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[接触烟尘工人下呼吸道的临床症状与表现]

[Clinical symptoms and findings in the lower airways of soot-exposed workers].

作者信息

Kandt D

出版信息

Z Erkr Atmungsorgane. 1985;165(1):25-41.

PMID:3851610
Abstract

Eighty three still exposed and 46 formerly exposed workers, exposed especially to dust of carbon black and extreme heat climate conditions up to 2 and 30 years, were asked using a standardized questionnaire concerning complaints of the lower airways. The workers were investigated clinically, by X-rays and functionally to find out disturbances of health in the lower airways. The sputum was investigated cytologically. Moreover, the certificates of death were checked. The results were compared to those of 144 control persons living in the same region. The still exposed and the formerly exposed workers were suffering from chronic bronchitis, from non-specific bronchial hyperreactivity and from obstructive ventilatory disturbances in dependence on the duration of exposition more frequently than the control persons. But the mean values of the one-second value of forced expiratory volume in per cent of the vital capacity of every group were not different. Severe disturbances of the lung function were stated in some cases mostly exposed more than 20 years. On 3 workers, exposed more than 20 years, roentgenological signs of a pneumoconiosis were diagnosed demonstrating the fibrogenic effect of carbon black. The cytological findings of sputum didn't show any new aspects. Compared to the other people no deviating frequencies of causes of death were found, especially not more cases with neoplasma. The mostly less frequencies of symptoms and findings of the formally exposed workers were estimated as a hint for regression of the disturbance. The expected dependence of the signs on smoking habits was not recognized. So the exposition described was emphasized as a professional noxious factor, particularly as compared to the control persons important differences were found and the influence of the duration of exposition on the symptoms and findings was significant. Workers exposed to soot suffering from chronic bronchitis, nonspecific hyperreactivity, and especially obstructive ventilatory disturbances should be held in pulmonary dispensary in time.

摘要

83名仍在接触(粉尘)的工人和46名曾经接触过(粉尘)的工人,他们尤其接触炭黑粉尘且处于极端炎热气候条件下长达2年至30年,使用标准化问卷询问他们下呼吸道的不适情况。对这些工人进行了临床检查、X光检查和功能检查,以查明下呼吸道的健康障碍。对痰液进行了细胞学检查。此外,还检查了死亡证明。将结果与居住在同一地区的144名对照人员的结果进行了比较。与对照人员相比,仍在接触(粉尘)的工人和曾经接触过(粉尘)的工人更频繁地患有慢性支气管炎、非特异性支气管高反应性和阻塞性通气障碍,且这些病症与接触时长有关。但每组用力呼气量一秒率占肺活量百分比的平均值并无差异。在一些接触时间超过20年的工人中发现了严重的肺功能障碍。在3名接触时间超过20年的工人中,诊断出尘肺病的X光征象,证明了炭黑的致纤维化作用。痰液的细胞学检查结果未显示任何新情况。与其他人相比,未发现死亡原因的异常频率,尤其是肿瘤病例并未增多。曾经接触过(粉尘)的工人症状和检查结果大多较少,这被认为是病情缓解的迹象。未发现症状与吸烟习惯之间预期的相关性。因此,所述的接触被强调为一种职业有害因素,特别是与对照人员相比发现了重要差异,且接触时长对症状和检查结果的影响显著。接触煤烟且患有慢性支气管炎、非特异性高反应性,尤其是阻塞性通气障碍的工人应及时送往肺病防治所。

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