Baser M E, Tockman M S, Kennedy T P
Am Rev Respir Dis. 1985 Feb;131(2):203-8. doi: 10.1164/arrd.1985.131.2.203.
We performed preshift and postshift spirometry and administered a standardized respiratory symptoms questionnaire to 174 white males currently employed in polyvinylchloride (PVC) fabrication to examine the acute and chronic respiratory effects of work exposure. Although there were no significant differences between the in-plant comparison group and any department with potential exposures, there was evidence for respiratory effects in the combined group of comparison and exposed workers. In the combined group, duration of employment was significantly associated with decrements in adjusted cross-shift ratio of forced expiratory volume in one second to forced vital capacity (FEV1/FVC), preshift FEV1/FVC, and prevalence of chronic cough and chronic phlegm. In nonsmokers, the prevalences of chronic wheeze and chest tightness were high (36.0 and 50.5%, respectively). The age-adjusted prevalence of chronic wheeze in nonsmokers was also elevated 3.54-fold when compared with that in a community study in the literature. We conclude that the cross-sectional design and in-plant comparison group may mask the effects of exposures on the entire plant population, and that employment in this plant is associated with patterns of obstructive air-flow limitation and respiratory symptoms consistent with exposure to pulmonary irritants. These results suggest that possible agents of pulmonary effects in PVC fabrication are not limited to vinyl chloride monomer, PVC dust, and PVC thermal degradation products.
我们对174名目前受雇于聚氯乙烯(PVC)制造行业的白人男性进行了班前和班后的肺功能测定,并发放了标准化的呼吸道症状问卷,以研究工作暴露对呼吸道的急慢性影响。尽管厂内对照组与任何可能接触有害物质的部门之间没有显著差异,但在对照组和接触组工人的合并组中存在呼吸道影响的证据。在合并组中,就业年限与一秒用力呼气量与用力肺活量的调整后跨班比值(FEV1/FVC)、班前FEV1/FVC以及慢性咳嗽和慢性咳痰的患病率下降显著相关。在不吸烟者中,慢性喘息和胸闷的患病率很高(分别为36.0%和50.5%)。与文献中的一项社区研究相比,不吸烟者中慢性喘息的年龄调整患病率也升高了3.54倍。我们得出结论,横断面设计和厂内对照组可能掩盖了暴露对整个工厂人群的影响,并且在该工厂工作与阻塞性气流受限模式和与接触肺部刺激物一致的呼吸道症状有关。这些结果表明,PVC制造中可能导致肺部影响的因素不限于氯乙烯单体、PVC粉尘和PVC热降解产物。