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[铸造工人的黏液纤毛清除功能与呼吸功能]

[Mucociliary clearance and respiratory function in foundry workers].

作者信息

Di Lorenzo L, Pegorari M M, Capozzi D, Margiotta M, Carpinelli G, Cassano F, Zocchetti C, Sacchitelli F, De Francesco G, Soleo L

机构信息

Istituto di Medicina del Lavoro, Università degli Studi di Bari.

出版信息

Med Lav. 1994 Nov-Dec;85(6):481-95.

PMID:7731407
Abstract

The aim of the study was to establish whether changes occur in respiratory function, particularly mucociliary clearance, among second fusion smeltery workers. The research covered 93 male smelters employed in steel forming and casting and 116 male workers of an electric power station, considered as non-exposed. Physiological, pathological and occupational histories of all subjects under study were available. An ECCS respiratory symptoms questionnaire was administered to all subjects ad the two groups also underwent a general medical examination, a spirometry and a chest X-ray. During the medical examination sputum was collected from the subjects to measure mucus transport rate on frog palate, expressed as Normalised Frog Palate Transport Rate (NFPTR). For the environmental research, dust, fumes and gas samplings were taken either at a fixed station or by means of personal dosimeters. Environmental research revealed very low concentrations of respiratory irritants (total dust: 0.2-6.8 mg/m3; respirable dust: 0.1-4.9 mg/m3; total silica: < 2-15.5%; respirable silica: < 0.004-0.3 mg/m3; iron: 0.008-0.085 mg/m3; chromium and manganese: < 0.001 mg/m3; fumes and gases: well below the TLV. The two groups were homogeneous with regard to age and smoking habits. Exposed workers showed rales, dyspnoea and spontaneous phlegm more frequently than non-exposed workers. NFPTR alterations were checked in 49 out of 81 exposed and in 18 out of 81 non-exposed subjects (chi squared = 22.9; p < 0.001). Stratification of the results according to smoking habits further confirmed the strong association between occupational exposure and NFPTR alterations. Smelters showed significantly lower mean NFPTR values compared to non-exposed subjects; also, the mean value of NFPTR in the exposed was below 0.70, which is considered the lowest individual limit in normal subjects. The only variable which explains a large part of the variability of NFPTR is past work in a smeltery rather than in an electric power station. The spirometries showed that only the mean PEF values were significantly lower among the exposed. Stratified analysis of the results according to smoking habits in the two groups revealed a close association between smeltery work and reduction of PEF to under 80% of the ECCS 1983 theoretical values, independently of smoking habits. We also compared the mean PEF values, both as measured values and as percent values of the ECCS 1983 theoretical values, stratified for occupational exposure and smoking; the results again showed that differences between these mean values were mainly due to current or past work in the foundry.(ABSTRACT TRUNCATED AT 400 WORDS)

摘要

该研究的目的是确定二次熔炼厂工人的呼吸功能是否发生变化,尤其是黏液纤毛清除功能。该研究涵盖了93名从事钢铁成型和铸造的男性冶炼工人以及116名被视为未接触者的发电站男性工人。所有研究对象都有生理、病理和职业病史。对所有研究对象进行了ECCS呼吸症状问卷调查,两组人员还接受了全面的医学检查、肺功能测定和胸部X光检查。在医学检查过程中,收集了研究对象的痰液,以测量蛙腭上的黏液运输速率,以标准化蛙腭运输速率(NFPTR)表示。对于环境研究,在固定站点或通过个人剂量计进行了粉尘、烟雾和气体采样。环境研究显示,呼吸刺激物浓度非常低(总粉尘:0.2 - 6.8毫克/立方米;可吸入粉尘:0.1 - 4.9毫克/立方米;总二氧化硅:<2 - 15.5%;可吸入二氧化硅:<0.004 - 0.3毫克/立方米;铁:0.008 - 0.085毫克/立方米;铬和锰:<0.001毫克/立方米;烟雾和气体:远低于阈限值。两组在年龄和吸烟习惯方面具有同质性。与未接触者相比,接触工人出现啰音、呼吸困难和咳痰的频率更高。在81名接触者中的49名和81名未接触者中的18名中检查了NFPTR改变(卡方 = 22.9;p < 0.001)。根据吸烟习惯对结果进行分层进一步证实了职业接触与NFPTR改变之间的密切关联。与未接触者相比,冶炼工人的平均NFPTR值显著更低;此外,接触者的NFPTR平均值低于0.70,这被认为是正常受试者的最低个体限值。唯一能解释NFPTR大部分变异性的变量是过去在冶炼厂而非发电站工作。肺功能测定显示,仅接触者的平均呼气峰流速(PEF)值显著更低。根据两组吸烟习惯对结果进行分层分析显示,冶炼厂工作与PEF降至低于ECCS 1983理论值的80%之间存在密切关联,与吸烟习惯无关。我们还比较了按职业接触和吸烟分层的平均PEF值,既作为测量值,也作为ECCS 1983理论值的百分比值;结果再次表明,这些平均值之间的差异主要归因于当前或过去在铸造厂的工作。(摘要截选至400字)

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