Chen Y H, Wu T N, Liou S H
Department of Family Medicine, Tri-Service General Hospital, Nei-Hu, Taipei, Taiwan, 114, Republic of China.
J Occup Environ Med. 2001 Nov;43(11):969-75. doi: 10.1097/00043764-200111000-00007.
The purpose of the study was to follow up an earlier observation of pulmonary function among workers employed in firebrick-manufacturing factories. A 2-year follow-up study of pulmonary function among 442 workers in 30 firebrick-manufacturing factories was designed. Excluding 79 workers with a history of other occupational dust exposure, changes in pulmonary function of 291 firebrick workers were compared with pulmonary function in 72 control subjects over a period of 2 years. Baseline pulmonary function values (i.e., forced expiratory volume in 1 second [FEV1]/forced vital capacity [FVC] and forced expiratory flow after 50% of vital capacity has been expelled [FEF50%] in smoking firebrick workers, and FEV1/FVC and FEF75% in nonsmoking firebrick workers) were significantly lower than those in the comparison group. The statistical method for repeated measurements was used for comparison of the difference between follow-up and baseline lung function. There was no significant difference in FVC and FEV1 changes between firebrick workers and those in the comparison group during the 2-year follow-up period. The decreases in FEV1/FVC, peak expiratory flow rate, maximal midexpiratory flow, and FEF50% in the firebrick workers were significantly greater than in the comparison group, after adjustment for smoking status. The FEV1, maximal midexpiratory flow, FEF50%, and FEF75% also showed a dose-response relationship with job titles. The decrement of pulmonary function in the 2-year follow-up period was the worst in burning work, followed by crushing and molding. The results show that workers in firebrick-manufacturing factories with exposure to silica-containing dusts may contract obstructive pulmonary function defects.
该研究的目的是对早期观察到的耐火砖制造厂工人的肺功能情况进行随访。设计了一项针对30家耐火砖制造厂442名工人的肺功能为期2年的随访研究。排除79名有其他职业性粉尘接触史的工人，将291名耐火砖工人的肺功能变化与72名对照受试者在2年期间的肺功能进行比较。基线肺功能值（即吸烟的耐火砖工人的1秒用力呼气容积[FEV1]/用力肺活量[FVC]以及呼出肺活量50%后的用力呼气流量[FEF50%]，以及不吸烟的耐火砖工人的FEV1/FVC和FEF75%）显著低于对照组。采用重复测量的统计方法比较随访和基线肺功能之间的差异。在2年随访期内，耐火砖工人与对照组在FVC和FEV1变化方面无显著差异。在调整吸烟状况后，耐火砖工人的FEV1/FVC、呼气峰值流速、最大呼气中期流速和FEF50%的下降幅度显著大于对照组。FEV1、最大呼气中期流速、FEF50%和FEF75%也与职称呈剂量反应关系。在2年随访期内，肺功能下降在烧制工作中最为严重，其次是破碎和成型工作。结果表明，接触含硅粉尘的耐火砖制造厂工人可能会出现阻塞性肺功能缺陷。
