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接触松香焊剂烟雾的工人的呼吸道疾病:持续的健康问题。

Respiratory disease in workers exposed to colophony solder flux fumes: continuing health concerns.

作者信息

Palmer K, Crane G

出版信息

Occup Med (Lond). 1997 Nov;47(8):491-6. doi: 10.1093/occmed/47.8.491.

Abstract

The objectives of this study were to establish the prevalence of respiratory, eye, nose and throat symptoms of likely work-relation in workers exposed to colophony solder flux fumes and to assess their lung function. A cross-sectional study was conducted in four medium-sized electronics firms in which control measures to capture solder flux fume were absent or visibly ineffective. All female solders and women working adjacent to soldering stations completed an administered questionnaire concerning symptoms, work history and current soldering frequency. Measurements were made of their forced vital capacity (FVC) and forced expiratory volume in one second (FEV1) during the course of a working shift, using a Vitallograph-Compact portable spirometer. Using weekly hours of soldering as a crude index of current exposure, workers were classified into high (> or = 37 h/wk) and low (< or = 20 h/wk) exposure groups, and their health responses were compared in the analysis. Individuals with symptoms suggestive of work-related asthma were also asked to provide serial peak flow measurements over a further 2-week period, and adequate returns were charted and read by two physicians experienced in the diagnosis of occupational asthma. Data were collected on 152 female workers (overall participation rate = 97%). Symptoms of recurrent, persistent wheeze and/or chest tightness were reported by 75 (49%) of interviewees; 36 (24%) gave a history typical of occupational asthma and six more (4%) a history of pre-existing asthma worsened at work. Twenty-one (14%) of the workforce complained of recurrent breathlessness on moderate exertion; 41 workers (27%) had work-related symptoms of the nose or throat and 25 (16%) had work-related eye symptoms. The odds ratios for 'all wheeze', shortness of breath, and work-related eye, nose and chest symptoms were all significantly greater (raised about 4-5 fold) in women who soldered > or = 37 h/wk when compared with those soldering < or = 20 h/wk. After adjustment by logistic regression for atopy, age and smoking status even higher risk estimates were generally obtained. The odds ratios (OR) and 95% confidence intervals (CI) for high vs. low were: for 'all wheeze', OR = 7.2, CI = 2.5-20.7; for work-related eye symptoms, OR = 5.2, CI = 1.4-19.8; for work-related nasal symptoms, OR = 4.0, CI = 1.4-11.1 and for occupational asthma symptoms, OR = 5.2, CI = 1.4-14.2. Mean FEV1 and FVC percentage difference from expected were slightly lower in full-time solderers than in part-time solderers, but the differences were not significant. Thirty-seven of the 51 workers (73%) who were asked to carry out serial peak flow measurements completed an adequate return: 27 of these records confirmed the presence of asthma, and in all of the cases the history suggested onset post-dating employment in soldering. Eleven peak flow records were indicative of occupational asthma. The health problems associated with colophony solder flux were documented over 18 years ago, but are still clearly apparent in situations where adequate control has not been achieved.

摘要

本研究的目的是确定接触松香焊剂烟雾的工人中可能与工作有关的呼吸道、眼睛、鼻子和喉咙症状的患病率,并评估他们的肺功能。在四家中型电子公司进行了一项横断面研究,这些公司缺乏捕获焊剂烟雾的控制措施或这些措施明显无效。所有女性焊工以及在焊接工位附近工作的女性都完成了一份关于症状、工作经历和当前焊接频率的调查问卷。在一个工作班次期间,使用维他福克紧凑型便携式肺活量计测量她们的用力肺活量(FVC)和一秒用力呼气量(FEV1)。以每周焊接小时数作为当前接触的粗略指标,将工人分为高接触组(≥37小时/周)和低接触组(≤20小时/周),并在分析中比较他们的健康反应。有疑似与工作相关哮喘症状的个体还被要求在另外2周内提供连续的峰值流量测量数据,由两名有职业性哮喘诊断经验的医生对足够的回复进行记录和解读。收集了152名女性工人的数据(总体参与率 = 97%)。75名(49%)受访者报告有反复、持续的喘息和/或胸闷症状;36名(24%)有典型的职业性哮喘病史,另外6名(4%)有工作时原有哮喘加重的病史。21名(14%)工人抱怨中度用力时反复出现呼吸急促;41名工人(27%)有与工作相关的鼻子或喉咙症状,25名(16%)有与工作相关的眼睛症状。与每周焊接≤20小时的女性相比,每周焊接≥37小时的女性中“所有喘息”、呼吸急促以及与工作相关的眼睛、鼻子和胸部症状的优势比均显著更高(提高约4至5倍)。在通过逻辑回归对特应性、年龄和吸烟状况进行调整后,通常会得到更高的风险估计值。高接触组与低接触组的优势比(OR)和95%置信区间(CI)为:“所有喘息”,OR = 7.2,CI = 2.5 - 20.7;与工作相关的眼睛症状,OR = 5.2,CI = 1.4 - 19.8;与工作相关的鼻部症状,OR = 4.0,CI = 1.4 - 11.1;职业性哮喘症状,OR = 5.2,CI = 1.4 - 14.2。全职焊工的平均FEV1和FVC与预期的百分比差异略低于兼职焊工,但差异不显著。在被要求进行连续峰值流量测量的51名工人中,有37名(73%)完成了足够的回复:其中27份记录证实存在哮喘,并且在所有这些病例中,病史表明发病时间在开始从事焊接工作之后。11份峰值流量记录表明为职业性哮喘。与松香焊剂相关的健康问题在18年前就有记录,但在未实现充分控制的情况下仍然明显存在。

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