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呼吸系统健康问题与焊接暴露:一项加拿大队列研究。

Respiratory Ill-Health and Welding Exposures: A Canadian Cohort Study.

作者信息

Galarneau Jean-Michel, Beach Jeremy, Cherry Nicola

机构信息

Faculty of Kinesiology, University of Calgary, Calgary, Canada.

College of Physicians and Surgeons of Alberta, Edmonton, Canada.

出版信息

Am J Ind Med. 2025 Feb;68(2):99-111. doi: 10.1002/ajim.23678. Epub 2024 Dec 11.

Abstract

INTRODUCTION

Respiratory ill-health in welders is well documented but without a clear indication of exposures responsible.

METHODS

In a Canadian cohort study of welders and electrical workers, we collected self-reports of asthma/wheeze and rhinitis at each 6-monthly contact for up to 5 years. Physician diagnoses of asthma and chronic obstructive pulmonary disease (COPD/bronchitis) were extracted from the Alberta administrative health database (AHDB). Welders provided task-specific information at each contact. Estimates were derived for cumulative exposure to particulates, chromium, and nickel. Factors associated with time to first and recurrent events were identified by proportional hazards regression, adjusting for sex, age, and smoking.

RESULTS

Of 1001 welders and 884 workers in electrical trades recruited, 1338 in Alberta were matched to the AHDB. Welders were more at risk of physician-diagnosed COPD/bronchitis than those in the electrical trades (HR for first report = 1.87; 95% CI = 1.27-2.77) but not of asthma. Times to first self-report of asthma/wheezing (HR = 1.58; 95% CI = 1.23-2.04) and rhinitis (HR = 1.29; 95%CI = 1.11-1.49) were shorter in welders. Among welders, time to physician-diagnosed asthma was weakly related to cumulative nickel exposure (mg/m_h/100) (HR = 1.08; 95% CI = 1.00-1.17). COPD/bronchitis was related to cumulative exposure to total dust (g/m_h) (HR = 1.01; 95% CI = 1.00-1.03) and to chromium (mg/m_h/100) (HR = 1.14; 95% CI = 1.04-1.26). The risk of both asthma and COPD/bronchitis reduced with time using local exhaust ventilation. Self-reported rhinitis increased with cumulative nickel exposure (HR = 1.00; 95% CI = 1.00-1.01).

CONCLUSIONS

Welders were at increased risk of COPD/bronchitis, with risk related to cumulative dust and chromium exposure. Nickel exposure increased the risk of asthma and rhinitis.

摘要

引言

焊工呼吸系统健康问题已有充分记录,但尚不清楚具体的致病暴露因素。

方法

在一项针对加拿大焊工和电工的队列研究中,我们在长达5年的时间里,每6个月收集一次关于哮喘/喘息和鼻炎的自我报告。从艾伯塔省行政卫生数据库(AHDB)中提取医生对哮喘和慢性阻塞性肺疾病(COPD/支气管炎)的诊断。焊工在每次接触时提供特定任务的信息。对颗粒物、铬和镍的累积暴露量进行了估算。通过比例风险回归确定与首次发病和复发事件时间相关的因素,并对性别、年龄和吸烟情况进行了调整。

结果

在招募的1001名焊工和884名电工中,艾伯塔省的1338人与AHDB进行了匹配。焊工被医生诊断为COPD/支气管炎的风险高于电工(首次报告的风险比=1.87;95%置信区间=1.27-2.77),但哮喘风险无差异。焊工首次自我报告哮喘/喘息(风险比=1.58;95%置信区间=1.23-2.04)和鼻炎(风险比=1.29;95%置信区间=1.11-1.49)的时间较短。在焊工中,医生诊断哮喘的时间与镍的累积暴露量(mg/m³·h/100)弱相关(风险比=1.08;95%置信区间=1.00-1.17)。COPD/支气管炎与总粉尘的累积暴露量(g/m³·h)(风险比=1.01;95%置信区间=1.00-1.03)和铬的累积暴露量(mg/m³·h/100)(风险比=1.14;95%置信区间=1.04-1.26)相关。使用局部排风通风后,哮喘和COPD/支气管炎的风险均随时间降低。自我报告的鼻炎与镍的累积暴露量增加相关(风险比=1.00;95%置信区间=1.00-1.01)。

结论

焊工患COPD/支气管炎的风险增加其风险与粉尘和铬的累积暴露有关。镍暴露会增加哮喘和鼻炎的风险。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/2c3f/11731498/3ae0b0f1396f/AJIM-68-99-g001.jpg

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