Sames Chris, Gorman Des F, Mitchell Simon J, Gamble Greg
Medical Officer to the Royal New Zealand Naval Health Service and involved in the Diving Medical Directorate to the New Zealand Department of Labour.
Diving Hyperb Med. 2009 Sep;39(3):133-7.
Long-term effects of occupational diving on lung function are uncertain. No previous study has been conducted on New Zealand occupational divers. The aim of this study was to investigate changes in divers' lung function over a five year period.
The lung function data of all occupational divers with two spirometric determinations separated by a five year interval (N = 336 out of 1,475 currently registered divers) were entered into a database and analysed for changes (5.6 years mean). The trends were correlated against gender, smoking status and years of diving experience (as more accurate diving exposure data were not available). Spirometric indices were compared with predicted reference values derived from New Zealand (WRS), Australian (Gore), and American (NHANES III and Knudson) populations.
Small, but signifi cant, decreases were found in FEV1 (0.27% against predicted per annum, P = 0.02) and PEF (0.47% per annum, P = 0.04) using the NHANES III equations. No other changes in lung function parameters reached statistical significance (P < 0.05) using any of the four sets of prediction equations. No changes correlated significantly with reported years diving.
Observed changes to occupational divers' lung function tests over 5.6 years were small and unrelated to years of diving, which might be due to a 'healthy worker effect'. Clinical relevance is unlikely, but this requires further evaluation. There was significant disparity in normative values derived from the four sets of prediction equations and there is some consequential concern about the ongoing utility of such surveillance of New Zealand professional divers.
职业潜水对肺功能的长期影响尚不确定。此前尚未对新西兰职业潜水员进行过研究。本研究的目的是调查潜水员在五年期间肺功能的变化。
将所有间隔五年进行两次肺活量测定的职业潜水员的肺功能数据（在1475名当前注册的潜水员中，有336名）录入数据库，并分析其变化情况（平均5.6年）。将这些趋势与性别、吸烟状况和潜水经验年限进行相关性分析（由于没有更准确的潜水暴露数据）。将肺活量指标与来自新西兰（WRS）、澳大利亚（戈尔）和美国（NHANES III和克努森）人群的预测参考值进行比较。
使用NHANES III方程发现，第一秒用力呼气容积（FEV1，每年相对于预测值下降0.27%，P = 0.02）和呼气峰值流速（PEF，每年下降0.47%，P = 0.04）有小幅但显著的下降。使用四组预测方程中的任何一组，肺功能参数的其他变化均未达到统计学显著性（P < 0.05）。没有变化与报告的潜水年限有显著相关性。
在5.6年期间观察到的职业潜水员肺功能测试变化很小，且与潜水年限无关，这可能是由于“健康工人效应”。临床相关性不太可能，但这需要进一步评估。四组预测方程得出的标准值存在显著差异，因此对新西兰职业潜水员进行此类监测的持续效用存在一些担忧。
