Antó J M, Sunyer J, Rodriguez-Roisin R, Suarez-Cervera M, Vazquez L
Department d'Epidemiologia, Institut Municipal d'Investigació Mèdica, Barcelona, Spain.
N Engl J Med. 1989 Apr 27;320(17):1097-102. doi: 10.1056/NEJM198904273201701.
Since 1981, 26 outbreaks of asthma have been detected in the city of Barcelona. The geographic clustering of cases close to the harbor led us to consider the harbor as the probable source of the outbreaks. We therefore studied the association between the unloading of 26 products from ships in the harbor and outbreaks of asthma in 1985 and 1986. All 13 asthma-epidemic days in these two years coincided with the unloading of soybeans (lower 95 percent confidence limit of the risk ratio, 7.2). Of the remaining 25 products, only the unloading of wheat was related to the epidemics of asthma, although when adjusted for the unloading of soybeans the relation was not statistically significant. High-pressure areas and mild southeasterly to southwesterly winds, which favored the movement of air from the harbor to the city, were registered on all epidemic days. Particles of starch and episperm cells that were recovered from air samplers placed in the city had morphologic characteristics identical to those of soybean particles. Furthermore, the lack of bag filters at the top of one of the harbor silos into which soybeans were unloaded allowed the release of soybean dust into the air. We conclude that these outbreaks of asthma in Barcelona were caused by the inhalation of soybean dust released during the unloading of soybeans at the city harbor.
自1981年以来，巴塞罗那市已检测到26起哮喘病爆发事件。病例在港口附近的地理聚集使我们认为港口可能是这些爆发事件的源头。因此，我们研究了1985年和1986年从港口船舶卸载的26种产品与哮喘病爆发之间的关联。这两年中所有13个哮喘流行日都与大豆卸载时间重合（风险比的95%置信下限为7.2）。在其余25种产品中，只有小麦卸载与哮喘流行有关，不过在对大豆卸载进行校正后，这种关系无统计学意义。在所有流行日都记录到有利于空气从港口向城市流动的高压区以及温和的东南风到西南风。从放置在市内的空气采样器中回收的淀粉颗粒和种皮细胞具有与大豆颗粒相同的形态特征。此外，其中一个卸载大豆的港口筒仓顶部缺少袋式过滤器，使得大豆粉尘释放到空气中。我们得出结论，巴塞罗那的这些哮喘病爆发是由在城市港口卸载大豆期间释放的大豆粉尘吸入所致。
