附錄一

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1 American thoracic society : Standardization of spirometry. Am J Respir Crit Care Med 152: , Castellan RM, Olenchock SA, Kinsley KB, Hankinson JL : Inhaled endotoxin and decreased spirometric values:an exposure-response relation for cotton dust. N Engl J Med 317: , Christiani DC, Velazquez A, Wilcox M, Olenchock SA : Airborne endotoxin concentrations in various work areas within a cotton mill in central America. Environ Res 60: , 1993a. Christiani DC, Wegman DH, Eisen EA, Ye TT, Lu PL, Olenchock SA : Cotton dust and gram-negative bacterial endotoxin correlations in two cotton textile mills. Am J Ind Med 23: , 1993b. Christiani DC, Ye TT, Wegman DH, Eisen EA, Dai HL, Lu PL : Cotton dust exposure, across-shift drop in FEV 1, and five-year change in lung function. Am J Respir Crit Care Med 150: , 1994a. Christiani DC, Ye TT, Wegman DH, Eisen EA, Dai HL, Lu PL : Pulmonary function among cotton textile workers. Chest 105: , 1994b. Christiani DC, Ye TT, Zhang S, Wegman DH, Eisen EA, Ryan LA, Olenchock SA, Pothier L, Dai HL : Cotton dust and endotoxin exposure and long-term decline in lung function: results of a longitudinal study. Am J Ind Med 35: , Christiani DC, Wang XR, Pan LD, Zhang HX, Sun BX, Dai HL, Eisen EA, Wegman DH, Olenchock SA : Longitudinal changes in pulmonary function and respiratory symptoms in cotton textile workers. Am J Respir Crit Care Med 163: , Gokani VN, Doctor PB, Ghosh SK : Isolation and identiciaction of gram negative bacteria from raw baled cotton and synthetic textile fibers with special reference to environmental GNB and endotoxin concentrations of 53

2 textile mill. Am Ind Hyg Assoc J 48: , Glindmeyer H, Diem J, Hughes J : Factors influencing the interpretation of FEV1 declines across the working shift. Chest 79:71s-75s, Glindmeyer H, Lefante JJ, Jones RN, Rando RJ, Kader HM, Weill H : Exposure-related declines in the lung function of cotton textile workers. Am Rev Respir Dis 144: , Glindmeyer HW, Lefante JJ, Jones RN, Rando RJ, Weill H : Cotton dust and Across-shift change in FEV 1 as predictors of annual change in FEV 1. Am J Respir Crit Care Med 149: , Guideline on Validation of the Limulus Amebocyte Lysate Test as an End-Product Endotoxin Test for Human and Animal Parenteral Drugs, Biological Products, and Medical Devices. U.S. Department of Health and Human Services, Public Health Service, Food and Drug Administration, December Helsing KJ, Comstock GW, Speizer FE : Comparison of three standardized questionnaires on respiratory symptoms. Am Rev Respir Dis 120: , Haglind P, Rylander R : Exposure to cotton dust in an experimental cardroom. Br J Ind Med 41: , Jacobs RR : Airborne endotoxins:an association with occupational lung disease. Appl Ind Hyg 4:50-56, Keman S, Jetten M, Douwes J, Borm P : Longitudinal changes in inflammatory markers in nasal lavage of cotton workers: relation to endotoxin exposure and lung function changes. Int Arch Occup Environ Health 71: , Kennedy SM, Christiani DC, Eisen EA, Wegman DH, Greaves IA, Olenchock SA, Ye TT, Lu PL : Cotton dust and exdotoxin exposure-response relationships in cotton textile workers. Am Re Respir Dis 135: , 54

3 1987. Li D, Zhong YN, Rylander R, Ma QY, Zhou XY : Longitudinal study of the health of cotton workers. Occup Envron Med 52: , Macek C : Bacterial endotoxin may be culprit in Monday fever. JAMA 247: , Mark D, Vincent JH : A new personal sampler for airborne total dust in workplaces. Ann Occup Hyg 30:89-102, Niven RM, Fletcher AM, Picjering CAC, Fishwick D, Warburton CJ, Simpson JCG, Francis H, Oldham LA : Chronic bronchitis in textile workers. Thorax 52:22-27, Olenchock SA, Christiani DC, Mull JC, Ye TT, Lu PL : Airborne endotoxin concentrations in various work areas within two cotton textile mills in the People s Republic of China. Biomed Environ Sci 3: , Rylander R : The role of endotoxin for reactions after exposure to cotton dust. Am J Ind Med 12: , Sandstorm T, Bjermer, L, Rylander, R : Lipopolysaccharide(LPS) inhalation on healthy subjects increases neutrophils, lymphocytes and fibronectin levels in bronchoalveolar lavage fluid. Eur Respir J 5: , Schwartz DA, Thorne PS, Yagla SJ, Burmeister LF, Olenchock SA, Watt JL, Quinn TJ : The role of endotoxin in grain dust-induced lung disease. Am J Respir Crit Care Med 152: , Simpson JCG, Niven RM, Pickering CAC, Fletcher AM, Oldham LA, Francis HM : Prevalence and predictors of work related respiratory symptoms in workers exposed to organic dusts. Occup Environ Med 55: , Su HJ, Chen HL, Huang CF, Lin CY, Li FC, Milton DK : Airborne fungi and endotoxin concentrations in different areas within textile plants in Taiwan: A 3-tear study. Environ Res section A 89:58-65, Tabak S, Broday DM, Tabak I, Manor G : Occupational exposure to cotton dust 55

4 in cottonseed oil mills. Appl Occup Environ Hyg 17: , Vincent JH, Mark D : Comparison of criteria for defining inspirable aerosol and development of appropriate samplers. Am Ind Hyg Assoc J 48: , Wang XR, Pan LD, Zhang HX, Sun BX, Dai HL, Christiani DC : Follow-up study of respiratory health of newly-hired female cotton textile workers. Am J Ind Med 41: , : Taiwan Textile Federation

5 1 n=208 n=480 p 0.046* * <= > ± ± ± ± * <= > ± ± a a a WHO

6 2 n=208 n=480 p FVC(l) Mean±SD 3.19± ± FEV 1 (l) Mean±SD 2.78± ± *

7 3 a n=138 a n=69 p ± ± ± ± ± ± * a a a a

8 3 a n=138 a n=69 p a a

9 4 n=138 n=69 p FVC(l) Mean±SD 3.02± ± FEV 1 (l) Mean±SD 2.61± ±

10 p 0.000* * * FVC(l) Mean±SD 3.19± ± * FEV 1 (l) Mean±SD 2.78± ± * 0.000* *

11 a 6 FVC ml 95%p * * * * * a GEE 63

12 6 FVC ml a 95%P a * * * * a GEE 64

13 a 7 FEV1 ml GEE 95%p * * * * * * * * a GEE 65

14 a 7 FEV1 ml 95% p a * * * a GEE 66

15 a 8 ±SD ± ± ± ± ± ± ± ± ± ± a mg/m 3 67

16 a 9 ±SD GSD ± ± ± ± ± ± ± ± ± ± ± ± a mg/m 3 68

17 a 10 ±SD GSD A ± ± ± ± ± ± ± ± ± ± ± B ± ± ± ± ± ± ± ± ± ± C ± ± ± ± ± ± ± ± ± ± a mg/m 3 69

18 a 11 ±SD GSD ± ± ± ± ± ± ± ± ± ± ± ± ± a EU/m 3 70

19 a 12 ±SD GSD A ± ± ± ± ± ± ± ± ± ± ± B ± ± ± ± ± ± ± ± ± ± C ± ± ± ± ± ± ± ± ± ± a EU/m 3 71

20 13 mg/m 3 a p EU/m * A * A B C mg/m 3 b 10.57± ± c 0.001* log EU/m 3 d 0.92± ± c 0.000* a Spearman s rank correlation b A B C c Pearson corrleation d 72

21 14 GEE 208 FVC(ml) FEV 1 (ml) β 95%CI p β 95%CI p / * * * * * * / * /

22 15 GEE 208 FVC(ml) FEV 1 (ml) 95%CI p 95%CI p / * * * * * * / * / WHO /

23 16 GEE 208 FVC(ml) FEV 1 (ml) 95%CI p 95%CI p / * * * * * * / * / / / / * 75

24 17 GEE 208 FVC(ml) FEV 1 (ml) 95%CI p 95%CI p / * * * * * * / * / WHO /

25 18 GEE 208 FVC(ml) FEV 1 (ml) 95%CI p 95%CI p / * * * * * * / * / / / /

26 19 GEE 208 FVC(ml) FEV 1 (ml) 95%CI p 95%CI p / * * * * * * / * / /

27 20 GEE 208 FVC(ml) FEV 1 (ml) 95%CI p 95%CI p / * * * * * * / * / / / /

28 21 GEE 208 FVC(ml) FEV 1 (ml) 95%CI p 95%CI p / * * * * * * / * / / * *

29 22 GEE 208 FVC(ml) FEV 1 (ml) 95%CI p 95%CI p / * * * * * * / * / / *

30 23 GEE 208 FVC(ml) FEV 1 (ml) 95%CI p 95%CI p / * * * * * * / * / /

31 24 GEE 208 FVC(ml) FEV 1 (ml) 95%CI p 95%CI p / * * * * * * / / / /

32 25 logit GEE 208 a / 0.22 b OR 95%CI c p OR 95%CI c p / / WHO / * * a / b / c OR 95%CI 84

33 26 logit GEE 208 a / 0.28 b OR 95%CI c p OR 95%CI c p * / / WHO / a / b / c OR 95%CI 85

34 27 GEE 138 FVC(ml) FEV 1 (ml) 95%CI p 95%CI p / * * * * * * / log mg/m

35 28 GEE 138 FVC(ml) FEV 1 (ml) 95%CI p 95%CI p / * * * * * * / * log EU/m

36 29 GEE 138 FVC(ml) FEV 1 (ml) 95%CI p 95%CI p / * * * * * * /

37 1 mg/m3 EU/m 3 mg/m EU/m 3 R square

38 2 log log log mg/m3 3 log EU/m log mg/m log EU/m 3 R square

39 Christiani et al., Am J Ind 5 FEV 1 Med, ml FEV 1 30ml ml GEE mg/m 3 years FEV 1 β p 0.03 Li et al., FEV 1 Occup Envron FEV % 1 Med, % 1 10 Glindmeyer et al., Am J 200µg/m 3 cross-shift Respir Crit FEV 1, FEV 1 200ml Care Med, 1994 Wang et al., % Am J Ind 6.7% Med, 2002 FEV 1 70ml FEV 1 FEV 1 2.3% 91

40 Castellan et al., N Engl J Vertical elutriators Med,1987 mg/m EU/m 3 FEV % FEV 1 r 0.08 p 0.43 FEV 1 exposure response relationr 74 p Schwartz et al., Am J Respir Crit 4.8±11.3mg/m 3 Care 0.07±0.29mg/m 3 p Med, ±7208.6EU/m 3 3.1±22.4EU/m 3 p % vs. 9.5% 30.5% vs. 5.7% 9.4% vs. 1.9% 14.3% vs. 1.9% 14.1% vs. 0.9% FEV % Simpson et al.,occup 38.1% Environ 45.2% 15.5% Med,1998 Prevalence rate ratio, PRR 1.28 p 0.001,95%CI=1.16 to p 0.001,95%CI=1.05 to 1.17 Haglind et al., Br J Ind 0.58mg/m 3 Med, EU/m 3 FEV mg/m 3 800EU/m 3 FEV 1 Keman et al., 11 Inflammatory markers Int Arch interleukin 8 Occup IL-8 IN-6 soluble tumor necrosis factor receptor 75 Environ stnf-r75 soluble intercellular adhesion molecule 1 Health,1998 ICAM-1cell count uric acid albumin EU/m 3 IL-8 uric acid albumin 92

41 Su et al., Environ 37mm 0.4µm PVC Res,2002 liters/min 6486 EU/m EU/m EU/m EU/m 3 Olenchock et al., Biomed Environ vertically elutriated VE 37mm 5µm PVC Sci, ±0.2 liters/min 6 37mm 5µm PVC 20 liters/min ±0.19 mg/m ±0.16 mg/m ±384 EU/m ±524 EU/m Christiani et al., Environ vertically elutriated VE 37mm Res,1993a 5µm PVC 7.4±0.2 liters/min mg/m mg/m 3 18 EU/m EU/m 3 Castellan et 108 vertically elutriated al., N Engl J mg/ m EU/ Med,1987 m 3 r=0.07;p=0.46 Christiani et 146 vertically elutriated vertically elutriated al., Am J Ind 99% Med, 1993b mg/ m mg/ m EU/ m EU/ m 3 Spearman s rank correlation r s 0.66 p r s 0.79 p r s 0.67 p r s 0.18 p=0.58 r s 0.86 p r s 0.94 p

42 Simpson et al., Occup Environ Med, 1998 r=0.7, p

43 acceptability criteria artifacts flow-rate curve volume-time curve volume-time curve exptraoplated volume 5% FVC / volume-time 10 reproducibility createria FVC FEV1 5% FVC FEV1 200 FVC FEV 1 FVC FEV

44 HI-298 A B C CV CV CV C.V. coefficient of variation / 100% 96

45 1 2 3 mg mg mg mg CV% mg mg mg mg CV% mg

46 Standards EU/ml 3/18 Sample Concentration BackCalcConc Wells Values MeanValue Std.Dev CV% St C C St D D St E E St F F St G2 G Smallest standard value Largest standard value NC 3/18 Sample Wells Values R Result MeanResult Std.Dev CV% Co01 B2 B R R R Outside standard range 98

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48 ( ) ( ) : ( ) ( ) ( ) ( ) ( ) ( ) 100

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Williams-Campbell 2-3 Marfan's syndrome / % ~ 48% common variable immunodeficiency CVID X- X-linked agammaglobulinemia XLA lga - IgA Ig

Williams-Campbell 2-3 Marfan's syndrome / % ~ 48% common variable immunodeficiency CVID X- X-linked agammaglobulinemia XLA lga - IgA Ig 315 2012 COPD 2005 2011 [1-2] 2010 [3-4] [5] 3.7 / 10 [6] 52 / 10 [5] 100 / 10 18 ~ 34 4.2 / 10 70 272 / 10 [7] CT 50 CT - COPD 15% ~ 30% COPD 50% [11] DOI: 10. 3877/ cma. j. issn. 1674-6880. 2012. 05.