Roach S A, Rappaport S M
Northern California Occupational Health Center, School of Public Health, University of California, Berkeley 94720.
Am J Ind Med. 1990;17(6):727-53. doi: 10.1002/ajim.4700170607.
Threshold Limit Values (TLVs) represent conditions under which the TLV Committee of the American Conference of Governmental Industrial Hygienists (ACGIH) believes that nearly all workers may be repeatedly exposed without adverse effect. A detailed research was made of the references in the 1976 Documentation to data on "industrial experience" and "experimental human studies." The references, sorted for those including both the incidence of adverse effects and the corresponding exposure, yielded 158 paired sets of data. Upon analysis it was found that, where the exposure was at or below the TLV, only a minority of studies showed no adverse effects (11 instances) and the remainder indicated that up to 100% of those exposed had been affected (8 instances of 100%). Although, the TLVs were poorly correlated with the incidence of adverse effects, a surprisingly strong correlation was found between the TLVs and the exposures reported in the corresponding studies cited in the Documentation. Upon repeating the search of references to human experience, at or below the TLVs, listed in the more recent, 1986 edition of the Documentation, a very similar picture has emerged from the 72 sets of clear data which were found. Again, only a minority of studies showed no adverse effects and TLVs were poorly correlated with the incidence of adverse effect and well correlated with the measured exposure. Finally, a careful analysis revealed that authors' conclusions in the references (cited in the 1976 Documentation) regarding exposure-response relationships at or below the TLVs were generally found to be at odds with the conclusions of the TLV Committee. These findings suggest that those TLVs which are justified on the basis of "industrial experience" are not based purely upon health considerations. Rather, those TLVs appear to reflect the levels of exposure which were perceived at the time to be achievable in industry. Thus, ACGIH TLVs may represent guides of levels which have been achieved, but they are certainly not thresholds.
阈限值(TLVs)代表了美国政府工业卫生学家会议(ACGIH)的TLV委员会认为几乎所有工人都可反复接触而无不良影响的条件。对1976年文献中关于“工业经验”和“人体实验研究”数据的参考文献进行了详细研究。对那些既包括不良影响发生率又包括相应接触水平的参考文献进行分类后,得到了158组配对数据。经分析发现,当接触水平等于或低于阈限值时,只有少数研究显示无不良影响(11例),其余研究表明高达100%的接触者受到了影响(有8例为100%)。尽管阈限值与不良影响发生率的相关性很差,但在文献中引用的相应研究报告的接触水平与阈限值之间却发现了惊人的强相关性。在对1986年版文献中列出的等于或低于阈限值的人体经验参考文献再次进行检索时,从找到的72组明确数据中出现了非常相似的情况。同样,只有少数研究显示无不良影响,阈限值与不良影响发生率的相关性很差,而与测量的接触水平相关性良好。最后,仔细分析发现,参考文献(1976年文献中引用)中作者关于等于或低于阈限值时的接触-反应关系的结论通常与TLV委员会的结论不一致。这些发现表明,那些基于“工业经验”确定的阈限值并非纯粹基于健康考虑。相反,那些阈限值似乎反映了当时认为在工业中可以达到的接触水平。因此,ACGIH阈限值可能代表了已达到的水平的指导值,但它们肯定不是阈限值。