Kuo H W, Chang C L, Liang W M, Chung B C
Institute of Environmental Health, China Medical College, Taichung, Taiwan, ROC.
Occup Med (Lond). 1999 Nov;49(8):499-505. doi: 10.1093/occmed/49.8.499.
The objectives of this study were to determine the relationship between exposure levels and respiratory abnormalities, to measure FVC and FEV1(1) changes per year based on work duties and to investigate the prevalence of and factors related to pneumoconiosis. A total of 583 male workers from 50 iron foundries in central Taiwan were investigated. First, workers' respiratory symptoms were categorized using a modified American Thoracic Society (ATS) questionnaire and then were verified by physician's examination. Next, pulmonary function tests were performed including: forced vital capacity (FVC), forced expiratory volume in one second (FEV1) and forced expiratory flow rate. A chest radiograph was used to diagnose pneumoconiosis according to ILO criteria. Furnace workers were found to have the highest prevalence of chronic phlegm, thoracic disorders and chronic bronchitis. In general, smokers had a higher prevalence of respiratory symptoms as compared with non-smokers. Pulmonary function abnormalities and pneumoconiosis were closely linked to smoking and work duration. After adjusting for age, height and smoking there was a significant decrease based on work duration in FVC and FEV1 for furnace and moulding workers compared with after-processing and administrative workers. The overall prevalence of pneumoconiosis was 8.8%, highest among furnace (16.3%) and after-processing workers (11.4%) and lowest among administrative workers (2.5%). Using multiple logistic regression, the risk of developing pneumoconiosis (as compared with the administrative workers) for furnace workers was highest (8.98 times greater risk), followed by after-processing workers (6.77 times greater risk) and moulding workers (5.41 times greater risk). Prolonged exposure to free silica, and smoking habits, can result in respiratory abnormalities among foundry workers.
本研究的目的是确定接触水平与呼吸异常之间的关系,根据工作职责测量每年的用力肺活量(FVC)和第一秒用力呼气容积(FEV1)变化,并调查尘肺病的患病率及相关因素。对台湾中部50家铸铁厂的583名男性工人进行了调查。首先,使用改良的美国胸科学会(ATS)问卷对工人的呼吸道症状进行分类,然后由医生检查进行核实。接下来,进行肺功能测试,包括:用力肺活量(FVC)、第一秒用力呼气量(FEV1)和用力呼气流量率。根据国际劳工组织(ILO)标准,使用胸部X光片诊断尘肺病。发现熔炉工人慢性咳痰、胸部疾病和慢性支气管炎的患病率最高。一般来说,吸烟者的呼吸道症状患病率高于非吸烟者。肺功能异常和尘肺病与吸烟和工作时长密切相关。在调整年龄、身高和吸烟因素后,与后处理和行政工作人员相比,熔炉和造型工人的FVC和FEV1基于工作时长有显著下降。尘肺病的总体患病率为8.8%,在熔炉工人(16.3%)和后处理工人(11.4%)中最高,在行政工作人员(2.5%)中最低。使用多因素逻辑回归分析,熔炉工人患尘肺病的风险(与行政工作人员相比)最高(风险高8.98倍),其次是后处理工人(风险高6.77倍)和造型工人(风险高5.41倍)。长期接触游离二氧化硅和吸烟习惯会导致铸造工人出现呼吸异常。