Textile Workers In Shanghai Research Articles

The Political Heritage of Textile Districts: Shanghai and Mumbai

This article examines the evolution of mill districts in Shanghai and Mumbai across the 20th century as cases of political heritage—in which the socio-spatial formations of factory and neighbourhood produced new meanings of citizenship for the workers in each city. Using historical materials from the textile industry in each city, government reports, housing data, and secondary sources, this article first traces the origins of Shanghai’s textile industry in the 19th century to its connections with Bombay’s textile mills, then examines the emergence of working-class neighbourhoods as they acquired distinctive patterns of tenement housing, shopfronts, and street life. The main finding is that despite clear differences in the two cities in terms of religion, culture, and politics, the ‘mill district’ became a socio-cultural formation central to the identity and memory of generations of textile workers in Shanghai and Mumbai. A concluding section examines the similar process in each city in the 21st century in which mill compounds and neighbourhoods were converted into high-end commercial real estate and sites for consumption and leisure.

Risk of Pancreatic Cancer in Female Textile Workers in Shanghai, China, Exposed to Metals, Solvents, Chemicals, and Endotoxin: Follow-Up to a Nested Case-Cohort Study.

We studied associations between pancreatic cancer and occupational exposures to metals, solvents, chemicals, and endotoxin in a cohort of female textile workers in Shanghai, China. To assess the longer-term influences of these agents on pancreatic cancer we extended follow-up of this previously studied cohort. We utilized a job exposure matrix to assess occupational exposures for 481 pancreatic cancer cases and a randomly selected sub-cohort of 3191 non-cases. We calculated hazard ratios and 95% confidence intervals using Cox proportional hazards modeling adapted for the case-cohort design. We observed a statistically significant trend of increasing hazard ratios associated with solvent exposure, but no associations with any of the remaining occupational exposures, including endotoxin and metals. Our findings of increasing risk of pancreatic cancer with solvent exposures are consistent with published literature.

Night Shift Work and Lung Cancer Risk Among Female Textile Workers in Shanghai, China

In 2007, the International Agency for Research on Cancer classified shift work that involves circadian disruption as a probable human carcinogen. Suppression of the anti-neoplastic hormone, melatonin, is a presumed mechanism of action. We conducted a case-cohort study nested within a cohort of 267,400 female textile workers in Shanghai, China. Newly diagnosed lung cancer cases (n = 1451) identified during the study period (1989–2006) were compared with an age-stratified subcohort (n = 3040). Adjusting for age, smoking, parity, and endotoxin exposure, relative risks [hazard ratios (HRs)] were estimated by Cox regression modeling to assess associations with cumulative years and nights of rotating shift work. Results did not consistently reveal any increased risk of lung cancer among rotating shift work or statistically significant trends for both cumulative years (HR 0.82, 95% CI 0.66 to 1.02; Ptrend = 0.294) and nights (HR 0.81, 95% CI 0.65 to 1.00; Ptrend = 0.415). Further analyses imposing 10- and 20-year lag times for disease latency also revealed similar results. Contrary to the initial hypothesis, rotating nighttime shift work appears to be associated with a relatively reduced lung cancer risk although the magnitude of the effect was modest and not statistically significant.

Occupational exposures and risk of stomach and esophageal cancers: update of a cohort of female textile workers in Shanghai, China.

Associations between stomach and esophageal cancer and exposures to dusts, metals, chemicals, and endotoxin in the workplace are not very well understood, particularly in women. We followed 267,400 female textile workers in Shanghai, China for cancer incidence from 1989 to 2006. Stomach (n = 1374) and esophageal (n = 190) cancer cases were identified and a comparison subcohort (n = 3187) was randomly selected. Cox proportional hazard modeling was used, adjusting for age and smoking. Increasing stomach cancer risk was observed with increasing duration of synthetic fiber dust exposure (p = 0.03), although the magnitude of effect was small (20 + years: HR = 1.2, 95% CI 1.1-1.4). Trends with endotoxin exposure were modestly inversed for esophageal cancer and increased for stomach cancer, but with little deviation from a null association. Our findings demonstrate that long durations of synthetic fiber dust exposure can increase stomach cancer risk in women, but provide limited support for associations with other textile industry exposures.

Shift work and breast cancer among women textile workers in Shanghai, China.

Although night-shift work has been associated with elevated risk of breast cancer in numerous epidemiologic studies, evidence is not consistent. We conducted a nested case-cohort study to investigate a possible association between shift work including a night shift and risk of breast cancer within a large cohort of women textile workers in Shanghai, China. The study included 1,709 incident breast cancer cases and 4,780 non-cases. Data on historical shift work schedules were collected by categorized jobs from the factories, where the study subjects had worked, and then were linked to the complete work histories of each subject. No jobs in the factories involved exclusively night-shift work. Therefore, night shift was evaluated as part of a rotating shift work pattern. Hazard ratios and 95% confidence intervals were calculated using Cox proportional hazards modeling adapted for the case-cohort design for years of night-shift work and the total number of nights worked. Additionally, analyses were repeated with exposures lagged by 10 and 20years. We observed no associations with either years of night-shift work or number of nights worked during the entire employment period, irrespective of lag intervals. Findings from the age-stratified analyses were very similar to those observed for the entire study population. The findings from this study provide no evidence to support the hypothesis that shift work increases breast cancer risk. The positive association between shift work and breast cancer observed in Western populations, but not observed in this and other studies of the Chinese population, suggests that the effect of shift work on breast cancer risk may be different in Asian and Caucasian women.

Occupational Exposures and Risk of Stomach and Esophageal Cancer among a Cohort of Female Textile Workers in Shanghai, China

China has disproportionately higher burdens of stomach and esophageal cancer. Tobacco, alcohol and dietary factors alter risk, but the effects of occupational exposures are not well understood, par...

Possible pro-carcinogenic association of endotoxin on lung cancer among Shanghai women textile workers.

Background:Endotoxin (lipopolysaccharide) is a widespread contaminant in many environmental settings. Since the 1970s, there has been generally consistent evidence indicating reduced risks for lung cancer associated with occupational endotoxin exposure.Methods:We updated a case–cohort study nested within a cohort of 267 400 female textile workers in Shanghai, China. We compared exposure histories of 1456 incident lung cancers cases diagnosed during 1989–2006 with those of a reference subcohort of 3022 workers who were free of lung cancer at the end of follow-up. We applied Cox proportional hazards modelling to estimate exposure–response trends, adjusted for age and smoking, for cumulative exposures lagged by 0, 10, and 20 years, and separately for time windows of ⩽15 and >15 years since first exposure.Results:We observed no associations between cumulative exposure and lung cancer, irrespective of lag interval. In contrast, analyses by exposure time windows revealed modestly elevated, but not statistically significant relative risks (∼1.27) at the highest three exposure quintiles for exposures that occurred >15 years since first exposure.Conclusions:The findings do not support a protective effect of endotoxin, but are suggestive of possible lung cancer promotion with increasing time since first exposure.

Occupational Exposure to Magnetic Fields and Breast Cancer Among Women Textile Workers in Shanghai, China

Exposure to magnetic fields (MFs) is hypothesized to increase the risk of breast cancer by reducing production of melatonin by the pineal gland. A nested case-cohort study was conducted to investigate the association between occupational exposure to MFs and the risk of breast cancer within a cohort of 267,400 female textile workers in Shanghai, China. The study included 1,687 incident breast cancer cases diagnosed from 1989 to 2000 and 4,702 noncases selected from the cohort. Subjects' complete work histories were linked to a job-exposure matrix developed specifically for the present study to estimate cumulative MF exposure. Hazard ratios and 95% confidence intervals were calculated using Cox proportional hazards modeling that was adapted for the case-cohort design. Hazard ratios were estimated in relation to cumulative exposure during a woman's entire working years. No association was observed between cumulative exposure to MFs and overall risk of breast cancer. The hazard ratio for the highest compared with the lowest quartile of cumulative exposure was 1.03 (95% confidence interval: 0.87, 1.21). Similar null findings were observed when exposures were lagged and stratified by age at breast cancer diagnosis. The findings do not support the hypothesis that MF exposure increases the risk of breast cancer.

Evidence of a paradoxical relationship between endotoxin and lung cancer after accounting for left truncation in a study of Chinese female textile workers

IntroductionOccupational exposure to endotoxin, found in Gram-negative bacteria in organic material, has been associated predominantly with a reduced risk of lung cancer among workers. An inverse exposure–response gradient among women...

Reproductive factors and risk of lung cancer in female textile workers in Shanghai, China

Hormonal factors may play a role in the development of lung cancer in women. This study examined the relationship between lung cancer and reproductive factors in a large cohort of women, most of whom never smoked (97%). A cohort of 267,400 female textile workers in Shanghai, China, enrolled in a trial of breast self-examination provided information on reproductive history, demographical factors, and cigarette smoking at enrollment in 1989-91. The cohort was followed until July of 2000 for incidence of lung cancer; 824 cases were identified. Hazard ratios (HR) and 95% confidence intervals (CI) associated with selected reproductive factors were calculated using Cox proportional hazards modeling, adjusting for smoking, age, and also parity when relevant. Nulliparous women were at increased risk compared to parous women (HR = 1.33, 95% CI 1.00-1.77). Women who had gone through menopause at baseline were at increased risk compared to women of the same age who were still menstruating. Risk was higher in women with a surgical menopause (HR = 1.64, 95% CI 0.96-2.79) than in those with a natural menopause (HR = 1.35, 95% CI 0.84-2.18), and risk was highest in those postmenopausal women with a hysterectomy and bilateral oophorectomy at baseline (HR = 1.39, 95% CI 0.96-2.00), although the risk estimates were not statistically significant. These results support experimental data that demonstrate a biological role for hormones in lung carcinogenesis.

Occupational exposures and mortality from cardiovascular disease among women textile workers in Shanghai, China

Exposure to textile fiber dusts, like particulate air pollution, may be associated with cardiovascular disease (CVD) mortality. Bacterial endotoxin, a potent inflammagen found in cotton dust, may be a specific risk factor. Female textile workers (N = 267,400) in Shanghai, China were followed for CVD mortality (1989-2000). Factory exposures were approximated by sector classifications based on materials and processes. Quantitative endotoxin and cotton dust measures were available for a subcohort (n = 3,188). Cox proportional hazards modeling was used to estimate hazard ratios (HR) and 95% confidence interval (CI). Slightly elevated mortality risk for the cotton sector was seen for ischemic stroke (HR = 1.12, 95% CI: 0.97-1.31) and hemorrhagic stroke (HR = 1.12, 95% CI: 1.02-1.23). Similar hemorrhagic stroke mortality risk was observed in high dust sectors (HR = 1.12, 95% CI: 1.02-1.24). No association was observed for ischemic heart disease. Exposures in textile factories may have contributed to CVD mortality among this cohort. The specific components of these exposures that may be harmful are not clear and should be further investigated.

Reproductive history and mortality from cardiovascular disease among women textile workers in Shanghai, China

Few studies have examined the possible effects of reproductive factors on cardiovascular disease (CVD) risks in Asian women. A cohort of 267,400 female textile workers in Shanghai, China, was administered a questionnaire at enrolment (1989-91) and followed for mortality through 2000. Relative risks (hazard ratios) for ischaemic heart disease (IHD), ischaemic stroke and haemorrhagic stroke were calculated using Cox proportional hazards modelling, adjusting for relevant co-variates. Risks were not consistently associated with age at menopause, parity, stillbirths, miscarriages or duration of lactation. An increasing trend in IHD mortality risk, but not stroke, was observed with decreasing age at menarche. There was no evidence of increased CVD mortality risk by oral or injectable contraceptive use or induced abortions. As expected, greater mortality rates from CVD and increased CVD risks were also observed with smoking. Use of steroid contraceptives, induced abortions and reduced parity from China's one-child-per-family policy has not had an adverse effect on risk of CVD mortality in this cohort.

Occupational exposures and mortality from cardiovascular disease among women textile workers in Shanghai, China

ObjectivesTo explore whether cardiovascular disease (CVD) mortality is associated with occupational exposures in the textile industry, including bacterial endotoxin, a contaminant in cotton dust and a potent inflammagen.MethodsA cohort of...

Risk of lung cancer in relation to contiguous windows of endotoxin exposure among female textile workers in Shanghai

Exposure to endotoxin has been consistently associated with a reduced risk of lung cancer. However, there is a paucity of information regarding temporal aspects of this relationship. The objective of this study was to investigate the associations between contiguous windows of endotoxin exposure and risk of lung cancer. Data were reanalyzed from a case-cohort study (602 cases, 3,038 subcohort) of female textile workers in Shanghai, China. Cumulative endotoxin exposure was partitioned into two windows: ≥20 and <20years before risk. Exposure-response relations were examined using categorical and non-linear (semi-parametric) models, accounting for confounding by previous exposure windows. There was an inverse trend of decreasing risk of lung cancer associated with increasing levels of endotoxin exposure ≥20years before risk (p trend=0.02). Women in the highest two categories of cumulative exposures had hazard ratios of 0.78 (95% CI 0.60-1.03) and 0.77 (95% CI 0.58-1.02) for lung cancer, respectively, in comparison with unexposed textile workers. There was, however, a weaker association and not statistically significant between lung cancer and endotoxin exposure accumulated in the more recent window (<20years before risk). Results provide further evidence that endotoxin exposure that occurred 20years or more before risk confers the strongest protection against lung cancer, indicating a possible early anti-carcinogenic effect. Further studies are needed to better understand the underlying biological mechanisms for this effect.

Unexpected excessive chronic obstructive pulmonary disease mortality among female silk textile workers in Shanghai, China

ObjectiveTo investigate chronic obstructive pulmonary disease (COPD) mortality among textile workers.MethodsA total of 267 400 Chinese female textile employees were monitored for COPD mortality from 1989 to 2000. Textile factories...

Lung cancer and occupational exposures other than cotton dust and endotoxin among women textile workers in Shanghai, China

ObjectivesNumerous epidemiological studies of lung cancer among textile workers worldwide consistently indicate reduced risks related to cotton dust exposure, presumably due to endotoxin contamination. Our objective was to investigate associations...

Fruit and Vegetable Intakes Are Associated with Lower Risk of Breast Fibroadenomas in Chinese Women1–3

Fibroadenomas are common benign breast conditions among women and account for ~50% of breast biopsies performed. Dietary factors are known to influence benign breast conditions in the aggregate, but little is known of their association specifically with fibroadenoma. Our objective in this study was to evaluate the association between dietary and other factors and fibroadenoma risk. A case-control study, nested in a randomized trial of breast self-examination (BSE) in Chinese textile workers in Shanghai, China, was conducted between 1989 and 2000. The study sample included 327 affected women and 1070 controls. Women were administered a FFQ and a questionnaire that elicited reproductive and gynecological history and other information. Odds ratios, as estimates of relative risks, were calculated using multivariate conditional logistic regression. Significant decreasing trends in risk of fibroadenoma were observed with intake of fruits and vegetables and with number of live births, and a reduced risk was also associated with natural menopause, oral contraceptive use, and moderate exercise (walking and gardening). Increased risk of fibroadenoma was associated with heavy physical activity in one's 20s, breast cancer in a first-degree relative, and a history of prior benign breast lumps; and significant increasing trends in risk were observed with numbers of BSE per year and years of education. In conclusion, a diet rich in fruits and vegetables and the use of oral contraceptives may reduce risk of fibroadenoma.

Re: Lung Cancer Risk Among Female Textile Workers Exposed to Endotoxin

Background Reduced risk of lung cancer among workers in the cotton textile industry has been observed since the 1970s. Bacterial endotoxin, a contaminant of raw cotton fiber and cotton dust, has been proposed as a protective agent that may act through the innate and acquired immune systems. We examine the association between endotoxin exposure and lung cancer risk in a cohort of female textile workers. Methods We conducted a case – cohort study nested within a cohort of 267 400 female textile workers in Shanghai, China. We compared the cumulative exposure histories of 628 case patients diagnosed with incident lung cancer from January 1, 1989, through December 31, 1998, with those of a lung cancer – free reference subcohort of 3184 workers who were frequency matched by 5-year age-groups to all cancer patients in the cohort. Cumulative endotoxin exposure for all participants was based on historic measurements and on additional measurements for this study. Relative risks and 95% confidence intervals (CIs) were estimated by hazard ratios (HRs) from Cox proportional hazards models. We conducted exposure – response trend analyses by use of cumulative exposures with lag times of 0, 5, 10, 15, or 20 years to account for disease latency. All analyses controlled for age and smoking status. All statistical tests were two-sided. Results Cumulative exposure to endotoxin was strongly, statistically significantly, and inversely associated with lung cancer risk. The inverse trend was greatest with a 20-year lag time, for which highest endotoxin exposure was associated with a statistically significantly 40% less risk of lung cancer (HR = 0.60, 95% CI = 0.43 to 0.83; P trend across quintiles = .002) than nonexposure. From a reported population rate of lung cancer among women in Shanghai of 19.1 per 100 000 for the year 2000 and the estimated reduction in risk of lung cancer observed for 20 years of endotoxin exposure in this population of workers, the incidence of lung cancer in this cohort was reduced by approximately 7.6 per 100 000 (range = 3.2 – 10.9 per 100 000). Conclusions Long-term and high-level exposure to endotoxin, compared with no exposure, appears to be associated with a reduced risk of lung cancer in this cohort.

Physical activity, physical exertion, and miscarriage risk in women textile workers in Shanghai, China

Strenuous occupational physical activity and physical demands may be risk factors for adverse reproductive outcomes. A retrospective study in the Shanghai, China textile industry study collected women's self-reported reproductive history. Occupational physical activity assessment linked complete work history data to an industry-specific job-exposure matrix. Odds ratios (OR) and 95% confidence intervals (CI) were estimated by multivariate logistic regression for the first pregnancy outcome and utilized generalized estimating equations to consider all pregnancies per woman. Compared with women employed in sedentary jobs, a reduced risk of miscarriage was found for women working in jobs with either light (OR 0.18, 95% CI: 0.07, 0.50) or medium (OR 0.24, 95% CI: 0.08, 0.66) physical activity during the first pregnancy and over all pregnancies (light OR 0.32, 95% CI: 0.17, 0.61; medium OR 0.43, 95% CI: 0.23, 0.80). Frequent crouching was associated with elevated risk (OR 1.82, 95% CI: 1.14, 2.93; all pregnancies per woman). Light/medium occupational physical activity may have reduced miscarriage risk, while specific occupational characteristics such as crouching may have increased risk in this cohort.

Dust and chemical exposures, and miscarriage risk among women textile workers in Shanghai, China

Introduction:To investigate possible associations between miscarriage and occupational exposures in the Shanghai textile industry.Methods:A retrospective cohort study of miscarriages among 1752 women in the Shanghai textile industry was conducted. Reproductive...