Chest
Volume 89, Issue 6, June 1986, Pages 795-799
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Clinical Investigations
Pulmonary Function in Pi M and MZ Grainworkers

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Twenty-eight men with the Pi MZ phenotype who have been employed in the Saskatchewan country grain elevators and thus regularly exposed to high levels of grain dust, were case matched for age, years of employment, employment status, smoking status, and smoking history with grainworkers of type Pi M. Individuals answered a questionnaire, had a chest roentgenogram, skin tests, and performed a battery of pulmonary function tests. There were no differences between the two groups in prevalence of symptoms or atopy. Although not statistically significant, the MZ group had three times as many individuals with abnormal roentgenograms suggestive of COPD as the M group. The Pi MZ grainworkers had consistently poorer mean results for the pulmonary function tests with significantly lower mean values for FEV1, FEV1/FVC, MMFR, and V˙max50, leading us to suggest that Pi MZ individuals may be at higher risk of COPD than Pi M individuals, but only in the presence of other risk factors such as grain dust exposure.

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Subjects

In a province-wide survey, we studied 1,395 or approximately 80 percent of male grain workers from the Saskatchewan country grain elevators.14 Among the 1,395, 35 had the Pi MZ phenotype as determined by acid starch gel electrophoresis and crossed Immunoelectrophoresis.15 Twenty-nine agreed to participate in the current study; of the remaining six, one had died, three could not be located, and two refused to participate. A case-matched control subject could not be identified for one, leaving a

Results

Mean age, height, weight, graindust exposure, and smoking data are summarized in Table 1. As expected, there were no differences in values between the two groups. The prevalence of symptoms, positive skin tests, and roentgenographic abnormalities suggestive of COPD are shown in Table 2. Roentgenographic abnormalities included diffuse vascular deficiency, depressed diaphragm, and hyperinflation. There were no significant differences in prevalence of symptoms or skin test positivity. There was a

Discussion

Cotton et al12 have shown in a case-matched study of smoking and nonsmoking grainworkers and community control subjects that both working in the country grain elevators and smoking are associated with reduced lung function, and that these two factors behave in an additive fashion. We have carried out our study on a group of men all of whom were exposed to grain dust in the grain elevators, and thus, have an increased risk of lung dysfunction.

As well, 22 of the 28 pairs of men studied were

Acknowledgments

The authors wish to express their appreciation to the following organizations and individuals for their assistance in carrying out this study; The Saskatchewan Wheat Pool, Pioneer Grain, United Grain Growers and Federal Grain, individual members of the Saskatchewan Grain Handlers Union and their families, Drs. J. Rankin and G. doPico for permission to use their questionnaire, Miss Debbie Hall for assistance with data analysis, Mrs. Ruth Day, Mrs. Jacquie Bramley and Mrs. Lesley McBain for

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This study was supported by Health and Welfare Canada Grant No. 6608-1083-40 and MRC Grant No. 8657.

Manuscript received August 9; revision accepted November 19.

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