尸检中的铂矿工人矽肺。

Silicosis at autopsy in platinum mine workers.

机构信息

National Institute for Occupational Health, National Health Laboratory Service, Johannesburg, South Africa.

出版信息

Occup Med (Lond). 2013 Apr;63(3):196-202. doi: 10.1093/occmed/kqs211. Epub 2013 Feb 7.

Abstract

BACKGROUND

South Africa is the largest producer of platinum group metals in the world. Platinum is found in the Bushveld Complex in the north-east of the country. This volcanic intrusion contains many other minerals, including crystalline silica. Little is known about the health risks in the platinum mining industry.

AIMS

To explore the potential for platinum mine workers to develop silicosis.

METHODS

Autopsies are performed at the National Institute for Occupational Health, for compensation purposes. Platinum mine workers, who had worked for more than a year and had silicosis and/or fibrotic nodules in the lymph nodes, were identified from the autopsy database. An exhaustive search of other available data sources was undertaken to exclude exposure to silica dust in the gold mining industry.

RESULTS

Eighty-five of 3863 (2.2%) platinum mine workers employed for more than a year had silicosis at autopsy; an additional 490 (12.7%) had fibrotic nodules in the lymph nodes. After reviewing all data sources, five mine workers with silicosis and 25 with fibrotic nodules in the lymph nodes fulfilled the study inclusion criteria.

CONCLUSIONS

This case series supports the suggestion that there is a risk of silica exposure in platinum mine workers, a hypothesis supported by the few silica dust measurements taken in the platinum mines. The mining companies should be cognisant of this risk. The recording of comprehensive work histories and the routine measurement of silica dust levels should be enforced to enable risk of disease to be quantified in future studies.

摘要

背景

南非是世界上最大的铂族金属生产国。铂存在于该国东北部的布什维尔德杂岩体中。这种火山侵入体含有许多其他矿物质,包括结晶二氧化硅。对于铂矿开采行业的健康风险知之甚少。

目的

探索铂矿工人患矽肺的可能性。

方法

国家职业健康研究所进行尸检是为了赔偿目的。从尸检数据库中确定了在铂矿工作一年以上且患有矽肺和/或淋巴结纤维化结节的矿工。对其他可用数据源进行了详尽的搜索,以排除在金矿开采行业接触二氧化硅粉尘的可能性。

结果

在 3863 名工作一年以上的铂矿工人中,有 85 人(2.2%)在尸检时患有矽肺;另有 490 人(12.7%)淋巴结有纤维化结节。在审查了所有数据源后,有 5 名患有矽肺的矿工和 25 名患有淋巴结纤维化结节的矿工符合研究纳入标准。

结论

本病例系列支持铂矿工人存在接触二氧化硅风险的假设,这一假设得到了在铂矿中进行的少量二氧化硅粉尘测量的支持。采矿公司应该意识到这一风险。应记录全面的工作经历并定期测量二氧化硅粉尘水平,以便在未来的研究中量化疾病风险。

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