O'Neil C E
Tulane Medical Center, New Orleans, Louisiana 70112.
Am J Med Sci. 1990 Apr;299(4):265-75. doi: 10.1097/00000441-199004000-00009.
Inhaled low molecular weight chemicals (LMWC) encountered in the work-place can induce airways disease. Most LMWC are irritants and if exposure levels are high enough or if there is extended exposure, can cause inflammation of the eyes, respiratory tract, and alveolar membrane without class specific antibody production or involvement of cellular mechanisms. Reflex or inflammatory bronchoconstriction may result. At lower concentrations, some of these LMWC are haptenic and induce respiratory symptoms by immune mechanisms. Dose and duration of exposure, as well as physiochemical properties of the agent and host factors, influence the effect that a given agent may have on an individual. It is important to distinguish between irritant and hypersensitivity responses for diagnostic purposes and for subsequent patient management. However, long term effects of sub-lethal exposure to primary irritants, such as SO2 or chemicals which are irritants at high concentrations but can also induce antibody formation, such as the isocyanates and acid anhydrides, are not clear.
在工作场所接触到的吸入性低分子量化学物质（LMWC）可引发气道疾病。大多数LMWC是刺激性物质，如果接触水平足够高或接触时间延长，可导致眼睛、呼吸道和肺泡膜炎症，而不会产生特定类别抗体或涉及细胞机制。可能会导致反射性或炎症性支气管收缩。在较低浓度下，其中一些LMWC具有半抗原性，并通过免疫机制诱发呼吸道症状。接触剂量和持续时间，以及化学物质的理化性质和宿主因素，会影响特定化学物质对个体的影响。为了诊断目的和后续患者管理，区分刺激性反应和超敏反应很重要。然而，亚致死剂量的主要刺激性物质（如二氧化硫）或高浓度时具有刺激性但也能诱导抗体形成的化学物质（如异氰酸酯和酸酐）的长期影响尚不清楚。
