Zock J P, Heederik D, Brunekreef B
Environmental and Occupational Health, Wageningen Agricultural University, Wageningen, The Netherlands.
Am J Respir Crit Care Med. 1999 Jan;159(1):137-42. doi: 10.1164/ajrccm.159.1.9803026.
There is limited knowledge about which internal and external factors influence respiratory effects of occupational endotoxin exposure. Relationships between endotoxin exposure, work-related respiratory symptoms, and acute peak flow changes were studied in 97 shift workers in the potato processing industry. For each worker, across-shift peak flow changes were determined for morning, afternoon, and night shifts. A higher endotoxin exposure was associated with an increased prevalence of work-related symptoms, a smaller peak expiratory flow (PEF) increase across the morning shift, and a larger PEF decrease across afternoon and night shifts. The largest effects occurred during the afternoon shift. No consistent differences between smokers and nonsmokers, and between atopics and nonatopics were observed. We conclude that endotoxin exposure in the potato processing industry is related to across-shift peak flow changes and the occurrence of work-related respiratory symptoms. The host factors smoking and atopy are not important confounding or effect-modifying factors in these relationships. In respiratory health studies among shift workers, it is important to investigate all work shifts before drawing definitive conclusions about exposure-response relationships.
关于哪些内部和外部因素会影响职业性内毒素暴露的呼吸效应，目前所知有限。我们对97名马铃薯加工业轮班工人进行了研究，探讨内毒素暴露、与工作相关的呼吸道症状以及急性峰值流速变化之间的关系。对于每名工人，测定了早班、中班和夜班期间的跨班次峰值流速变化。较高的内毒素暴露与工作相关症状的患病率增加、早班期间呼气峰值流速（PEF）增加幅度较小以及中班和夜班期间PEF下降幅度较大有关。最大的影响发生在中班。未观察到吸烟者与非吸烟者之间以及特应性个体与非特应性个体之间存在一致差异。我们得出结论，马铃薯加工业中的内毒素暴露与跨班次峰值流速变化以及与工作相关的呼吸道症状的发生有关。宿主因素吸烟和特应性在这些关系中并非重要的混杂或效应修饰因素。在轮班工人的呼吸健康研究中，在就暴露-反应关系得出明确结论之前，对所有工作班次进行调查很重要。
