Mwaiselage Julius, Moen Bente, Bråtveit Magne
Centre for International Health, University of Bergen, Armauer Hansen Building N-5021, Bergen, Norway.
Int Arch Occup Environ Health. 2006 Jan;79(1):49-56. doi: 10.1007/s00420-005-0019-x. Epub 2005 Jul 28.
The effects of cement dust exposure on acute respiratory health were assessed among 51 high exposed and 33 low exposed male cement workers. The ability of the questionnaire to diagnose acute decrease in ventilatory function was also assessed.
Acute respiratory symptoms were recorded by interview using a structured optimal symptom score questionnaire. Peak expiratory flow (PEF) was measured preshift and postshift for each worker with a Mini-Wright PEF meter. Personal respirable dust (n=30) and total dust (n=15) were measured with 37-mm Cyclone and 37-mm closed-faced Millipore cassette. Twenty-nine workers had concurrent respirable dust, PEF and questionnaire on the same day.
The geometric means of personal respirable dust and total dust among high exposed were 4.0 and 13.2 mg/m(3), respectively, and 0.7 and 1.0 mg/m(3) among low exposed. High exposed workers had more acute cough, shortness of breath and stuffy nose than the low exposed. Mean percentage cross-shift decrease in PEF was significantly more pronounced among high exposed workers than low exposed (95% CI 1.1, 6.1%). For workers with concurrent respirable dust, PEF and questionnaire assessment, an exposure-response relationship was found between log-transformed respirable dust and percentage cross-shift decrease in PEF (4.5% per unit of log-respirable dust in mg/m(3) ; 95% CI 3.3, 5.6%). Respirable dust exposure >/=2.0 mg/m(3) versus <2.0 mg/m(3) was associated with increased prevalence ratio for cough (7.9) and shortness of breath (4.2). Shortness of breath was associated with the highest sensitivity (0.87) and specificity (0.83) for diagnosing a percentage cross-shift decrease in PEF of >/=10%.
The observed acute respiratory health effects among the workers are most likely due to exposure to high concentrations of irritant cement dust. The results also highlight the usefulness of the questionnaire for health surveillance of the acute respiratory health effect.
在51名高暴露和33名低暴露的男性水泥工中评估水泥粉尘暴露对急性呼吸健康的影响。还评估了该问卷诊断通气功能急性下降的能力。
使用结构化的最佳症状评分问卷通过访谈记录急性呼吸道症状。使用Mini-Wright呼气峰值流量计在每个工人班前和班后测量呼气峰值流量（PEF）。用37毫米旋风仪和37毫米封闭面密理博盒式采样器测量个人可吸入粉尘（n = 30）和总粉尘（n = 15）。29名工人在同一天同时进行了可吸入粉尘、PEF和问卷调查。
高暴露组个人可吸入粉尘和总粉尘的几何均值分别为4.0和13.2毫克/立方米，低暴露组分别为0.7和1.0毫克/立方米。高暴露工人比低暴露工人有更多的急性咳嗽、呼吸急促和鼻塞。高暴露工人PEF跨班下降的平均百分比明显高于低暴露工人（95%CI 1.1，6.1%）。对于同时进行可吸入粉尘、PEF和问卷调查评估的工人，发现对数转换后的可吸入粉尘与PEF跨班下降百分比之间存在暴露-反应关系（每单位对数可吸入粉尘毫克/立方米为4.5%；95%CI 3.3，5.6%）。可吸入粉尘暴露≥2.0毫克/立方米与＜2.0毫克/立方米相比，咳嗽（7.9）和呼吸急促（4.2）的患病率比值增加。呼吸急促对于诊断PEF跨班下降百分比≥10%具有最高的敏感性（0.87）和特异性（0.83）。
观察到的工人急性呼吸健康影响很可能是由于接触高浓度刺激性水泥粉尘所致。结果还突出了该问卷在急性呼吸健康影响健康监测中的有用性。
