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接触含氧化锌烟雾的工人的短期通气效应:强迫振荡技术与肺活量测定法的比较

Short-term ventilatory effects in workers exposed to fumes containing zinc oxide: comparison of forced oscillation technique with spirometry.

作者信息

Pasker H G, Peeters M, Genet P, Clément J, Nemery B, Van de Woestijne K P

机构信息

Laboratorium voor Pneumologie, K.U. Leuven, Belgium.

出版信息

Eur Respir J. 1997 Jul;10(7):1523-9. doi: 10.1183/09031936.97.10071523.

Abstract

Following the occurrence of metal fume fever in some subjects after the installation of an electric furnace in a steel plant, a survey was undertaken to examine whether subjects exposed to fumes containing zinc oxide would exhibit a detectable impairment in ventilatory function, and whether a forced oscillation technique (FOT) was more suited for this detection than conventional spirometry. Pulmonary function measurements were made in 57 exposed workers (production or maintenance) and 55 nonexposed workers (maintenance or strandcasting department) at the beginning and near the end of a work shift (day or night). Maximal expiratory volumes and flows were measured by means of a pneumotachograph, and respiratory resistance (Rrs) and reactance at various frequencies by means of a FOT. These measurements were repeated 1 day later. During the day shift, there were no significant differences in pulmonary function between exposed and control workers. However, during the night shift, an influence of exposure on pulmonary function was revealed both by spirometry and by FOT: workers exposed at night showed a slight decrease in vital capacity (VC) and in forced expiratory volume in one second (FEV1), and a decline in respiratory resistance (Rrs) with oscillation frequency, that were more marked than in unexposed subjects. In contrast to the frequency dependence of Rrs, the changes of lung volumes and expiratory flows were related to differences in initial values between exposed and nonexposed workers. The decrease in FEV1 was maintained the day after exposure. The forced oscillation technique proved at least as sensitive as spirometry to detect small across-shift changes in ventilatory function. Although the effects on pulmonary function were small, it is likely that they represent a subclinical response to the inhalation of small quantities of zinc oxide.

摘要

在某钢铁厂安装电炉后,部分人员出现了金属烟热。为此开展了一项调查,以检验接触含氧化锌烟雾的人员通气功能是否会出现可检测到的损害,以及强迫振荡技术(FOT)在检测方面是否比传统肺量计更适用。在一个工作日(白班或夜班)开始时和接近结束时,对57名接触烟雾的工人(生产或维修人员)和55名未接触烟雾的工人(维修或连铸部门人员)进行了肺功能测量。通过呼吸流速计测量最大呼气量和流速,通过强迫振荡技术测量不同频率下的呼吸阻力(Rrs)和电抗。一天后重复这些测量。在白班期间,接触烟雾的工人和对照工人的肺功能没有显著差异。然而,在夜班期间,肺量计和强迫振荡技术均显示接触烟雾对肺功能有影响:夜间接触烟雾的工人肺活量(VC)和一秒用力呼气量(FEV1)略有下降,呼吸阻力(Rrs)随振荡频率下降,且比未接触烟雾的受试者更为明显。与Rrs的频率依赖性不同,肺容积和呼气流量的变化与接触烟雾和未接触烟雾工人的初始值差异有关。FEV1的下降在接触后的第二天仍然存在。强迫振荡技术在检测通气功能的微小跨班变化方面至少与肺量计一样敏感。尽管对肺功能的影响较小,但很可能这些影响代表了对吸入少量氧化锌的亚临床反应。

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