Background: Although occupational exposures contribute to a significant proportion of obstructive lung disease, the phenotype of obstructive lung disease associated with work-related organic dust exposure independent of smoking remains poorly defined. Objective: We identified the relative contributions of smoking and occupational endotoxin exposure to parenchymal and airway remodeling as defined by quantitative computed tomography (CT). Methods: The Shanghai Textile Worker Study is a longitudinal study of endotoxin-exposed cotton workers and endotoxin-unexposed silk workers that was initiated in 1981. Spirometry, occupational endotoxin exposure, and smoking habits were assessed at 5-year intervals. High-resolution computed tomography (CT) was performed in 464 retired workers in 2011, along with quantitative lung densitometric and airway analysis. Results: Significant differences in all CT measures were noted across exposure groups. Occupational endotoxin exposure was associated with a decrease (–1.3%) in percent emphysema (LAAI-950), a 3.3-Hounsfield unit increase in 15th percentile density, an 18.1-g increase in lung mass, and a 2.3% increase in wall area percent. Current but not former smoking was associated with a similar CT phenotype. Changes in LAAI-950 were highly correlated with 15th percentile density (correlation –1.0). Lung mass was the only measure associated with forced expiratory volume in 1 sec (FEV1) decline, with each 10-g increase in lung mass associated with an additional loss (–6.1 mL) of FEV1 (p = 0.001) between 1981 and 2011. Conclusions: There are many similarities between the effects of occupational endotoxin exposure and those of tobacco smoke exposure on lung parenchyma and airway remodeling. The effects of occupational endotoxin exposure appear to persist even after the cessation of exposure. LAAI-950 may not be a reliable indicator of emphysema in subjects without spirometric impairment. Lung mass is a CT-based biomarker of accelerated lung function decline. Citation: Lai PS, Hang J, Zhang F, Sun J, Zheng BY, Su L, Washko GR, Christiani DC. 2016. Imaging phenotype of occupational endotoxin-related lung function decline. Environ Health Perspect 124:1436–1442;?http://dx.doi.org/10.1289/EHP195.
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机译：背景：尽管职业性暴露在阻塞性肺疾病中占很大比例，但与吸烟无关的与工作相关的有机粉尘暴露相关的阻塞性肺疾病的表型仍然不清楚。目的：我们确定了吸烟和职业性内毒素暴露对实质和气道重塑的相对贡献，这是由定量计算机断层扫描（CT）确定的。方法：《上海纺织工人研究》是一项始于1981年的内毒素暴露的棉布工人和未暴露内毒素的丝工的纵向研究。每5年对肺活量，职业内毒素暴露和吸烟习惯进行评估。 2011年对464名退休工人进行了高分辨率计算机断层扫描（CT），同时进行了定量肺密度测定和气道分析。结果：各个暴露组在所有CT测量中均存在显着差异。职业性内毒素暴露与肺气肿百分比降低（–1.3％）（LAAI-950），第15个百分位数密度增加3.3豪斯菲尔德单位，肺质量增加18.1 g和壁面积增加2.3％百分。当前但不是以前吸烟与相似的CT表型有关。 LAAI-950的变化与第15个百分位数的密度高度相关（相关系数为–1.0）。肺质量是与1秒内呼气量减少（FEV1）相关的唯一度量，在1981年至2011年之间，肺质量每增加10g，FEV1就会另外损失（–6.1 mL）（p = 0.001）。结论：职业内毒素暴露与烟草烟雾暴露对肺实质和气道重塑的影响有很多相似之处。职业性内毒素暴露的影响似乎持续存在，即使停止暴露也是如此。对于没有肺功能损害的受试者，LAAI-950可能不是肺气肿的可靠指标。肺部肿块是加速肺功能下降的基于CT的生物标记。引文：赖PS，Hang J，Zhang F，Sun J，Zheng BY，Su L，Washko GR，Christiani DC。 2016.职业性内毒素相关肺功能的成像表型下降。 Environ Health Perspect 124：1436–1442;？http：//dx.doi.org/10.1289/EHP195。
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