Le Moual N, Orlowski E, Schenker M B, Avignon M, Brochard P, Kauffmann F
INSERM U169, Villejuif, France.
Occup Environ Med. 1995 Oct;52(10):634-43. doi: 10.1136/oem.52.10.634.
The aim of this analysis of the French Cooperative PAARC (Pollution Atmosphérique et Affections Respiratoires Chroniques) survey, was to test whether occupational exposures to dusts, gases, or chemical fumes or to specific hazards, estimated by job exposure matrices, were related to a decrease in forced expiratory volume in one second (FEV1).
The most recent occupation was recorded in adults, aged 25-59, from non-manual worker households. Analysis was restricted to 10,046 subjects whose occupation was encountered at least 10 times in the study and who performed good FEV1 tracings. From occupational title, exposures to dusts, gases, and chemical fumes, and to specific hazards were classified in three categories (no, low, and high) with a British, a French, and an Italian job exposure matrix. Specific hazards were analysed for the British and French job exposure matrices for the same 42 specific dusts, gases, and chemical fumes. To limit spurious associations, a selection of seven hazard groups and 12 specific hazards was set before the start of the analysis. Based on the consistency of the relations according to sex and the British and French job exposure matrices, associations of age, height, city, and smoking adjusted FEV1 score with occupational exposures were classified as very likely, possible, or unlikely.
For the three job exposure matrices and both sexes clear exposure-response relations between the level of exposure to dusts, gases, and chemical fumes, and a decrease in FEV1 were found. Associations with FEV1 were classified as very likely for known hazards such as organic dusts and textile dusts, and not previously recognised hazards such as polycyclic aromatic hydrocarbons (PAHs) and detergents, and as possible for solvents, waxes and polishes, and diesel fumes. Associations found for PAHs and solvents were confirmed by the Italian job exposure matrix. Associations remained significant in women, but not in men, after adjustment for educational level.
Hypotheses have been generated for exposure to detergents, PAHs, and solvents, but they need to be interpreted with caution before replication. Significant associations found for known risk factors with a decrease in FEV1 are arguments for the validity of the matrices. Despite the expected limitations of job exposure matrices, these results encourage further work to improve exposure assessment by job exposure matrices.
本次对法国PAARC（大气污染与慢性呼吸道疾病）合作调查的分析旨在检验，通过工作接触矩阵估算的职业性接触粉尘、气体、化学烟雾或特定危害因素是否与一秒用力呼气量（FEV1）下降有关。
记录了来自非体力劳动者家庭的25至59岁成年人的最新职业。分析仅限于10046名受试者，这些受试者的职业在研究中至少出现过10次，且FEV1描记良好。根据职业名称，使用英国、法国和意大利的工作接触矩阵将接触粉尘、气体、化学烟雾和特定危害因素分为三类（无、低、高）。针对英国和法国的工作接触矩阵，对相同的42种特定粉尘、气体和化学烟雾分析了特定危害因素。为限制虚假关联，在分析开始前选定了7个危害组和12种特定危害因素。根据性别以及英国和法国工作接触矩阵中关系的一致性，将年龄、身高、城市和吸烟调整后的FEV1得分与职业接触之间的关联分为极有可能、有可能或不太可能。
对于三种工作接触矩阵以及男女两性，均发现粉尘、气体和化学烟雾接触水平与FEV1下降之间存在明确的接触-反应关系。与FEV1的关联被分类为极有可能的有已知危害因素，如有机粉尘和纺织粉尘，以及先前未被认识到的危害因素，如多环芳烃（PAHs）和洗涤剂；被分类为有可能的有溶剂、蜡和上光剂以及柴油烟雾。PAHs和溶剂的关联得到了意大利工作接触矩阵的证实。在调整教育水平后，关联在女性中仍然显著，但在男性中不显著。
已针对洗涤剂、PAHs和溶剂的接触提出了假设，但在重复验证之前需谨慎解读。已知风险因素与FEV1下降之间的显著关联是这些矩阵有效性的论据。尽管工作接触矩阵存在预期的局限性，但这些结果鼓励开展进一步工作，以通过工作接触矩阵改进接触评估。
