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科罗拉多州一个采矿社区的矽肺病风险。

Risk of silicosis in a Colorado mining community.

作者信息

Kreiss K, Zhen B

机构信息

Department of Medicine, National Jewish Center for Immunology and Respiratory Medicine, University of Colorado school of Medicine, Denver, USA.

出版信息

Am J Ind Med. 1996 Nov;30(5):529-39. doi: 10.1002/(SICI)1097-0274(199611)30:5<529::AID-AJIM2>3.0.CO;2-O.

Abstract

We investigated exposure-response relations for silicosis among 134 men over age 40 who had been identified in a previous community-based random sample study in a mining town. Thirty-two percent of the 100 dust-exposed subjects had radiologic profusions of small opacities of I/O or greater at a mean time since first silica exposure of 36.1 years. Of miners with cumulative silica exposures of 2 mg/m3-years or less, 20% had silicosis; of miners accumulating > 2 mg/m3 years, 63% had silicosis. Average silica exposure was also strongly associated with silicosis prevalence rates, with 13% silicotics among those with average exposure of 0.025-0.05 mg/m3, 34% among those with exposures of > 0.05-0.1 mg/m3, and 75% among those with average exposures > 0.1 mg/m3. Logistic regression models demonstrated that time since last silica exposure and either cumulative silica exposure or a combination of average silica exposure and duration of exposure predicted silicosis risk. Exposure-response relations were substantially higher using measured silica exposures than using estimated silica exposures based on measured dust exposures assuming a constant silica proportion of dust, consistent with less exposure misclassification. The risk of silicosis found in this study is higher than has been found in workforce studies having no follow-up of those leaving the mining industry and in studies without job title-specific silica measurements, but comparable to several recent studies of dust exposure-response relationships which suggest that a permissible exposure limit of 0.1 mg/m3 for silica does not protect against radiologic silicosis.

摘要

我们对134名40岁以上男性的矽肺病暴露-反应关系进行了调查,这些男性是在之前一个矿业城镇基于社区的随机抽样研究中被识别出来的。在100名接触粉尘的受试者中,32%在首次接触二氧化硅后的平均36.1年时,胸部X线显示有I/O级或更高等级的小阴影密集度。累积二氧化硅暴露量在2mg/m³-年及以下的矿工中,20%患有矽肺病;累积暴露量>2mg/m³-年的矿工中,63%患有矽肺病。平均二氧化硅暴露量也与矽肺病患病率密切相关,平均暴露量为0.025-0.05mg/m³的人群中,矽肺病患者占13%;暴露量>0.05-0.1mg/m³的人群中,这一比例为34%;平均暴露量>0.1mg/m³的人群中,矽肺病患者占75%。逻辑回归模型表明,自上次接触二氧化硅后的时间以及累积二氧化硅暴露量,或者平均二氧化硅暴露量与暴露时长的组合,均可预测矽肺病风险。与基于假设粉尘中二氧化硅比例恒定的测量粉尘暴露量估算的二氧化硅暴露量相比,使用实测二氧化硅暴露量得出的暴露-反应关系要高得多,这与较低的暴露误分类情况一致。本研究中发现的矽肺病风险高于那些未对离开采矿业的人员进行随访的劳动力研究,以及未针对特定工作岗位测量二氧化硅暴露量的研究,但与近期几项关于粉尘暴露-反应关系的研究结果相当,这些研究表明,二氧化硅的职业接触限值为0.1mg/m³并不能预防放射性矽肺病。

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