烟草作业环境中工人过敏性呼吸系统损害的调查

目的 调查分析烟草粉尘对接尘工人过敏性呼吸系统损害及其可能致病因素。方法 对某卷烟厂进行劳动卫生学调查和真菌污染状况调查,同时对130名接尘工人和112名对照工人进行呼吸系统症状询问调查、胸部X线检查、肺通气功能测定及黑根霉特异性IgE抗体水平的测定、黑根霉抗原皮肤点刺试验和鼻粘膜抗原激发试验。结果 卷烟厂各车间粉尘浓度超过国家标准,各个车间检测出8个种属的霉菌,其含量明显高于对照现场,其中主要为黑根霉和姻曲霉。接尘工人咳嗽、咯痰、胸闷、气短、鼻塞、流鼻涕等症状阳性率明显高于对照工人,肺通气功能指标异常率明显高于对照工人,并且11．4％的男性工人和11．7％的女性工人检出有过敏性鼻炎,4名男性工人(5．7％)X线检查发现肺部有点状阴影。黑根霉特异性IgE抗体试验阳性率高达31．2％,皮肤点刺试验阳性率达11．5％,鼻粘膜抗原激发试验阳性率为4．6％。结论 烟草作业现场中存在的霉菌和粉尘与接尘工人呼吸系统损害有关,真菌污染是导致接尘工人过敏性呼吸系统损害的原因之一。     

烟草粉尘对接尘工人呼吸系统损害的调查分析

对某卷烟厂进行了劳动卫生学调查 ,同时对接尘工人进行了呼吸系统症状调查及肺通气功能测定。结果显示 ,接尘工人咳嗽、咳痰、胸闷、鼻塞、流鼻涕等症状阳性率明显高于对照工人 ,肺通气功能显著低于对照工人。     

烟草尘对作业工人呼吸系统损害的调查研究

目的探讨烟草作业环境中烟草尘对作业工人呼吸系统的损害。方法对烟草作业环境进行职业卫生现场调查、采样检测及分析,并对作业工人进行肺通气功能测定、胸部X线检查和呼吸系统症状的调查等职业健康体检。结果作业环境中烟草尘浓度在0.2～28.8mg/m3,生产性粉尘作业监测点超标率为29.12%,烟草尘作业危害岗位占32.02%;1322名接触烟草尘工人肺功能通气损害的为73人,肺功能异常率为5.52%;X胸片检查肺纹理增粗、紊乱改变121例,占9.15%;24.28%的工人出现咳嗽,21.56%的工人出现咳痰;调查显示接触烟草尘浓度高、时间长的作业工人肺部病变增加。结论烟草作业现场中存在的烟草尘与接尘工人呼吸系统损害有关,是导致接尘工人呼吸系统损害的原因。     

某水泥厂非吸烟接尘工人呼吸系统损害的调查

目的 探讨接尘不吸烟工人呼吸系统的损害。方法 对水泥厂122名接尘不吸烟工人及对照组进行呼吸系统询问调查和肺功能测定。结果 接尘组工人呼吸症状阳性率明显高于对照组，肺功能明显下降，FVC、FEV1、FEF25-75、明显下降，差异均有显著性。结论 水泥粉尘作业工人呼吸系统和肺功能损害是严重的，应采取防护措施。     

水泥粉尘对作业工人鼻腔的损伤作用

目的: 探讨水泥粉尘对作业工人鼻腔的损伤作用。方法: 检查609例水泥粉尘作业工人、416 例矽尘作业工人、及287 例非接尘工人鼻腔疾病患病率及鼻腔粘膜的病理改变。结果: 水泥粉尘接触工人鼻腔疾病患病率明显高于矽尘作业工人及非接尘工人 (P< 0.05)。而且与接触粉尘的浓度、接尘工龄存在接触水平-反应关系。水泥粉尘所致鼻腔疾病主要表现为干燥性鼻炎, 鼻前庭炎, 鼻窦炎, 鼻中隔糜烂、溃疡与矽尘组比较有显著性差异(P< 0.05)。鼻粘膜细胞涂片检查, 水泥尘组鼻粘膜细胞损害较矽尘组、非接尘组严重。结论: 水泥粉尘对作业工人鼻腔有较强的损伤作用     

烟叶复烤厂粉尘对接尘工人呼吸系统影响的研究

本文对某烟叶复烤厂进行了劳动卫生学调查，对３０１名接尘工人与３２３名对照工人进行了呼吸系统症状的调查与肺功能检测。该厂作业现场粉尘几何平均浓度波动范围１２．７８～２３．８５ｍｇ／ｍ＾３，粉尘中游离ＳｉＯ２含量为２．４２～１０．７８％。与对照组相比，接尘工人呼吸系统症状的阳性率明显增高，ＦＶＣ、ＦＥＶ１、ＭＭＦ、Ｖ５０、Ｖ２５等肺功能指标明显下降，肺功能异常率显著增高，多数指标具有显著性差异。接尘工     

烟草粉尘对卷烟厂作业工人的肺脏损害

对蚌埠市卷烟行业接触烟草粉尘的２１６名生产工人进行了综合性调查和探讨。发现烟草粉尘可导致肺功能改变，并对肺脏有明显损害。经胸部摄片，诊断出烟草工人尘肺５例。通过１６０名卷烟工人的死因调查，死于呼吸系统疾病的居首位，占３７．５％，说明烟草尘是损害肺脏的有害粉尘。因此改进卷烟行业的工艺流程、加强通风防尘措施、定期对作业工人进行体格检查，是卷烟厂迫切需要解决的重要课题。     

汽车轮胎胶粒所致交通警察呼吸系统损害及其致敏性调查

目的探讨汽车轮胎胶粒对交通警察（以下简称“交警”）呼吸系统损害及其致敏性。方法对455名外勤交警及243名对照者进行呼吸系统症状询问调查及肺通气功能用力肺活量（FVC）、第1秒用力呼气容积（FEV1.0）、最大呼气中期流速（MMF）、呼出肺活量50％时的最大呼气流速（V50）等指标测定；并进行455名外勤交警及230名对照人员汽车轮胎胶粒血清特异性IgE抗体水平测定，以及汽车轮胎胶粒抗原的皮肤针刺试验，对其中汽车轮胎胶粒特异性IgE抗体阳性的66名外勤交警及5名对照人员进行鼻黏膜激发试验；对66名汽车轮胎胶粒特异性IgE抗体阳性的外勤交警进行硫酸特布他林吸入试验。结果交警咳嗽、咳痰、胸闷、气短、打喷嚏、鼻塞、流鼻涕等症状的阳性率分别为38．02％、27．03％、20．00％、23．08％、27．47％、32．09％、34．95％，明显高于对照组，差异有统计学意义（P〈0．01或P〈0．05）；交警组汽车轮胎胶粒特异性IgE抗体阳性率为14．51％，明显高于对照组，差异有统计学意义（P〈0．01或P〈0．05）；交警组的皮肤针刺试验阳性率为23．73％，明显高于对照组（3．04％）；汽车轮胎胶粒特异性IgE抗体阳性者鼻黏膜激发试验阳性率为54．55％，与对照组比较，差异有统计学意义（P〈0．01和P〈0．05）；交警肺通气功能FVC、FEV1.0、MMF、V50实测值／预计值的百分比明显低于对照组，66例汽车轮胎胶粒特异性IgE抗体阳性者硫酸特布他林吸入试验阳性44例，占调查交警总人数的9．67％。结论汽车轮胎胶粒是导致交通警察肺通气功能损害的原因之一，汽车轮胎胶粒有引起交通警察过敏性哮喘的可能。     

叶腊石磨粉作业职业危害调查

[目的]调查叶腊石磨粉对工人的职业危害。[方法]对8家叶腊石磨粉厂作业环境进行劳动卫生学调查，对接触叶腊石粉尘的84名工人和不接触粉尘的60名人员进行健康检查。[结果]8家企业作业场所作业岗位粉尘浓度626．7mg／m^3，大大超过国家卫生标准(2mg／m^3)，接尘组肺话量和FEVt％低于对照组(P＜0．05，P＜0．01)，接尘组尘肺患者患病率20．2％(17／84)。[结论]叶腊石粉尘对作业工人呼吸系统损害明显。     

石材制品厂非吸烟接尘工人呼吸系统损害研究

「目的」探讨接尘不吸烟工人呼吸系统的损害。「方法」对石制品１２４名接尘不吸烟工人及对照组进行呼吸系统询问调查和肺功能测定。「结果」接尘组工人呼吸症状阳性率明显高于对照组,肺功能明显下降,ＦＶＣ、ＦＥＶ１、ＦＥＦ２５－７５明显下降,均有显著性差异。「结论」矽尘作业工人呼吸系统和肺功能损害是严重的,应采取防护措施。     

Environmental mycological study and allergic respiratory disease among tobacco processing workers

This study presents the results of an investigation of respiratory symptoms, lung function, chest X-ray examinations, analysis of specific IgE antibodies and skin prick tests to fungi on 130 tobacco-processing workers and 112 control workers. Industrial hygiene survey and environmental mycological studies were also performed. The average dust concentrations ranged from 13.76 to 29.55 mg/m(3) in the tobacco processing workshops. Also, the numbers of fungi colonies in the processing environments were much higher than those in the control environments. The prevalences of chronic respiratory or nasal symptoms in exposed workers were significantly higher than those in control workers (p<0.05 or p<0.01). The prevalences of lung function abnormalities in the exposed workers were significantly higher than those in control workers (p<0.05). The positive prevalences of specific IgE reactions to fungi (26.92% for A.fumigatus and 51.54% for Rhizopus nigricans) in exposed workers were also significantly higher than those in control workers (p<0.01). The positive prevalences of the skin prick test showed that 18.46% of the exposed workers were positive to A. fumigatus and 23.85% were positive to Rhizopus nigricans. Our results suggested that tobacco processing workers may develop respiratory diseases related to tobacco dust and we consider that fungi might be one of the allergens causing allergic respiratory or nasal diseases in tobacco processing workers.     

变应性鼻炎血清特异性IgE及皮肤点刺实验与症状的相关性

目的探讨变应性鼻炎血清特异性IgE（sIgE）及皮肤点刺实验与症状的关系。方法对40例变应性鼻炎患者进行症状评分，同时实施标准化皮肤点刺试验，采用UniCAP系统检测仪检测血清特异性IgE，并进行外周血嗜酸细胞（Eosinophil，Eos）计数。结果血清特异性IgE水平与皮肤点刺试验阳性强度及外周血嗜酸细胞计数具有显著的相关性（相关系数分别为0．483和0．384，P〈0．05）；血清特异性IgE水平和皮肤点刺试验阳性强度与变应性鼻炎的症状积分无显著相关性（P〉0．05）。结论血清特异性IgE水平和标准化皮肤点刺试验阳性强度不能反应症状的程度，但任选一种方法对变应性鼻炎的诊断和鉴别诊断有重要的临床意义。     

Glove-related rhinopathy among hospital personnel

Hypersensitivity to natural rubber latex (NRL) in health care personnel exposed to powdered latex gloves appears as conjunctivitis, rhinitis, nasal congestion, cough, dyspnea, or bronchial asthma in approximately 30% of all cases with latex allergy while most of the patients have contact urticaria. The purpose of the present study was to determine the prevalence of latex-induced allergic rhinitis in health care workers using NRL gloves on a daily basis. Clinical examination accompanied by skin prick test (SPT) with latex glove extracts and common aeroallergens, measurements of specific IgE to NRL, and lung function tests were performed in 25 symptomatic workers and 11 latex-exposed asymptomatic controls. Sensitization to NRL was detected using SPT in one (4%) of 25 symptomatic workers but not in any of the asymptomatic controls. Positive SPT to aeroallergens was demonstrated in 8/25 symptomatic workers and 6/11 controls. Measurements of forced vital capacity, forced expiratory volume in 1 sec, and bronchial methacholine challenge did not show any significant differences between the study groups. In conclusion, NRL-aeroallergen-induced occupational rhinitis may occur among physicians and nurses who have a frequent use of latex gloves on a daily basis at hospital work. However, a relatively low prevalence of NRL-induced occupational rhinitis is associated with profuse consumption of no-powder sterile gloves. © 1996 Wiley-Liss, Inc.     

Urinary platinum in hospital personnel occupationally exposed to platinum-containing antineoplastic drugs

A group of 57 female workers employed in the processing of poultry food and 51 nonexposed control workers were studied to determine the possible relation between respiratory and immunological findings in poultry food workers. The prevalences of all chronic respiratory symptoms were significantly higher in exposed than in control workers (P < 0.01) except for occupational asthma. The highest prevalence of chronic respiratory symptoms in exposed workers was found for chronic cough (49.1 %), followed by dyspnea (43.9%), rhinitis (38.6%), chronic phlegm (31.6%), and chronic bronchitis (26.3%). Occupational asthma was found in 5.3% of exposed workers. Exposed workers with a positive skin prick test to poultry food extract demonstrated higher prevalences of all chronic respiratory symptoms than those with negative skin tests, although the difference was statistically significant only for rhinitis (P < 0.05). The most frequent skin reactions were found for poultry food extract (exposed: 66.7%; control: 25.5%; P < 0.05). An increased IgE serum level was found in 19 (33.3%) of the exposed and in four (7.8%) of the control workers (P < 0.01). Three exposed workers with occupational asthma demonstrated an increased serum IgE level. Our data confirm previous results indicating that occupational exposure to poultry food dust may be associated with the development of chronic respiratory symptoms and immunological changes in exposed workers.     

Occupational sensitization to lactase in the dietary supplement industry

Aerogen lactase exposure carries a risk for the development of allergic asthma and rhinitis; only a few occupationally affected patients have been reported. The authors report the results of allergy testing with employees of a lactase tablets manufacturing plant. The survey involved 13 workers, including a questionnaire, spirometry, basophil activation test (BAT), and skin prick tests (SPTs) with lactase and a panel of common aeroallergens. Furthermore, lactase-specific immunoglobulin E (IgE) antibodies were analyzed. Sensitization to lactase could be proven for 9 workers by SPT and BAT; specific IgE antibodies could be detected in serum samples of all sensitized. However, IgE levels ≥0.35 kU/L were only found in 4 sera. These data confirm that occupational exposure to lactase can induce IgE-mediated respiratory sensitization resulting in allergic diseases. Protective measures should thus be obligatory when working with lactase.     

柞蚕丝生产环境所致职业性呼吸系统损害的研究

目的 探讨柞蚕丝生产环境对工人呼吸系统的损害。方法 对绢绸厂作业生产环境进行了真菌学调查,并对197名相等柞蚕丝加工工人及40名不接触尘毒的对照工人进行呼吸系统症状的询问调查,胸部X线检查及抗芽枝霉和抗交链孢霉抗体的测定。结果 柞蚕丝加工工人各工序真菌数量较对照现场明显增高,其优势菌种为芽枝霉及交链孢霉;柞蚕丝加工工人呼吸系统症状阳性率明显高于对照组,并有4例X线胸片出现片状炎性影,15人经常出现发热症状。柞蚕丝加工工人血清中抗芽枝霉和抗交链孢霉抗体均显著高于对照组。结论 芽枝霉和交链孢霉可能是柞蚕发生产环境引起过敏性呼吸系统疾病的致病因子。     

Occupational asthma caused by samba (Triplochiton scleroxylon) wood dust in a professional maker of wooden models of airplanes: A case study

Objectives

Wood dust is a known occupational allergen that may induce, in exposed workers, respiratory diseases including asthma and allergic rhinitis. Samba (obeche, Triplochiton scleroxylon) is a tropical tree, which grows in West Africa, therefore, Polish workers are rarely exposed to it. This paper describes a case of occupational asthma caused by samba wood dust.

Material and Methods

The patient with suspicion of occupational asthma due to wood dust was examined at the Department of Occupational Diseases and Clinical Toxicology in the Nofer Institute of Occupational Medicine. Clinical evaluation included: analysis of occupational history, skin prick tests (SPT) to common and occupational allergens, determination of serum specific IgE to occupational allergens, serial spirometry measurements, metacholine challenge test and specific inhalation challenge test with samba dust

Results

SPT and specific serum IgE assessment revealed sensitization to common and occupational allergens including samba. Spirometry measurements showed mild obstruction. Metacholine challenge test revealed a high level of bronchial hyperactivity. Specific inhalation challenge test was positive and cellular changes in nasal lavage and induced sputum confirmed allergic reaction to samba.

Conclusions

IgE mediated allergy to samba wood dust was confirmed. This case report presents the first documented occupational asthma and rhinitis due to samba wood dust in wooden airplanes model maker in Poland.     

Respiratory effects of occupational exposure to tobacco dust.

Few investigations of the respiratory effects of occupational exposure to tobacco dust have been carried out and the threshold limit value has not well been established. A cross sectional survey on a sample of 223 male and female workers at a cigar and cigarette factory in Lucca (Tuscany) showed a significantly higher prevalence of wheezing, attacks of shortness of breath with wheezing, dyspnoea, and rhinitis than in a reference population. A trend towards a decrease in forced end expiratory flows according to smoking habit and work duration was evident. Positive skin prick tests were observed in 26% of men and 23% of women and were positively associated with duration of work and negatively with cigarette smoking. Thin interstitial space involvement was observed on chest x ray examination in almost half the female workers with more than 35 years exposure. These findings suggest that prolonged exposure to tobacco dust may have negative health effects and that it is advisable to establish a threshold limit value for tobacco dust different from that of inert dust.