大连市医用X射线工作者健康状况动态观察

目的为了保障放射工作人员的健康,观察长期接触小剂量照射对放射工作人员的影响,为职业病诊断提供基础资料。方法应用前瞻性流行病学研究方法,对大连市从事医用X射线工作人员进行4年的观察研究分析内在变化及影响因素,同时选取非接触射线的人群进行对照。结果医用X射线工作人员神经衰弱综合征、手部损伤发生率、眼晶体混浊、及外周血象、微核异常率及染色体畸变率等指标明显高于对照组,经统计学分析,差异有统计学意义。结论长期小剂量电离辐射对放射工作人员健康具有一定的影响,加强放射防护工作,定期健康监护,贯彻职业病防治法对保证放射工作人员健康与安全尤为重要。     

Four-year follow-up of effects of toluene diisocyanate exposure on the respiratory system in polyurethane foam manufacturing workers

A 4-year cohort study was designed to assess the exposure-effect relationship of working in polyurethane foam (PF) manufacturing factories with exposure to toluene diisocyanate (TDI) and its effects on the respiratory system. This paper describes the results of the first cross-sectional observations. The study population included 90 male workers who had been working in PF factories for 0.5-25 years (mean 13.3 years) (PF workers) and 44 reference workers in the same factories. The mean exposure concentration of TDI calculated from 129 personal samples was 3.2 ppb. Peak exposure excursions above 20 ppb occurred in 16 of 129 samples. Pulmonary function and its change during the working day as assessed by examining the forced expiratory flow-volume curve, respiratory impedance, and airway resistance and specific airway conductance were not different in the PF workers from those in the reference workers. Chest X-radiographs did not show any noteworthy radiological changes. Prevalences of "phlegm in winter," "nasal stuffiness or discharge in winter," and "irritation of eye and throat mucous membranes" were significantly higher in the PF workers. The findings indicate that TDI exposure at levels around 3 ppb may not adversely affect the pulmonary function over many years of exposure of those who are not hypersensitive to TDI. The causal chemicals inducing some respiratory and irritative symptoms could not be specifically identified since the PF workers were exposed not only to TDI but also to other irritative agents in the PF manufacturing processes.     

水泥粉尘作业职业危害早期检测指标初探

目的　探讨水泥粉尘职业危害的早期检测指标。　方法　运用职业流行病学调查方法 ,调查和分析了 85名水泥粉尘作业工人和 80名对照组的自觉症状、肺通气功能和尿羟脯氨酸 (HYP)。　结果　接尘工人的上呼吸道及眼部刺激症状显著增多 ,与对照组比较差异有显著性意义 (P <0 .0 5 ) ;肺通气功能各项指标均明显低于对照组 ,差异有非常显著性意义 (P <0 .0 0 1) ;两组尿羟脯氨酸 (HYP)含量差异无显著性意义 (P >0 .1)。　结论　长期接触水泥粉尘可引起以阻塞性肺通气功能障碍为主的肺功能损害 ,肺通气功能可作为水泥粉尘职业危害的早期检测指标 ;尿羟脯氨酸 (HYP)作为水泥粉尘职业危害的早期检测指标并不满意。     

Occupational lead exposure

Summary Quantitative measures of saccadic eye movements were examined in 52 lead exposed autobody shop workers and 52 age matched controls with no history of occupational lead exposure. Three characteristics of saccadic eye movements were studied: 1) saccade accuracy; 2) number of overshoots; and 3) maximum velocity. The results indicated that workers exposed to inorganic lead showed a decrease in saccade accuracy and an increase in overshoots compared with controls. Saccade maximum velocity was lower in lead exposed workers than in controls but the difference was just short of statistical significance. Correlations between measures of saccadic eye movements and indicators of lead absorption—blood lead (Pb-B) and zinc protoporphyrin (ZPP) levels-were analyzed in the lead exposed workers. Saccade accuracy was negatively correlated with both Pb-B and ZPP levels. The number of overshoots was not correlated with either Pb-B or ZPP levels. Saccade maximum velocity was not correlated with Pb-B, however, there was a significant negative correlation with ZPP. Age effects observed in the control group were disrupted in lead exposed workers. In addition, saccadic eye movements in younger workers (below 30 years old) were more affected by exposure to inorganic lead than were saccadic eye movements in older workers (50 years and older). It is proposed that these findings are consistent with a relatively rapid buildup of metabolically active lead burden observed in the study group. The data suggest that quantitative assessment of eye movements may be an important tool for studying subclinical central nervous system (CNS) dysfunction due to inorganic lead exposure.Part of this study was presented at the XX International Congress on Occupational Medicine, Cairo, Egypt, Sept. 26–29 (1981)This study was supported in part by NIEHS grant ES00928 of the National Institute of Health, US Department of Health and Human Services     

Studies of the eye in the early diagnosis of deviations in the health status of workers in the oil-refining industry]

Workers engaged in oil-refining industries are exposed to constant occupation-related factors resulting in specific changes of the eye (moderate irritations of the palpebral conjunctiva, bulbar conjunctiva degeneration, angiopathy of the retina, and distortions in the light/darkness adaptation of the eye). There was a direct correlation between the changes and degrees of exposure to the hazardous occupational factors and their effects on the nervous, cardio-vascular and digestion systems. This proved a possibility of using respective data of ophthalmologic examinations for an early diagnosis of somatic diseases in the workers.     

Four-year follow-up of effects of toluene diisocyanate exposure on the respiratory system in polyurethane foam manufacturing workers

Fifty-seven polyurethane foam manufacturing workers (PF workers) and 24 reference workers were followed for 4 years to clarify the effects on pulmonary function of working in PF factories with exposure to toluene diisocyanate (TDI). No significant differences in the average annual losses (AALs) of pulmonary function for 4 years were observed among the 28PF workers whose TDI exposure levels were very low (mean = 0.1 ppb, group L), the remaining 29 PF workers with mean TDI exposure of 5.7 ppb (group H), and the reference workers. However, 15 PF workers in group H who had experienced peak exposure excursions to 30 ppb or above with a mean concentration of 8.2 ppb showed significantly larger AALs in percentage maximal mid-expiratory flow, forced expiratory volume in 1 s ratio to vital capacity (FVC), and forced expiratory flow at 25% of FVC than expected, and significantly larger AALs in some obstructive pulmonary function indices than those of the 14 remaining PF workers in group H whose peak exposure excursion levels were 3-14 ppb with a mean time-weighted average (TWA) of 1.7 ppb, group L, and the reference workers. These findings suggest that the peak exposure excursion level of TDI might be important in inducing obstructive pulmonary function changes in the PF workers rather than the TWA exposure levels, though further comparative studies of the AAL in those who are exposed to different peak exposure excursion levels but the same mean exposure levels are necessary. From the standpoint of prevention, the proposition that peak exposure excursion levels exceeding 20 ppb should be avoided is reasonable.     

A study of respiratory effects from exposure to 2.0 ppm formaldehyde in occupationally exposed workers

It has been suggested that exposure to formaldehyde (FA) induces asthmatic symptomatology. We have previously studied healthy and asthmatic individuals and found that lung function was unaltered by controlled exposures to 2.0 ppm FA with and without mild exercise. Our present study extends these observations to a group of hospital laboratory workers routinely exposed to FA. Fifteen laboratory workers were exposed in double-blind, random sequence to 0 and 2 ppm FA for 40 min in an environmental chamber with temperature and relative humidity held constant at 23 degrees C and 50%, respectively. These exposures were repeated on two more occasions with a 10-min exercise regimen (450 kpm/min) after being in the chamber 5 min. In addition, a symptom diary and measurements of peak expiratory flow rate (PEFR) were recorded for 24 hr after exposure. Lung function remained unaltered for all 4 exposure days; e.g., mean FEV1.0 for the group did not change by more than 3% at any testing time on any exposure day. Also, there were no delayed obstructive changes as measured by PEFR recordings. Symptoms were mild and transient with unusual odor and eye irritation the most frequent complaint. No lower airway symptoms were reported. We conclude that this group of healthy laboratory workers did not experience any acute or delayed lung function changes from exposure to 2.0 ppm FA at rest and with exercise and that irritative symptoms were few.     

Study of the lipoprotein pattern among workers exposed to lead

Occupational exposure to lead fumes constitutes a serious problem in Egypt, since a considerable number of workers might be involved in its deleterious effect. The present study aimed to elucidate the effect of lead exposure on the lipoprotein pattern of exposed workers. The study has been carried out in a plant manufacturing lead batteries. It consists of 89 workers exposed to lead and 25 control subjects. Fasting blood samples were collected for the determination of serum lipoprotein pattern and their cholesterol and phospholipid content. Levels of lead in blood and delta amino levulinic acid in urine have been determined as biological indices of lead exposure. Lead exposure caused mainly a cumulative effect on the cholesterol and phospholipid content of lipoproteins since only workers exposed for more than 10 years showed significant changes. These changes might be referred to the effect of lead exposure on liver and/or on trace metal metabolism.     

Relationship between acetone exposure concentration and health effects in acetate fiber plant workers

In order to clarify the effects of acetone (AC) exposure on health, a cross-sectional study was carried out in 110 male AC-exposed and 67 male nonexposed shift workers. The AC workers ranged in age from 18.7 to 56.8 years (mean: 37.6 years) and in length of AC exposure from 0.5 to 34.3 years (mean: 14.9 years). The nonexposed workers ranged in age from 20.7 to 57.5 years (mean: 41.9 years). AC exposure levels assessed by personal passive monitors and biological monitoring indices measured at the end of the workshift were 19.6–1018 ppm in the breathing zone (AC-E, mean: 364 ppm), 2.5–422 ppm in alveolar air (AC-A, mean: 97.3 ppm) 4–220 mg/1 in blood (AC-B, mean 66.0 ppm), and 0.75–170 mg/l in urine (AC-U, mean: 37.8 mg/1). Symptoms at the end of the workshift with good exposure-response relationships were eye irritation, tearing, and acetone odor, and symptoms within the previous 6 months with good exposure-response relationships were heavy, vague, or faint feeling in the head, nausea, loss of weight, and slow healing of an external wound. In the 30–44 year age range, simple reaction time and digit span scores in a short computerized neuro-behavioral test battery were significantly lower in AC workers, but exposure-response relationships were not clear. Manifest Anxiety Scale scores, Self-rating Depression Scale scores, R-R interval variation on the ECG, hematological examinations, serum biochemistry examinations for liver function, and phagocytic activity of peripheral neutrophils did not show any AC-related differences between the two groups. In view of the reported findings, the current occupational exposure limit of 750 ppm recommended by many governmental and academic associations seems to be too high to prevent the health effects of AC observed in this study.     

Radiologic abnormalities in South African mica millers: a survey of a mica milling plant in the Limpopo Province

All 73 workers at a South African mica milling plant were surveyed for radiographic evidence of abnormalities related to dust exposures at work. Chest x-rays were taken and questionnaires administered to determine occupational and environmental exposure histories. Dust levels to which workers were exposed were measured. All but one of 12 airborne inhalable and respirable dust levels were below the occupational exposure limits (OEL-RLs) of 10 mg/m3 and 5 mg/m3 respectively. The mica concentrations were below the OEL-RL of 1 mg/m3 for respirable mica. Mean age and service duration of the workers were 45 and 14 years, respectively. 19 workers (27%) had changes referable to their exposures to asbestos, mica, silica, or combinations. Of these, four showed additional radiographic changes in keeping with tuberculous lung scarring. Six had evidence of lung changes consistent with past tuberculosis alone. Rates of radiologic abnormalities were higher in older workers and those with longer service. An association between mica and radiologic changes could not be convincingly shown because of the nature of the survey and the co-exposure to other mineral dusts. Nevertheless, six workers had radiologic changes consistent with pneumoconiosis attributable to mica or the combination of mica and silica.     

Prevalence of objective eye manifestations in people working in office buildings with different prevalences of the sick building syndrome compared with the general population

Summary A cross-sectional clinical epidemiological study was carried out among 169 office workers in four Copenhagen town halls with different prevalences of the sick building syndrome. The results were compared with those in 112 subjects randomly selected from the general population. Biomicroscopic eye manifestations, such as premature break-up of the precorneal tear film, absence of foam at the inner eye canthus and epithelial damage of the bulbar conjunctiva, were investigated together with self-reported eye complaints. Although intercorrelated, the objective eye manifestations independently were statistically associated with self-reported eye complaints in office workers. The prevalence of the objective eye manifestations was significantly elevated in office workers compared with the general population and most pronounced for the buildings with a high prevalence of the sick building syndrome (P < 0.001). In the general population, subjects with a non-industrial occupation, including office workers, had a significantly higher prevalence of objective eye manifestations than those with an industrial occupation (P = 0.03), but the prevalence was still significantly lower than that among the office workers in buildings with a high prevalence of the sick building syndrome (P<0.001). Since possible confounders were found not to explain the difference in prevalence of objective eye manifestations and complaints among the two populations, it is concluded that the office environment (buildings and/or type of office work) promotes these objective changes accompanied by self-reported complaints.     

Markers of cadmium exposure in workers in a cadmium pigment factory after changes in the exposure conditions

The objective of this study was to assess changes in concentrations of cadmium in the blood (Cd-B), cadmium in the urine (Cd-U), beta2-microglobulin in the serum (beta2-mG-S) and beta2-microglobulin in the urine (beta2-mG-U) of workers at a cadmium (Cd) pigment factory in Japan in which exposure conditions improved. We evaluated reversibility of these markers in continuously employed workers in relation to changes in exposure levels resulting from improvements in the workplace and the reduced production of Cd. Our study involved both environmental and biological monitoring. Data were collected for four years. We measured the Cd concentration in the air of each work area, using the time-weighted average (TWA). Cd-B and Cd-U were measured in workers as direct indices of Cd exposure. beta2-mG-S and beta2-mG-U were measured as markers of renal tubular function. Exposure levels were high in all work areas, according to the criteria set by the American Conference of Governmental Industrial Hygienists (ACGIH). Workers' Cd-B and Cd-U concentrations reflected high levels of exposure. Correlation was found between these direct indices and beta2-mG-S concentrations. Since the second year, ambient Cd concentrations decreased and reacted markers have been improved. Our results suggest that Cd-B, Cd-U, beta2-mG-S and beta2-mG-U are appropriate markers for monitoring both the level of Cd exposure and the tubular function of workers. Reversibility of urinary low molecular weight protein was observed in the workers over the four years.     

Ocular disorders among workers exposed to mercury

Mercury vapor exposed workers may show ocular changes, as well as other systems affection. A sample of 84 workers in preparing mercury fulminate were examined for conjunctival corneal and lenticular manifestation of long duration exposure, together with mercury urinary output. Lens changes were found in 50% of the involved workers while keratopathy as recorded in 34.5% of them. No statistically significant association was found between the occurrence of eye lesions and levels of urinary elimination of mercury. These results suggest local absorption of this element is most probably the underlying cause of ocular affection.     

Dust exposure, eye redness, eye cytology and mucous membrane irritation in a tobacco industry

Summary In a study of 75 workers employed in a tobacco factory producing cheroots we measured cellular contents of tear fluid, redness of eyes, discomfort, total (0–5.7 mg/m³) and respirable dust in the breathing zone and total ambient dust by stationary sampling (0.08–1.0 mg/m³). A matched group of 50 office workers in a telephone company (total ambient dust concentration between 0.08–0.13 mg/m³) was similarly examined as referents. We found a difference between the two companies with regard to cell counts, with tobacco workers having the largest numbers except for lymphocytes. Among tobacco workers we furthermore found that the number of cuboidal and columnar epithelial cells increased during the day. The increase of cuboidal cells, however, occurred mainly in a small group of tobacco workers exposed to the highest concentrations of tobacco dust (mean =1.26 mg/m³). No difference in the sensation of eye irritation was found between companies, but increased irritation in the morning was associated with increased exposure to total dust during the work-shift among tobacco workers. A dose-dependent difference in photographically measured eye redness was found among the tobacco workers. It could not be explained by differences in tobacco smoking, sex, age, sleeping habits or use of glasses. Irritation of lips and upper airways as reported by questionnaire were more common in tobacco workers than in referents. In conclusion the tobacco workers, more often than the referents, had complaints and objective changes in the mucous membranes of the eyes. These may be related to tobacco dust exposure.     

广东省1 180名放射工作人员健康状况分析

目的了解广东省卫生系统放射工作人员健康状况,为放射防护管理工作提供科学依据。方法按照卫生部《放射工作人员健康管理规定》中的要求和方法,对2005年广东省部分医疗单位1180名放射工作人员进行了放射性健康检查,包括临床和实验室检查。结果受检者主诉项目以神经衰弱症候群为主,且放射工龄10年以上者均高于10年以下者(P<0.01)。体征主要表现为手部皮肤、指甲改变,牙龈出血等。眼晶状体混浊率41.5%。各项临床症状均有随放射工龄增加而阳性体征增高的现象。实验室检查,不同级医院放射工作人员各项检查指标结果虽有差异,但无显著性(P>0.05)。不同放射工龄工作人员各项检查指标结果显示20年以上与以下者有较大差异(P<0.01)。结论小剂量低剂量率长期照射对机体有一定程度的影响,特别是对高放射工龄组人员影响较大。     

Radiographic changes in a group of chrysotile miners and millers exposed to low asbestos dust concentrations

Radiographic changes in 342 Quebec asbestos miners exposed to low levels of asbestos dust for an average period of 20 years were studied. Their estimated cumulative exposure ranged from 7 fibres per cubic centimeter X years (f-y/cc) to 300 f-y/cc. Of these workers, 2.1% showed a small opacity score of 1/0 or more and 2.7% showed pleural changes. No linear relationship could be established between small opacity score and any index of exposure to asbestos. Pleural changes were related to age. A referent group of office workers within the same mining industry showed a prevalence of 2.1% (1/48) for small irregular opacities 1/0 or more, and for pleural changes.     

Electrophysiologic changes in workers with "low" blood lead levels

In spite of numerous studies, the minimum level of lead exposure at which "sub-clinical" electrophysiologic abnormalities appear is still under discussion. Furthermore, it has not been clarified whether the electrophysiologic changes are directly related to PbB levels or to duration of exposure. This study was conducted on a group of 62 subjects occupationally exposed to lead with average blood lead levels below 50 microgram/100 ml and durations of exposure of less than 10 years. A reduction of motor and sensory nerve conduction velocities and sensory action potential amplitude of the median nerve was found in the subjects exposed to lead, as compared with a control group. Such abnormalities were already present in workers with the lowest blood lead levels, but were more severe in workers whose blood lead levels had exceeded 70 microgram/100 ml, even if this occurred only once in the last two years. The electrophysiologic changes did not correlate with duration of exposure but occurred very soon after initial exposure to lead.     

Radiographic changes in a group of chrysotile miners and millers exposed to low asbestos dust concentrations.

Radiographic changes in 342 Quebec asbestos miners exposed to low levels of asbestos dust for an average period of 20 years were studied. Their estimated cumulative exposure ranged from 7 fibres per cubic centimeter X years (f-y/cc) to 300 f-y/cc. Of these workers, 2.1% showed a small opacity score of 1/0 or more and 2.7% showed pleural changes. No linear relationship could be established between small opacity score and any index of exposure to asbestos. Pleural changes were related to age. A referent group of office workers within the same mining industry showed a prevalence of 2.1% (1/48) for small irregular opacities 1/0 or more, and for pleural changes.     

广西人造宝石加工业流动女工职业健康危害现况调查

目的 了解广西人造宝石加工业流动女工职业健康危害状况,为制定保护宝石家庭作坊式加工业流动女工职业健康对策提供参考依据。方法 采用中国疾病预防控制中心职业卫生与中毒控制所统一制定的女工职业健康调查问卷,选择广西梧州市从事人造宝石加工的2095名流动女工进行问卷调查。结果 广西人造宝石加工以家庭作坊、农民工为主,作业场所的卫生设施简陋,存在的主要职业性危害因素有粉尘、噪声、氢氟酸、局部微小振动。流动女工平均年龄为30岁,平均职业工龄为5年,文化程度比较低,未受到职业健康监护;以腰背痛、眼睛不适、头痛头晕的主诉症状为主,且发生率随着工龄的增长而增高。结论 广西人造宝石加工业职业卫生防护措施及职业健康监护未能得到有效的实施。需要加强宣传教育及管理,将家庭作坊纳入职业卫生监管体系。     

Dust exposure,eye redness,eye cytology and mucous membrane irritation in a tobacco industry

In a study of 75 workers employed in a tobacco factory producing cheroots we measured cellular contents of tear fluid, redness of eyes, discomfort, total (0-5.7 mg/m3) and respirable dust in the breathing zone and total ambient dust by stationary sampling (0.08-1.0 mg/m3). A matched group of 50 office workers in a telephone company (total ambient dust concentration between 0.08-0.13 mg/m3) was similarly examined as referents. We found a difference between the two companies with regard to cell counts, with tobacco workers having the largest numbers except for lymphocytes. Among tobacco workers we furthermore found that the number of cuboidal and columnar epithelial cells increased during the day. The increase of cuboidal cells, however, occurred mainly in a small group of tobacco workers exposed to the highest concentrations of tobacco dust (mean = 1.26 mg/m3). No difference in the sensation of eye irritation was found between companies, but increased irritation in the morning was associated with increased exposure to total dust during the workshift among tobacco workers. A dose-dependent difference in photographically measured eye redness was found among the tobacco workers. It could not be explained by differences in tobacco smoking, sex, age, sleeping habits or use of glasses. Irritation of lips and upper airways as reported by questionnaire were more common in tobacco workers than in referents. In conclusion the tobacco workers, more often than the referents, had complaints and objective changes in the mucous membranes of the eyes. These may be related to tobacco dust exposure.