Kauppi Paula, Järvelä Merja, Tuomi Timo, Luukkonen Ritva, Lindholm Tuula, Nieminen Riina, Moilanen Eeva, Hannu Timo
University of Helsinki and Helsinki University (Central) Hospital, Respiratory Diseases and Allergology, Helsinki, Finland.
Occupational Medicine, Finnish Institute of Occupational Health, Helsinki, Finland.
Toxicol Rep. 2015 Jan 2;2:357-364. doi: 10.1016/j.toxrep.2014.12.015. eCollection 2015.
The aim of this study was to investigate inflammatory and respiratory responses to welding fume exposure in patients with suspected occupational asthma.
Sixteen patients referred to the Finnish Institute of Occupational Health underwent mild steel (MS) and stainless steel (SS) welding challenge tests, due to suspicion of OA. Platelet count, leucocytes and their differential count, hemoglobin, sensitive CRP, lipids, glucose and fibrinogen were analyzed in addition to interleukin (IL)-1β, IL-6, IL-8, TNF-α, endothelin-1, and E-selectin in plasma samples. Peak expiratory flow (PEF), forced expiratory volume in 1 min (FEV) and exhaled nitric oxide (NO) measurements were performed before and after the challenge test. Personal particle exposure was assessed using IOM and a mini sampler. Particle size distribution was measured by an Electric Low Pressure Impactor (ELPI).
The number of leukocytes, neutrophils, and platelets increased significantly, and the hemoglobin level and number of erythrocytes decreased significantly after both the MS and SS exposure tests. Five of the patients were diagnosed with OA, and their maximum fall in FEV values was 0.70 l (±0.32) 4 h after SS exposure. MS welding generated an average inhalable particle mass concentration of 31.6, and SS welding of 40.2 mg/m. The mean particle concentration measured inside the welding face shields by the mini sampler was 30.2 mg/m and 41.7 mg/m, respectively.
Exposure to MS and SS welding fume resulted in a mild systemic inflammatory response. The particle concentration from the breathing zones correlated with the measurements inside the welding face shields.
本研究旨在调查疑似职业性哮喘患者对焊接烟雾暴露的炎症和呼吸反应。
16名转诊至芬兰职业健康研究所的患者因疑似职业性哮喘接受了低碳钢（MS）和不锈钢（SS）焊接激发试验。除了分析血浆样本中的白细胞介素（IL）-1β、IL-6、IL-8、肿瘤坏死因子-α、内皮素-1和E-选择素外，还分析了血小板计数、白细胞及其分类计数、血红蛋白、敏感C反应蛋白、脂质、葡萄糖和纤维蛋白原。在激发试验前后进行呼气峰值流速（PEF）、1分钟用力呼气量（FEV）和呼出一氧化氮（NO）测量。使用IOM和微型采样器评估个人颗粒暴露情况。通过低压冲击器（ELPI）测量颗粒大小分布。
在MS和SS暴露试验后，白细胞、中性粒细胞和血小板数量显著增加，血红蛋白水平和红细胞数量显著下降。5名患者被诊断为职业性哮喘，他们在SS暴露后4小时FEV值的最大下降为0.70升（±0.32）。MS焊接产生的平均可吸入颗粒物质量浓度为31.6，SS焊接为40.2毫克/立方米。微型采样器在焊接面罩内测得的平均颗粒浓度分别为30.2毫克/立方米和41.7毫克/立方米。
暴露于MS和SS焊接烟雾会导致轻度全身炎症反应。呼吸区域的颗粒浓度与焊接面罩内的测量结果相关。
