Kennedy S M, Chan-Yeung M, Teschke K, Karlen B
Occupational Hygiene Program, Respiratory Division, Department of Medicine, and Department of Health Care and Epidemiology, University of British Columbia, Vancouver, British Columbia, Canada.
Am J Respir Crit Care Med. 1999 Jan;159(1):87-93. doi: 10.1164/ajrccm.159.1.9804071.
To investigate early pulmonary responses to metalworking fluid exposure, we enrolled first-year machinist apprentices and apprentices in three other trades into a 2-yr longitudinal study. We obtained complete data for 82 machinists and 159 control subjects. Tests included respiratory questionnaires, spirometry, methacholine challenge, and allergy skin tests. Details on duration of exposure were collected by interview and 68 representative full shift personal samples for "total aerosol" were obtained from 13 shops (mean: 0.46 mg/m3, range: < 0.7 to 3.65 mg/m3). Machinists and control subjects did not differ at baseline. At follow-up, average change in bronchial responsiveness was double in machinists compared with control subjects (p = 0.05), and machinists were more likely to have developed new bronchial hyperresponsiveness (BHR) with asthmalike symptoms. In linear regression analysis, for predictors of methacholine slope, increased BHR was associated with duration of exposure to both synthetic and soluble metalworking fluids (p < 0.05); in logistic regression analysis, for predictors of BHR, only duration of exposure to synthetic fluids was a significant predictor. Results were not changed when workers with PC20 < 8 mg/ml at baseline were excluded. We conclude that exposure to water-based metalworking fluids (especially synthetic fluids) is associated with increasing BHR during the first 2 yr of exposure.
为了研究金属加工液暴露对肺部的早期影响，我们招募了一年级机械师学徒以及其他三个行业的学徒参与一项为期两年的纵向研究。我们获取了82名机械师和159名对照对象的完整数据。测试包括呼吸问卷、肺功能测定、乙酰甲胆碱激发试验和过敏皮肤试验。通过访谈收集暴露持续时间的详细信息，并从13家工厂获取了68份具有代表性的“总气溶胶”全时段个人样本（平均值：0.46毫克/立方米，范围：<0.7至3.65毫克/立方米）。机械师和对照对象在基线时无差异。随访时，机械师的支气管反应性平均变化是对照对象的两倍（p = 0.05），并且机械师更有可能出现具有哮喘样症状的新的支气管高反应性（BHR）。在线性回归分析中，对于乙酰甲胆碱斜率的预测因素，BHR增加与合成和可溶性金属加工液的暴露持续时间相关（p < 0.05）；在逻辑回归分析中，对于BHR的预测因素，只有合成液的暴露持续时间是一个显著预测因素。排除基线时PC20<8毫克/毫升的工人后，结果没有改变。我们得出结论，在暴露的头两年中，接触水基金属加工液（尤其是合成液）与BHR增加有关。
