Shearer S
Gold Fields West Hospital, Westonaria, South Africa.
Am J Ind Med. 1990;17(2):225-39. doi: 10.1002/ajim.4700170207.
A study was made on the hydration and serum electrolyte changes in 55 black underground gold miners who presented with heat disorders, and control data were obtained on 52 surface and 50 underground workers without symptoms. Cases were admitted for assessment and treatment, and a questionnaire was administered on symptoms, work, fluid intake, alcohol intake, recent health, and past history of heat disorders. Twenty-eight men had experienced heat disorders in the past. Blood specimens on days 0, 1, 2, and 7 for serum sodium, potassium, magnesium, calcium, inorganic phosphate, and serum total protein were obtained from 55 cases, of which 22 also had estimations of hemoglobin and hematocrit. Initial serum electrolyte levels, because of hemoconcentration, were found to be a poor indicator of underlying changes. Changes in serum total protein were used to correct electrolyte levels for dehydration, which showed deficits in serum total sodium and potassium. This method of correction, when compared with one using hemoglobin and hematocrit, showed similar but smaller changes in serum electrolytes. The cases were divided into subgroups of "cramps" and "collapse"; no significant differences were seen in ambient conditions, age, or electrolyte changes. The cramps group, however, had drunk significantly more water. The findings overall were those of dehydration and salt depletion.
对55名出现热紊乱症状的黑人地下金矿工人的水合作用和血清电解质变化进行了研究，并获取了52名无症状的地面工人和50名地下工人的对照数据。这些病例入院接受评估和治疗，并填写了一份关于症状、工作、液体摄入量、酒精摄入量、近期健康状况以及热紊乱病史的问卷。28名男性过去曾经历过热紊乱。从55例病例中采集了第0、1、2和7天的血液标本，检测血清钠、钾、镁、钙、无机磷和血清总蛋白，其中22例还检测了血红蛋白和血细胞比容。由于血液浓缩，初始血清电解质水平被发现不能很好地反映潜在变化。血清总蛋白的变化用于校正脱水引起的电解质水平，结果显示血清总钠和钾存在缺乏。与使用血红蛋白和血细胞比容的校正方法相比，这种校正方法显示血清电解质的变化相似但较小。病例被分为“痉挛”和“虚脱”亚组；在环境条件、年龄或电解质变化方面未观察到显著差异。然而，痉挛组饮用的水量明显更多。总体研究结果显示存在脱水和盐分缺乏。
