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机械工人的气道反应性、呼吸道症状及可溶性油雾暴露情况。

Airway responsiveness, respiratory symptoms, and exposures to soluble oil mist in mechanical workers.

作者信息

Massin N, Bohadana A B, Wild P, Goutet P, Kirstetter H, Toamain J P

机构信息

Institut National de Recherche et de Sécurité, INRS, Vandoeuvre-lès-Nancy, France.

出版信息

Occup Environ Med. 1996 Nov;53(11):748-52. doi: 10.1136/oem.53.11.748.

Abstract

OBJECTIVES

To assess the relation between measured levels of exposure to soluble oil mists in a plant manufacturing ball bearings, and both respiratory symptoms and airway responsiveness in the workforce.

METHODS

114 male workers exposed to oil mist and 55 unexposed male controls from nearby factories were studied. Soluble oil mist concentrations were measured with area samplers. Respiratory symptoms were assessed by questionnaire and measurement of airway responsiveness to methacholine with an abbreviated method. Subjects were labelled positive to methacholine airway challenge (MAC+) if forced expiratory volume in one second (FEV1) fell by > or = 20%. The linear dose-response slope was calculated as the percentage fall in FEV1 at the last dose divided by the total dose given.

RESULTS

Geometric mean concentrations of oil mists ranged from 0.65 mg/m3 (GSD 1.29) to 2.20 mg/m3 (GSD 1.55) based on 92 measurements obtained from 1979-93. The prevalence of chronic cough or phlegm, bouts of bronchitis, and dyspnoea was greater among exposed workers than among controls (odds ratio (OR) 4.64, P = 0.002 for chronic cough and phlegm). After adjustment for smoking and age, dyspnoea was significantly related to an index of cumulative exposure to oil mist (OR 1.44, P = 0.006/10 y.mg/m3). The proportion of MAC+ subjects was similar in the two groups. However, after adjustment for baseline FEV1 and age, the dose-response slope was significantly steeper among exposed workers than among controls (P = 0.01), a finding indicating airway hyperresponsiveness in the exposed workers. Furthermore, the dose-response slope was significantly related to baseline FEV1, age, and, after adjustment for FEV1, the index of cumulative exposure to oil (P = 0.004).

CONCLUSION

Subjects with exposure to soluble oil mist in the metal industry are at risk of developing both respiratory symptoms and airway hyperresponsiveness.

摘要

目的

评估一家生产滚珠轴承工厂中测得的可溶性油雾暴露水平与工人呼吸道症状及气道反应性之间的关系。

方法

对114名接触油雾的男性工人和55名来自附近工厂的未接触男性对照进行研究。使用区域采样器测量可溶性油雾浓度。通过问卷调查评估呼吸道症状,并采用简化方法测量气道对乙酰甲胆碱的反应性。如果一秒用力呼气容积(FEV1)下降≥20%,则受试者被标记为乙酰甲胆碱气道激发试验阳性(MAC+)。线性剂量反应斜率计算为最后剂量时FEV1下降的百分比除以给予的总剂量。

结果

根据1979 - 1993年获得的92次测量结果,油雾的几何平均浓度范围为0.65毫克/立方米(几何标准差1.29)至2.20毫克/立方米(几何标准差1.55)。接触组工人中慢性咳嗽或咳痰、支气管炎发作和呼吸困难的患病率高于对照组(慢性咳嗽和咳痰的优势比(OR)为4.64,P = 0.002)。在调整吸烟和年龄后,呼吸困难与油雾累积暴露指数显著相关(OR 1.44,P = 0.006/10年·毫克/立方米)。两组中MAC+受试者的比例相似。然而,在调整基线FEV1和年龄后,接触组工人的剂量反应斜率明显比对照组更陡(P = 0.01),这一发现表明接触组工人存在气道高反应性。此外,剂量反应斜率与基线FEV1、年龄以及在调整FEV1后与油雾累积暴露指数显著相关(P = 0.004)。

结论

金属行业中接触可溶性油雾的受试者有出现呼吸道症状和气道高反应性的风险。

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