Wang X, Yu I T, Wong T W, Yano E
Department of Community and Family Medicine, Faculty of Medicine, Chinese University of Hong Kong, Hong Kong.
Am J Ind Med. 1999 Feb;35(2):124-31. doi: 10.1002/(sici)1097-0274(199902)35:2<124::aid-ajim3>3.0.co;2-m.
Although severe impairment of pulmonary function is believed to occur commonly in complicated pneumoconiosis, the relationships of simple coal workers' pneumoconiosis (CWP) to pulmonary function and respiratory symptoms have remained under debate. The study aims to investigate if simple pneumoconiosis is associated with significant impairment of pulmonary function and increased risk of respiratory symptoms.
Spirometry and diffusing capacity were performed in 205 miners with simple CWP and 289 without X ray evidence of pneumoconiosis, who were selected from a large underground coal mine in China. A questionnaire on occupational history and respiratory symptoms including breathlessness, chronic cough, and phlegm was administered. The presence or absence of emphysema on their X-ray films was also evaluated. Logistic regression and multiple linear regression analysis were applied to estimate the independent effect of CWP on respiratory symptoms and parameters of pulmonary function.
On the average, the miners with CWP had lower values of pulmonary function and higher prevalences of respiratory symptoms, and emphysema than did those without. The simple CWP was associated with increased risk of the respiratory symptoms after adjusting for age, smoking, and years underground. Regression analysis showed that the CWP had significantly independent effects on parameters of pulmonary function. Even when the effects of emphysema, respiratory symptoms indicating chronic bronchitis were taken into consideration, the significant relationship between CWP and decrements in FVC and diffusing capacity remained.
The findings of this study are consistent with simple CWP being a contributor to significant decrements in pulmonary function, and to increased risk of respiratory symptoms.
尽管人们认为在复杂性尘肺病中肺功能严重受损很常见，但单纯性煤工尘肺（CWP）与肺功能及呼吸道症状之间的关系仍存在争议。本研究旨在调查单纯性尘肺病是否与肺功能显著受损及呼吸道症状风险增加有关。
对从中国某大型地下煤矿选取的205例患有单纯性CWP的矿工和289例无尘肺病X线证据的矿工进行了肺活量测定和弥散功能检测。发放了一份关于职业史和呼吸道症状（包括气短、慢性咳嗽和咳痰）的问卷。还评估了他们X线胸片上是否存在肺气肿。应用逻辑回归和多元线性回归分析来估计CWP对呼吸道症状和肺功能参数的独立影响。
平均而言，患有CWP的矿工肺功能值较低，呼吸道症状和肺气肿的患病率高于未患CWP的矿工。在调整年龄、吸烟和井下工作年限后，单纯性CWP与呼吸道症状风险增加有关。回归分析表明，CWP对肺功能参数有显著的独立影响。即使考虑到肺气肿以及提示慢性支气管炎的呼吸道症状的影响，CWP与用力肺活量（FVC）和弥散功能下降之间的显著关系仍然存在。
本研究结果表明，单纯性CWP会导致肺功能显著下降，并增加呼吸道症状风险。
