ELWOOD P C, PEMBERTON J, MERRETT J D, CAREY G C, MCAULAY I R
Br J Ind Med. 1965 Jan;22(1):27-37. doi: 10.1136/oem.22.1.27.
A study of byssinosis and other respiratory symptoms in 2,528 flax workers aged 35 years and over in Northern Ireland is reported. This represented 82·5% of the total available population. Only 3% of workers were not seen because of absence or a refusal to co-operate. Workers were interviewed using a questionnaire based on the Questionnaire on Respiratory Symptoms (Medical Research Council, 1960a) with additional questions relating to respiratory symptoms at work. Byssinosis was found in workers in all stages of the industry, though its prevalence was highest in flax preparers; wet spinners and wet polishers did not appear to be at serious risk of developing the condition. When the effects of other relevant factors had been allowed for, age, duration of employment, and smoking habits, differences between the prevalence in the two sexes were found to be very small. The associations between byssinosis and the age of workers and their durations of employment in flax-preparing occupations were complex, and it was thought that a selective discharge of affected workers before the study might, in part at least, explain the absence of marked associations between these variables. Marked associations were found between both chronic bronchitis and exertional dyspnoea and the type of occupation in the mill. Workers in the early preparing occupations had a considerably higher prevalence of these conditions than expected on a null hypothesis. There were also marked associations between byssinosis and bronchitis, and between byssinosis and dyspnoea. The possible importance of these associations with regard to the aetiology of byssinosis is discussed, and it is suggested that byssinosis represents an acute, specific effect of certain textile dusts on the respiratory system, superimposed on a non-specific chronic bronchitic process.
本文报告了一项针对北爱尔兰2528名年龄在35岁及以上的亚麻工人的棉尘病及其他呼吸道症状的研究。这一群体占全部可研究人群的82.5%。仅有3%的工人因缺勤或拒绝合作而未被纳入研究。研究人员使用了一份基于《呼吸症状调查问卷》(医学研究委员会,1960a)的问卷对工人进行访谈,并额外增加了与工作时呼吸症状相关的问题。棉尘病在该行业的各个阶段的工人中均有发现,不过在亚麻预处理工人中患病率最高;湿纺工和湿整饰工似乎没有患上该病的严重风险。在考虑了其他相关因素,如年龄、工作时长和吸烟习惯后,发现两性之间的患病率差异非常小。棉尘病与工人年龄及其在亚麻预处理职业中的工作时长之间的关联较为复杂,研究人员认为,在研究之前可能存在选择性解雇患病工人的情况,这至少在一定程度上解释了这些变量之间缺乏明显关联的原因。研究发现,慢性支气管炎和劳力性呼吸困难与工厂中的职业类型之间存在明显关联。处于早期预处理职业的工人患这些疾病的患病率比在零假设下预期的要高得多。棉尘病与支气管炎之间以及棉尘病与呼吸困难之间也存在明显关联。本文讨论了这些关联在棉尘病病因学方面的潜在重要性,并提出棉尘病代表了某些纺织粉尘对呼吸系统的急性、特异性影响,叠加在非特异性慢性支气管炎过程之上。