Lemasters G K, Lockey J E, Levin L S, McKay R T, Rice C H, Horvath E P, Papes D M, Lu J W, Feldman D J
Department of Environmental Health, University of Cincinnati College of Medicine, OH 45267-0182, USA.
Am J Epidemiol. 1998 Nov 1;148(9):910-9. doi: 10.1093/oxfordjournals.aje.a009717.
An industry-wide pulmonary morbidity study was undertaken to evaluate the respiratory health of employees manufacturing refractory ceramic fibers at five US sites between 1987 and 1989. Refractory ceramic fibers are man-made vitreous fibers used for high temperature insulation. Of the 753 eligible current employees, 742 provided occupational histories and also completed the American Thoracic Society respiratory symptom questionnaire; 736 also performed pulmonary function tests. Exposure to refractory ceramic fibers was characterized by classifying workers as production or nonproduction employees and calculating the duration of time spent in production employment. The risk of working in the production of refractory ceramic fibers and having one or more respiratory symptoms was estimated by adjusted odds ratios and found to be 2.9 (95 percent confidence interval 1.4-6.2) for men and 2.4 (95 percent confidence interval 1.1-5.3) for women. The effect of exposure to refractory ceramic fibers on forced vital capacity (FVC), forced expiratory volume in 1 second (FEV1), the ratio of the two (FEV1/FVC), and forced expiratory flow (liters/second) between 25 percent and 75 percent of the FVC curve (FEF(25-75)) was evaluated by multiple regression analysis using transformed values adjusted for height, by dividing by the square of each individual's height. For men, there was a significant decline in FVC for current and past smokers of 165.4 ml (p < 0.01) and 155.5 ml (p = 0.04), respectively, per 10 years of work in the production of refractory ceramic fibers. For FEV1, the decline was significant (p < 0.01) only for current smokers at 134.9 ml. For women, the decline was greater and significant for FVC among nonsmokers, who showed a decrease of 350.3 ml (p = 0.05) per 10 years of employment in the production of refractory ceramic fibers. These findings indicate that there may be important sex differences in response to occupational and/or environmental exposure.
1987年至1989年间，在美国五个工厂开展了一项全行业范围的肺部发病率研究，以评估生产耐火陶瓷纤维的员工的呼吸健康状况。耐火陶瓷纤维是用于高温隔热的人造玻璃纤维。在753名符合条件的在职员工中，742人提供了职业史，并完成了美国胸科学会呼吸症状问卷；736人还进行了肺功能测试。通过将工人分为生产或非生产员工，并计算其从事生产工作的时长来表征耐火陶瓷纤维暴露情况。通过调整后的比值比估计了从事耐火陶瓷纤维生产且出现一种或多种呼吸症状的风险，结果发现男性为2.9（95%置信区间1.4 - 6.2），女性为2.4（95%置信区间1.1 - 5.3）。采用经身高校正的转换值，通过除以每个个体身高的平方进行多元回归分析，评估了耐火陶瓷纤维暴露对用力肺活量（FVC）、第1秒用力呼气量（FEV1）、二者比值（FEV1/FVC）以及FVC曲线25%至75%之间的用力呼气流量（升/秒）（FEF(25 - 75)）的影响。对于男性，当前吸烟者和既往吸烟者每从事10年耐火陶瓷纤维生产工作，FVC分别显著下降165.4毫升（p < 0.01）和155.5毫升（p = 0.04）。对于FEV1，仅当前吸烟者下降显著（p < 0.01），为134.9毫升。对于女性，非吸烟者的FVC下降幅度更大且显著，每从事10年耐火陶瓷纤维生产工作，下降350.3毫升（p = 0.05）。这些发现表明，在对职业和/或环境暴露的反应方面可能存在重要的性别差异。
