Eschenbacher W L, Kreiss K, Lougheed M D, Pransky G S, Day B, Castellan R M
Division of Respiratory Disease Studies, National Institute for Occupational Safety and Health, Morgantown, West Virginia, USA.
Am J Respir Crit Care Med. 1999 Jun;159(6):2003-8. doi: 10.1164/ajrccm.159.6.9808002.
A work-related interstitial lung disease has been diagnosed in workers at five nylon flock facilities in three different states and a Canadian province. The National Institute for Occupational Safety and Health hosted a workshop at which consulting pulmonary pathologists reviewed lung tissue samples from all the cases for which lung biopsy material was available (15 of 20 cases known in January 1998). After independent review and scoring of these lung tissue specimens, the pathologists reached consensus that the histopathological findings revealed a characteristic lesion-a lymphocytic bronchiolitis and peribronchiolitis with lymphoid hyperplasia represented by lymphoid aggregates. The pathologists noted that the pathological findings were distinctive when compared with known lung conditions. The clinical presentation for the cases generally included cough, dyspnea, restrictive ventilatory defect with reduction in diffusing capacity, and interstitial markings on chest radiographs or high-resolution computed tomography (HRCT) scans. Six of the cases improved after removal from workplace exposure without medical treatment. Six others, who had recovered with medical treatment and removal from the workplace, had relapses in both symptoms and objective findings after attempting to return to nylon flock work. With this and other evidence supporting the existence of chronic interstitial pneumonitis associated with nylon flock processing, workshop participants recommended surveillance for early identification of affected workers and their removal from further workplace exposure.
在三个不同州和一个加拿大省份的五家尼龙绒毛加工工厂的工人中，已诊断出与工作相关的间质性肺病。美国国家职业安全与健康研究所举办了一次研讨会，会上咨询肺病理学家对所有有肺活检材料的病例（1998年1月已知的20例中的15例）的肺组织样本进行了审查。在对这些肺组织标本进行独立审查和评分后，病理学家达成共识，即组织病理学发现显示出一种特征性病变——淋巴细胞性细支气管炎和细支气管周围炎，并伴有以淋巴样聚集为代表的淋巴样增生。病理学家指出，与已知的肺部疾病相比，这些病理发现具有独特性。这些病例的临床表现通常包括咳嗽、呼吸困难、限制性通气功能障碍伴弥散功能降低，以及胸部X光片或高分辨率计算机断层扫描（HRCT）上的间质纹理。其中6例在脱离工作场所暴露且未接受治疗后病情有所改善。另外6例在接受治疗并脱离工作场所后康复，但在试图重返尼龙绒毛加工工作后，症状和客观检查结果均复发。鉴于此以及其他支持与尼龙绒毛加工相关的慢性间质性肺炎存在的证据，研讨会参与者建议进行监测，以便早期识别受影响的工人并使其脱离进一步的工作场所暴露。
