DoPico G A, Reddan W, Flaherty D, Tsiatis A, Peters M E, Rao P, Rankin J
Am Rev Respir Dis. 1977 Jun;115(6):915-27. doi: 10.1164/arrd.1977.115.6.915.
A survey of 300 grain elevator workers revealed that 77 per cent complained of eye symptoms; 64 per cent, of nasal symptoms; and 88 per cent, of one or more respiratory symptoms on exposure to airborne grain dust. Symptoms on exposure were independent of age and length of employment. Cough and wheezing on exposure were more common among smokers than nonsmokers (P less than 0.025). Nineteen per cent of the workers had had episodes of grain fever. The prevalence of chronic bronchitis was 37 per cent (42 per cent of smokers and 30 per cent of nonsmokers). Wheezes on auscultation were found in 23 per cent. Measurements of lung ventilatory function, as well as diffusing capacity, correlated significantly with age and smoking habits, but not with length of employment. Thirty-seven per cent of the workers had an abnormal mean forced expiratory flow during the middle half of the forced vital capacity (47 per cent of smokers and 13 per cent of nonsmokers), and 34 per cent had an abnormal maximal expiratory flow after exhalation of 50 per cent of the forced vital capacity (40 per cent of smokers and 13 per cent of nonsmokers), whereas only 13 per cent had an abnormal ratio of 1-sec forced expiratory volume to forced vital capacity. There was no correlation between precipitins to fungi, bacteria, grain, or grain dust antigens and acute or chronic respiratory symptoms, lung function, or grain fever. There was, however, a significant correlation between cutaneous reactivity to grain dust and wheezing on exposure (P less than 0.02). Abnormal flows at low lung volumes were more common among cutaneous reactors to common allergens. We concluded that exposure to airborne grain dust can cause acute inflammatory reaction to the exposed mucosa, and it is highly probable that grain dust contributes and, in some cases, causes chronic airway disease.
对300名谷物升降机工人的调查显示，77%的人抱怨有眼部症状；64%的人有鼻部症状；88%的人在接触空气中的谷物粉尘时出现一种或多种呼吸道症状。接触粉尘时出现的症状与年龄和工作年限无关。接触粉尘时咳嗽和喘息在吸烟者中比不吸烟者更常见（P<0.025）。19%的工人曾有谷物热发作。慢性支气管炎的患病率为37%（吸烟者中为42%，不吸烟者中为30%）。听诊时有哮鸣音的占23%。肺通气功能以及弥散能力的测量结果与年龄和吸烟习惯显著相关，但与工作年限无关。37%的工人在用力肺活量的中间一半时间内平均用力呼气流量异常（吸烟者中为47%，不吸烟者中为13%），34%的工人在呼出50%用力肺活量后最大呼气流量异常（吸烟者中为40%，不吸烟者中为13%），而只有13%的人1秒用力呼气量与用力肺活量的比值异常。对真菌、细菌、谷物或谷物粉尘抗原的沉淀素与急性或慢性呼吸道症状、肺功能或谷物热之间没有相关性。然而，对谷物粉尘的皮肤反应性与接触时的喘息之间存在显著相关性（P<0.02）。对常见过敏原皮肤反应阳性者中，低肺容量时的异常流量更为常见。我们得出结论，接触空气中的谷物粉尘可导致暴露黏膜的急性炎症反应，谷物粉尘很可能在某些情况下促成并导致慢性气道疾病。
