Auchincloss J H, Abraham J L, Gilbert R, Lax M, Henneberger P K, Heitzman E R, Peppi D J
State University of New York, College of Medicine, Pulmonary Section, Syracuse 13210.
Br J Ind Med. 1992 Dec;49(12):832-6. doi: 10.1136/oem.49.12.832.
Forty two of 125 former workers in a factory in Syracuse, New York, which manufactured hard metal parts from tungsten carbide and cobalt, were studied by chest radiographs, spirometry, and plethysmographically determined lung volumes. The plant was closed in 1982 and the studies were performed in 1983-5. Recorded measurements of carbide dust concentrations were only mildly excessive by modern standards, but deceitful efforts to reduce the apparent concentration of dust were known to have occurred during an inspection by the Occupational Safety and Health Administration. Lung biopsies in four cases in the study and necropsy in one of the 83 cases not studied during life showed giant cell interstitial pneumonia and appreciable concentrations of tungsten carbide. This information indicates that exposure was substantial. Four workers had evidence of pulmonary fibrosis by chest radiographs; two of these workers had normal pulmonary function. Fourteen had abnormal pulmonary function, five of whom had a restrictive pattern, eight a pattern of air trapping, and one a combined pattern. Thus radiographic, or functional abnormalities, or both occurred in 16 of the 42 cases studied. No correlation with duration of exposure was established. Progressive clinically important disease (one fatal) has been found in four ex-workers, two in each of the restrictive and air trapping groups. These findings suggest that poorly regulated dust concentrations in a hard metals factory possibly cause pulmonary abnormalities and sometimes severe illness.
纽约锡拉丘兹一家工厂的125名 former workers 中,有42人接受了胸部X光检查、肺活量测定和体积描记法测定肺容量的研究。该工厂用碳化钨和钴制造硬质金属部件,于1982年关闭,研究在1983年至1985年进行。按照现代标准,记录的碳化钨粉尘浓度仅略超标,但职业安全与健康管理局检查时发现,曾存在降低明显粉尘浓度的欺骗行为。该研究中的4例肺活检以及生前未研究的83例中的1例尸检显示有巨细胞间质性肺炎和可观的碳化钨浓度。这些信息表明接触程度很大。4名工人胸部X光片有肺纤维化证据;其中2名工人肺功能正常。14人肺功能异常,其中5人呈限制性模式,8人呈气体潴留模式,1人呈混合模式。因此,在研究的42例中,有16例出现了影像学或功能异常,或两者皆有。未发现与接触时长相关。在4名 former workers 中发现了进展性的、具有临床重要性的疾病(1例死亡),限制性和气体潴留组各有2例。这些发现表明,硬质金属工厂中粉尘浓度监管不力可能导致肺部异常,有时还会引发严重疾病。