Ergün Recai, Evcik Ender, Ergün Dilek, Ergan Begüm, Özkan Esin, Gündüz Özge
Clinic of Chest Diseases, Dışkapı Yıldırım Beyazıt Training and Research Hospital, Ankara, Turkey.
Clinic of Radiology, Ankara Occupational Diseases Hospital, Ankara, Turkey.
Balkan Med J. 2017 May 5;34(3):263-268. doi: 10.4274/balkanmedj.2016.0795. Epub 2017 Apr 6.
The number of studies where non-malignant pulmonary diseases are evaluated after occupational arsenic exposure is very few.
To investigate the effects of occupational arsenic exposure on the lung by high-resolution computed tomography and pulmonary function tests.
Retrospective cross-sectional study.
In this study, 256 workers with suspected respiratory occupational arsenic exposure were included, with an average age of 32.9±7.8 years and an average of 3.5±2.7 working years. Hair and urinary arsenic levels were analysed. High-resolution computed tomography and pulmonary function tests were done.
In workers with occupational arsenic exposure, high-resolution computed tomography showed 18.8% pulmonary involvement. In pulmonary involvement, pulmonary nodule was the most frequently seen lesion (64.5%). The other findings of pulmonary involvement were 18.8% diffuse interstitial lung disease, 12.5% bronchiectasis, and 27.1% bullae-emphysema. The mean age of patients with pulmonary involvement was higher and as they smoked more. The pulmonary involvement was 5.2 times higher in patients with skin lesions because of arsenic. Diffusing capacity of lung for carbon monoxide was significantly lower in patients with pulmonary involvement.
Besides lung cancer, chronic occupational inhalation of arsenic exposure may cause non-malignant pulmonary findings such as bronchiectasis, pulmonary nodules and diffuse interstitial lung disease. So, in order to detect pulmonary involvement in the early stages, workers who experience occupational arsenic exposure should be followed by diffusion test and high-resolution computed tomography.
评估职业性砷暴露后非恶性肺部疾病的研究数量极少。
通过高分辨率计算机断层扫描和肺功能测试,研究职业性砷暴露对肺部的影响。
回顾性横断面研究。
本研究纳入256名疑似职业性砷暴露的呼吸系统工人,平均年龄32.9±7.8岁,平均工作年限3.5±2.7年。分析头发和尿液中的砷含量,并进行高分辨率计算机断层扫描和肺功能测试。
职业性砷暴露工人中,高分辨率计算机断层扫描显示18.8%的肺部有病变。在肺部病变中,肺结节是最常见的病变(64.5%)。肺部病变的其他表现为18.8%的弥漫性间质性肺疾病、12.5%的支气管扩张和27.1%的大疱性肺气肿。肺部有病变的患者平均年龄较大,吸烟量也更多。因砷导致皮肤病变的患者肺部病变发生率高5.2倍。肺部有病变的患者一氧化碳弥散量显著降低。
除肺癌外,长期职业性吸入砷暴露可能导致支气管扩张、肺结节和弥漫性间质性肺疾病等非恶性肺部病变。因此,为了早期发现肺部病变,职业性砷暴露工人应接受弥散试验和高分辨率计算机断层扫描检查。