Donham K J, Merchant J A, Lassise D, Popendorf W J, Burmeister L F
Department of Preventive Medicine and Environmental Health, University of Iowa, Iowa City 52242.
Am J Ind Med. 1990;18(3):241-61. doi: 10.1002/ajim.4700180303.
A combined epidemiological and intervention study was conducted on 207 swine confinement farmers with matched comparison subjects. The objectives of the study were to define, in detail, the nature and disease determinants in this exposed group and to explore methods of disease prevention. This 5 year prospective study included three annual medical assessments of workers and complementary work environment assessments. Between the first and second assessment periods, an in-depth educational intervention was conducted. An industrial hygiene consultation intervention was conducted between the second and third measurement periods. Outcome measurements included changes in knowledge, attitudes, and behavior following educational intervention. Additionally, the outcomes measured included changes in medical and environmental assessment over the 3 year assessment periods. Results of the baseline respiratory symptoms assessment are reported here. Nearly 20% of swine confinement workers reported chronic cough, and 25% reported phlegm (American Thoracic Society questionnaire). Both symptoms were significantly more prevalent in the confinement workers compared to a blue collar comparison group, but only phlegm production was more prevalent compared to nonconfinement farmers. Work-related symptoms were reported much more frequently than chronic symptoms (e.g., 87% of confinement workers reported work-related cough). Bronchitis as well as airways reactivity were all significantly more prevalent in confinement workers compared to nonconfinement workers. Smoking seemed to have an additive effect with confinement exposure. Bronchitis and chest tightness symptoms were reported to be more severe upon return to work after an absence of 7 days or more. Finally, 34% of workers reported episodes of organic dust toxic syndrome.
对207名养猪场饲养员及其匹配的对照对象进行了一项流行病学与干预相结合的研究。该研究的目的是详细确定这一暴露群体中的疾病性质和决定因素，并探索疾病预防方法。这项为期5年的前瞻性研究包括对工人进行三次年度医学评估以及对工作环境进行补充评估。在第一次和第二次评估期间，进行了深入的教育干预。在第二次和第三次测量期间，进行了工业卫生咨询干预。结果测量包括教育干预后知识、态度和行为的变化。此外，测量的结果还包括3年评估期内医学和环境评估的变化。本文报告了基线呼吸症状评估的结果。近20%的养猪场饲养员报告有慢性咳嗽，25%报告有咳痰（美国胸科学会问卷）。与蓝领对照组相比，这两种症状在饲养员中更为普遍，但与非饲养场农民相比，只有咳痰更为普遍。与慢性症状相比，与工作相关的症状报告更为频繁（例如，87%的饲养员报告有与工作相关的咳嗽）。与非饲养场工人相比，支气管炎和气道反应性在饲养场工人中更为普遍。吸烟似乎与饲养场暴露有叠加效应。据报告，缺勤7天或更长时间后重返工作岗位时，支气管炎和胸闷症状更为严重。最后，34%的工人报告有有机粉尘中毒综合征发作。
