Laraqui C, Harourate K, Belamallem I, Benhaymoud N, Verger C
Société marocaine de Médecine du travail et d'ergonomie, Rennes.
Rev Mal Respir. 1996 Oct;13(5):485-92.
The addition of encapsulated enzymes (proteases and lipases) to detergents in Morocco dates from 1993. We have carried out a retrospective survey which has enabled us to evaluate the prevalence of the clinical symptoms and respiratory function problems in two groups, one exposed and the other non-exposed. This enquiry which concerns 32 exposed workers and 42 non-exposed consisted of a questionnaire (CECA OMS), a chest x-ray and some respiratory function tests. The medical study involves a question in the workplace with an evaluation of dust levels (weight of dust and enzyme activity). Fifty seven per cent of those exposed had clinical respiratory symptomatology against only 7 per cent of those who were not exposed. Rhinitis, asthma, cough, chronic bronchitis, eczema and conjunctivitis were significantly more frequent in those exposed than in the non-exposed. Respiratory function was altered in 65.5 per cent of the exposed against only 38.6 per cent of those who were not exposed. The overall lung function was of an obstructive type. The peak flow (VEMS) were more frequently reduced in those exposed (25 per cent) than in the non-exposed (7.14 per cent). These anomalies were worst at the end of a day's work. Atopy seems to be a potentiating factor. Tobacco interferes significantly in the alteration of respiratory function parameters. The enquiry in the work place revealed evidence of insufficient means of protection for the work force and elevated levels of dust which pass the mean recommended atmospheric values (500 mcg per cubic mm). On the other hand, enzymatic activity of the dust collected remained within normal limits (< 0.5 GU/m3). It is thus imperative to develop means for collective prevention (a more effective encapsulation of the enzymes, work in closed areas, ventilation with more effective dust extraction) and individuals (protective clothing and specific respiratory masks for the enzymes) to maximally reduce the risk.
摩洛哥自1993年起在洗涤剂中添加包封酶（蛋白酶和脂肪酶）。我们进行了一项回顾性调查，得以评估两组人群中临床症状和呼吸功能问题的患病率，一组为暴露组，另一组为非暴露组。这项涉及32名暴露工人和42名非暴露工人的调查包括一份问卷（CECA OMS）、一次胸部X光检查和一些呼吸功能测试。医学研究涉及工作场所的一个问题以及对粉尘水平（粉尘重量和酶活性）的评估。暴露组中有57%的人有临床呼吸道症状，而非暴露组中只有7%的人有此类症状。鼻炎、哮喘、咳嗽、慢性支气管炎、湿疹和结膜炎在暴露组中的发生率明显高于非暴露组。65.5%的暴露组人员呼吸功能出现改变，而非暴露组中这一比例仅为38.6%。总体肺功能呈阻塞型。暴露组中峰值流量（VEMS）降低的情况比非暴露组更频繁（分别为25%和7.14%）。这些异常在一天工作结束时最为严重。特应性似乎是一个增强因素。烟草对呼吸功能参数的改变有显著影响。工作场所调查显示，劳动力的防护手段不足，粉尘水平超过了推荐的大气平均值（每立方毫米500微克）。另一方面，所收集粉尘的酶活性仍在正常范围内（<0.5 GU/m3）。因此，必须制定集体预防措施（更有效的酶包封、在封闭区域工作、采用更有效的粉尘抽取通风）和个人预防措施（防护服和针对酶的特定呼吸面罩），以最大程度降低风险。
