Graham W G, Ashikaga T, Hemenway D, Weaver S, O'Grady R V
Pulmonary Division, Biometry Facility, University of Vermont, Burlington.
Chest. 1991 Dec;100(6):1507-14. doi: 10.1378/chest.100.6.1507.
The issue of whether low levels of granite dust exposure lead to radiographic abnormalities after a lifetime of exposure has not been settled. In 1983, we carried out a radiographic survey of the Vermont granite industry, consisting of quarry and stone shed workers who had been exposed to the low dust levels prevailing in the industry since 1938 to 1940. Films were read by three "B" readers, using the ILO classification system, which requires the identification of both rounded and irregular opacities, as well as combinations of both. X-ray films were taken of 972 workers, out of a total work force of approximately 1,400. Of these films, 28 (3 percent) were interpreted by either two or three of the three readers as showing abnormalities consistent with pneumoconiosis. Only seven films (or 0.7 percent of the entire cohort) showed nodular or rounded opacities of the type typically seen in uncomplicated silicosis. The remainder of the abnormal x-ray films showed irregular opacities, largely in the lower lung zones, which are of uncertain significance, but may be related to heavy cigarette smoking and aging, and possibly dust inhalation. In addition, total gravimetric dust concentrations in the workplace were measured; 417 respirable-size mass samples showed concentrations of 601 micrograms/cu m +/- 368 micrograms/cu m. Using previously published estimates of 10 percent quartz in granite dust, the average quartz concentration was 60 micrograms/cu m. Twelve percent of the samples exceeded 100 micrograms/cu m, the current OSHA standard for quartz. We conclude that control of quartz exposure in the Vermont granite industry to levels which are on average less than the current OSHA standard has essentially eliminated definite radiographic changes of silicosis. The significance of the irregular opacities in the lower lung zones seen on a majority of the 28 x-ray films judged to be abnormal is not clear.
低水平的花岗岩粉尘暴露在一生的接触后是否会导致影像学异常这一问题尚未得到解决。1983年,我们对佛蒙特州花岗岩行业进行了一次影像学调查,调查对象包括自1938年至1940年以来接触该行业普遍存在的低粉尘水平的采石场和石棚工人。由三位“B”级阅片师使用国际劳工组织(ILO)分类系统阅读胸片,该系统要求识别圆形和不规则形的不透光区以及两者的组合。在约1400名总劳动力中,对972名工人进行了X光片拍摄。在这些胸片中,三位阅片师中有两位或三位将其中28张(3%)解读为显示与尘肺病相符的异常。只有7张胸片(占整个队列的0.7%)显示出典型的单纯矽肺中所见的结节状或圆形不透光区。其余异常胸片显示不规则不透光区,主要位于肺下区,其意义尚不确定,但可能与大量吸烟、衰老以及可能的粉尘吸入有关。此外,还测量了工作场所的总重量粉尘浓度;417份可吸入粒径质量样本显示浓度为601微克/立方米±368微克/立方米。根据先前公布的花岗岩粉尘中石英含量为10%的估计值,平均石英浓度为60微克/立方米。12%的样本超过了目前职业安全与健康管理局(OSHA)规定的石英标准100微克/立方米。我们得出结论,将佛蒙特州花岗岩行业的石英暴露控制在平均低于当前OSHA标准的水平,基本上消除了矽肺明确的影像学改变。在判定为异常的28张胸片中,大多数胸片上肺下区出现的不规则不透光区的意义尚不清楚。