Christiani D C, Ye T T, Wegman D H, Eisen E A, Dai H L, Lu P L
Department of Environmental Health, Harvard School of Public Health, Boston.
Chest. 1994 Jun;105(6):1713-21. doi: 10.1378/chest.105.6.1713.
Longitudinal variability in respiratory responses, including symptom reporting and across-shift change in ventilatory function, were examined in relation to long-term loss of ventilatory function in a group of 447 cotton textile workers in Shanghai, China. The study used a standardized respiratory questionnaire and standardized spirometric testing before and after a work shift on the first day of the workweek. Prediction equations for FEV1 were generated from a group of silk textile workers from the same city. Environmental samples included both vertical elutriated cotton dust and endotoxin levels. There was considerable variability in symptom reporting between the baseline and 5-year follow-up survey for all symptoms. However, subjects who consistently reported symptoms had a significantly accelerated 5-year loss in FEV1 compared with those who never reported symptoms. Subjects with symptoms of chest tightness or dyspnea at one survey lost FEV1 at a rate intermediate between the never or both groups. Moreover, subjects with an across-shift change in FEV1 of more than 5 percent at both surveys had the greatest loss in FEV1 over 5 years (-267 ml) when compared with one-time responders (-224 ml), and nonresponders (-180 ml), though the differences were not significant. Workers with chest tightness and chronic bronchitis in both surveys were overrepresented in the high dust and endotoxin areas. Our results indicate that even with substantial survey-to-survey variability in responses, there is important information contained in both questionnaires and across-shift spirometry. Among cotton workers, consistent responders to either symptom questionnaire or across-shift FEV1 decrements of > or = 5 percent appear to be at increased risk for lung function impairment.
在中国上海的447名棉纺织工人中，研究了呼吸反应的纵向变异性，包括症状报告和通气功能的轮班间变化，并将其与通气功能的长期丧失相关联。该研究在工作周第一天的轮班前和轮班后使用了标准化的呼吸问卷和标准化的肺活量测试。FEV1的预测方程是根据来自同一城市的一组丝织工人得出的。环境样本包括垂直淘析的棉尘和内毒素水平。在所有症状的基线调查和5年随访调查之间，症状报告存在相当大的变异性。然而，与从未报告过症状的受试者相比，持续报告症状的受试者FEV1的5年丧失明显加速。在一次调查中有胸闷或呼吸困难症状的受试者FEV1的丧失率介于从未有症状的受试者和两组都有症状的受试者之间。此外，在两次调查中FEV1轮班间变化超过5%的受试者在5年中FEV1的丧失最大（-267毫升），相比之下，一次性有反应的受试者（-224毫升）和无反应的受试者（-180毫升），尽管差异不显著。在高粉尘和内毒素区域，两次调查中都有胸闷和慢性支气管炎的工人比例过高。我们的结果表明，即使调查之间的反应存在很大变异性，问卷和轮班间肺活量测定中都包含重要信息。在棉纺织工人中，对症状问卷或轮班间FEV1下降≥5%持续有反应的人似乎肺功能受损风险增加。
