Ulvestad Bente, Lund May Brit
Kreftregisteret, Montebello, Oslo.
Tidsskr Nor Laegeforen. 2003 Aug 28;123(16):2292-5.
As tunnel workers are exposed to particles from drilling, blasting and diesel exhaust, we aimed to assess the occurrence of respiratory symptoms and lung function decline in underground construction workers and relate these findings to exposure.
212 tunnel workers and a reference group of 205 outdoor construction workers participated in a cross-sectional study. Respiratory symptoms and lung function were studied in relation to exposure. A subgroup of 29 non-smoking concrete workers who had been exposed to tunnel environment for one year, were examined by acoustic rhinometry, exhaled NO, spirometry and a questionnaire. Finally 122 tunnel workers were included in a prospective study in 1991 and re-examined in 1999.
Among the tunnel workers the prevalence of chronic obstructive pulmonary disease (COPD) was 14% vs. 8% in the reference subjects. Compared to the reference subjects, the tunnel workers had a significant decrease in FEV1, related to years of exposure. Concrete workers from the tunnel site had significantly increased exhaled NO levels and nasal mucosal swelling compared to subjects who had performed similar tasks outdoors. The decrease in FEV1 was associated with cumulative exposure to respirable dust and quartz.
Inhalation of construction-generated dust and gases enhances the risk of chronic obstructive pulmonary disease in tunnel workers.
由于隧道工人暴露于钻孔、爆破和柴油废气产生的颗粒中，我们旨在评估地下建筑工人呼吸道症状的发生率和肺功能下降情况，并将这些结果与暴露情况相关联。
212名隧道工人和205名室外建筑工人组成的参照组参与了一项横断面研究。研究了呼吸道症状和肺功能与暴露的关系。对29名接触隧道环境一年的非吸烟混凝土工人亚组进行了鼻声反射测量、呼出一氧化氮检测、肺活量测定并填写了问卷。最后，122名隧道工人于1991年纳入一项前瞻性研究，并于1999年进行了重新检查。
隧道工人中慢性阻塞性肺疾病（COPD）的患病率为14%，而参照对象为8%。与参照对象相比，隧道工人的第一秒用力呼气容积（FEV1）显著下降，与暴露年限有关。与在户外执行类似任务的对象相比，来自隧道工地的混凝土工人呼出的一氧化氮水平显著升高，鼻黏膜肿胀。FEV1的下降与可吸入粉尘和石英的累积暴露有关。
吸入建筑产生的粉尘和气体增加了隧道工人患慢性阻塞性肺疾病的风险。
