Dufresne A, Loosereewanich P, Bégin R, Dion C, Ecobichon D, Muir D C, Ritchie A C, Perrault G
McGill University, Department of Occupational Health, Faculty of Medicine, Montréal, Québec, Canada.
J Expo Anal Environ Epidemiol. 1998 Jul-Sep;8(3):375-98.
The first objective of the study was to investigate the relationships between quantitative lung mineral dust burdens, dust exposure history, and pathological fibrosis grading in silicotic workers. The second objective was to evaluate the association between particle size parameters, concentration of retained silica particles and the severity of the silicosis. Sixty-seven paraffin-embedded lung tissue samples of silicotic patients were analyzed. The cases of silicosis included 39 non-lung cancer patients and 28 patients with lung cancer. All of the cases were gold miners in the Province of Ontario, Canada.
Particles, both angular and fibrous, were extracted from lung parenchyma by a bleach digestion method, mounted on copper microscopic grids by a carbon replica technique, and analyzed by transmission electron microscopy (TEM) and energy dispersive spectroscopy (EDS). Quartz concentration was also determined by X-ray diffraction (XRD) on a silver membrane filter after the extraction from the lung parenchyma.
Total particles, silica, clay, and quartz also increase in concentration with increased age at death, although the trends are not statistically significant. Quartz concentration has a statistically significant correlation with the silicosis severity score (r = +0.45, p < 0.001), with the geometric mean concentration increasing from 2.24 micrograms/mg in the group having silicosis severity score less than 1 to 4.80 micrograms/mg in group with highest score. Quartz concentration is the only significant explanatory variable of the silicosis severity with a regression coefficient of +0.41 (p < 0.001).
Among several dust exposure variables extracted from the work history of the miners, the calendar year of first exposure was the primary significant determinant of lung retained total particles, silica, and clay minerals, except for quartz. A statistically significant linear relationship between lung quartz concentration and silicosis severity in the gold miners was observed (p < 0.001). Among the several types of lung particles detected, quartz was the only significant determinant of the silicosis severity in the gold miners in this study and vice versa, although it explained only 20% of the variation in the severity. This study suggested no significant linear relationship between the duration of dust exposure and the lung burden of any particle types in the gold miners.
本研究的首要目标是调查矽肺患者肺部矿物粉尘定量负荷、粉尘接触史与病理纤维化分级之间的关系。第二个目标是评估颗粒大小参数、留存二氧化硅颗粒浓度与矽肺严重程度之间的关联。对67例矽肺患者的石蜡包埋肺组织样本进行了分析。矽肺病例包括39例非肺癌患者和28例肺癌患者。所有病例均为加拿大安大略省的金矿工人。
通过漂白消化法从肺实质中提取角状和纤维状颗粒,采用碳复型技术将其安装在铜显微镜载网上,并用透射电子显微镜(TEM)和能量色散光谱(EDS)进行分析。从肺实质中提取后,还通过X射线衍射(XRD)在银膜滤器上测定石英浓度。
尽管趋势无统计学意义,但总颗粒、二氧化硅、粘土和石英的浓度也随死亡年龄的增加而增加。石英浓度与矽肺严重程度评分具有统计学显著相关性(r = +0.45,p < 0.001),几何平均浓度从矽肺严重程度评分小于1的组中的2.24微克/毫克增加到评分最高组中的4.80微克/毫克。石英浓度是矽肺严重程度的唯一显著解释变量,回归系数为+0.41(p < 0.001)。
在从矿工工作史中提取的几个粉尘接触变量中,首次接触的日历年是肺部留存总颗粒、二氧化硅和粘土矿物(石英除外)的主要显著决定因素。观察到金矿工人肺部石英浓度与矽肺严重程度之间存在统计学显著线性关系(p < 0.001)。在本研究检测到的几种肺颗粒类型中,石英是金矿工人矽肺严重程度的唯一显著决定因素,反之亦然,尽管它仅解释了严重程度变异的20%。本研究表明,金矿工人的粉尘接触持续时间与任何颗粒类型的肺部负荷之间无显著线性关系。