Ng T P, Chan S L
Dept of Community, Occupational and Family Medicine, National University of Singapore, Lower Kent Ridge.
Eur Respir J. 1992 Sep;5(8):986-91.
Lung function tests (forced expiratory volume in one second (FEV1), forced vital capacity (FVC) and FEV1/FVC %) were related to silica exposure and the extent of radiological opacities in a study of 206 active and 132 previously employed granite workers from two quarries. The investigations included detailed personal interviews, spirometric testing and radiographic examination of the chest. The chest X-ray films were read randomly and independently by three readers, using International Labour Office (ILO) standard films. Cumulative exposure to respirable silica (mg.m-3-yr) and total granite dust (million particles per cubic foot (mppcf-yr)) were estimated for each subject based on his years of employment at various jobs and historical and current measurements of quarry-, period- and job-specific exposures. The results suggest that chronic simple silicosis, especially for profusion category 2 and 3, was associated with significant lung function loss. As expected, mixed dust fibrosis was associated with little or no functional disturbance. Massive fibrosis was associated with significant obstructive and restrictive impairment. No additional effect of exposure to respirable silica on lung function loss was found after allowing for the presence of "silicosis". However, exposure to total dust (mppcf-yr) appeared to be associated with some lung function loss independent of silicosis. Our results indicate that chronic simple silicosis is not a benign disease; silica exposure is the primary cause, but the lung function loss in silicotics is directly attributable to the fibrotic lung disease. However, exposure to total granite dust beyond the respirable size range may separately produce additional lung function loss.
在一项对来自两个采石场的206名在职花岗岩工人和132名曾从事该工作的工人的研究中，肺功能测试（一秒用力呼气量（FEV1）、用力肺活量（FVC）和FEV1/FVC%）与二氧化硅暴露及放射学不透明度程度相关。调查包括详细的个人访谈、肺量计测试和胸部X光检查。胸部X光片由三名阅片者随机独立阅片，采用国际劳工组织（ILO）标准片。根据每位受试者在不同工作岗位的工作年限以及采石场、时间段和特定工作岗位的历史和当前暴露量测量值，估算其可吸入二氧化硅（mg.m-3-yr）和总花岗岩粉尘（每立方英尺百万颗粒数（mppcf-yr））的累积暴露量。结果表明，慢性单纯矽肺，尤其是密集度为2级和3级的，与显著的肺功能丧失有关。正如预期的那样，混合性粉尘纤维化与很少或没有功能障碍有关。大块纤维化与显著的阻塞性和限制性损害有关。在考虑到“矽肺”的存在后，未发现可吸入二氧化硅暴露对肺功能丧失有额外影响。然而，总粉尘暴露量（mppcf-yr）似乎与一些独立于矽肺的肺功能丧失有关。我们的结果表明，慢性单纯矽肺并非良性疾病；二氧化硅暴露是主要原因，但矽肺患者的肺功能丧失直接归因于肺纤维化疾病。然而，暴露于可吸入粒径范围之外的总花岗岩粉尘可能会单独导致额外的肺功能丧失。
