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职业暴露与医生诊断的哮喘

Occupational exposures and physician-diagnosed asthma.

作者信息

Xu X, Christiani D C

机构信息

Department of Environmental Health, Harvard School of Public Health, Boston.

出版信息

Chest. 1993 Nov;104(5):1364-70. doi: 10.1378/chest.104.5.1364.

Abstract

Data from a community-based random sample of 3,606 adults 40 to 69 years of age residing in Beijing, China, were used to examine the relationship between occupational exposures to dusts and gases/fumes and physician-diagnosed asthma. The prevalence of asthma was 3.9 percent for men and 3.8 percent for women. After adjusting for sex, age, education, residential areas, indoor coal combustion, and smoking status, the attributable risks of asthma were 1.7 percent and 1.2 percent for dust and gas/fume exposure, respectively. The adjusted odds ratios of asthma for dust and gas/fume exposed groups were 1.6 (95 percent confidence interval [CI], 1.1 to 2.2) and 1.4 (95 percent CI, 0.9 to 2.1), which were independent of sex and smoking status. When subjects were classified into none, dust-only, gas/fume-only, and both-exposure groups, the estimated odds ratios of asthma were 1.3 (95 percent CI, 0.9 to 2.1) in dust-only group, 0.9 (95 percent CI, 0.5 to 1.9) in fume-only group, and 2.1 (95 percent CI, 1.2 to 3.6) in both-exposure group, suggesting a combining effect of the two agents. There was an exposure-response relationship between dust and gas/fume exposures and asthma. In analysis of specific occupational agents, our findings are consistent with previously reported airway effects of organic dusts, but they also suggest that exposure to organic solvents may result in asthma, particularly when combined with dust.

摘要

来自中国北京3606名年龄在40至69岁之间的社区随机抽样成年人的数据,用于研究职业性接触粉尘和气体/烟雾与医生诊断哮喘之间的关系。男性哮喘患病率为3.9%,女性为3.8%。在调整了性别、年龄、教育程度、居住地区、室内燃煤和吸烟状况后,粉尘和气体/烟雾接触导致哮喘的归因风险分别为1.7%和1.2%。粉尘和气体/烟雾暴露组哮喘的调整后比值比分别为1.6(95%置信区间[CI],1.1至2.2)和1.4(95%CI,0.9至2.1),这与性别和吸烟状况无关。当受试者被分为无暴露、仅粉尘暴露、仅气体/烟雾暴露和双重暴露组时,仅粉尘暴露组哮喘的估计比值比为1.3(95%CI,0.9至2.1),仅烟雾暴露组为0.9(95%CI,0.5至1.9),双重暴露组为2.1(95%CI,1.2至3.6),表明两种因素存在联合作用。粉尘和气体/烟雾暴露与哮喘之间存在暴露-反应关系。在对特定职业因素的分析中,我们的研究结果与先前报道的有机粉尘对气道的影响一致,但也表明接触有机溶剂可能导致哮喘,尤其是与粉尘联合接触时。

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