Cotes J E
Department of Physiological Sciences, Medical School, Newcastle upon Tyne, UK.
Occup Med (Lond). 2000 Aug;50(6):440-9. doi: 10.1093/occmed/50.6.440.
The Pneumoconiosis Research Unit (PRU) was set up to obtain the information needed to eliminate pneumoconiosis of coal workers. To this end, instruments and procedures were developed for dust sampling, delivering dust to animals, testing lung function, reading chest radiographs, conducting respiratory surveys and extracting the relevant information. A provisional estimate of safe working conditions was made using data from four pits. The National Coal Board extended the research to an additional 20 pits, refined the estimate and applied it nationally. Meanwhile at PRU aspects of treatment were explored, immunological techniques were added to the repertoire of skills, other occupational disorders were highlighted and new information obtained on biological variation in lung function and blood pressure. The work laid the foundations for medical epidemiology and evidence-based medicine. Starting in 1959, the Unit took the lead in a world campaign to control lung diseases due to asbestos. This account indicates how these successes were achieved, what were the failures, some tensions which developed and what might have been if some events had been handled differently. If there is a message, it is that for success in research the problem under consideration should be the prime focus of attention and resources.
尘肺病研究单位(PRU)的设立是为了获取消除煤矿工人尘肺病所需的信息。为此,开发了用于粉尘采样、给动物输送粉尘、测试肺功能、解读胸部X光片、进行呼吸调查以及提取相关信息的仪器和程序。利用来自四个煤矿的数据对安全工作条件进行了初步估计。国家煤炭委员会将研究扩展到另外20个煤矿,完善了估计并在全国范围内应用。与此同时,PRU对治疗方面进行了探索,将免疫技术纳入技能范围,突出了其他职业性疾病,并获得了关于肺功能和血压生物变异的新信息。这项工作为医学流行病学和循证医学奠定了基础。从1959年开始,该单位在全球控制石棉所致肺病的运动中发挥了带头作用。本报告说明了这些成功是如何取得的,有哪些失败之处,出现了哪些紧张局面,以及如果某些事件处理方式不同可能会怎样。如果说有一个启示的话,那就是要想研究取得成功,所考虑的问题应该是关注的首要焦点和资源投入的方向。