Hogstedt C, Söderholm B, Bodin L
Br J Ind Med. 1980 Aug;37(3):299-306. doi: 10.1136/oem.37.3.299.
ABSTRACT Sudden deaths and chronic cardiovascular diseases have been reported in excess frequency from the explosives industry. Forty-two active dynamite workers and 43 healthy, unexposed workers have been studied by ambulatory electrocardiographic monitoring during two 24-hour periods covering an exposed shift and the “abstinence phase,” 40-64 hours after the last exposure to dynamite. To achieve comparability the non-exposed individuals were screened for risk factors of heart disease in the same way as those employed in exposed work. No statistically significant differences were found between the groups concerning the mean individual number of ventricular or supraventicular ectopic beats per hour or per 10 000 heart beats during the whole recorded time. Among those who showed only ectopic beats in one of the two periods dynamite workers tended to have more ectopic beats in the second period. “Complicated” ventricular ectopic beats (multifocal, bigemeny, or coupled) were seen in six dynamite workers and four controls. The only observed period of ventricular tachycardia was seen in a dynamite worker on Monday morning. The mean individual corrected QT-time was similar between the two groups, and there was no tendency towards longer QT-times among the dynamite workers during the abstinence period. Continuous monitoring detected several cases with pronounced ventricular arrhythmias despite normal short-time ECG and may be used to investigate the heart rhythm in active workers.
摘要 据报道，炸药行业突发死亡和慢性心血管疾病的发生频率过高。对42名在职炸药工人和43名健康的未接触者进行了动态心电图监测，监测在两个24小时期间进行，涵盖一个接触轮班以及最后一次接触炸药后40 - 64小时的“禁戒期”。为了实现可比性，对未接触者按照与接触工作的人员相同的方式进行心脏病风险因素筛查。在整个记录时间内，两组之间每小时或每10000次心跳的室性或室上性异位搏动的平均个体数量没有统计学上的显著差异。在两个时间段中只有一个时间段出现异位搏动的人员中，炸药工人在第二个时间段往往有更多的异位搏动。在6名炸药工人和4名对照者中出现了“复杂的”室性异位搏动（多灶性、二联律或成对出现）。仅在一名炸药工人周一上午观察到室性心动过速。两组之间平均个体校正QT间期相似，在禁戒期炸药工人中没有QT间期延长的趋势。连续监测发现，尽管短时间心电图正常，但仍有几例出现明显的室性心律失常，可用于调查在职工人的心律。
