Sobaszek A, Edme J L, Boulenguez C, Shirali P, Mereau M, Robin H, Haguenoer J M
C.E.R.E.S.T.E., Institut de Médecine du Travail, Lille, France.
J Occup Environ Med. 1998 Mar;40(3):223-9. doi: 10.1097/00043764-199803000-00004.
In the last few years, many studies have been carried out concerning the effects of fumes from stainless steel (SS) welding on the health of welders. The respiratory effects of exposure to SS welding fumes have already been studied, but the results of lung function investigations have not been consistent. However, the main factor of risk for the welders' health seems to be related to the great concentration of chromium and nickel contained in fumes coming from SS welding. The aim of this study was to detect the chronic effects of SS welding exposure on pulmonary symptoms and ventilatory function tests. Respiratory symptoms and lung function tests were studied in 134 SS welders and 252 controls (C). Welders and controls were of similar average age, height, and duration in employment. The smoking habits of the groups were also similar. The medical questionnaire on respiratory symptoms was a version of the Medical Research Council questionnaire, modified by the British Occupational Hygiene Society. The flow-volume curves were performed with a calibrated pneumotachograph spirometer before each subject started working. After adjustment for tobacco habits, the SS welders presented a higher prevalence of bronchial irritative symptoms such as cough (P = 0.01) or sputum production (P = 0.02) than the controls. On the other hand, chronic bronchitis appeared to be significantly linked to tobacco consumption. The pulmonary function analysis underscored no significant difference between stainless steel welders and controls (forced expiratory volume in one second, observed/predicted: SS = 0.99 vs C = 0.98; maximal midexpiratory flow, observed/predicted: SS = 0.90 vs C = 0.92; maximal expiratory flow at 50 % of the forced vital capacity, observed/predicted: SS = 0.95 vs C = 0.95). On the other hand, by the mean of the two-ways analysis, a significant tobacco effect was found, without exposure or interaction of tobacco-exposure effects. There was no influence of the specific welding processes on the spirographic parameters, but a decrease in spirographic values after 25 years of welding activity was evident. The results of multiple regression indicated that age was not a confounding factor.
在过去几年中,已经开展了许多关于不锈钢(SS)焊接烟雾对焊工健康影响的研究。暴露于SS焊接烟雾的呼吸道影响已经得到研究,但肺功能调查结果并不一致。然而,对焊工健康构成风险的主要因素似乎与SS焊接产生的烟雾中所含的高浓度铬和镍有关。本研究的目的是检测SS焊接暴露对肺部症状和通气功能测试的慢性影响。对134名SS焊工和252名对照者(C)进行了呼吸道症状和肺功能测试。焊工和对照者的平均年龄、身高和工作年限相似。两组的吸烟习惯也相似。关于呼吸道症状的医学问卷是医学研究委员会问卷的一个版本,由英国职业卫生协会修改。在每个受试者开始工作前,使用校准的呼吸流速仪肺活量计进行流量-容积曲线测试。在调整吸烟习惯后,SS焊工出现咳嗽(P = 0.01)或咳痰(P = 0.02)等支气管刺激性症状的患病率高于对照者。另一方面,慢性支气管炎似乎与烟草消费显著相关。肺功能分析强调不锈钢焊工和对照者之间没有显著差异(一秒用力呼气量,实测/预测值:SS = 0.99 vs C = 0.98;最大呼气中期流速,实测/预测值:SS = 0.90 vs C = 0.92;用力肺活量50%时的最大呼气流量,实测/预测值:SS = 0.95 vs C = 0.95)。另一方面,通过双向分析的方法,发现了显著的烟草效应,不存在烟草暴露效应的暴露或相互作用。特定的焊接工艺对肺功能参数没有影响,但焊接活动25年后肺功能值有所下降。多元回归结果表明年龄不是一个混杂因素。