Henneberger P K, Eisen E A, Ferris B G
Occupational Health Program, Harvard School of Public Health, Boston, Massachusetts 02115.
Br J Ind Med. 1989 Nov;46(11):765-72. doi: 10.1136/oem.46.11.765.
Pulmonary function was studied among pulp and paper workers from a production facility in New Hampshire. Subjects were first tested in the 1960s and then surveyed at regular intervals up to 1985. The current study examined results for the 339 subjects who participated in at least one of the two most recent follow up surveys in 1979 and 1985. For the 171 subjects who were tested in both surveys, the pulmonary function values were higher and the effect of pulp mill work was diminished compared with the findings for the 168 subjects who were tested in just one of the two surveys. To avoid the loss of less healthy subjects and the subsequent bias in effect estimate, the 1985 data were analysed cross sectionally with the inclusion of data from 1979 for those subjects who had not been followed up in the last survey. The subjects with work experience in the pulp mill had mean levels of forced expiratory volume in one second (FEV1) and forced vital capacity (FVC) lower than those of unexposed subjects who had never worked in the pulp or paper production areas. Based on parameter estimates from regression analysis, each year of employment in the pulp operation was associated with a -5.8 ml change in FEV1 (p = 0.08) and a -7.2 ml change in FVC (p = 0.04). Ninety one per cent of the subjects with pulp mill experience had terminated employment in that area of the company, so the association with decreased lung function appears to be a non-reversible effect that persisted after the cessation of exposure.
对新罕布什尔州一家生产工厂的纸浆和造纸工人的肺功能进行了研究。研究对象在20世纪60年代首次接受测试，之后定期接受调查，直至1985年。当前的研究考察了参与1979年和1985年这两次最新随访调查中至少一次的339名研究对象的结果。在两次调查中都接受测试的171名研究对象，其肺功能值更高，与仅在两次调查中的一次接受测试的168名研究对象的结果相比，纸浆厂工作的影响有所减弱。为避免健康状况较差的研究对象流失以及随后效应估计中的偏差，对1985年的数据进行了横断面分析，纳入了在最后一次调查中未接受随访的研究对象1979年的数据。有纸浆厂工作经历的研究对象的一秒用力呼气量（FEV1）和用力肺活量（FVC）的平均水平低于从未在纸浆或造纸生产区域工作过的未暴露研究对象。根据回归分析的参数估计，在纸浆生产中每工作一年，FEV1的变化为-5.8毫升（p = 0.08），FVC的变化为-7.2毫升（p = 0.04）。有纸浆厂工作经历的研究对象中有91%已终止在公司该领域的工作，因此肺功能下降的关联似乎是一种在接触停止后仍持续存在的不可逆效应。
