van Kampen V, Hoffmeyer F, Deckert A, Kendzia B, Casjens S, Neumann H D, Buxtrup M, Willer E, Felten C, Schöneich R, Brüning T, Raulf M, Bünger J
Institute for Prevention and Occupational Medicine of the German Social Accident Insurance, Institute of the Ruhr-University Bochum (IPA), Bochum, Germany.
German Social Accident Insurance, Institution for the public sector in North Rhine-Westphalia, Düsseldorf, Germany.
Occup Environ Med. 2016 Dec;73(12):829-837. doi: 10.1136/oemed-2016-103692. Epub 2016 Aug 9.
To determine the risk of German compost workers developing chronic respiratory effects from long-term exposure to bioaerosols.
Respiratory health was determined in 74 currently exposed compost workers and 37 non-exposed controls after 13 years of follow-up. In addition, 42 former compost workers (drop-outs) who left their work during the follow-up period were also examined. Respiratory symptoms and working conditions were assessed using identical questionnaires as at baseline. In addition, lung function was measured using the same spirometer as in the initial study. Sera from both surveys were tested for specific IgE and IgG antibodies to moulds and the risk of work-related symptoms was evaluated using regression approaches for prospective studies with binary data.
In the follow-up period, the number of participants reporting cough significantly increased in compost workers and drop-outs compared to the controls. Working as a compost worker for at least 5 years increased the relative risk for cough (RR 1.28; 95% CI 1.2 to 1.4) and for cough with phlegm (RR 1.32; 95% CI 1.2 to 1.5). Current and former compost workers had slightly lower predicted percentage of forced expiratory volume in 1 s and predicted percentage of forced vital capacity than controls, but decrease in lung function during follow-up was not different among the 3 groups. In addition, no significant changes could be detected in antibody concentrations.
Our results suggest that chronic exposure to bioaerosols in composting plants is related to a significantly higher risk for cough with phlegm, indicating chronic bronchitis. However, compost workers showed no higher incidence of deterioration of pulmonary function over the study.
确定德国堆肥工人长期接触生物气溶胶后发生慢性呼吸道影响的风险。
对74名目前仍在接触堆肥的工人和37名未接触的对照人员进行了13年的随访,以确定其呼吸健康状况。此外,还对42名在随访期间离职的前堆肥工人(退出者)进行了检查。使用与基线时相同的问卷评估呼吸症状和工作条件。此外,使用与初始研究相同的肺活量计测量肺功能。对两次调查的血清进行检测,以确定针对霉菌的特异性IgE和IgG抗体,并使用二元数据前瞻性研究的回归方法评估与工作相关症状的风险。
在随访期间,与对照组相比,报告咳嗽的堆肥工人和退出者的人数显著增加。从事堆肥工作至少5年增加了咳嗽的相对风险(相对风险1.28;95%可信区间1.2至1.4)和咳痰咳嗽的相对风险(相对风险1.32;95%可信区间1.2至1.5)。目前和以前的堆肥工人1秒用力呼气量预测百分比和用力肺活量预测百分比略低于对照组,但随访期间三组肺功能下降情况无差异。此外,抗体浓度未检测到显著变化。
我们的结果表明,堆肥厂长期接触生物气溶胶与咳痰咳嗽的风险显著增加有关,提示慢性支气管炎。然而,在研究期间,堆肥工人肺功能恶化的发生率并未更高。