Jönsson Lena S, Tinnerberg Håkan, Jacobsson Helene, Andersson Ulla, Axmon Anna, Nielsen Jørn
Division of Occupational and Environmental Medicine, Lund University Hospital, 22185, Lund, Sweden.
Medical Statistics and Epidemiology Unit, R&D Centre Skåne, Skåne University Hospital, Lund, Sweden.
Int Arch Occup Environ Health. 2015 Nov;88(8):1131-40. doi: 10.1007/s00420-015-1041-2. Epub 2015 Mar 6.
We aimed to follow diary-registered symptoms from eyes and airways in mild steel welders and relate them to different exposure measures. Furthermore, we would clarify the influence of possible effect modifiers.
Non-smoking welders with (N = 74) and without (N = 32) work-related symptoms the last month were enroled. Symptoms and work tasks each day for three two-week periods during 1 year were obtained. Respirable dust (RD) was measured 1 day each period for each worker. The personal daily exposure was assessed as: (1) days at work, (2) welding time and (3) estimates of RD from welding and grinding, calculated from diary entries and measurements.
Only 9.2 % of the particle measurements exceed the Swedish occupational exposure limit (OEL; 5 mg/m(3)). Days at work increased the risk of symptoms studied: eyes: 1.79 (1.46-2.19), nasal: 2.16 (1.81-2.58), dry cough: 1.50 (1.23-1.82) and wheezing and/or dyspnoea: 1.27 (1.03-1.56; odds ratio, 95 % confidence interval). No clear dose-response relationships were found for the other exposure estimates. Eye symptoms increased by number of years welding. Nasal symptoms and dry cough increased having forced expiratory volume in first second below median at baseline. Wheezing and/or dyspnoea increased in winter, by number of years welding, having a negative standard skin-prick test and having a vital capacity above median at baseline.
The current Swedish OEL may not protect welders against eye and airway symptoms. The results add to the evidence that welders should be offered regular medical surveillance from early in the career.
我们旨在追踪低碳钢焊工眼部和呼吸道的日记记录症状，并将其与不同的接触测量指标相关联。此外，我们将阐明可能的效应修饰因素的影响。
招募了上个月有（N = 74）和无（N = 32）与工作相关症状的非吸烟焊工。获取了1年中三个为期两周的时间段内每天的症状和工作任务。每个工人在每个时间段内的1天测量可吸入粉尘（RD）。个人每日接触量评估如下：（1）工作日天数，（2）焊接时间，以及（3）根据日记记录和测量计算得出的焊接和打磨产生的RD估计值。
仅9.2%的颗粒物测量值超过瑞典职业接触限值（OEL；5毫克/立方米）。工作日天数增加了所研究症状的风险：眼部：1.79（1.46 - 2.19），鼻部：2.16（1.81 - 2.58），干咳：1.50（1.23 - 1.82），喘息和/或呼吸困难：1.27（1.03 - 1.56；比值比，95%置信区间）。对于其他接触估计值，未发现明确的剂量反应关系。眼部症状随焊接年限增加而增加。鼻部症状和干咳在基线时第一秒用力呼气量低于中位数时增加。喘息和/或呼吸困难在冬季增加，随焊接年限增加，皮肤点刺试验为阴性且基线时肺活量高于中位数时增加。
当前瑞典的OEL可能无法保护焊工免受眼部和呼吸道症状的影响。这些结果进一步证明，应在焊工职业生涯早期就为其提供定期医疗监测。
