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PubMed2004

Interaction of atopy and smoking on respiratory effects of occupational dust exposure: a general population-based study.

BACKGROUND: For individual exposures, effect modification by atopy or smoking has been reported on the occurrence of occupational airway disease. It is unclear if effect modification can be studied in a general population by an aggregated exposure measure. Assess relationship between airway obstruction and occupational exposure using a job-exposure-matrix (JEM) classifying jobs into 3 broad types of exposure, and test for effect modification by atopy, and smoking. METHODS: Data from 1,906 subjects were analyzed, all participants of the European Community Respiratory Health Survey. Job titles were categorized by an a priori constructed job exposure matrix into three classes of exposure to respectively organic dust, mineral dust, and gases/ fumes. Relationships were assessed for 'current wheeze', bronchial hyperresponsiveness (BHR), 'current asthma' (wheeze+BHR), and 'chronic bronchitis' (morning phlegm or morning cough), and lung function. RESULTS: Subjects with organic dust exposure in their work environment more frequently had 'current asthma' (OR 1.48, 95% C.I. 0.95;2.30), and a lower FEV1 (-59 mL, 95% C.I. -114;-4). The relationship was only present in asthmatic workers, and their risk was four-fold greater than in subjects with either atopy or exposure alone. Mineral dust exposure was associated with 'chronic bronchitis' (OR 2.22, 95% C.I. 1.16;4.23) and a lower FEV1/FVC ratio (-1.1%, 95% C.I. -1.8;-0.3). We observed an excess risk in smokers, greater than the separate effects of smoking or mineral dust exposure together. CONCLUSION: Occupational exposure to organic dust is associated with an increased risk of asthma, particularly in atopics. Chronic bronchitis occurs more frequently among individuals exposed to mineral dust, and smoking doubles this risk.

Adult↗
PubMed1983

Interaction between erythrocyte plasma membrane and silicate dusts.

Lysis of erythrocytes in vitro leading to release of hemoglobin has often been used as a convenient test system for predictive toxicological evaluation of noxious particulates encountered as pollutants in occupational and environmental atmospheres. However, in spite of several studies with silica and silicate dusts, the exact biochemical mechanism for membrane damage is not clear. Therefore, detailed biochemical studies were conducted. Screening of a large number of fugitive dust samples indicated that the dissolution of silica under assay conditions has a qualitative relation to hemolytic potency. The strong capacity of slate mine dust to cause hemolysis was studied in detail. The kinetics of lysis indicated that on prolonged contact the adsorption of hemoglobin altered the lytic index. Coating of dust with serum, albumin or polyvinylpyrrolidone (PVP) and some lipids reduced lytic potency markedly, while EDTA was ineffective. Altering the surface chemistry of dust by heating, alkali treatment, washing with water, and acid washing reduced hemolysis in increasing order. Thus, chemical interactions between dusts and membranes are involved in hemolysis, and it may be concluded that the interaction of dust constituents with biomembranes is one of the likely mechanisms involved in the toxicity of particulate air pollutants.

Adsorption↗
PubMed1986

In vitro release of arachidonic acid and in vivo responses to respirable fractions of cotton dust.

It was considered that the fall in lung function seen after exposure to cotton dust may be attributable in part to the activity of arachidonic acid metabolites, such as leucotrienes as well as to the more established release of histamine by cotton dust. However, we found that cotton and barley dusts elicited poor release of arachidonic acid from an established macrophage like cell line compared with that observed with other organic dusts. In the experimental animal, pulmonary cellular responses to both cotton and barley dust were similar to those evoked by moldy hay and pigeon dropping dusts, although after multiple doses a more severe response was seen to cotton and barley. Since both moldy hay and pigeon droppings elicit a greater arachidonic acid release than cotton or barley, a role for arachidonic acid in inducing the cellular response is less likely than other factors. There are limitations to our conclusions using this system, i.e., the arachidonic acid may be released in a nonmetabolized form, although it is noted that the two dusts with the greatest arachidonic acid release produce their clinical responses in humans largely by hypersensitivity mechanisms.

Animals↗
PubMed1995

Pesticides in household dust and soil: exposure pathways for children of agricultural families.

Child of agriculture families are likely to be exposed to agricultural chemicals, even if they are not involved in farm activities. This study was designed to determine whether such children are exposed to higher levels of pesticides than children whose parents are not involved in agriculture and whose homes are not close to farms. Household dust and soil samples were collected in children's play areas from 59 residences in eastern Washington State (26 farming, 22 farmworker, and 11 nonfarming families). The majority of the farm families lived within 200 feet of an operating apple or pear orchard, whereas all reference homes were located at least a quarter of a mile from an orchard. Four organophosphorous (OP) insecticides commonly used on tree fruit were targeted for analysis: azinphosmethyl, chlorpyrifos, parathion, and phosmet. Samples were extracted and analyzed by gas chromatography/mass selective detection. Pesticide concentrations in household dust were significantly higher than in soil for all groups. OP levels for farmer/farm-worker families ranged from nondetectable to 930 ng/g in soil (0.93 ppm) and from nondetectable to 17,000 ng/g in dust (17 ppm); all four OP compounds were found in 62% of household dust samples, and two-thirds of the farm homes contained at least one OP above 1000 ng/g. Residues were found less frequently in reference homes and all levels were below 1000 ng/g. Household dust concentrations for all four target compounds were significantly lower in reference homes when compared to farmer/farmworker homes (Mann Whitney, U test; p < 0.05). These results demonstrate that children of agricultural families have a higher potential for exposure to OP pesticides than children of nonfarm families in this region. Measurable residues of a toxicity, I compound registered exclusively for agricultural use, azcnphosmettyl were found in household dust samples from all study homes, suggesting that low level exposure to such chemicals occurs throughout the region. Children's total and cumulative exposure to this pesticide class from household dust, soil, and other sources warrants further investigation.

Adult↗
PubMed1999

Distribution of pesticides and polycyclic aromatic hydrocarbons in house dust as a function of particle size.

House dust is a repository for environmental pollutants that may accumulate indoors from both internal and external sources over long periods of time. Dust and tracked-in soil accumulate most efficiently in carpets, and the pollutants associated with dust and soil may present an exposure risk to infants and toddlers, who spend significant portions of their time in contact with or in close proximity to the floor and who engage in frequent mouthing activities. The availability of carpet dust for exposure by transfer to the skin or by suspension into the air depends on particle size. In this study, a large sample of residential house dust was obtained from a commercial cleaning service whose clients were homeowners residing in the Raleigh-Durham-Chapel Hill (Research Triangle) area of North Carolina. The composite dust was separated into seven size fractions ranging from < 4 to 500 microm in diameter, and each fraction was analyzed for 28 pesticides and 10 polycyclic aromatic hydrocarbons (PAHs). Over 20% of the fractionated dust sample consisted of particles < 25 microm in diameter. Fourteen pesticides and all 10 of the target PAHs were detected in one or more of the seven size-fractionated samples. Sample concentrations reported range from 0.02 to 22 microg/g; the synthetic pyrethroids cis- and trans-permethrin were the most abundant pesticide residue. The concentrations of nearly all of the target analytes increased gradually with decreasing particle size for the larger particles, then increased dramatically for the two smallest particle sizes (4-25 microm and < 4 microm).

Air Pollution, Indoor↗
PubMed2004

Vegetable oil sprinkling as a dust reduction method in swine confinement.

The aim of this project was evaluate the effectiveness of an oil sprinkling system as a dust-reduction method for swine production facilities. This article presents the results of the second-year experiment of a multi-year study. The first-year experiment demonstrated that a 5% oil-water emulsion automatically applied at the rate of 3 and 5 g/pig/day achieved a 23% to 34% reduction in total dust. The modifications for the second year experiment included: (1) increasing oil application rate to 7 and 8 g/pig/day, (2) replacing sprinkler heads to achieve a smaller droplet size and a more direct spray pattern on pen-floor surfaces, and (3) more closely matching the treatment and control rooms by stage in the pig production cycle. Four swine finishing rooms were used for this study; two were treatment rooms (soybean oil at 7 g/pig/day, and canola oil 8 g/pig/day) and two were control rooms. The treatment rooms had a low-pressure oil-sprinkling system, which sprinkled 5% oil-to-water mixture 12 times per day, 12 s each time. Concentrations of several environmental contaminants were measured. The average total dust concentration in the control rooms was 1.39 mg/m3. The average total dust concentration in the treatment rooms was 0.65 mg/m3. The treatment reduced dust by an average of 52%, (p = 0.0001). There was no difference in the degree of dust control between soybean oil and canola oil. The respirable dust concentrations were very low in all rooms, and there were no significant differences between rooms in ammonia, carbon dioxide, temperature, or humidity.

Agricultural Workers' Diseases↗
PubMed2004

Pneumoconiosis in rush mat workers exposed to clay dye "sendo" dust: clinical, radiologic, and histopathologic features in seven patients.

STUDY OBJECTIVES: The purpose of this study was to describe the clinical, chest radiographic, high-resolution CT, and histopathologic features of clay dye "sendo" dust pneumoconiosis in seven rush mat ("tatami") workers. PATIENTS: Seven patients with a history of occupational exposure to sendo dust and radiographic changes suggestive of pneumoconiosis were retrospectively reviewed. RESULTS: The duration of exposure ranged from 15 to 45 years (median, 30 years). Three patients had cough, and four patients had abnormal pulmonary function test results. Chest radiographs showed nodular opacities < 3 mm in diameter (types p and q) in all patients. The standard International Labor Office profusion score ranged from 0/1 to 1/1 (median, 1/0). High-resolution CT demonstrated small nodular opacities (types p and q) in all seven patients. In four patients, high-resolution CT demonstrated branching centrilobular structures, airway ectasia, airway wall thickening, and emphysematous changes. None of the patients had conglomerate nodules, large opacities, honeycombing, pleural effusion, or lymphadenopathy. Microscopic examination of the specimens obtained by open lung biopsy or transbronchial lung biopsy revealed nodular fibrosis with accumulation of dust-laden macrophages, but no silicotic nodules. Needle-like particles of 1 to 20 microm in length were evident among the dust deposits, and birefringent crystals were identified under polarizing microscopy. Four of seven patients showed intra-alveolar fibroblastic foci similar to Masson bodies, accompanied by dust deposition. CONCLUSION: Rush mat workers' sendo dust pneumoconiosis is caused by dust containing free silica. The radiographic and high-resolution CT findings consist of small nodular opacities < 3 mm in diameter and bronchial and bronchiolar abnormalities.

Aged↗
PubMed1981

Vegetable ingredients of dusts in textile and nontextile cotton industries.

The objective was to determine if garnetting and raw cotton dusts differed in botanical composition. Estimates of dust composition were based on the contents of gross trash in cotton raw materials and the potential of each gross trash component to be converted into less than 10 mum particulate by a laboratory abrasion test. All types of garnetting dusts are predicted to contain a lower percent content of leaflike material than raw cotton dust. Garnetting dusts arising from linter-polyester blends are estimated to contain only 20 to 25 percent of the concentration of leaflike ingredients predicted to be present in raw cotton dusts. The low prevalence of byssinosis reported in the garnetting industry may be explained, in part, by the relatively low percent content of leaflike particulate in this cotton dust.

Dust↗
PubMedDate not supplied

Quantification of house dust mite allergens in ambient air.

The house dust mites Dermatophagoides pteronyssinus and Dermatophagoides farinae are important sources of indoor allergens. In sensitized patients, house dust mites induce and exacerbate diseases like asthma bronchiale, rhinitis, and conjunctivitis. The most significant exposure of persons occurs overnight in bed and to a lesser extent, during the daytime while performing activities like vacuum cleaning or bed making. In general, house dust mite antigens are quantified in samples of reservoir dust of carpets or beds. Yet, assessing allergens in ambient air would better represent human exposures because inhalation is the main route of uptake, and a close correlation between levels of floor and air antigens has not yet been proved. Unfortunately, because of extremely low airborne particle concentrations, analyses are difficult to perform and depend on sophisticated sampling strategies, as well as on sensitive immunometric detection assays. Using monoclonal immunoassays, house dust mite antigens, quantified in undisturbed conditions in ambient air, are found at pg/m3 levels. The disturbance of reservoir dust by vacuum cleaning or bed making increases the airborne allergen levels up to ng/m3 concentrations. In this review, we discuss the current knowledge regarding the analysis of airborne house dust mites in both undisturbed and disturbed ambient air. The advantages and disadvantages of different sampling strategies are outlined.

Air Pollution, Indoor↗
PubMed2005

Agricultural dust production in standard and conservation tillage systems in the San Joaquin Valley.

The negative health effects of repeated dust exposure have been well documented. In California's San Joaquin Valley, agricultural operations may contribute substantially to airborne particulates. We evaluated four management systems to assess impacts on dust production and soil properties for a cotton (Gossypium hirsutum L.)-tomato (Lycopersicon esculentum Mill.) rotation: standard tillage with (STCC) and without (STNO) cover crop, and conservation tillage with (CTCC) and without (CTNO) cover crop. Gravimetric analysis of total dust (TD, <100-mum aerodynamic diameter) and respirable dust (RD, 4-mum aerodynamic diameter) samples collected in the plume generated by field implements showed that dust concentrations for CTNO treatments were about one-third of their STNO counterparts for both cumulative TD and RD measured throughout the two-year rotation, primarily due to fewer in-field operations. The TD and RD production for STNO and STCC was comparable, whereas the CTCC system produced about twice as much TD and RD as CTNO. Energy dispersive spectroscopy (EDS) analyses showed absolute increases of 8 and 39% organic fragments in STCC and CTCC over STNO and CTNO, respectively, while organic fragments in the TD increased by 6% in both cover crop treatments. Soil C content was positively correlated with clay content and increased by an average of 0.12 and 0.07% in the cover crop and non-cover crop treatments, respectively, although soil C for each treatment showed a distinct response to a field texture gradient. While dust emissions show an immediate decrease due to fewer field operations for the conservation tillage treatments, long-term sampling is necessary to determine the effects that increased aggregation through organic matter additions may have on dust production.

Agriculture↗
PubMed2005

Assessment of respirable dust and its free silica contents in different Indian coalmines.

Assessment of respirable dust, personal exposures of miners and free silica contents in dust were undertaken to find out the associated risk of coal workers' pneumoconiosis in 9 coal mines of Eastern India during 1988-91. Mine Research Establishment (MRE), 113A Gravimetric Dust Sampler (GDS) and personal samplers (AFC 123), Cassella, London, approved by Director General of Mines Safety (DGMS) were used respectively for monitoring of mine air dust and personal exposures of miners. Fourier Transform Infra-red (FTIR) Spectroscopy determined free silica in respirable dusts. Thermal Conditions like Wet Bulb Globe Temperature (WBGT) index, humidity and wind velocity were also recorded during monitoring. The dust levels in the face return air of both, Board & Pillar (B&P) and Long Wall (LW) mining were found above the permissible level recommended by DGMS, Govt. of India. The drilling, blasting and loading are the major dusty operations in B&P method. Exposures of driller and loader were varied between, 0.81-9.48 mg/m3 and 0.05-9.84 mg/m3 respectively in B&P mining, whereas exposures of DOSCO loader, Shearer operator and Power Support Face Worker were varied between 2.65-9.11 mg/m3, 0.22-10.00 mg/m3 and 0.12-9.32 mg/m3 respectively in LW mining. In open cast mining, compressor and driller operators are the major exposed groups. The percentage silica in respirable dusts found below 5% in all most all the workers except among query loaders and drillers of open cast mines.

Coal Mining↗
PubMed2006

Respirable dust exposure and respiratory health in male Taiwanese steelworkers.

The objective of this cross-sectional study was to investigate the prevalence and determinants of respiratory symptoms and lung function and their association with occupational dust exposure in Taiwanese steelworkers. The study was conducted on an integrated-steel company in Taiwan from March 1989 to February 1990. After excluding workers in the coke ovens and ex-smokers, we performed physical examinations on 1,339 male workers in the iron making and steel making factories. Subjects were interviewed regarding respiratory symptoms using a Chinese version of the American Thoracic Society respiratory questionnaire and were examined with respect to their lung function using spirometry. Objective dust exposure was measured using personal air sampling with 277 valid samples. Prevalences of cough frequently, chronic cough, phlegm frequently, chronic phlegm, wheezing occasionally, and breathlessness were 11.4%, 9.3%, 14.6%, 11.9%, 2.6%, and 6.5%, respectively. Duration of employment, smoking, subjective dustiness, and past respiratory illnesses can predict these respiratory symptoms. Average respirable dust exposure significantly decreased the forced vital capacity (FVC) and forced expiratory volume in one second (FEVI.0) in smoking workers. In the non-smokers, an effect of respirable dust exposure on FEVl.0/FVC was shown. Since the main ingredients of dust in such a steelworks usually contained mixtures of oxides and silicates other than silica dust, respirable dust exposure in steelworks might impair lung function, especially among smokers.

Adult↗
PubMedDate not supplied

Elevated levels of IL-6, INF-gamma, and TNF-alpha in mice in response to cotton dust are modulated by anti-TNF-alpha antiserum.

Acute pulmonary neutrophilic inflammation triggered by cotton dust exposure is one of the features of organic dust syndrome. Studies with a mouse model have reproduced the inflammation and have shown the presence of tumor necrosis factor-alpha (TNF-alpha) in the bronchoalveolar lavage (BAL) fluid of mice following a 3-h exposure to respirable cotton dust particles. A cover glass technique for cytospin samples of BAL cells resulted in a 42-fold increase in cell count, with 76% neutrophils, 13% lymphocytes, and 10% macrophages, after cotton dust exposure. Immunohistochemical staining of lung specimens with anti-TNF-alpha antiserum revealed TNF in the cells surrounding pulmonary airways and vessels. Cotton dust exposure resulted in elevated TNF-alpha, IL-6, and INF-gamma in BAL fluid, INF-gamma and IL-6 in serum. Administration of anti-TNF-alpha antiserum prior to the organic dust exposure resulted in a marked attenuation of the pulmonary inflammatory cell response, as well as decreased IL-6 and TNF-alpha levels in BAL fluid and decreased IL-6 and INF-gamma in serum. These results indicate TNF modulation of the dust-induced toxic alveolitis and cytokine production.

Acute Disease↗
PubMed1986

Serum IgE, skin and radioallergosorbent tests for house dust and mites in asthmatic children.

Thirty asthmatic children were given an intradermal skin test, total IgE measurements and the radioallergosorbent test (RAST) against house dust and house dust mites (Dermatophagoides pteronyssinus and Dermatophagoides farinae). Results of the intradermal skin test and RAST were highly positive with overall agreement in 95.6%. The correlation coefficient between the total IgE and the RAST to house dust was 0.35 (p less than 0.05). There was no significant difference between the total IgE and the RAST to D. pteronyssinus and D. farinae (p greater than 0.05). The highly significant correlation coefficient between house dust and house dust mites (D. farinae, p less than 0.0001; D. pteronyssinus, p less than 0.00001) was determined by RAST. House dust has been found to be the most important allergen in children in Taiwan. The role of mites as a possible allergen in house dust also showed a highly significant correlation in our study.

Adolescent↗
PubMed2002

Occupational dust exposure and the risk of laryngeal cancer in Turkey.

OBJECTIVES: A hospital-based case-referent study was conducted to identify occupational risk factors for laryngeal cancer. In a previous report an association was found between laryngeal cancer and occupations with potential dust exposure; a job-exposure matrix was developed to aid further evaluation of laryngeal cancer risks from five occupational dust exposures. METHODS: Among 7631 cancer cases from the Okmeydani Hospital, Istanbul, between 1979 and 1984, 958 larynx cancer cases were identified among men. After exclusions, 940 laryngeal cancer cases and 1519 referents were available. A standardized questionnaire was used to obtain basic information on the patients. Seven-digit standard occupational and industrial codes were created to classify the job and industrial titles. A job-exposure matrix was developed for occupational dusts, including silica, asbestos, wood, cotton, and grain, and age-, smoking-, and alcohol-adjusted odds ratios (OR) and 95% confidence intervals (95% CI) were calculated to evaluate risks of laryngeal cancer. RESULTS: An excess of laryngeal cancer occurred for workers potentially exposed to silica and cotton dust, particularly for supraglottic cancer (OR 1.8, 95% CI 1.3-2.3, for silica and OR 1.6, 95% CI 1.1-2.5, for cotton dust), and there was a significant dose-response relationship with silica exposure. No relationship was found between laryngeal cancer and asbestos, grain, or wood dust exposures. CONCLUSION: Laryngeal cancer, especially supraglottic tumors, is associated with silica and cotton dust exposures in Turkey.

Dust↗
PubMed1983

[A follow-up study on pulmonary functions of workers exposed to various forms of dust. Observation on the workers of pneumoconiosis in Kitakyushu].

Serial spirograms of 121 dust workers whose chest X-rays were found to be "class 1" of the diagnostic criteria for pneumoconiosis were obtained during 1978-80. Yearly changes of pulmonary function variables (%VC, FEV1, FEV1/FVC%,V25/H, and V50/V25) by age, smoking habit, total years of exposure to dust, and work history were evaluated. The average age of the dust workers was 48.0 +/- 5.5 years, and the average years of exposure to dust was 21.6 +/- 6.8 years in 1978. Eighty-two dust workers smoked with the mean smoking history of 24.7 pack-years. No significant differences of spirograms were found between the smoking and non-smoking groups. Among the smokers, however, linear regression of FEV1/FVC% by age gradually decreased during 1978-80. All the pulmonary function variables showed no correlation with smoking history as well as total years of dust exposure. All the dust workers were classified into eight types of work by their histories; crushing and quarrying operators, brick mason, foundry and grinding operators, asbestos workers, underground miners, refractory material workers, pyrites roasters, and welders. The underground miners showed lower FEV1/FVC% and V25 than the average. However, the difference of such pulmonary function variables by eight types of work was not significant by analysis of variance. Since aging is the most dominant factor for pulmonary dysfunction, a longer observation on this group will be needed.

Age Factors↗
PubMedDate not supplied

[Exposure to wood dust in a group of carpentry craftsmen in secondary wood processing].

In order to evaluate the risk connected with wood dust exposure in millwork on a group of 13 craft industries, 74 area dust samplings and 74 personal dust samplings were made. In personal samplings both the total portion and the respirable fraction were calculated. Area samplings showed dust levels (average, standard deviation, fiducial limit, FLS95%) under ACGIH TLV-TWA for soft wood dust: TLV-TWA for hard wood was basically reached, and OTL levels gave evidence for high risk of exceeding TLV-TWA in the medium-long term. The exposure levels by personal samplings (average, standard deviation, fiducial limit, FLS95%) were clearly over TLV-TWA, both for hard woods and, although less clear, for soft woods. OTL levels gave evidence for a frankly unacceptable exposure condition in the medium-long term. Differences between average levels of total dust exposure (2.5 mg/m3) and respirable portion (2.3 mg/m3) were not statistically significant (p > 0.05) as well as the differences among the 4 groups of companies with homogeneous product activity (p > 0.05). In consideration of toxicological peculiarity of wood dust and carcinogenicity of wood manufacture as exposure circumstances classified in group 1 by IARC, the results show the need for prevention measures to reduce workers' exposure risk, by means of environmental improvement and better work organization, technological structures, individual attitudes and personal protection.

Air Pollutants, Occupational↗
PubMed1999

Effects of inhalation of dust and endotoxin on respiratory tracts of pigs.

OBJECTIVE: To assess the effects of inhalation of feed flour dust and dustborne endotoxin on respiratory tracts of pigs. ANIMALS: 29 healthy Belgian Landrace pigs. PROCEDURE: Pigs housed in an environmental chamber were exposed for 6 days to feed flour dust (1 to 15 mg/m3) and dustborne endotoxins (50 to 2,500 ng/m3). Effects were evaluated by measuring albumin concentration, lactate dehydrogenase (LDH) activity, cell composition of nasal lavage (NL) and bronchoalveolar lavage (BAL) fluids and blood, and percentages of CD4+ and CD8+ T lymphocytes in blood and lavage fluids. Dustborne endotoxin was obtained by mixing endotoxins from Escherichia coli (serotype O127:B8) with feed flour before spraying the flour in the environmental chamber. RESULTS: Exposure did not affect cell composition of NL fluid or blood. Total cell counts of BAL fluids were increased in all groups exposed to dust. Macrophage counts were increased in pigs exposed to inhalable dust concentrations as low as 4.4 mg/m3, and lymphocyte counts were increased in groups exposed to high dust concentrations. Percentages of CD4+ and CD8+ T lymphocytes in blood and lavage fluids were unchanged. In all dust-exposed groups, albumin content of BAL fluid was increased, whereas LDH activity was unaffected. Macrophage and lymphocyte infiltration and edema in the bronchi were identified by light microscopy. Effects attributable to E. coli endotoxin exposure were not identified. CONCLUSIONS: Inhalation of feed flour dust did not affect nasal mucosa but did induce bronchial airway inflammation. Dustborne endotoxins did not have effects attributable to endotoxin alone.

Albumins↗