Robins T, Seixas N, Franzblau A, Abrams L, Minick S, Burge H, Schork M A
Department of Environmental and Industrial Health, University of Michigan, USA.
Am J Ind Med. 1997 May;31(5):510-24. doi: 10.1002/(sici)1097-0274(199705)31:5<510::aid-ajim4>3.0.co;2-x.
Exposure to metalworking fluids has been linked to modest cross-shift reductions in FEV1 and occupational asthma. To identify responsible agents, we measured personal exposures to thoracic particulate (TP), viable plus nonviable thoracic bacteria (BAC), and vapor phase nicotine (VPN) (as a surrogate for tobacco particulate) among 83 machinists exposed to soluble oils and 46 dry assemblers working in an automotive transmission machining plant using biocides infrequently. The participants completed interviews and performed pre- and postshift spirometry on Monday and Thursday of the same week in each of three rounds of data collection (June 1992, January 1993, June 1993). Generalized estimating equations were used to combine information across rounds in multiple regression models of cross-shift and cross-week changes in forced expiratory volume, I second (FEV1) and forced vital capacity (FVC). Mean seniority was 19 years among machinists. Mean personal TP levels were 0.41 mg/m3 in machinists and 0.13 mg/m3 in assemblers. Six of the 83 machinists and none of the 46 assemblers experienced a greater than 19% cross-shift decrement in FEV1 or FVC at least once (p = .07). In regression models using either TP or BAC, among subjects with lower baseline (Monday preshift) FEV1/FVC ratios, increasing exposure was significantly associated with increasing cross-shift decrements in FEV1 and FVC in linear models, and with increased likelihood of a 10% or greater cross-shift decrement in FEV1 or FVC in logistic models. Adjustment of TP for VPN did not affect models significantly. We conclude that clinically important cross-shift decrements in pulmonary function are associated with exposure to metalworking fluid aerosols within a high-seniority population.
接触金属加工液与第一秒用力呼气容积（FEV1）出现适度的班内下降以及职业性哮喘有关。为了确定致病因素，我们测量了83名接触可溶性油的机械师以及46名在一家汽车变速器加工工厂从事干式装配工作且很少使用杀菌剂的工人的个人胸段颗粒物（TP）、存活及非存活胸段细菌（BAC）和气相尼古丁（VPN，作为烟草颗粒物的替代物）暴露量。在三轮数据收集（1992年6月、1993年1月、1993年6月）的每一轮中，参与者在同一周的周一和周四完成访谈并进行班前和班后肺功能测定。在多元回归模型中，使用广义估计方程来合并各轮数据，以分析用力呼气容积1秒（FEV1）和用力肺活量（FVC）的班内和跨周变化。机械师的平均工龄为19年。机械师的个人TP平均水平为0.41毫克/立方米，装配工人为0.13毫克/立方米。83名机械师中有6人、46名装配工人中无人至少有一次FEV1或FVC班内下降超过19%（p = 0.07）。在使用TP或BAC的回归模型中，对于基线（周一班前）FEV1/FVC比值较低的受试者，在线性模型中，暴露增加与FEV1和FVC的班内下降增加显著相关，在逻辑模型中，与FEV1或FVC班内下降10%或更多的可能性增加相关。对TP进行VPN校正后，模型未受到显著影响。我们得出结论，在高工龄人群中，临床上重要的肺功能班内下降与接触金属加工液气溶胶有关。
