van Rooy F G B G J, Smit L A M, Houba R, Zaat V A C, Rooyackers J M, Heederik D J J
Division of Environmental Epidemiology, Institute for Risk Assessment Sciences, PO Box 80.178, NL-3508 TD Utrecht, The Netherlands.
Occup Environ Med. 2009 Feb;66(2):105-10. doi: 10.1136/oem.2008.039560. Epub 2008 Sep 19.
Four diacetyl workers were found to have bronchiolitis obliterans syndrome. Exposures, respiratory symptoms, lung function and exposure-response relationships were investigated.
175 workers from a plant producing diacetyl between 1960 and 2003 were investigated. Exposure data were used to model diacetyl exposure. Lung function and questionnaire data on respiratory symptoms were compared to a general population sample and respiratory symptoms to an internal reference group.
Workers were potentially exposed to acetoin, diacetyl, acetaldehyde and acetic acid. Historic diacetyl exposure ranged from 1.8 to 351 mg/m(3), and from 3 to 396 mg/m(3) for specific tasks. Diacetyl workers reported significantly more respiratory symptoms compared to the general population sample (continuous trouble with breathing (prevalence ratio (PR) = 2.6; 95% CI 1.3 to 5.1), daily cough (PR = 1.5; 95% CI 1.1 to 2.1), asthma attack (ever) (PR = 2.0; 95% CI 1.2 to 3.4), doctor diagnosed asthma (PR = 2.2; 95% CI 1.3 to 3.8) and asthma attack in the last year (PR = 4.7; 95% CI 1.9 to 11.4)) and to a minimally exposed internal reference group (ever trouble with breathing (PR = 2.8; 95% CI 1.1 to 7.0) and work-related shortness of breath in the last year (PR = 7.5; 95% CI 1.1 to 52.9)). Lung function did not differ between groups. A positive relationship between exposure and FEV(1) was found.
The excess of respiratory symptoms in this retrospective cohort suggests that diacetyl production poses an occupational hazard. Limited historical exposure data did not support a quantitative individual diacetyl exposure-response relationship, but our findings suggest that preventive measures are prudent.
发现4名二乙酰工人患有闭塞性细支气管炎综合征。对暴露情况、呼吸道症状、肺功能及暴露-反应关系进行了调查。
对1960年至2003年间一家生产二乙酰的工厂的175名工人进行了调查。使用暴露数据对二乙酰暴露进行建模。将肺功能和呼吸道症状问卷数据与一般人群样本进行比较，并将呼吸道症状与内部低暴露参考组进行比较。
工人可能接触到乙偶姻、二乙酰、乙醛和乙酸。历史二乙酰暴露范围为1.8至351毫克/立方米，特定任务的暴露范围为3至396毫克/立方米。与一般人群样本相比，二乙酰工人报告的呼吸道症状明显更多（持续呼吸问题（患病率比（PR）=2.6；95%可信区间1.3至5.1）、每日咳嗽（PR=1.5；95%可信区间1.1至2.1）、哮喘发作（既往）（PR=2.0；95%可信区间1.2至3.4）、医生诊断的哮喘（PR=2.2；95%可信区间1.3至3.8）以及去年的哮喘发作（PR=4.7；95%可信区间1.9至11.4）），与低暴露内部参考组相比也是如此（既往呼吸问题（PR=2.8；95%可信区间1.1至7.0）以及去年与工作相关的呼吸急促（PR=7.5；95%可信区间1.1至52.9））。各组之间肺功能无差异。发现暴露与第一秒用力呼气容积（FEV₁）之间存在正相关关系。
该回顾性队列中呼吸道症状过多表明二乙酰生产存在职业危害。有限的历史暴露数据不支持个体二乙酰暴露-反应关系的定量分析，但我们的研究结果表明采取预防措施是明智的。
