吸烟与矽肺：某矿区的定群研究

通过对1077名井下矿工队列的28年回顾性定群研究,发现吸烟组矽肺发病率为13.02%,非吸烟组为6.85%。吸烟组矽肺的标化发病率比为171.43(95%CI=144.69～203.97)。以接尘工龄作时间变量,用Weibull回归模型分析累积接尘量和吸烟对矽肺的影响。结果表明在平衡了接尘工龄后,累积接尘量和吸烟对矽肺发病的影响有显著性意义,说明了有吸烟习惯的接尘工人发生矽肺的危险度比不吸烟者大。因此,在预防矽肺的措施上,应强调控制吸烟的重要性。     

在煤矿工人中开展预防与控制艾滋病的健康教育及行为干预研究

目的 在煤矿工人中开展艾滋病健康教育及行为干预研究，预防和控制艾滋病在我市的传播和流行。方法 选择平煤集团二矿、六矿、十一矿的矿工300名作为研究对象，进行不同形式的艾滋病健康教育及行为干预，时间为4个月，并在干预前、后各进行1次问卷调查。结果 通过健康教育及培训，矿工防治艾滋病知识知晓率由53.37%提高到86.41%；通过行为干预，矿工非婚性行为安全套使用率由38.33%上升到69.67%。结论 开展健康教育及行为干预效果明显，今后还应强化对高危人群的健康教育及行为干预。     

云锡矿工肺癌组织DAPK基因表达及其甲基化异常

目的探讨云锡矿工肺癌组织DAPK基因的蛋白表达及其甲基化异常。方法收集云锡矿工肺癌组织50例及10例正常肺组织。采用免疫组化检测DAPK蛋白表达,采用原位细胞凋亡检测法检测细胞凋亡,采用甲基化特异性聚合酶链反应检测DAPK基因启动子甲基化。结果50例癌组织中,38?PK蛋白表达阴性,36%检测到DAPK基因启动子异常甲基化,DAPK蛋白表达与细胞凋亡有关(P<0·05),DAPK基因启动子异常甲基化与DAPK蛋白表达呈负相关(P<0·05)。结论①云锡矿工肺癌组织中DAPK基因表达减少或缺失;②云锡矿工肺癌发生发展可能与DAPK基因异常甲基化有关。     

Cross sectional and longitudinal study on selenium, glutathione peroxidase, smoking, and occupational exposure in coal miners

OBJECTIVES—To understand the variations of selenium (Se) concentration relative to changes in occupational exposure to coal dust, taking into account age and changes in smoking habits in miners surveyed twice, in 1990 and 1994. To better understand the relation of Se concentration with glutathione peroxidase activities (GSH-Px) in these miners.
METHODS—In 1994, blood samples were obtained from active (n=131) and retired (n=40) miners without coal worker''s pneumoconiosis, in whom Se concentration was available at both surveys and in whom International Labour Organisation (ILO) profusion grade had not been changed. Active miners were exposed to high dust concentrations (n=48) or low dust concentrations (n=83). Miners were classified into three subgroups according to their estimated cumulative exposure to dust, and into three subgroups according to their smoking habits.
RESULTS—Selenium concentration and GSH-Px activities were significantly lower in active than in retired miners (Se adjusted means: 62.6 v 72.2 ng/ml p=0.01). Moreover, Se concentration was lower in miners exposed to high compared with those exposed to low dust concentrations (adjusted means: 59.4 v 65.8). In miners exposed to high dust concentrations, Se concentration was significantly lower whereas erythrocyte GSH-Px activity was significantly higher in the subgroup with estimated cumulative exposure >68 mg/m³.y. In all miners, plasma GSH-Px activity was correlated with Se concentration (r=0.22, p<0.005). The 4 year Se changes were negatively related to exposure to high dust concentrations and positively related to change in exposure from high to retirement and to change from smoker to ex-smoker (p=0.01).
CONCLUSION—The variations of Se concentration in relation to changes in occupational exposure to coal dust and in smoking habits, and the close correlation found between plasma Se concentration and GSH-Px activity suggest that both are required in antioxidant defence. These results agree well with the hypothesis that the decrease in Se concentration reflects its use against reactive oxygen species generated by exposure to coal mine dust and by smoking.


     

煤矿工人血液流变学变化临床分析

目的了解煤矿工人血液流变学变化情况，探讨引起血液流变学增高的原因及查找对策。方法将1623例门诊检查血液流变学的体检者，分成实验组（煤矿工人组）和对照组（非煤矿工人组），分析两组各年龄段血液流变学变化情况，比较两组血液流变学总体增高情况；实验组血液流变学变化与煤矿工人井下作业工作年限、接触煤粉尘量、合并肺部疾病关系，统计学分析采用X2检验。结果煤矿工人组血液流变学总体增高率为53．33％，明显高于非煤矿工人组的27．91％（P〈0．01）；血液流变学增高随煤矿工人井下工作年限、接触煤粉尘量的增加而呈上升趋势；血液流变学与伴有肺部疾病密切相关（P〈0．05）。结论煤矿工人血液流变学总体水平偏高，血液粘度相应增高，易合并心脑血管疾病，严重影响煤矿工人生活质量，及时改善生产环境、加强个人防护、加强宣传至关重要。     

螺旋CT及高KV摄影在煤工尘肺诊断中的价值

目的：评价螺旋CT及高KV摄影在煤工尘肺诊断中的价值。方法分析52例煤工尘肺的螺旋CT表现及高KV摄影胸片征象。结果螺旋CT检查的52例中有31例出现散在的0.2 cm~0.9 cm圆形结节影,大于1.0 cm的大结节有16例,35例患者有不同程度肺气肿,14例分别患有新老肺结核灶,39例有不同组的淋巴结肿大或钙化。结论螺旋CT在显示煤工尘肺直接征象和间接征象上较常规胸片敏感,可以弥补X线平片的许多不足,有利于煤工尘肺的正确诊断和鉴别诊断,特别有利于煤工尘肺的早期诊断。     

湖南省部分非铀矿山氡的放射卫生学研究

本文报道了湖南省20个非铀矿山的氡子体水平调查结果。平均氡子体浓度在0.21～1107μJm^-3,最高值在O.26～5720lμJm^-3.65%的矿山氡子体浓度超过了我国放射卫生防护标准, 这些矿山矿工接受的氡字体年平均暴露量在o.15～765.7WLM.大部分矿山防护条件较差, 9个矿山已观察到矿工肺癌, 其中50年代建矿的较为突出。     

TMCHB: a possible alternative to DNCB in skin testing for immune competence

The desirability is considered of an alternative to dinitrochlorobenzene (DNCB) in assessing immune competence by skin testing. The choice of an alternative allergen is discussed, taking into account the different concentration which would be necessary for weaker allergens. The alternative proposed is 1-(2,6,6-trimethyl-2-cyclohexen-1-yl)-2-butenone (TMCHB).     

镍矿退休矿工肺通气功能的7年追踪观察

为探讨离尘矿工肺通气功能的变化情况，在某镍矿对１１０名退休接尘矿工进行了肺通气功能的７年追踪观察。结果显示：无论是一般追踪观察，还是配对追踪观察，退休组ＦＶＣ、ＦＥＶ１．０的年均下降值较对照组高（Ｐ＜０．０５或Ｐ＜０．０１）；１９８８年与１９８１年相比，退休组异常率的增高、异常程度的加重均有显著或非常显著意义，对照组则未见差别。提示：离尘工人的肺通气功能损害未因脱离粉尘作业而消除或减轻。