D'Adda F, Borleri D, Migliori M, Mosconi G, Medolago G, Virotta G, Colombo F, Seghizzi P
Istituto di Medicina del Lavoro, Ospedali Riuniti di Bergamo, Italy.
Sci Total Environ. 1994 Jun 30;150(1-3):179-86. doi: 10.1016/0048-9697(94)90148-1.
The induction of cardiac effects in hard metal workers is uncertain. This study investigates cardiac function of a group of 31 hard metal workers with or without pulmonary disease. The average duration of exposure to cobalt containing dusts was 10.4 years (range 1-30), while the environmental levels of cobalt exposure ranged from 0.09 to 13.6 mg/m3 Co. Cardiac function has been studied by: ECG (electrocardiogram), exercise test (ET), ECG 24 h according to Holter (ECGH), echocardiogram (ECHO) and radionuclide angiocardiography with 99Tc (RNA). The aims of this work were (i) to show the existence of cobalt myocardiopathy in the workers analyzed and, (ii) to find an early indicator of cardiac dysfunction which could be used in the clinical examination of hard metal workers. Within the group of patients with hard metal lung disease, cases of myocardiopathy of doubtful aetiology have been found. The cardiac indexes obtained through RNA show ventricular dysfunction in healthy hard metal workers which could be a manifestation of initial pulmonary artery hypertension or of an early occult cor pulmonale due to an unknown fibrotic lung disease.
硬质合金工人心脏效应的诱发情况尚不确定。本研究调查了31名患有或未患有肺部疾病的硬质合金工人的心脏功能。接触含钴粉尘的平均时长为10.4年(范围为1 - 30年),而环境中的钴暴露水平在0.09至13.6毫克/立方米钴之间。通过以下方式研究心脏功能:心电图(ECG)、运动试验(ET)、根据动态心电图监测仪进行的24小时心电图监测(ECGH)、超声心动图(ECHO)以及使用99锝进行的放射性核素心血管造影(RNA)。这项工作的目的是:(i)在分析的工人中证实钴性心肌病的存在,以及(ii)找到可用于硬质合金工人临床检查的心脏功能障碍早期指标。在患有硬质合金肺病的患者群体中,已发现病因存疑的心肌病病例。通过RNA获得的心脏指数显示,健康的硬质合金工人存在心室功能障碍,这可能是初始肺动脉高压的表现,或是由于未知的纤维化肺病导致的早期隐性肺心病的表现。