Wang X R, Yano E, Nonaka K, Wang M, Wang Z
Department of Hygiene and Public Health, Teikyo University School of Medicine, Tokyo, Japan.
Arch Environ Health. 1998 Jul-Aug;53(4):292-8. doi: 10.1080/00039899809605711.
Researchers disagree about whether exposure to asbestos causes significant respiratory impairments and airway obstruction in the absence of radiographic asbestosis and smoking. To obtain confirmatory information, the authors examined pulmonary function of 208 nonsmoking female asbestos workers who did not have asbestosis and 136 controls. The authors observed an overall lower single-breath carbon monoxide diffusing capacity in the asbestos workers than in controls. In addition, significant decreases in percentage vital capacity, percentage forced vital capacity, and percentage mean forced expiratory flow during the middle half of the forced vital capacity were evident in the older workers. Logistic regression analysis revealed that asbestos exposure was associated with abnormal single-breath carbon monoxide diffusing capacity, vital capacity, and mean forced expiratory flow during the middle half of the forced vital capacity among the older workers. The age-related decline in vital capacity, forced vital capacity, and mean forced expiratory flow during the middle half of the forced vital capacity was significantly greater in the asbestos workers than the controls. The findings imply that asbestos-exposure per se contributes predominantly to restricted lung volume and reduced single-breath carbon monoxide diffusing capacity. Asbestos may also cause slight airway obstruction, especially in workers who are heavily exposed.
对于在没有影像学石棉肺和吸烟的情况下,接触石棉是否会导致严重的呼吸功能损害和气道阻塞,研究人员存在分歧。为了获得确凿的信息,作者检查了208名无石棉肺的非吸烟女性石棉工人和136名对照者的肺功能。作者观察到,石棉工人的单次呼吸一氧化碳弥散能力总体上低于对照者。此外,老年工人的肺活量百分比、用力肺活量百分比以及用力肺活量中间一半时间的平均用力呼气流量均有显著下降。逻辑回归分析显示,在老年工人中,接触石棉与单次呼吸一氧化碳弥散能力异常、肺活量以及用力肺活量中间一半时间的平均用力呼气流量异常有关。石棉工人肺活量、用力肺活量以及用力肺活量中间一半时间的平均用力呼气流量与年龄相关的下降幅度明显大于对照者。这些发现表明,石棉暴露本身主要导致肺容积受限和单次呼吸一氧化碳弥散能力降低。石棉还可能导致轻微的气道阻塞,尤其是在接触大量石棉的工人中。