign-body granuloma developed at the site of muslin wrapping and Aron Alpha A coating of an internal carotid artery aneurysm. The importance of avoiding the use of muslin, especially close to the optic nerve and chiasm, is emphasized.

The laparotomy pad, the laundry and intestinal adhesions.

Uncoated laparotomy pads and pads coated with Hydron were put through an ordinary laundry procedure. A long-chain quaternary detergent remained in the pads and was not removed in the final rinse. In addition, Hydron was found, as expected. Implications of the presence of detergent in the peritoneal cavity are considered.