水泥尘、电焊尘、矽尘对工人肺功能影响的比较

为了解不同性质的粉尘对工人肺功能影响,比较危害程度,探讨肺功能检查在接尘工人体检中的应用价值。本文选择接触水泥尘、电焊尘、矽尘的三组工人进行调查,并设对照。全部工人用日产ST—200型呼吸分析仪进行肺功能测定,同时摄胸大片检查。结果表明:各种粉尘对工人肺功能的损害都非常明显,水泥尘组的FVC％、MMEF、PEFR、(?)_(75)、(?)_(25)明显低于对照组、尤以小气道指标更为明显。电焊尘组的VC、FEV_1、PEFR、(?)_(75)的四项指标与对照组比较具有显著性或极显著差异。而矽尘组的VC、FEV_1、MMEF、PEFR、(?)_(75)的下降与对照组比较有显著或极显著差异;对大气道的损害以矽尘和电焊尘较为明显,水泥尘次之,而对小气道的损害依次为水泥尘、矽尘、电焊尘。接尘工人肺功能的损害出现在X光胸片改变之前。肺功能检查可作为观察接尘工人早期肺部病变的一项指标。     

固井水泥粉尘对作业工人肺功能的影响

为了探讨油田固井水泥粉尘对接尘工人肺功能的影响;选择接尘工龄>5 a的固井水泥粉尘作业工人120人作为接尘组,行政后勤不接尘工人70人作为对照组(两组工人均为男性,年龄组成和吸烟率无差异),进行肺功能测定。结果表明,接尘组工人肺活量(VC)、用力肺活量(FVC)、每分钟最大通气量(MVV)、1秒用力肺活量(FEV1)和FEV1/FVC%均低于对照组(P<0.01);流速容量测定结果显示,接尘组工人小气道功能指标V50/H、V25/H、V25/H%均低于对照组(P<0.01)。接尘工人肺功能损伤程度以轻、中度为主,肺功能损伤类型以阻塞型为主。提示,固井水泥粉尘可致接尘工人肺功能一定程度的损伤。     

金属粉尘对男性作业工人呼吸系统影响的调查

为了探讨金属粉尘作业工人的呼吸系统症状阳性率和肺通气功能状况,我们选择129名接触金属粉尘的作业工人作为接触组,126名非接触粉尘的作业工人作为对照组,采用美国胸科协会制订的标准化呼吸系统症状询问表和用力肺活量测试方法进行了调查。结果显示,咳嗽、咯痰、气短、喘息等呼吸系统症状阳性率和慢性支气管炎患病率,接触组中吸烟者(27.13%,20.15%,17.83%,19.38%,16.93%)和非吸烟者(14.73%,10.85%,15.50,10.85%,8.13%)高于对照组中吸烟者(13.49%,9.52%,8.73%,11.11%,8.97%)和非吸烟者(7.93%,7.14%,8.73%,4.76%,4.05%),差异均有统计学意义(P<0.05),且以接触组中吸烟者发生率最高。肺通气功能指标FVC,FEV1.0,FEV1.0%的实测值占预计值百分比,接触组中吸烟者(83.23±18.03,84.42±21.36,89.50±13.31)和非吸烟者(86.83±15.61,85.59±17.16,90.67±18.13)低于对照组中吸烟者(93.44±12.49,88.75±12.56,93.97±17.13)和非吸烟者(94.86±11.19,90.63±12.27,94.73±16.02),差异均有统计学意义(P<0.05)。接触组中吸烟者和非吸烟者FVC,FEV1.0,FEV1.0%的实测值占预计值百分比随着接尘工龄的延长而呈递减趋势,尤其吸烟者和非吸烟者接尘工龄≤5 a组分别与接尘工龄≥11 a组比较,差异均有统计学意义(P<0.05)。说明金属粉尘与作业工人呼吸系统功能的变化有直接关系;吸烟是金属粉尘作业工人发生呼吸系统功能损伤的危险因素;且随着接尘工龄的延长有加重的趋势。     

水泥生产性粉尘作业危害调查

目的 了解水泥生产性粉尘作业危害情况，探讨防治职业病危害对策和依据。方法 对水泥生产现场劳动卫生学调查并做生产性粉尘作业危害程度分级，以接尘工人为调查组，非接尘工作的管理人员为对照组进行健康检查。结果 水泥生产场所的粉尘浓度高(108．5mg／m^2)，工人接尘作业时间长(360min占8h劳动日的75％)，接尘作业时间肺总通气量大[5904L／(d．人)]，粉尘作业危害程度级别高(Ⅲ级)；接尘作业工人慢性上呼吸道炎患病率高，较对照组有显著性意义，尘肺患病率高达3.29％，尘肺种类既有矽肺也有水泥尘肺。结论 水泥生产作业的粉尘危害严重，呈现粉尘浓度高，粉尘作业危害程度级别高，尘肺患病率高的“三高”趋势。提示降低生产场所粉尘浓度，减少工人的接尘作业时间，降低劳动强度，是预防水泥生产性粉尘危害的有效措施。     

25527名粉尘作业工人肺功能检查结果分析

了解银川市粉尘作业工人肺功能异常状况及影响因素。将粉尘作业工人按不同地区、性别、年龄、企业规模、行业、接尘类别、工龄等因素分成不同组别,分析比较肺功能检查结果。结果显示,25 527名粉尘作业工人中检出5132例肺功能异常者,检出率为20.10%。粉尘作业工人肺功能异常检出率灵武市最高(21.56%),贺兰县最低(6.70%),小型企业(23.75%)高于大型(20.56%)、中型(17.30%)及微型企业(1.20%),采矿行业最高(21.95%),电力、热力、燃气及水生产和供应行业最低(8.36%);粉尘作业工人肺功能异常检出率随着年龄的增加呈上升趋势;接触煤尘作业工人的肺功能异常检出率(20.68%)高于接触水泥尘(12.31%)、矽尘(7.40%)及铸造尘(8.73%)作业工人的肺功能异常检出率;不同地区、年龄、企业规模、行业、接尘类别及工龄,各因素的组内异常检出率比较,差异均有统计学意义(P<0.05)。提示,采矿行业应制定完善的通风防尘措施;出台相关政策,限定接尘工作年限,定期为中老年粉尘作业工人进行职业健康检查;强化新入职接尘作业工人的上岗前职业防护教育。     

矽尘对人血铜蓝蛋白水平和碱性磷酸酶活力的影响

目的了解矽尘对人血清铜蓝蛋白(CP)水平和碱性磷酸酶(ALP)活力的影响。方法对44例确诊的矽肺患者、90名接尘工人及48名健康对照者血CP水平和ALP活力进行了测定。结果矽肺患者血清CP水平、ALP活力均明显高于对照组及接尘工人(P<0.05),且随着矽肺病程发展ALP呈下降趋势(P<0.05)。结论接触粉尘可使细胞内氧化代谢产物蓄积,从而使其活力、功能活跃,但机体对矽尘所致损伤可能会由初期代偿和适应发展到后期失代偿。     

粉尘对鼻纤毛传送速度的影响

本文报道144例接触煤、金属、木尘工人鼻粘膜纤毛传送速度。与非接尘工人比较,其结果接尘工人明显低于非接尘工人(P<0.01)。按医学统计方法将鼻粘膜传送速度进行分级,求得不同种类粉尘作用下纤毛传送速度分布,并用多因素线性回归分析得出其速度y(因变量)与接尘工龄(x_1)、粉尘种类(x_2)和粉尘浓度(x_3)密切相关,其回归方程式为y=8.784090-0.0355(x_1)-0.3856(x_2)+0.0353(x_3),RR=0.2394,P<0.05。本法对判断鼻粘膜损害提供科学依据,亦可作为防治措施效果的评价。     

汽车制造业铸造作业工人职业健康状况分析

目的了解汽车制造业铸造粉尘对作业工人健康的影响。方法选择汽车制造业230名铸造工人为接尘组和200名非接触尘毒职工为对照组,通过职业健康体检,比较两组的健康状况。同时测定生产环境中粉尘浓度及二氧化硅含量。结果生产环境粉尘中游离SiO2含量为12.2%￣85.3%,粉尘浓度0.5￣1.75mg/m3,合格率为80%;接尘组工人自觉症状中咳嗽、咯痰、气短阳性率及体检项目中慢性咽炎、慢性鼻炎检出率均明显高于对照组(P<0.05或P<0.01);接尘组肺功能指标(FEF25%￣75%、FEF75%)均低于对照组(P<0.05);小气道功能异常率接尘组为8.3%,对照组为2.5%,两组比较,差异有显著性(P<0.01)。结论汽车制造业铸造粉尘可影响作业工人的健康,尤其对呼吸系统损害更明显,应加强防护措施。     

深圳市宝安区1 150名粉尘作业工人职业病危害调查

目的 了解深圳市宝安区粉尘作业工人职业病危害状况,为制定本地职业病防治措施提供科学依据.方法 对1 150名接尘工人进行健康检查.分析粉尘作业接尘工龄、工种、肺功能相关指标.结果 接尘组与对照组相比,FEV1.0/FVC明显降低,差异有统计学意义(P<0.05).与二氧化硅组相比,其他组临床症状(咳嗽、咳痰、气促、胸部不适、其他反应)均减少,差异有统计学意义(P<0.05).与1年工龄组相比,5年工龄以上者肺功能异常检出率明显增高,差异有统计学意义(P<0.05). 结论 粉尘对接尘工人健康有一定危害,尤其是二氧化硅;肺功能损伤与接触粉尘种类和工龄有关.用人单位应注意加强对职业病的管理,减少职业病的发生.     

几种粉尘对鼻粘膜损伤及多因素线性回归分析

报道144例接触木、煤、金属粉尘工人的鼻粘膜细胞学检查结果。这三种粉尘可产生不同程度的病理损伤,经多因素线性回归分析,其损伤程度与接尘工龄、粉尘浓度、种类量明显相关。其回归方程有助于作业环境危害程度的判断,亦可为防尘措施评价提供科学依据。     

Respiratory health effects from occupational exposure to wood dust in sawmills

Spirometric lung functions were recorded for 109 workers (mean age 26.4 +/- 8.2 yr) occupationally exposed (mean exposure 8.9 +/- 7.7 yr) to soft wood dust in local sawmills along with 88 unexposed controls (mean age 28.7 +/- 9.9 yr) belonging to the same socioeconomic status to assess the prevalence of respiratory impairment in the exposed population. The results of the study showed a significantly higher prevalence of overall respiratory impairment in the exposed group even after standardizing for smoking habits (p less than 0.001). The adjusted rate for respiratory impairment in the exposed group was 29.4% as compared to 2.2% observed in the unexposed controls. The pattern of respiratory abnormality observed in the sawmill workers was predominantly the restrictive type (28.4%), indicating lower levels of forced vital capacity (FVC) in the exposed group; while in the control group, there were none with lung restriction The prevalence of airflow limitation, however, was similar in the exposed workers (1.8%) and controls (2.2%), thereby, indicating that bronchial obstruction was independent of wood dust exposure. It is concluded that the dust exposure in sawmills is associated mainly with restrictive type of pulmonary impairment in the exposed workers.     

Respiratory symptoms and ventilatory function in workers exposed to portland cement dust

The healthy worker effect and incomplete exposure information have been problems in former studies regarding the association between exposure to Portland cement dust and respiratory effects. We included former workers and made an individual estimation of particle exposure to reduce the selection bias in this controlled cross-sectional study on the effects of cement dust exposure on respiratory symptoms and ventilatory function in long-term exposed Norwegian cement plant workers. A total of 119 workers from the largest cement plant in Norway and 50 workers from a nearby control plant, born 1918 to 1938, performed spirometry and gave information on respiratory symptoms in 1998 and 1999. The prevalence of symptoms and mean pulmonary function indices were similar for exposed workers and controls. There was no dose-response-related increase in symptoms or decrease in lung function indices. The estimated power to detect a true difference between forced expiratory volume in one second (FEV1) in the two groups of 0.3l was 0.90, assuming 95% significance level. The prevalence of chronic obstructive pulmonary disease was 14.3% in the exposed group and 14.0% among the controls. These findings do not support the hypothesis that cement dust exposure has a negative impact on lung function or gives an increase in respiratory symptoms.     

Cotton dust inhalation and upper respiratory tract disease

Summary An epidemiological study among 203 workers of whom 119 were exposed to cotton dust and 84 controls revealed the occurence of byssinosis among 20.1% of the exposed group. Radiological examination of nasal sinuses was performed and the diagnosis was made without previous knowledge of the state of exposure of the workers or their pulmonary diagnosis. The exposed group showed a significant difference in the occurence of chronic bacterial sinusitis which also increases in prevalence by the increased duration of exposure to cotton dust. Non specific respiratory disease was significantly higher in prevalence among exposed workers (14.3%). No significant difference of allergic sinusitis was observed in the two groups although the whole population examined showed noticeably high rates of sinus diseases. Most of the air-borne cotton dust is composed of large fibers which have a greater probability of retention in the nasal and upper respiratory passages. Chronic irritation from this dust and superadded infection may explain the higher ration of chronic bacterial sinusitis and non specific respiratory disease. There was no association between byssinosis and any form of sinusitis.     

Respiratory illnesses and ventilatory function among workers at a cement factory in a rapidly developing country

Chronic exposure to Portland cement dust has been reported to lead to a greater prevalence of chronic respiratory symptoms and a reduction of ventilatory capacity. The seriousness of pulmonary function impairment and respiratory disease has not been consistently associated with the degree of exposure. Regular use of appropriate personal protective equipment, if available at the worksite, could protect cement workers from adverse respiratory health effects. For a variety of reasons, industrial workers in rapidly developing countries do not adequately protect themselves through personal protective equipment. This study explores the prevalence of chronic respiratory symptoms and ventilatory function among cement workers and the practice of use of personal protective equipment at work. An interviewer-administered questionnaire was used to collect information on sociodemographic characteristics, smoking profile and history of respiratory health among workers at a Portland cement plant (exposed) and workers occupationally unexposed to dust, fumes and gases (unexposed). Pulmonary function was assessed and pulmonary function impairment was calculated for the exposed and the unexposed workers. A higher percentage of the exposed workers reported recurrent and prolonged cough (30%), phlegm (25%), wheeze (8%), dyspnoea (21%), bronchitis (13%), sinusitis (27%), shortness of breath (8%) and bronchial asthma (6%). Among the unexposed, prevalences of these symptoms were 10, 5, 3, 5, 4, 11, 4 and 3%, respectively. Ventilatory function (VC, FVC, FEV(1), FEV(1)/VC, FEV(1)/FVC and PEF) was significantly lower in the exposed workers compared with unexposed workers. These differences could not be explained by age, body mass index (BMI) or pack-years smoked. Ventilatory function impairment, as measured by FEV(1)/FVC, showed that 36% of the exposed workers had some ventilatory function impairment compared with 10% of those unexposed. Certain jobs with greater exposure to cement dust had lower ventilatory function compared with others among the exposed workers. It was concluded that adverse respiratory health effects (increased frequency of respiratory symptoms and decreased ventilatory function) observed among cement workers could not be explained by age, BMI and smoking, and were probably caused by exposure to cement dust.     

Respiratory symptoms and pulmonary function in flour processing workers in the baking industry

Respiratory symptoms and ventilatory capacity were studied in 63 flour processing male bakery workers in Umtata, Transkei, Southern Africa. The controls were from a bottling plant in the same city. Both groups were black Africans from the Xhosa-speaking population. The studied population was nonsmoking and no significant difference was noted in age, race, sex, or height between the groups. The exposed workers had significantly lower forced expiratory indices than the control group. Mean percent predicted values of forced expiratory volume in one second (FEV₁), forced expiratory ratio (FEV₁/FVC x 100), forced mid-expiratory flow between 25% and 75% of FVC (FMF), forced expiratory flow between the first 200 ml and 1.200 ml of FVC (FEF 200-1,200), and peak expiratory flow rate (PEF) were, respectively, 11.2%, 20.0%, 31.0%, 27.4%, and 36.1% lower in the exposed group compared with the controls. The prevalence of forced expiratory ratio less than 70% in the exposed group was 37% while in the controls it was 8%. The prevalence of PEF rate less than 5 l/s in the exposed group was 32% while in the controls it was 11%. The exposed workers reported a significantly higher prevalence of respiratory symptoms compared to the controls. The prevalence of nasal symptoms, phlegm, and cough in the exposed workers was 53.9%, 30.1%, and 25.4%, respectively. The present study demonstrated that exposure to flour dust in flour processing workers in the baking industry is associated with significantly lower pulmonary functions and a higher prevalence of respiratory symptoms, and that these workers show signs of airway obstruction, compared to workers not exposed to flour. Flour processing workers have a significant occupationally related respiratory impairment.     

Cement dust exposure and ventilatory function impairment: an exposure-response study

We investigated cumulative total cement dust exposure and ventilatory function impairment at a Portland cement factory in Tanzania. All 126 production workers were exposed. The control group comprised all 88 maintenance workers and 32 randomly chosen office workers. Exposed workers had significantly lower forced vital capacity (FVC), forced expiratory volume in 1 second (FEV1), peak expiratory flow rate (PEF), FEV1/FVC, FVC%, FEV1% and PEF%, than controls adjusted for age, duration of employment, height, and pack-years. Cumulative total dust exposure was significantly associated with reduced FVC, forced expiratory volume in 1 second, and peak expiratory flow rate adjusted for age, height and pack-years. Cumulative total dust exposure more than 300 mg/m year versus lower than 100 mg/m years was significantly associated with increased risk of developing airflow limitation (odds ratio = 9.9). The current occupational exposure limit for total cement dust (10 mg/m) appears to be too high to prevent respiratory health effects among cement workers.     

Nasal symptoms among workers exposed to soft paper dust

Objectives: To clarify whether occupational exposure to paper-dust is associated with an increased risk of non-infectious rhinitis. Methods: Thirty-seven workers exposed to paper-dust in a soft-paper mill were compared with 36 unexposed controls. The study was performed under normal working conditions during the non-pollen season. Medical and occupational history was taken down in a comprehensive questionnaire and nasal symptoms were scored on a visual analogue scale (VAS). Pulmonary and nasal function was assessed by spirometry, acoustic rhinometry and peak nasal inspiratory flow. Nasal lavage was analysed for interleukin-8 (IL-8) and nasal transit time was monitored with the saccharine test. Concentrations of inhalable dust for each exposed subject during the day of the clinical study were measured with personal sampling devices. Results: There was an increased prevalence of nasal blockage and crust formation among the exposed workers. However, there was no difference with regard to acoustic rhinometry, nasal transit time or nasal peak inspiratory flow. In the whole population, IL-8 in nasal lavage was higher among men than among women, 193 ng/l vs 132 ng/l, P=0.006. There was also a positive trend (P=0.01) with increasing nasal IL-8 going from non-smokers (122 ng/l), ex-smokers (126 ng/l) to current smokers (235 ng/l). Conclusions: We have found that occupational exposure to paper-dust is associated with symptoms of nasal blockage and nasal crusting. We find no objective signs of nasal inflammation, even among the subgroup with the highest current exposure. Received: 13 March 2000 / Accepted: 5 August 2000     

Respiratory symptoms and chronic obstructive pulmonary disease among cement factory workers

OBJECTIVES: This study assessed chronic respiratory symptoms and chronic obstructive pulmonary disease (COPD) among workers exposed to cement dust at a Tanzanian cement factory. METHODS: A total of 120 exposed workers and 107 controls participated in this cross-sectional investigation. Information on demographics, occupational history, chronic respiratory symptoms, smoking habits, and use of respiratory protection equipment was collected by questionnaire. Ventilatory function testing and measurement of personal total dust exposure were also carried out. COPD was diagnosed for workers with chronic bronchitis who also had spirometric airflow obstruction. Chronic respiratory symptoms and COPD were correlated with cumulative total dust exposure and adjusted for age, pack-years, and education. RESULTS: The exposed workers had more chronic cough [odds ratio (OR) 4.5, 95% confidence interval (95% CI) 1.9-10.4], chronic sputum production (OR 10.8, 95% CI 4.4-26.4.), dyspnea (OR 5.3, 95% CI 1.9-15.2), work-related shortness of breath (OR 4.8, 95% CI 1.6-14.2), and chronic bronchitis (OR 5.5, 95% CI 2.0-15.3) than the controls. Chronic cough, chronic sputum production, dyspnea, work-related shortness of breath, and chronic bronchitis were significantly related to cumulative dust exposure of 20.0-99.9 and > or = 100.0 versus <20.0 mg/m3-years. The prevalence of COPD was higher for the exposed group (18.8%) than for the controls (4.8%). The odds ratio for COPD was significantly increased for cumulative dust exposure, > or = 100.0 versus <20.0 mg/m3-years (OR 11.2, 95% CI 2.2-56.0). CONCLUSIONS: Cement workers seem to be at high risk of developing chronic respiratory symptoms and COPD, probably caused by cumulative total dust exposure independent of smoking habits.     

Effects of vanadium on the upper respiratory tract of workers in a vanadium factory. A macroscopic and microscopic study.

An epidemiologic cross-sectional case-history study on the injurious effects of vanadium was carried out among the workers of a vanadium factory. The upper respiratory tract of 63 male workers exposed to vanadium dust was examined macroscopically and microscopically, and the findings were compared with those of a reference group of workers who were exposed to inert dust only. The groups compared were of similar ages and had similar smoking habits. Nasal smears and sputum cells were studied microscopically, and biopsies for histological study were taken from the nasal mucosa. The biopsies from the vanadium workers showed a significant increase in the number of plasma and round cells, and the histological picture was almost characteristic. There were no increased numbers of secretion eosinophils or other signs indicative of allergic inflammation.     

Dust exposure and respiratory health effects in cement production

Dust can be produced by almost all production processes in Portland cement factory. Dust exposure potentially can affect respiratory function. But evidence for respiratory effect of cement dust exposure has not been conclusive. In this study we assessed effect of cement dust exposure on respiratory function in a cement production factory. A respiratory symptoms questionnaire was completed and pulmonary function tests were carried out on 94 exposed and 54 non exposed workers at a cement factory in the east of Iran. Additionally, respirable dust level was determined by the gravimetric method. X-ray fluorescence (XRF) technique was performed to determine the silica phases and the SiO(2) contents of the bulk samples. The arithmetic means (AM) of personal respirable dust were 30.18 mg/m(3) in the crushing, 27 mg/m(3) in the packing, 5.4 mg/m(3) in the cement mill, 5.9 mg/m(3) in the kiln and 5.48 mg/m(3) in the maintenance that were higher than threshold limit value (TLV) of the American Conference of Governmental Industrial Hygienists (ACGIH) which is 5 mg/m(3). This value in the unexposed group was 0.93 mg/m(3). In this study cough, sputum, wheezing and dyspnea were more prevalent among exposed subjects. Exposed workers compared to the unexposed group showed significant reduction in Forced Expiratory Volume in one second (FEV(1)), Forced Vital Capacity (FVC), and Forced Expiratory Flow between 25% and 75% of the FVC (FEF(25-75%)) (P<0.05). It can be concluded that in our study there was close and direct association between cement dust exposure and functional impairment among the cement factory workers.