Henneberger P K, Attfield M D
Division of Respiratory Disease Studies, National Institute for Occupational Safety and Health, Morgantown, West Virginia 26505, USA.
Am J Respir Crit Care Med. 1996 May;153(5):1560-6. doi: 10.1164/ajrccm.153.5.8630602.
In a previous study of new miners from the National Study of Coal Workers' Pneumoconiosis (NSCWP), researchers examined changes in spirometry values associated with coal mine dust exposure (Br J Ind Med 1993; 50:929-937). An unusual pattern of dust-related effects was observed: initial sharp decrements in FVC and FEV1 were followed by partial recovery. In the current study, similar methods were used to analyze data from experienced miners. Each of 1,915 male subjects contributed data from two of the NSCWP field surveys: either Round 1 (1969-71) and Round 2 (1972-75) and Round 4 (1985-88). From the cross-sectional analysis at Round 1 or Round 2 (R1/R2), changes of +0.6 ml FVC and -0.5 ml FEV1 were associated with each mg/m3-yr of cumulative coal mine dust exposure, but were not statistically significant (p > 0.05). From the analysis of longitudinal change in spirometry from R1/R2 to Round 4 (R4), annual declines in FVC (-0.10 ml/yr per mg/m3-yr, p = 0.003) and FEV1 (-0.07 ml/yr per mg/m3-yr, p = 0.006) were associated with pre-R1/R2 exposure. Both the pattern and the magnitude of the exposure-response relationship were different for experienced versus new miners. Possible reasons for these contrasts include differences in cumulative exposure between the two groups and the healthy worker effect among experienced miners.
在之前一项针对全国煤矿工人尘肺病研究(NSCWP)中新矿工的研究中,研究人员检测了与煤矿粉尘暴露相关的肺功能测定值变化(《英国工业医学杂志》1993年;50:929 - 937)。观察到一种与粉尘相关影响的不寻常模式:用力肺活量(FVC)和第一秒用力呼气容积(FEV1)最初急剧下降,随后部分恢复。在当前研究中,使用了类似方法分析有经验矿工的数据。1915名男性受试者每人提供了来自NSCWP两次现场调查的数据:要么是第一轮(1969 - 1971年)和第二轮(1972 - 1975年),要么是第一轮(1969 - 1971年)和第四轮(1985 - 1988年)。从第一轮或第二轮(R1/R2)的横断面分析来看,每毫克/立方米 - 年的累积煤矿粉尘暴露与FVC增加0.6毫升和FEV1减少0.5毫升相关,但无统计学意义(p > 0.05)。从R1/R2到第四轮(R4)肺功能测定纵向变化的分析来看,FVC(-0.10毫升/年每毫克/立方米 - 年,p = 0.003)和FEV1(-0.07毫升/年每毫克/立方米 - 年,p = 0.006)的年下降与R1/R2之前的暴露相关。有经验矿工与新矿工相比,暴露 - 反应关系的模式和程度都不同。这些差异的可能原因包括两组累积暴露的差异以及有经验矿工中的健康工人效应。