Burton Clare M, Crook Brian, Scaife Helena, Evans Gareth S, Barber Christopher M
Centre for Workplace Health, Health and Safety Laboratory, Harpur Hill, Buxton, Derbyshire, UK.
Ann Occup Hyg. 2012 May;56(4):374-88. doi: 10.1093/annhyg/mer121. Epub 2012 Jan 20.
Potential demographic risk factors for outbreaks of respiratory disease due to water-based metalworking fluids (MWFs) were investigated through systematic review of published outbreak investigations.
Search terms were selected by a multidisciplinary team, assisted by an experienced library information service. Several computerized literature databases were searched for articles published between January 1990 and October 2011, relating to ill health outbreaks due to MWFs. Papers meeting the search criteria were reviewed in detail, and their references checked for additional articles. Study design and demographic details of the outbreak were extracted from the selected articles and entered into standardized evidence tables.
Thirty-five articles relating to investigations of 27 outbreaks of respiratory ill health attributed to MWF exposure were identified. The majority of reports were case series of disease or observational cross-sectional studies of symptoms and hygiene measurements. Eight of the outbreak investigations included an element of case-control analysis. Most outbreaks were from the USA, had occurred in large car- or aeronautical-manufacturing plants, and were associated with the use of central shared sumps. Hygiene studies have not demonstrated consistent risk factors for respiratory outbreaks, in terms of the type of MWF utilized, degree of microbial contamination, or levels of personal exposure. Six studies were identified that found workers with MWF exposure during outbreaks were more likely to report respiratory or systemic symptoms than unexposed control workers. Six case-control analyses were also identified that found workers with extrinsic allergic alveolitis (EAA) were more likely to demonstrate certain immune responses to microbial contaminants and/or used MWFs than workers without EAA.
Despite a number of detailed workplace and immunological studies of asthma and alveolitis outbreaks in MWF-exposed workforces, our understanding of their aetiology remains limited.
通过对已发表的疫情调查进行系统回顾，研究了水基金属加工液（MWF）引发呼吸道疾病爆发的潜在人口统计学风险因素。
由一个多学科团队在经验丰富的图书馆信息服务的协助下选择检索词。检索了几个计算机化文献数据库，以查找1990年1月至2011年10月期间发表的与MWF导致的健康不良疫情相关的文章。对符合检索标准的论文进行了详细审查，并检查其参考文献以查找其他文章。从选定的文章中提取疫情的研究设计和人口统计学细节，并录入标准化证据表。
确定了35篇与27起归因于MWF暴露的呼吸道健康不良疫情调查相关的文章。大多数报告是疾病病例系列或症状与卫生测量的观察性横断面研究。八项疫情调查包括病例对照分析的内容。大多数疫情发生在美国，发生在大型汽车或航空制造工厂，并且与使用中央共享油槽有关。就所使用的MWF类型、微生物污染程度或个人暴露水平而言，卫生研究尚未证明呼吸道疫情存在一致的风险因素。六项研究发现，在疫情期间接触MWF的工人比未接触的对照工人更有可能报告呼吸道或全身症状。还确定了六项病例对照分析，发现患有外源性过敏性肺泡炎（EAA）的工人比没有EAA的工人更有可能对微生物污染物和/或使用的MWF表现出某些免疫反应。
尽管对接触MWF的劳动力中的哮喘和肺泡炎疫情进行了许多详细的工作场所和免疫学研究，但我们对其病因的了解仍然有限。
