Wardyn Pierre-Marie, Edme Jean-Louis, de Broucker Virginie, Cherot-Kornobis Nathalie, Ringeval David, Amouyel Philippe, Sobaszek Annie, Dauchet Luc, Hulo Sébastien
Univ. Lille, CHU Lille, Institut Pasteur Lille, ULR 4483 - IMPECS - IMPact de l'Environnement Chimique sur la Santé humaine, F-59000, Lille, France.
Univ. Lille, ULR 4483 - IMPECS - IMPact de l'Environnement Chimique sur la, Santé humaine, F-59000, Lille, France.
Environ Res. 2023 Apr 1;222:115382. doi: 10.1016/j.envres.2023.115382. Epub 2023 Feb 1.
Although several studies have studied the relationship between occupational exposure to crystalline silica dust and respiratory mortality, few have examined the relationship with impairments in respiratory function and the exposure threshold triggering spirometric monitoring in exposed workers. The objective of the present study was to evaluate the impact of exposure to crystalline silica dust on respiratory function.
We included 1428 male participants (aged 40 to 65) recruited from the French general population, at random from electoral rolls, in the cross-sectional ELISABET study and for whom data on forced expiratory flow-volume curve indices z-scores (calculated using the Global Lung Function Initiative 2012 equations) and exposure (via a questionnaire) were available. A cumulative exposure index (CEI) for crystalline silica dust (CEI, expressed in mg.m.year) was calculated using the Matgéné occupational exposure matrix.
293 of the 1428 participants (20.52%) reported exposure to silica dust. We found that the adjusted z-scores for the forced expiratory volume in the first second/forced vital capacity (FEV/FVC) ratio decreased significantly as CEI increased. After adjustment, the adjusted z-scores for FEV/FVC (β: -0.426 (95% confidence interval (CI): -0.792, -0.060) per 1 mg m.year increment) and the mean forced expiratory flow between 25 and 75% of the forced vital capacity (FEF) (β: -0.552 (95% CI: -0.947, -0.157)) were significantly lower in the participants with CEI ≥1 mg m.year than in non-exposed participants. The likelihoods of having airway obstruction (odds ratio (OR): 3.056 (95% CI: 1.107, 7.626)) or having an impaired FEF (OR: 4.305 (95% CI: 1.393, 11.79)) were also significantly higher in participants with CEI ≥1 mg m.year.
Our results emphasize the importance of spirometry-based monitoring in workers exposed to more than 1 mg m.year of crystalline silica dust, in order to identify small airway obstruction or airway obstruction as early as possible.
尽管已有多项研究探讨了职业性接触结晶二氧化硅粉尘与呼吸道死亡率之间的关系，但很少有研究考察其与呼吸功能损害以及触发暴露工人进行肺功能监测的暴露阈值之间的关系。本研究的目的是评估接触结晶二氧化硅粉尘对呼吸功能的影响。
我们纳入了1428名年龄在40至65岁之间的男性参与者，他们是在横断面ELISABET研究中从法国普通人群中随机从选民名单招募而来的，且有关于用力呼气流量-容积曲线指数z分数（使用全球肺功能倡议2012年方程计算）和暴露情况（通过问卷）的数据。使用Matgéné职业暴露矩阵计算结晶二氧化硅粉尘的累积暴露指数（CEI，以mg·m·年表示）。
1428名参与者中有293名（20.52%）报告接触过二氧化硅粉尘。我们发现，随着CEI的增加，第一秒用力呼气容积/用力肺活量（FEV/FVC）比值的调整后z分数显著下降。调整后，每增加1mg·m·年，FEV/FVC的调整后z分数（β：-0.426（95%置信区间（CI）：-0.792，-0.060））和用力肺活量25%至75%之间的平均用力呼气流量（FEF）（β：-0.552（95%CI：-0.947，-0.157））在CEI≥1mg·m·年的参与者中显著低于未暴露参与者。CEI≥1mg·m·年的参与者出现气道阻塞的可能性（优势比（OR）：3.056（95%CI：1.107，7.626））或FEF受损的可能性（OR：4.305（95%CI：1.393，11.79））也显著更高。
我们的结果强调了对接触超过1mg·m·年结晶二氧化硅粉尘的工人进行基于肺功能测定的监测的重要性，以便尽早识别小气道阻塞或气道阻塞。
