Sunyer Jordi, Zock Jan Paul, Kromhout Hans, Garcia-Esteban Raquel, Radon Katja, Jarvis Deborah, Toren Kjell, Künzli Nino, Norbäck Dan, d'Errico Angelo, Urrutia Isabel, Payo Félix, Olivieri Mario, Villani Simona, Van Sprundel Marc, Antó Josep M, Kogevinas Manolis
Respiratory and Health Research Unit, Medical Research Institute, Barcelona, Spain.
Am J Respir Crit Care Med. 2005 Nov 1;172(9):1139-45. doi: 10.1164/rccm.200504-648OC. Epub 2005 Jul 22.
Occupational exposures to vapors, gas, dust, or fumes have been shown to be a risk factor of airway obstruction in cross-sectional studies in the general population.
Our aim was to study the relationships between specific occupations and occupational exposures during a 9-yr follow-up period and changes in lung function and symptoms of chronic bronchitis.
Subjects from the general population aged 20 to 45 yr were randomly selected in 1991-1993 within the European Community Respiratory Health Survey. Follow-up took place from 1998 to 2002 among 4,079 males and 4,461 females in 27 study centers. A total of 3,202 men and 3,279 women twice completed lung function measurements. Job history during follow-up was linked to a job exposure matrix and consequently translated into cumulative exposure estimates.
Individuals exposed to dusts, gases, and fumes during the period of follow-up did not have a steeper decline of FEV1 than did individuals with consistently white-collar occupations without occupational exposures (relative change among men and women, + 1.4 and -3.1 ml/yr, respectively; p > 0.2), nor an increase of prevalence or incidence of airway obstruction defined as an FEV1/FVC ratio of less than 0.7. The incidence of chronic phlegm increased in men exposed to mineral dust (relative risk, 1.94 [1.29-2.91]) and gases and fumes (relative risk, 1.53 [0.99-2.36]), which was not modified by smoking.
Occupational exposures to dusts, gases, and fumes occurring during the 1990s are associated with incidence of chronic bronchitis, although these did not impair lung function in a population of relatively young age.
在普通人群的横断面研究中，职业性接触蒸汽、气体、粉尘或烟雾已被证明是气道阻塞的一个风险因素。
我们的目的是研究在9年随访期内特定职业与职业暴露之间的关系，以及肺功能变化和慢性支气管炎症状。
1991年至1993年在欧洲共同体呼吸健康调查中，从20至45岁的普通人群中随机选取受试者。1998年至2002年在27个研究中心对4079名男性和4461名女性进行了随访。共有3202名男性和3279名女性两次完成了肺功能测量。随访期间的工作经历与工作暴露矩阵相关联，从而转化为累积暴露估计值。
在随访期间接触粉尘、气体和烟雾的个体，其第一秒用力呼气容积（FEV1）的下降幅度并不比一直从事无职业暴露的白领职业的个体更大（男性和女性的相对变化分别为+1.4和-3.1毫升/年；p>0.2），气道阻塞（定义为FEV1/FVC比值小于0.7）的患病率或发病率也没有增加。接触矿物粉尘（相对风险，1.94[1.29 - 2.91]）以及气体和烟雾（相对风险，1.53[0.99 - 2.36]）的男性慢性咳痰的发病率增加，且不受吸烟影响。
20世纪90年代发生的职业性接触粉尘、气体和烟雾与慢性支气管炎的发病率相关，尽管这些暴露并未损害相对年轻人群的肺功能。
