Kongerud J
Department of Thoracic Medicine, Rikshospitalet, University of Oslo, Norway.
Med Lav. 1992 Sep-Oct;83(5):414-7.
Epidemiological studies of aluminum potroom workers have been in progress in Norway since 1986. The occurrence of work-related asthmatic symptoms and their determinants were studied. Work-related asthmatic symptoms and airflow limitation were closely associated with duration of potroom employment. A significant relationship between current fluoride exposure and work-related asthmatic symptoms was observed in a smaller, cross-sectional population where a detailed exposure classification was carried out. A similar association and also a dose-response gradient was found in a longitudinal study of new employees. The existence of occupational asthma in aluminium potroom workers was confirmed by characteristic patterns of repeated peak flow measurements supported by changes in methacholine responsiveness in workers with suspected work-related asthma. Current smoking as a risk factor for work-related asthmatic symptoms was observed both in cross-sectional and in longitudinal investigations. Similarly to current fluoride exposure, a dose-response gradient was demonstrated in the association between work-related asthmatic symptoms and current amount of tobacco smoked. Allergy was not shown to be a determinant of work-related asthmatic symptoms in any part of the investigation. A family history of asthma and previous occupational exposure may have had some influence on the risk of developing symptoms but the findings were inconsistent and probably of minor importance. Methacholine challenge seemed inappropriate for the screening of aluminium potroom workers in order to detect work-related asthmatic symptoms, but was closely correlated to the severity of symptoms.(ABSTRACT TRUNCATED AT 250 WORDS)
自1986年以来,挪威一直在对铝电解车间工人进行流行病学研究。研究了与工作相关的哮喘症状及其决定因素。与工作相关的哮喘症状和气流受限与在铝电解车间工作的时长密切相关。在一个进行了详细暴露分类的较小横断面人群中,观察到当前氟暴露与工作相关的哮喘症状之间存在显著关系。在一项对新员工的纵向研究中也发现了类似的关联以及剂量反应梯度。通过对疑似与工作相关哮喘的工人进行乙酰甲胆碱反应性变化支持的重复峰值流量测量的特征模式,证实了铝电解车间工人中职业性哮喘的存在。在横断面和纵向调查中均观察到当前吸烟是与工作相关哮喘症状的一个风险因素。与当前氟暴露类似,在工作相关哮喘症状与当前吸烟量之间的关联中也显示出剂量反应梯度。在调查的任何部分,过敏均未被证明是与工作相关哮喘症状的一个决定因素。哮喘家族史和既往职业暴露可能对出现症状的风险有一定影响,但研究结果并不一致,可能重要性不大。乙酰甲胆碱激发试验似乎不适用于筛查铝电解车间工人以检测与工作相关的哮喘症状,但与症状严重程度密切相关。(摘要截选至250字)