Cowie H A, Wild P, Beck J, Auburtin G, Piekarski C, Massin N, Cherrie J W, Hurley J F, Miller B G, Groat S, Soutar C A
Institute of Occupational Medicine, 8 Roxburgh Place, Edinburgh EH8 9SU, UK.
Occup Environ Med. 2001 Dec;58(12):800-10. doi: 10.1136/oem.58.12.800.
To investigate possible relations between respiratory health and past airborne exposure to refractory ceramic fibres (RCFs) and respirable dust in workers at six European factories, studied previously in 1987.
The target population comprised all current workers associated with RCF production, plus others who had participated in 1987 "leavers". Information was collected on personal characteristics, chest radiographs, lung function, respiratory symptoms, smoking, and full occupational history. Regression analysis was used to study relations between indices of health of individual workers and of cumulative exposure to airborne dust and fibres, and likely past exposure to asbestos.
774 workers participated (90% of current workers, 37% of leavers). Profusion of small opacities in exposed workers (51% 0/1+; 8% 1/0+) was similar to that among an unexposed control group but higher than in new readings of the 1987 study films (11% 0/1+, 2% 1/0+). The large difference between 1987 and recent films may be, at least in part, a reading artefact associated with film appearance. Small opacities of International Labour Organisation (ILO) category 1/0+ were not associated with exposure. An association of borderline significance overall between 0/1+ opacities and exposure to respirable fibres was found for some exposure periods only, the time related pattern being biologically implausible. Pleural changes were related to age and exposure to asbestos, and findings were consistent with an effect of time since first exposure to RCFs. Among men, forced expired volume in 1 second (FEV(1)) and forced vital capacity (FVC) were inversely related to exposure to fibres, in current smokers only. FEV(1)/ FVC ratio and transfer factor (TL(CO)) were not related to exposures. The estimated restrictive effect was on average mild. Prevalence of respiratory symptoms was low. Chronic bronchitis and its associated symptoms (cough, phlegm) showed some association with recent exposure to respirable fibres. This could be due to an irritant effect of RCFs.
调查欧洲六家工厂工人的呼吸健康与过去空气中难熔陶瓷纤维（RCF）及可吸入粉尘暴露之间的可能关系，这些工厂曾在1987年进行过研究。
目标人群包括所有目前与RCF生产相关的工人，以及1987年参与研究的“离职人员”中的其他人。收集了个人特征、胸部X光片、肺功能、呼吸道症状、吸烟情况和完整职业史等信息。采用回归分析研究个体工人健康指标与空气中粉尘和纤维累积暴露以及可能的过去石棉暴露之间的关系。
774名工人参与了研究（占目前工人的90%，离职人员的37%）。暴露工人中小阴影的密集度（51%为0/1+；8%为1/0+）与未暴露对照组相似，但高于1987年研究胶片重新读片时的情况（11%为0/1+，2%为1/0+）。1987年和近期胶片之间的巨大差异可能至少部分是与胶片外观相关的读片假象。国际劳工组织（ILO）1/0+类别的小阴影与暴露无关。仅在某些暴露时间段发现0/1+阴影与可吸入纤维暴露之间总体存在边缘显著关联，时间相关模式在生物学上不合理。胸膜改变与年龄和石棉暴露有关，研究结果与首次接触RCF后的时间效应一致。在男性中，仅当前吸烟者的一秒用力呼气容积（FEV(1)）和用力肺活量（FVC）与纤维暴露呈负相关。FEV(1)/FVC比值和转移因子（TL(CO)）与暴露无关。估计的限制性效应平均较轻。呼吸道症状的患病率较低。慢性支气管炎及其相关症状（咳嗽、咳痰）与近期可吸入纤维暴露有一定关联。这可能是由于RCF的刺激作用。
