铬酸盐接触工人肺通气功能的动态观察

目的:探讨铬酸盐接触对工人肺通气功能的影响。方法:选择河南省某铬酸盐生产企业铬酸盐接触的95人为接触组,非铬酸盐接触的42人为对照组,于2010年冬季和2011年冬季,进行了连续2次职业健康体检,比较该人群肺通气功能的变化。结果:2010年铬酸盐接触组与对照组比较,发现肺通气功能指标用力肺活量forcedvital capacity,FVC,(75.38±15.23)L vs.(83.99±26.52)L]、一秒用力呼气容积(forced expiratory volume in onesecond,FEV1,(82.13±16.51)L vs.(91.24±30.03)L]、用力肺活量/一秒用力呼气容积(FEV1/FVC,112.10±13.23 vs.116.18±11.32)、呼气峰值流速peak expiratory flow,PEF,(74.31±28.09)L vs.(78.13±28.34)L]、最大呼吸流量maximal expiratory flow,MEF,(101.23±46.37)L/s vs.(110.02±41.40)L/s]、每分钟最大通气量maximum ventilation volume,MVV,(90.82±16.89)L/min vs.(99.95±22.61)L/min]均显著下降(P0.05)。2011年铬酸盐接触组与对照组比较,肺通气功能指标FVC(72.34±14.18)L vs.(81.01±20.79)L)、FEV1(76.04±16.20)L vs.(86.71±24.53)L]、FEV1/FVC(109.10±16.18 vs.114.08±10.79)、PEF(71.35±24.87)L/s vs.(75.36±20.67)L/s)、MEF(96.51±30.17)L/s vs.(107.11±34.81)L/s]、MVV(84.85±21.22)L/minvs.(96.77±22.63)L/min]亦有显著下降(P0.05),并且2011年与2010年相比较,接触组肺通气功能指标FEV1(76.04±16.20)L vs.(82.13±16.51)L]、MEF(96.51±30.17)L/s vs.(101.23±46.37)L/s]、MVV(84.85±21.22)L/min vs.(90.82±16.89)L/min]均显著下降(P0.05)。由FVC、FEV1、FEV1/FVC,这3种指标对肺功能损伤进行分级和分型发现,接触组损伤程度的分布与对照组无区别,而损伤类型则以限制型为主,且未观察到随时间的变化。对铬酸盐接触工人进行工种分层分析后发现,不同工种肺功能差异有统计学意义,提示工种对肺功能损伤影响显著。结论:提示长期铬酸盐接触对肺通气功能损伤明显,并受工种影响显著。

Dynamic observation of pulmonary ventilation function in workers contacting chromate

Objective:To explore changes of pulmonary ventilation function of chromate exposed workers.Methods: Ninety-five chromate exposed workers were used as exposure group,and forty-two workers without chromate exposure as control group.Pulmonary ventilation function was performed two times in the winter of 2010 and 2011 respectively in one chromate manufactured factory in Henan Province.Results: In 2010,pulmonary ventilation function of chromate exposed group compared with the control group,forced vital capacity,forced expiratory volume in one second,FEV1/FVC(112.10±13.23 vs.116.18±11.32),peak expiratory flow,maximal expiratory flow,maximum ventilation volume were significantly decreased(P<0.05).In 2011,pulmonary ventilation function of chromate exposed group compared with the control group,FVC(72.34±14.18)L vs.(81.01±20.79)L],FEV1(76.04±16.20)L vs.(86.71±24.53)L],FEV1/FVC(109.10±16.18 vs.114.08±10.79),PEF(71.35±24.87)L/s vs.(75.36±20.67)L/s],MEF(96.51±30.17)L/s vs.(107.11±34.81)L/s],MVV(84.85±21.22)L/min vs.(96.77±22.63)L/min] were also significantly decreased(P<0.05).2011 compared with 2010,pulmonary ventilation function of chromate exposed group FEV1(76.04±16.20)L vs.(82.13±16.51)L],MEF(96.51±30.17)L/s vs.(101.23±46.37)L/s],MVV(84.85±21.22)L/min vs.(90.82±16.89)L/min] were significantly decreased(P<0.05).Comparing the classification and category of pulmonary dysfunction based on FVC,FEV1,FVC/ FEV1,no difference was found for classification between the two groups and the category of pulmonary dysfunction almost belongs to limit type,which did not change with exposed time.Conclusion: Chronic chromate exposure can cause significant effects on pulmonary function of the workers,and the types of work in production can affect the results.