多年电弧焊导致的肺功能损害。

Pulmonary functional impairment from years of arc welding.

作者信息

Kilburn K H, Warshaw R H

机构信息

University of Southern California, School of Medicine, Environmental Sciences Laboratory, Los Angeles.

出版信息

Am J Med. 1989 Jul;87(1):62-9. doi: 10.1016/s0002-9343(89)80484-x.

DOI:10.1016/s0002-9343(89)80484-x

PMID:2787121

Abstract

PURPOSE

The adverse effects of arc welding on pulmonary function have been previously documented. However, in many of these studies, the effects of welding exposure and smoking were not separated. Also, some studies did not adjust for or ignored the effects of asbestosis on pulmonary function. We assessed the long-term effects of welding on pulmonary function in welders who had no evidence of asbestosis on chest radiographs, and adjusted each individual value for height, age, and years of cigarette smoking.

PATIENTS AND METHODS

The study consisted of 226 male construction welders who had never worked in shipyards. Forced vital capacity (FVC) and flows were measured by spirometry, chest radiographs were obtained and examined for evidence of asbestosis using International Labor Office (ILO) criteria, and thoracic gas volume (TGV) was determined by planimetry. The subjects were also administered an occupational and respiratory questionnaire. Data on workers with asbestosis (ILO profusion 1/0 or greater) and pleural abnormalities were excluded. The mean age for the 226 subjects without asbestosis was 45 years, mean height was 175.7 cm, and mean duration of welding was 21.3 years. Pulmonary function measurements are presented as mean percentage of predicted (pop) and adjusted for height, age, and years of smoking.

RESULTS

In 151 current cigarette smokers, mean midflows and terminal flows were decreased, FEF25-75 to 93.2 pop and FEF75-85 to 91.2 pop, but FVC, forced expiratory volume in one second (FEV1) and TGV were normal. The 43 nonsmokers also had reductions in flows but normal FVC and TGV. Flows in both groups were significantly (p less than 0.05) below those of the referent group. The regression coefficient was -0.0031 for years of welding and FVC pop, -0.0035 for FEV1 pop, and -0.0080 for midflow pop (FEF25-75) (all significant at p less than 0.05), but the coefficient for FEF75-85 pop was not significant. As calculated from regression equations, 40 years of welding would reduce FVC to 95.2 pop, FEV1 to 92.2 pop, midflow to 79.2 pop, and FEF75-85 to 81.7 pop.

CONCLUSION

Long-term exposure to welding gases and fumes reduced flows in small airways of welders without asbestosis.

摘要

目的

先前已有文献记载电弧焊对肺功能的不良影响。然而，在许多此类研究中，焊接暴露和吸烟的影响并未区分开来。此外，一些研究没有对石棉沉着病对肺功能的影响进行校正或忽略了这一影响。我们评估了胸部X线片无石棉沉着病证据的焊工中焊接对肺功能的长期影响，并对每个个体的身高、年龄和吸烟年限进行了校正。

患者与方法

本研究包括226名从未在造船厂工作过的男性建筑焊工。通过肺活量测定法测量用力肺活量（FVC）和流速，获取胸部X线片并按照国际劳工组织（ILO）标准检查是否有石棉沉着病证据，通过平面测量法测定胸腔气体容积（TGV）。还对受试者进行了职业和呼吸问卷调查。排除有石棉沉着病（ILO profusion 1/0或更高）和胸膜异常的工人的数据。226名无石棉沉着病的受试者的平均年龄为45岁，平均身高为175.7厘米，平均焊接时长为21.3年。肺功能测量结果以预测值（pop）的平均百分比表示，并对身高、年龄和吸烟年限进行了校正。

结果

在151名当前吸烟者中，平均中期流速和终末流速降低，FEF25 - 75降至93.2 pop，FEF75 - 85降至91.2 pop，但FVC、一秒用力呼气容积（FEV1）和TGV正常。43名不吸烟者的流速也降低，但FVC和TGV正常。两组的流速均显著（p < 0.05）低于参照组。焊接年限与FVC pop的回归系数为 - 0.0031，FEV1 pop为 - 0.0035，中期流速pop（FEF25 - 75）为 - 0.0080（均在p < 0.05时显著），但FEF75 - 85 pop的系数不显著。根据回归方程计算，40年的焊接会使FVC降至95.2 pop，FEV1降至92.2 pop，中期流速降至79.2 pop，FEF75 - 85降至81.7 pop。