Hoppin Jane A, Umbach David M, London Stephanie J, Alavanja Michael C R, Sandler Dale P
Epidemiology Branch and Biostatistics, National Institute of Environmental Health Sciences, National Institutes of Health, Department of Health and Human Services, Research Triangle Park, NC 27709-2233, USA.
Am J Respir Crit Care Med. 2004 Jun 15;169(12):1308-13. doi: 10.1164/rccm.200309-1228OC. Epub 2004 Apr 7.
Farmers engage in activities that result in exposure to diesel exhaust, solvents, welding fumes, and other respiratory irritants. Using the Agricultural Health Study, a cohort of pesticide applicators in Iowa and North Carolina, we evaluated the odds of wheeze associated with nonpesticide occupational exposures. We used logistic regression models controlling for age, state, smoking, and history of asthma or atopy to evaluate odds of wheeze in the past year among the 20898 farmers who provided complete information on all covariates. Driving diesel tractors was associated with elevated odds of wheeze (odds ratio = 1.31; 95% confidence interval = 1.13, 1.52); the odds ratio for driving gasoline tractors was 1.11 (95% confidence interval = 1.02, 1.21). A duration-response relationship was observed for driving diesel tractors but not for driving gasoline tractors. Activities involving solvent exposure, including painting and use of solvents for cleaning, were associated with an increased odds of wheeze in a duration-dependent fashion. The highest odds of wheeze for farm activities were for daily painting (odds ratio = 1.82; 95% confidence interval = 0.89, 3.73), an indication of daily solvent exposure. These results add to the growing body of evidence of adverse respiratory effects of diesel exposure on the lung and suggest exposure to solvents may contribute as well.
农民从事的活动会导致接触柴油废气、溶剂、焊接烟雾和其他呼吸道刺激物。利用农业健康研究(一项针对爱荷华州和北卡罗来纳州农药施用者的队列研究),我们评估了与非农药职业暴露相关的喘息几率。我们使用逻辑回归模型,对年龄、州、吸烟情况以及哮喘或特应性病史进行控制,以评估在20898名提供了所有协变量完整信息的农民中,过去一年出现喘息的几率。驾驶柴油拖拉机与喘息几率升高相关(优势比=1.31;95%置信区间=1.13,1.52);驾驶汽油拖拉机的优势比为1.11(95%置信区间=1.02,1.21)。观察到驾驶柴油拖拉机存在剂量-反应关系,但驾驶汽油拖拉机不存在。涉及溶剂暴露的活动,包括喷漆和使用溶剂进行清洁,与喘息几率增加呈剂量依赖关系。农场活动中喘息几率最高的是每日喷漆(优势比=1.82;95%置信区间=0.89,3.73),这表明存在每日溶剂暴露。这些结果进一步证明了柴油暴露对肺部产生不良呼吸影响的证据越来越多,并表明接触溶剂也可能有影响。