Dutkiewicz Jacek
Zakładu Biologicznych Szkodliwości Zawodowych Instytutu Medycyny Wsi w Lublinie.
Med Pr. 2004;55(1):31-40.
Over the last decade, there was noted a large advancement of knowledge on living organisms and their products posing a potential occupational risk. Novel risk factors, often new to science, were identified, the role and significance of already known factors better comprehended, and occupational groups endangered by biological hazards more thoroughly recognized. Novel viruses and prions, emerging in different parts of the world, may pose a particular threat to health and life of health care workers, agriculture workers and veterinarians. A new coronavirus (SCoV) that evoked a rapid outbreak of disease described as severe acute respiratory syndrome (SARS) in the first half of 2003 may serve as an example. The disease was particularly common among health care workers. Previously discovered zoonotic viruses, Nipah virus in pigs and Hendra virus in horses, may be a cause of fatal encephalitis in animal farmers. Hantaviruses (Puumala, Hantaan, Sin Nombre and others) infecting field rodents may be a cause of hemorrhagic fever with renal syndrome (HFRS) or pulmonary syndrome (HPS) in farmers and laboratory workers. Prions responsible for inducing a zoonotic variant of Creutzfeldt-Jakob disease (vCJD) are considered to be a potential cause of work-related infections in agricultural and health care workers, however, this assumption has not as yet been supported by any conclusive evidence. In many countries, blood-borne occupational infections with hepatitis C virus (HCV) is the major epidemiological problem among health care workers, mostly because no vaccine against this virus has been produced to date. Vaccinations effectively restricted the number of occupational infections with hepatitis B virus (HBV), and work-related infections with human immunodeficiency virus (HIV) causing acquired immunodeficiency syndrome (AIDS) are very rare. Hazardous bioserosols, occurring in many work environments, pose an occupational health hazard of particular importance. Many new biological factors present in organic dusts that may induce work-related allergic and immunotoxic diseases among farmers and workers of the agricultural and wood industries have been identified. Droplet aerosols, which are generated from water, oils, oil-water emulsions and other liquids in various work environments, may contain infectious agents (Legionella spp.) as well as allergic and/or toxic agents. It has been shown that allergens and endotoxins produced by Gram-negative bacteria occurring in oil mist from metalworking fluids may cause occupational respiratory diseases in workers of the metallurgic industry.
在过去十年中,人们对构成潜在职业风险的生物体及其产物的认识有了很大进展。确定了许多新的风险因素,这些因素往往是科学界新发现的;更好地理解了已知因素的作用和意义;更全面地认识了受到生物危害威胁的职业群体。在世界不同地区出现的新型病毒和朊病毒,可能对医护人员、农业工人和兽医的健康与生命构成特别威胁。2003年上半年引发被称为严重急性呼吸综合征(SARS)的快速疾病爆发的新型冠状病毒(SCoV)就是一个例子。这种疾病在医护人员中尤为常见。先前发现的人畜共患病毒,如猪的尼帕病毒和马的亨德拉病毒,可能是动物养殖者致命性脑炎的病因。感染田间啮齿动物的汉坦病毒(普马拉病毒、汉滩病毒、辛诺柏病毒等)可能是农民和实验室工作人员患肾综合征出血热(HFRS)或肺综合征(HPS)的病因。导致克雅氏病(vCJD)人畜共患病变体的朊病毒被认为是农业和医护人员工作相关感染的潜在病因,然而,这一假设尚未得到任何确凿证据的支持。在许多国家,医护人员中丙型肝炎病毒(HCV)经血液传播的职业感染是主要的流行病学问题,主要原因是迄今为止尚未研制出针对该病毒的疫苗。疫苗有效地限制了乙型肝炎病毒(HBV)职业感染的数量,而导致获得性免疫缺陷综合征(AIDS)的人类免疫缺陷病毒(HIV)工作相关感染非常罕见。在许多工作环境中出现的有害生物气溶胶构成了特别重要的职业健康危害。已确定有机粉尘中存在的许多新生物因素,可能会在农民以及农业和木材工业工人中引发与工作相关的过敏性和免疫毒性疾病。在各种工作环境中,由水、油、油水乳液和其他液体产生的飞沫气溶胶可能含有传染因子(军团菌属)以及过敏性和/或毒性因子。研究表明,金属加工液油雾中革兰氏阴性菌产生的过敏原和内毒素可能导致冶金行业工人患职业性呼吸道疾病。