陶瓷作业工人肺功能测试结果分析

目的了解陶瓷作业工人肺功能损害的情况,为预防尘肺病发生提供依据。方法选择某陶瓷厂200名接尘工人,平均年龄为（32.31±8.25）岁,另选取非接尘工人50名为对照组,平均年龄为（34.88±9.75）岁,采用意大利的spirolabII型的肺功能仪,测试的项目包括肺活量（VC）、用力呼吸肺活量（FVC）、第1s用力呼气量（FEV1）、一秒率（FEV1%）、最大呼气中段流速（FEF25-75）、最大呼气25%、50%、75%肺活量时流量（FEF25%、FEF50%、FEF75%）;应用SPSS13.0统计软件统计分析。结果接尘组的肺功能指标FEV1、FEV1%、FEF25-75、FEF50%、FEF75%明显低于对照组,差异有统计学意义（P〈0.05）;接尘工龄在10年～、15年～、20年～组的工人肺功能指标中VC、FVC、FEF25-75、FEF50%、FEF75%的测试均值明显低于接尘工龄〈5年组,差异有统计学意义（P〈0.05）。结论陶瓷粉尘对作业工人的肺功能有损害作用,且随着接尘工龄的增加肺功能受损害程度增加。     

某市灯饰加工工业接尘工人肺功能测定分析

目的了解某市灯饰加工工业接尘工人的肺功能损害情况。方法对某市某镇15家灯饰加工厂接尘工龄1年以上的300名男工进行肺功能测定,另选择该镇的150名非接尘男工作为对照组;并对灯饰加工厂进行粉尘测定。结果15家灯饰加工厂铝尘、矽尘浓度超标率分别为53.33%和86.67%,最高超标分别为2.2倍和16.0倍。矽尘中游离SiO2含量平均96.44%。接尘组肺通气功能的异常率显著高于对照组(P<0.01),用力肺活量(FVC)、第1秒用力肺活量(FEV1.0)、第1秒用力肺活量与用力肺活量之比(FEV1.0/FVC)、肺活量(VC)、最大呼气中期流速(FEF25-75)、最大呼气25%、50%、75%肺活量时流量(FEF25、FEF50、FEF75)均明显低于对照组(P<0.01)。肺通气功能随着接尘工龄的延长而降低(P<0.01)。结论灯饰加工工业粉尘可致接尘工人肺功能一定程度的损伤,应做好预防工作。     

惠州市某区宝石加工作业工人肺功能测定分析

目的了解惠州市某区宝石加工作业工人的肺功能损害情况。方法 2009年7月惠阳区疾病预防控制中心对该区宝石加工厂接尘工龄1a以上的214名男工进行肺功能测定,其中切石工人127例,打磨工人87例;另选择该厂的61名非接尘男工作为对照组;并对宝石加工厂空气中粉尘浓度进行测定。结果该宝石加工厂空气中矽尘浓度超标率超过77%,最高超标为9倍。矽尘中游离SiO2含量平均为47.29%。接尘组肺通气功能的异常率显著高于对照组(P0.01),用力肺活量(FVC)、第1秒用力肺活量(FEV1.0)、第1秒用力肺活量与用力肺活量之比(FEV1.0/FVC)、肺活量(VC)、最大呼气中期流速(FEF25-75)、最大呼气25%、50%、75%肺活量时流量(FEF25、FEF50、FEF75)均明显低于对照组(P0.01)。结论该宝石加工作业粉尘可致工人肺功能一定程度的损伤,应做好预防工作。     

陶瓷企业接尘工人肺功能研究

目的 探讨陶瓷粉尘作业工人肺功能损伤的特征。 方法 采用美能(日本) AS507型肺功能仪,测定某陶瓷厂"无尘肺"的967名接尘工人(接尘组)和197名非接尘健康工人(对照组)的肺通气功能。 结果 陶瓷粉尘总尘浓度为0.10~2.95 mg/m3,总尘浓度超标率为14.29%,呼吸性粉尘浓度超标率为3.57%;粉尘中游离SiO₂含量为21.3%~43.0%。接尘组VC、FVC、FEV 1、FEV 1%、FEF 25%和FEF 50%的数值均低于对照组,差异有统计学意义(P<0.05或P<0.01)。接尘组肺通气功能损伤和小气道损伤的发生率均高于对照组,差异有统计学意义(P<0.05)。接尘的吸烟者VC、FEV1和FEV1%数值与非吸烟者相比,差异有统计学意义(P<0.01)。接尘工人肺通气功能损伤发生率为7.45%(72/967),其中轻度损伤者占98.61%(71/72),限制性肺通气功能损伤占97.22%(70/72)。 结论 陶瓷粉尘可引起接尘工人肺功能的损伤,其损伤程度以轻度为多,损伤类型以限制型损伤为主。肺功能损伤主要与粉尘、接尘工龄、工种和吸烟等因素有关。     

炼油污水对作业工人呼吸系统影响的调查

目的了解炼油污水对呼吸系统健康的影响情况,为改善工作环境,保护工人健康提供依据.方法以炼油厂污水处理车间的工人为观察组,以无本调查涉及的有害物接触史,劳动强度、生活环境相似的其他车间的工人为对照组.用统一调查方案进行个案调查和肺功能的测定.结果观察组共102人,对照组115人,在年龄、身高、体重、吸烟等非研究因素方面差异无统计学意义.常见呼吸系统症状、体征,如咳嗽、胸闷、咽痛、气短等,观察组的阳性率明显高于对照组,差异有统计学意义.观察组肺功能指标(FEV1.0、MMF、FEF25、FEF50、FEF75)均明显低于对照组,差异有统计学意义.观察组中≥20年工龄者的肺功能指标(FEV1.0、MMF、FEF25、FEF50、FEF75)明显低于＜10年工龄者,差异有统计学意义.结论炼油污水工作环境对工人呼吸系统健康有影响,且随着工龄增长而加重.     

焦炉工人尿1-羟基芘与肺通气功能损伤的关系

目的研究焦炉工人尿1-羟基芘(1-OHP)及其蓄积作用与肺通气功能损伤的关系。方法于2009年6—7月选取某焦化厂185名焦炉作业工人为暴露组,同厂辅助工种145人为对照组。使用统一的调查表收集个人基本信息,采用高效液相色谱法检测作业环境空气中苯并(a)芘和研究对象尿1-OHP浓度,采用肺功能仪测定肺功能指标。结果暴露组工人25%肺活量时呼气流速(FEF25)、肺活量(VC)、用力肺活量(FVC)、第1秒用力呼气容积(FEV1)均低于对照组,差异有统计学意义(P0.05)。以尿1-OHP浓度2.3μmol/molCr为界值将暴露组分为高暴露和低暴露,高暴露组75%肺活量时呼气流速(FEF75)、FEF25、VC、FVC、FEV1均低于低暴露组,差异有统计学意义(P0.05)。多重线性逐步回归分析结果显示,暴露组尿1-OHP浓度与50%肺活量时呼气流速(FEF50)、FEF25、最大呼气流速(PEF)、VC、MVV、FEV1呈负相关(P0.05),尿1-OHP的蓄积作用与VC、FVC、MVV、FEV1呈负相关(P0.05)。结论焦炉工人尿1-OHP及其蓄积作用与肺功能损伤有关,可用来反映焦炉工人肺功能损伤情况。     

某露天铁矿工人PM_(2.5)暴露对心肺功能的影响

目的探讨接尘工作环境下不同浓度PM_(2.5)暴露对铁矿工人心肺功能的影响。方法本研究选择某露天铁矿不同工种的接尘人员267名,按照工作环境中PM_(2.5)的浓度高低,分为暴露组和对照组,并检测两组接尘工人的血压、心电图和肺功能。结果肺功能检测指标FEV1、MMEF、PEF、PEF%、FEF75、MEF75%、FEF50%、FEF25、FEF25%在暴露组和对照组工人的差异具有统计学意义(P0.05),暴露组低于对照组;暴露组和对照组均以轻中度肺损伤为主且损伤多为限制性通气障碍,暴露组与对照组异常率比较有统计学差异(P0.05)。暴露组和对照组的心电图异常以窦性心动过缓为主,两组之间患病率比较无统计学差异(P0.05)。暴露组和对照组高血压患病人数比较无统计学差异(P0.05)。结论该露天铁矿工作环境下的PM_(2.5)对接尘工人的肺功能有损害,且以限制性通气障碍为主。PM_(2.5)对心血管系统的早期影响还不能确定。     

某煤矿掘砌工人肺通气功能分析

[目的]了解煤矿掘砌工人肺通气功能损伤情况,探讨接尘工龄对肺功能的影响。[方法]。选取某煤矿纯掘砌工（纯掘砌作业工人）221名作为接尘组,选取该矿83名非接尘工人作为对照。行统一的体检和肺功能测定。测定结果均采用相对值,运用卡方检验、协方差分析进行统计学处理。[结果]接尘组非吸烟工人肺通气功能异常率与对照组差异不具有统计学意义（P〉0．05）,而接尘组吸烟工人肺通气功能异常率高于对照组（P〈0．05）。Mantel—Haenszel妒分析显示接尘组肺通气功能异常率高与对照组（P〈0．05）。以吸烟作为协变量,协方差分析结果显示,接尘组的用力肺活量、第一秒用力呼出量、呼气高峰流量、用力肺活量最大值、第一秒用力呼出量最大值明显低于对照组（尸〈0．05）。以吸烟为协变量,协方差分析结果显示,接尘组30年一工龄组呼气高峰流量和25％肺活量最大呼气流量明显低于10年～工龄组和20年～工龄组。以吸烟为分层因素,接尘组与对照组以及接尘组不同工龄间慢性阻塞性肺疾患患者分布差异均无统计学意义（P〉0．05）。[结论]掘砌作业工人肺通气功能明显低于对照组并随接尘工龄延长而降低。肺通气功能检测可以作为监测接尘作业工人肺部损失的指标。     

160例Ⅰ期煤工尘肺患者肺功能测定结果分析

目的探讨Ⅰ期煤工尘肺患者肺功能状态及肺通气功能损害的类型、年龄、接尘时间、工种、心肺合并症对肺功能的影响。方法采用日本美能MINATOAs-500型肺功能测定仪对160例Ⅰ期煤工尘肺及60名非粉尘作业工人进行肺通气功能测定,对所测定的结果比较分析。结果Ⅰ期煤工尘肺通气功能减退者99例,占61.9%。各项通气功能指标均明显低于对照组(P<0.001),尤以最大呼气中期流速(FEF)显著。结论160例Ⅰ期煤工尘肺通气功能障碍以混合型为主,并随着接尘工龄、年龄增加以及心肺合并症加重而肺通气功能随之下降,但与工种关系不密切。     

石油化工作业对工人肺通气功能的影响

目的了解石油化工(简称石化)作业对工人肺通气功能的影响,为更好地保护石化作业工人健康提供科学依据。方法采用整群抽样方法,通过问卷调查选择无吸烟史且半年内无呼吸系统疾病史的兰州市某石化企业接触刺激性气体工人(369人)和接触噪声工人(377人)分别为暴露组和对照组,采用spirovit SP-1型肺功能仪进行肺通气功能检查,检查指标为FVC、FEVl和FEVl/FVC。结果与对照组比较,暴露组FEVl、FEVl/FVC分别降低5.3%、4.8%(P0.05);暴露组肺功能异常率、阻塞性肺功能损伤发生率分别增高10.7%、12.9%(P0.05),其中,以男性、工龄≥20a者和年龄≥40岁者较高(P0.05)。结论石化作业对工人肺通气功能有一定危害,主要表现为阻塞性肺通气功能障碍,男性、工龄≥20a者和年龄≥40岁者损害明显,应定期对石化作业工人肺功能进行检查。     

小气道功能测定在粉尘作业人员职业健康监护及风险评估中的应用

[目的]了解粉尘作业对员工呼吸功能的影响,探讨小气道功能测定在粉尘作业人员职业健康监护及尘肺风险评估中的应用。[方法]2009年对某机械制造企业粉尘作业车间进行生产环境调查、粉尘浓度检测,对216名粉尘作业人员进行肺功能测定等职业健康检查及问卷调查。[结果]粉尘作业人员用力呼气75％肺活量的瞬间流量（forcedexpiratoryflowat75％offorcedvitalcapacity,FEF75％）的中位数为79％,低于正常值,用力肺活量（forcedvitalcapacity,FVC）、第1秒用力呼气容积（forcedexpiratoryvolumeinonesecond,FEV1）、1秒率（FEVl／FVC）、最高呼气流量（peakexpiratoryflow,PEF）、用力呼气25％肺活量的瞬间流量（forcedexpiratoryflowat25％FVC,FEF25％）、用力呼气50％肺活量的瞬间流量（forcedexpiratoryflowat50％ofFVC,FEF50％）的均数或中位数都在正常范围内,PEF、FEF25％、FEF50％和FEF75％异常的人员比例明显增高,分别为21．30％、BO．56％、45．37％和50．00％,而且这些参数异常人员接尘工龄较短,中位数分别为3．5年、4年、5年和5年。FVC、FEV1、FEV1／FVC、PEF、FEF25％、FEF50％、FEF75％异常人员的胸片检查异常比例分别为55．56％、60％．00、0、21．74％、15．15％、23．47％、25．00％。将胸片异常组与正常组的肺功能进行比较,胸片正常组的PEF、FEF25％、FEF50％的参数值低于异常组,差异有统计学意义（P〈0．05）。工龄10年以上的粉尘作业人员FEV1、FEF25％和FEF75％异常比例高于工龄较短组（P〈0．05）。[结论]粉尘作业人员存在气流受限、小气道功能障碍。随着接尘工龄的增加,FEV1、FEF25％和FEF75％异常人员有增多的趋势。该人群肺功能检查结果与胸片表现并不同步。在职业健康监护工作中,应对粉尘作业人员的肺功能尤其是小气道功能进行重点观察和动态对比分析,并将其作为尘肺风险评估的指标之一。建议在职业健康检查中将FEF25％、FEF50％、FEF75％等反映小气道功能的参数增设为监测指标。     

Obstructive pulmonary function defects among Taiwanese firebrick workers in a 2-year follow-up study.

The purpose of the study was to follow up an earlier observation of pulmonary function among workers employed in firebrick-manufacturing factories. A 2-year follow-up study of pulmonary function among 442 workers in 30 firebrick-manufacturing factories was designed. Excluding 79 workers with a history of other occupational dust exposure, changes in pulmonary function of 291 firebrick workers were compared with pulmonary function in 72 control subjects over a period of 2 years. Baseline pulmonary function values (i.e., forced expiratory volume in 1 second [FEV1]/forced vital capacity [FVC] and forced expiratory flow after 50% of vital capacity has been expelled [FEF50%] in smoking firebrick workers, and FEV1/FVC and FEF75% in nonsmoking firebrick workers) were significantly lower than those in the comparison group. The statistical method for repeated measurements was used for comparison of the difference between follow-up and baseline lung function. There was no significant difference in FVC and FEV1 changes between firebrick workers and those in the comparison group during the 2-year follow-up period. The decreases in FEV1/FVC, peak expiratory flow rate, maximal midexpiratory flow, and FEF50% in the firebrick workers were significantly greater than in the comparison group, after adjustment for smoking status. The FEV1, maximal midexpiratory flow, FEF50%, and FEF75% also showed a dose-response relationship with job titles. The decrement of pulmonary function in the 2-year follow-up period was the worst in burning work, followed by crushing and molding. The results show that workers in firebrick-manufacturing factories with exposure to silica-containing dusts may contract obstructive pulmonary function defects.     

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。     

A longitudinal study of lung function in jute processing workers.

A 5-y follow-up study of pulmonary function was conducted in 1982 and in 1987 for 50 current and retired jute-processing workers who had been employed for more than 10 y in a jute mill in China. Control subjects, who had no history of dust or gas exposure, were selected from a paper-packing plant in the same city. Forced expiratory maneuvers were conducted in the same manner in both 1982 and 1987. The jute workers' pulmonary functions, i.e., forced vital capacity (FVC), forced expiratory volume in 1 s (FEV1.0), and forced expiratory flow (FEF25-75%), were more compromised than were pulmonary functions in the controls for the same 5-y period; however, only the increased incidence of abnormal FEV1.0s in jute workers was statistically significant. Male jute workers had significantly higher annual decrements of FVC, FEV1.0, and FEF25-75% than did control workers. Regression analysis indicated that in 1987, predicted values of FEV1.0 and FEF25-75% for the jute workers were related to years of employment. Our results suggest that long-term exposure to jute dust could produce chronic loss of lung function.     

Occupational exposure to amorphous silica dust and pulmonary function.

Respiratory manifestations among 41 workers exposed to amorphous silica dust were compared with a control group comprising 90 workers of equivalent socioeconomic state in the same plant. Flow volumes were determined, blood gas concentrations were measured at rest and during exercise, chest radiographs were obtained, and data about respiratory symptoms were collected by questionnaire. A dust exposure index was calculated for each exposed worker. It was not possible to differentiate between the two groups from the questionnaire, blood gas analysis, or chest radiographs. On the other hand, the tests of respiratory function showed a significant decrease in forced expiratory flow (FEF25-75, FEF50, and FEF75) in the exposed group compared with the controls, although no correlation was found between the exposure index and pulmonary function. It appears that smoking and exposure to amorphous silica synergise to induce small airway disease.     

Occupational exposure to amorphous silica dust and pulmonary function

Respiratory manifestations among 41 workers exposed to amorphous silica dust were compared with a control group comprising 90 workers of equivalent socioeconomic state in the same plant. Flow volumes were determined, blood gas concentrations were measured at rest and during exercise, chest radiographs were obtained, and data about respiratory symptoms were collected by questionnaire. A dust exposure index was calculated for each exposed worker. It was not possible to differentiate between the two groups from the questionnaire, blood gas analysis, or chest radiographs. On the other hand, the tests of respiratory function showed a significant decrease in forced expiratory flow (FEF25-75, FEF50, and FEF75) in the exposed group compared with the controls, although no correlation was found between the exposure index and pulmonary function. It appears that smoking and exposure to amorphous silica synergise to induce small airway disease.