Ayar Orhan, Orcun Akdemir Mehmet, Erboy Fatma, Yazgan Serpil, Hayri Ugurbas Suat
a Department of Ophthalmology and.
b Department of Chest Diseases , Faculty of Medicine, Bulent Ecevit University , Zonguldak , Turkey.
Cutan Ocul Toxicol. 2017 Jun;36(2):114-117. doi: 10.1080/15569527.2016.1196698. Epub 2016 Jul 7.
Our study aimed at evaluating ocular findings and structural changes in coal mine workers who were chronically exposed to coal mine dust and diagnosed with pneumoconiosis.
Ocular findings of 161 eyes of 81 patients diagnosed with pneumoconiosis who had previously worked or are currently working in coal mines were analyzed. Forty-six coal mine workers and sex matched healthy people (n = 20) participated in the study. Workers who had early changes of pneumoconiosis were included in Group 1 (n = 17), workers diagnosed with pneumoconiosis were included in Group 2 (n = 29), and healthy subjects were included in Group 3 (n = 20). Outcome measures were the difference in peripapillary retinal nerve fiber layer (RNFL) thickness, choroidal thickness (CT), central macular thickness (CMT) and tear function tests between the groups.
RNFL thickness values in Group 1 and 2 were lower than in Group 3, the control group, in all quadrants except the temporal quadrant. However, there was no statistically significant difference in peripapillary RNFL thickness values in any quadrants among the three groups (p > 0.05). Central subfoveal choroidal thickness and CMT measurements were thinner in Group 1 and 2 than in the control group. However, this difference among groups was not statistically significant (p > 0.05). Mean schirmer's test result was 8.8 ± 1.6 mm in group 1, 7.1 ± 1.8 mm in Group 2 and 11.5 ± 3.6 mm in the control group. Mean tear break up time (BUT) test result was 7.1 ± 1.3 seconds (sec) in Group 1, 6.5 ± 1.8 sec in Group 2 and 10.4 ± 2.9 s in the control group. The Schirmer's test and BUT test results were both statistically significantly lower in coal mine workers (Group 1 and 2) compared to the control group. Group 1 and Group 2 did not show statistically significant difference in terms of Schirmer's test and BUT test results.
The association between pneumoconiosis and coal mine dust contiguity is thought to be due to the effect of coal dust by producing chronic inflammation. In addition, there are several trace elements in coal dust which are toxic to vital tissues. In this study, ocular findings suggest that systemic levels of trace elements and chronic inflammation may not reach to a level that influences ocular structures. Nonetheless, tear functions seem to be affected in coal mine workers.
This study suggests that the systemic effect of coal mine dust in ocular structures is not evident. However, direct contact with coal mine and fume leads to a decrease in tear function tests.
我们的研究旨在评估长期接触煤矿粉尘并被诊断为尘肺病的煤矿工人的眼部检查结果和结构变化。
分析了81例曾在煤矿工作或目前仍在煤矿工作且被诊断为尘肺病患者的161只眼睛的眼部检查结果。46名煤矿工人和性别匹配的健康人(n = 20)参与了该研究。尘肺病早期改变的工人被纳入第1组(n = 17),被诊断为尘肺病的工人被纳入第2组(n = 29),健康受试者被纳入第3组(n = 20)。观察指标为各组之间视乳头周围视网膜神经纤维层(RNFL)厚度、脉络膜厚度(CT)、中心黄斑厚度(CMT)和泪液功能测试的差异。
第1组和第2组除颞侧象限外,所有象限的RNFL厚度值均低于作为对照组的第3组。然而,三组之间任何象限的视乳头周围RNFL厚度值均无统计学显著差异(p>0.05)。第1组和第2组的中心凹下脉络膜厚度和CMT测量值均比对照组薄。然而,组间差异无统计学意义(p>0.05)。第1组的平均泪液分泌试验结果为8.8±1.6mm,第2组为7.1±1.8mm,对照组为11.5±3.6mm。第1组的平均泪膜破裂时间(BUT)试验结果为7.1±1.3秒,第2组为6.5±1.8秒,对照组为10.4±2.9秒。与对照组相比,煤矿工人(第1组和第2组)的泪液分泌试验和BUT试验结果均有统计学显著降低。第1组和第2组在泪液分泌试验和BUT试验结果方面未显示出统计学显著差异。
尘肺病与煤矿粉尘接触之间的关联被认为是由于煤尘产生慢性炎症的作用。此外,煤尘中有几种对重要组织有毒的微量元素。在本研究中,眼部检查结果表明,微量元素的全身水平和慢性炎症可能未达到影响眼部结构的程度。尽管如此,煤矿工人的泪液功能似乎受到了影响。
本研究表明,煤矿粉尘对眼部结构的全身影响不明显。然而,与煤矿和烟雾的直接接触导致泪液功能测试结果下降。