Malo J L, Cartier A, Dolovich J
Dept of Chest Medicine, Hôpital du Sacré-Coeur, Montreal, Canada.
Eur Respir J. 1993 Mar;6(3):447-50.
We describe a subject who developed asthma symptoms 2 yrs after being employed at a plant where metals were galvanized in heated zinc. The subject was not atopic. Baseline spirometry was normal three months after he left work but there was mild bronchial hyperresponsiveness to methacholine. Monitoring of forced expiratory volume in one second (FEV1) during a day at work showed a maximum fall in FEV1 of 24% at the end of the day and an increase in bronchial responsiveness on the following day. Environmental monitoring revealed that zinc and iron were present in the working environment at concentrations that were lower than the "threshold limit value-short term exposure level" (TLV-STEL) standards. Positive immediate skin tests to zinc sulphate at concentrations of 1 and 10 mg.ml-1 were obtained, although no specific immunoglobulin E (IgE) antibodies to zinc could be found. Skin tests with copper, chromium and cobalt were negative. Specific inhalation challenges were performed, having the subject inhale a solution of zinc sulphate at a 10 mg.ml-1 concentration for 6 min. An immediate reaction was elicited (maximum fall in FEV1 of 23%). We conclude that zinc can cause occupational asthma.
我们描述了一名受试者，其在一家使用加热锌进行金属镀锌的工厂工作2年后出现哮喘症状。该受试者并非特应性体质。他离职三个月后基线肺功能检查正常，但对乙酰甲胆碱有轻度支气管高反应性。在工作日对一秒用力呼气量（FEV1）进行监测发现，当天结束时FEV1最大下降了24%，且次日支气管反应性增加。环境监测显示，工作环境中锌和铁的浓度低于“阈限值-短期暴露水平”（TLV-STEL）标准。对浓度为1和10mg/ml的硫酸锌进行皮肤点刺试验呈阳性，尽管未发现针对锌的特异性免疫球蛋白E（IgE）抗体。对铜、铬和钴进行的皮肤试验为阴性。进行了特异性吸入激发试验，让受试者吸入浓度为10mg/ml的硫酸锌溶液6分钟。引发了即刻反应（FEV1最大下降23%）。我们得出结论，锌可导致职业性哮喘。
