Love R G, Muirhead M, Collins H P, Soutar C A
Institute of Occupational Medicine, Edinburgh.
Br J Ind Med. 1991 Apr;48(4):221-8. doi: 10.1136/oem.48.4.221.
The relations of lung function and chest radiographic appearances with exposure to inspirable dust were examined in 634 workers in five wool textile mills in west Yorkshire, randomly selected to represent fully the range of current exposures to wool mill dust. Most of these workers could be categorised into three large sex and ethnic groups; European men, Asian men, and Asian women. Exposures to inspirable dust had been measured at a previous survey and time spent in current job, and in the industry were used as surrogates for lifetime cumulative exposures. Chest radiographs were interpreted on the International Labour Office (ILO) scale by three medically qualified readers, and the results combined. Profusions of small opacities of 0/1 on the ILO scale, or greater, were present in only 6% of the population, and were not positively associated with current exposure to wool mill dust, or duration of exposure. In general, statistically significant relations between exposure and lung function indices were not found, with the exception of an inverse relation between the forced expiratory volume/forced vital capacity ratio and dust concentration in European women. A suggestive but not statistically significant inverse relation between FVC and current dust concentration was seen in Asian men. Substantial differences were found between mills in mean values of lung function variables after adjustment for other factors but these were not apparently related to the differences in dust concentrations between these mills. Dyeworkers and wool scourers (mostly European men in relatively dust free jobs) on average experienced an FEV1 251 ml lower than other workers when age, height, smoking habits, and occupational factors had been taken into account. Twenty four per cent of the workforce responded to intracutaneous application of one or more common allergens (weal diameter at least 4 mm), only 12 (7.9%) of these responding to wool extracts. Atopic subjects did not appear to have an increased susceptibility to the effects of inspirable wool dust on lung function. These studies suggest that exposure to wool mill dust may cause functional impairment in some workers but there is little indication from these data of frequent or severe dust related functional deficits. More detailed estimates of cumulative dust exposure by reconstruction of exposure histories might clarify associations between exposure to dust and lung function. These chest radiographic findings provide no evidence that exposure to wool mill dust is related to lung fibrosis.
在西约克郡的五家毛纺织厂的634名工人中,研究了肺功能和胸部X光表现与可吸入粉尘暴露之间的关系。这些工人是随机挑选的,以充分代表当前毛纺织厂粉尘暴露的范围。这些工人大多可分为三个大的性别和种族群体:欧洲男性、亚洲男性和亚洲女性。在之前的一项调查中测量了可吸入粉尘的暴露量,并将当前工作时间和在该行业的工作时间用作终身累积暴露量的替代指标。由三名具备医学资质的阅片者按照国际劳工组织(ILO)标准解读胸部X光片,并汇总结果。在ILO标准下,小阴影密集度为0/1或更高的情况仅在6%的人群中出现,且与当前毛纺织厂粉尘暴露或暴露时长无正相关。总体而言,未发现暴露与肺功能指标之间存在统计学显著关系,但欧洲女性的用力呼气量/用力肺活量比值与粉尘浓度呈负相关。在亚洲男性中,观察到用力肺活量(FVC)与当前粉尘浓度之间存在提示性但无统计学显著性的负相关。在对其他因素进行调整后,各工厂肺功能变量的平均值存在显著差异,但这些差异显然与各工厂粉尘浓度的差异无关。考虑年龄、身高、吸烟习惯和职业因素后,染色工人和洗毛工人(大多为从事相对无尘工作的欧洲男性)的平均第一秒用力呼气容积(FEV1)比其他工人低251毫升。24%的劳动力对一种或多种常见变应原的皮内注射有反应(风团直径至少4毫米),其中只有12人(7.9%)对羊毛提取物有反应。特应性个体似乎对可吸入羊毛粉尘对肺功能的影响没有更高的易感性。这些研究表明,接触毛纺织厂粉尘可能会导致一些工人出现功能损害,但从这些数据中几乎没有迹象表明存在频繁或严重的与粉尘相关的功能缺陷。通过重建暴露史对累积粉尘暴露进行更详细的估计,可能会阐明粉尘暴露与肺功能之间的关联。这些胸部X光检查结果没有提供证据表明接触毛纺织厂粉尘与肺纤维化有关。