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一组英国煤矿工人的粉尘暴露、从肺部回收的粉尘及相关病理学情况。

Dust exposure, dust recovered from the lung, and associated pathology in a group of British coalminers.

作者信息

Douglas A N, Robertson A, Chapman J S, Ruckley V A

出版信息

Br J Ind Med. 1986 Dec;43(12):795-801. doi: 10.1136/oem.43.12.795.

Abstract

The relation between dust exposure, retained lung dust, and pneumoconiosis have been examined in 430 dead coalminers who had participated in a large scale epidemiological survey of respiratory health. The men were divided into three groups depending on the presence of particular lesions in their lungs. Lungs containing no fibrotic lesions in excess of 1 mm were included in the "M" group, those with fibrotic lesions of between 1 mm and 9 mm in diameter were included in the "F" group, and those with any lesion 10 mm or more were categorised as having progressive massive fibrosis (PMF). The men were further divided into four groups according to the rank of coal mined at the colliery of employment. The mean weight of lung dust increased over the pathological range (M----F----PMF) regardless of the rank of coal mined. The men with PMF had not received unusually high exposures to dust in life but were found to have accumulated more dust in their lungs per unit of dust exposure than men without PMF, providing further evidence for differences in the patterns of deposition or clearance, or both, of dust in these men compared with those who do not develop PMF. For men who had mined the higher rank coals there was no difference in the composition of the lung dust between the pathological groups. Lungs from men mining low rank coal, however, showed a striking increase in the proportion of ash over the pathological groups (M, F, and PMF). In men who had mined low rank coal the proportion of ash in the airborne dust to which they had been exposed and in the dust retained in their lungs was, as expected, greater than in men who had worked with higher rank coals. For the same men, and particularly associated with the presence of some dust related fibrosis, the proportion of ash in retained dust was higher than that in the dust to which the men were exposed suggesting the occurrence of selective deposition or retention of the mineral components of dust in this group.

摘要

在430名参与大规模呼吸健康流行病学调查的已故煤矿工人中,研究了粉尘暴露、肺内残留粉尘与尘肺病之间的关系。根据肺部特定病变的存在情况,将这些男性分为三组。肺部纤维化病变不超过1毫米的纳入“M”组,直径在1毫米至9毫米之间的纤维化病变纳入“F”组,任何病变达到10毫米或以上的则归类为进行性大块纤维化(PMF)。根据就业煤矿所开采煤炭的等级,这些男性进一步分为四组。无论所开采煤炭的等级如何,肺内粉尘的平均重量在病理范围内(M----F----PMF)均有所增加。患有PMF的男性在生活中并未受到异常高的粉尘暴露,但发现与未患PMF的男性相比,每单位粉尘暴露下他们肺内积累的粉尘更多,这为这些男性与未患PMF的男性在粉尘沉积或清除模式或两者方面存在差异提供了进一步证据。对于开采高等级煤炭的男性,各病理组之间肺内粉尘成分没有差异。然而,开采低等级煤炭男性的肺部,各病理组(M、F和PMF)的灰分比例显著增加。正如预期的那样,开采低等级煤炭的男性所接触的空气中粉尘以及肺内残留粉尘中的灰分比例,高于从事高等级煤炭工作的男性。对于同一批男性,特别是与一些与粉尘相关的纤维化存在相关的情况下,残留粉尘中的灰分比例高于他们所接触粉尘中的灰分比例,这表明该组中粉尘的矿物成分存在选择性沉积或保留现象。

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