Wilson J R, Raven P B
Department of Physiology, Texas College of Osteopathic Medicine, Fort Worth 76107.
Am Ind Hyg Assoc J. 1989 Jan;50(1):51-7. doi: 10.1080/15298668991374309.
The Occupational Safety and Health Administration (OSHA) mandate requiring medical information for respirator users provides the physician with little or no guidance as to what objective criteria may be valuable in assessing the worker's ability to use a respirator safely. Therefore, the purpose of this study is to use the results of clinical pulmonary function testing to predict performance time on maximal- and endurance-type exercise tests. Respirator mask wear reduced clinical pulmonary function measures from 7%-15% from mouthpiece controls. The resistances of the mask reduced forced vital capacity by an average of 11.6% (0.65 L); forced expiratory volume in 1 sec by 7.3% (0.33 L); and maximum voluntary ventilation in 15 sec by 7.4% (12.4 L/min). Stepwise linear regression analysis was used to determine the clinical pulmonary function measures that were the best predictors of work performance. The MVV.25 with the respirator was determined to be the best predictor of maximal exercise performance both with and without the respirator. The difference in peak inspired flow with and without the respirator was the best predictor of performance time with the respirator during the endurance walk to exhaustion. Recommendations are made to the physician for procedures for determining a worker's pulmonary capacity and calculating the effect of the respirator in reducing that capacity. This information then will allow the physician to determine safe levels of ventilation for a particular work task.
职业安全与健康管理局（OSHA）要求为呼吸器使用者提供医学信息，但对于评估工人安全使用呼吸器能力时哪些客观标准可能有价值，该要求几乎没有或根本没有为医生提供指导。因此，本研究的目的是利用临床肺功能测试结果来预测最大运动和耐力型运动测试中的表现时间。佩戴呼吸器面罩会使临床肺功能指标比口含器对照组降低7% - 15%。面罩阻力使用力肺活量平均降低11.6%（0.65升）；1秒用力呼气量降低7.3%（0.33升）；15秒最大自主通气量降低7.4%（12.4升/分钟）。采用逐步线性回归分析来确定作为工作表现最佳预测指标的临床肺功能指标。佩戴呼吸器时的MVV.25被确定为无论有无呼吸器时最大运动表现的最佳预测指标。佩戴和不佩戴呼吸器时吸气峰值流量的差异是耐力步行至疲惫过程中佩戴呼吸器时表现时间的最佳预测指标。向医生提出了关于确定工人肺容量以及计算呼吸器降低该容量效果的程序的建议。这些信息将使医生能够确定特定工作任务的安全通气水平。
