Schlünssen V, Schaumburg I, Heederik D, Taudorf E, Sigsgaard T
Department of Occupational and Environmental Medicine, Skive Hospital, DK 7800 Skive, Denmark.
Occup Environ Med. 2004 Jun;61(6):504-11. doi: 10.1136/oem.2003.007815.
To investigate the relation between wood dust exposure and different indices of asthma among woodworkers and non-exposed subjects.
A total of 302 woodworkers and 71 non-exposed subjects answered a respiratory health questionnaire, underwent a non-specific bronchial provocation test using the Yan method, and received a skin prick test with 12 common inhalant allergens. Subgroups performed repeated peak flow monitoring and underwent a reversibility test. A total of 347 dust measurements among 234 woodworkers were performed with passive dust monitors.
The overall geometric mean (geometric standard deviation) exposure to inhalable dust was 0.96 (2.02) mg/m3. There was a tendency to increased risk of asthma among atopic woodworkers compared to atopic non-exposed subjects, with ORs between 3.0 (0.8-11.9) (symptomatic BHR) and 1.3 (0.5-4.2) (work related symptoms). In woodworkers, asthma was associated with atopy, with ORs between 7.4 (2.8-19.7) (symptomatic BHR) and 4.2 (2.4-7.7) (asthma symptoms). Asthma was related to dust level, most pronounced for symptomatic BHR among atopics, with OR 22.9 (1.0-523.6) for the highest compared to the lowest dust level. For work related asthma symptoms the association with dust level was seen only for non-atopics.
Wood dust exposure was associated with asthma, despite a low dust level compared to other studies. Atopy was an important effect modifier in the association between asthma and wood dust exposure.
调查木工和未接触者中木材粉尘暴露与哮喘不同指标之间的关系。
共有302名木工和71名未接触者回答了呼吸健康问卷,采用殷氏法进行了非特异性支气管激发试验,并接受了12种常见吸入性变应原的皮肤点刺试验。亚组进行了重复峰值流量监测并接受了可逆性试验。使用被动粉尘监测仪对234名木工进行了总共347次粉尘测量。
可吸入粉尘的总体几何平均(几何标准差)暴露量为0.96(2.02)mg/m³。与特应性未接触者相比,特应性木工患哮喘的风险有增加趋势,症状性支气管高反应性的比值比在3.0(0.8 - 11.9)之间,工作相关症状的比值比在1.3(0.5 - 4.2)之间。在木工中,哮喘与特应性相关,症状性支气管高反应性的比值比在7.4(2.8 - 19.7)之间,哮喘症状的比值比在4.2(2.4 - 7.7)之间。哮喘与粉尘水平有关,在特应性患者中症状性支气管高反应性最为明显,最高粉尘水平与最低粉尘水平相比,比值比为22.9(1.0 - 523.6)。对于工作相关哮喘症状,仅在非特应性患者中观察到与粉尘水平的关联。
尽管与其他研究相比粉尘水平较低,但木材粉尘暴露与哮喘有关。特应性是哮喘与木材粉尘暴露之间关联的重要效应修饰因素。