Calisti R, Sgarzi A, Ardissone S, Bernardi P, Di Federico E, De Ruggiero N
Servizio di Medicina Preventiva e Igiene del Lavoro USL 27, Bologna Ovest.
Med Lav. 1991 Jan-Feb;82(1):30-7.
The paper reports a case of asbestosis in a truck driver whose anamnesis, at first, revealed no evidence of previous exposure to asbestos, whether occupational or extra occupational. A pleuro-pulmonary fibrosis was discovered in 1987, following an episode of exudative pleurisy on the right side. The thickened pleura was then surgically removed. In the samples of pleuro-pulmonary fibroid tissue taken during the operation, typical asbestos bodies were demonstrated in optical microscopy. The analysis of possible exposure to asbestos that might not have been referred in the anamnesis revealed that in at least six widely used truck models (of which three were driven by the worker from 1958 to 1984), the presence of an asbestos winding around a manifold found on the bottom or on the side of the engine. In such trucks, the engine is inside the driver's cab, covered by a cowling set on the floor. Asbestos fibers could enter the driver's cab through a little window in the cowling or through outlets in the dashboard, carried by the airflow generated by the big fan at the back of the radiator and by the truck motion itself. The window or the outlets remained open during cold periods of the year to allow the air, warmed by the motor, to enter the driver's cab.
该论文报道了一名卡车司机患石棉沉着病的病例。该司机的既往史起初未显示有过职业性或非职业性石棉接触史。1987年，在右侧发生渗出性胸膜炎后，发现了胸膜肺纤维化。随后手术切除了增厚的胸膜。在手术中获取的胸膜肺纤维瘤组织样本中，光学显微镜下发现了典型的石棉小体。对既往史中可能未提及的石棉接触情况进行分析后发现，至少在六种广泛使用的卡车车型中（其中三种是该工人在1958年至1984年期间驾驶的），发动机底部或侧面的歧管周围存在石棉缠绕。在这类卡车中，发动机位于驾驶室内，由安装在地板上的整流罩覆盖。石棉纤维可通过整流罩上的小窗口或仪表板上的通风口进入驾驶室，由散热器后部的大风扇产生的气流以及卡车自身的运动携带。在一年中的寒冷时期，窗口或通风口保持打开状态，以便发动机加热的空气进入驾驶室。
