氟作业对员工心电图的影响

[目的]探讨有机氟、氢氟酸接触对作业员工心电图影响。[方法]将接触有机氟、氢氟酸员工设为接触组,另设对照组。对于两组按性别、年龄、工龄分层进行心电图检查,并用气相色谱法、离子选泽性电极法测定作业环境有机氟、氢氟酸浓度。结果采用≯检验分析。[结果]作业场所监测四氟乙烯浓度、六氟丙烯浓度、八氟异丁烯浓度、氢氟酸浓度,均在国家卫生标准范围之内。有机氟、氢氟酸作业〉35岁员工的心电图异常率明显高于对照组,主要表现在心律失常、左室高电压等。[结论]低浓度有机氟、氢氟酸接触对〉35岁作业员工心血管系统可能会产生一定的影响。     

铝电解作业工人神经行为功能研究

目的探讨铝作业工人神经行为功能的改变及其接触水平效应／反应关系。方法采用ＷＨＯ推荐的神经行为功能测试组合（ＮＣＴＢ）对某铝厂３１８名工人进行测试分析。结果除情感状态部分项目外的所有测试项目标准分均低于对照组,提示接触铝作业在听记忆、视感知记忆、运动敏捷度及其准确性方面已有显著改变,这种改变随铝作业工龄的延长而更加显著,尤其是工龄１５年以上者;逐步回归分析结果提示,ＮＣＴＢ标准分随累计接尘量的增加而逐渐减少,两者存在接触水平效应／反应关系。结论切实降低作业场所空气中铝粉尘浓度以及减少接铝作业时间是降低铝对神经行为功能损害的重要途径,ＮＣＴＢ测试可以成为接触铝作业工人健康监护的早期敏感指标。     

接触混合苯作业人员血红蛋白含量的变化

目的：探讨从事混合苯作业人员血红蛋白（Hb）含量变化。方法：分析男女从业人员的Hb含量与接毒浓度、接毒工龄、接毒年龄的关系。结果：作业人员Hb含量较正常的下限低（P＜0．001）,男性从业人员的Hb含量与接毒浓度间存在负相关（P＝0．039）,女性的Hb含量与接毒工龄间存在正相关。结论：从事混苯作业人员Hb含量有明显下降,改善作业环境及就业后定期体检应作为职业卫生工作的重点。     

三硝基甲苯接触者血清生化指标的变化

目的探讨三硝基甲苯(TNT)对接触者血清生化指标的影响。方法以某化工厂TNT作业工人40名为接触组,某学校教职员工40名为对照组,采集空腹静脉血,分别测定血清丙氨酸氨基转移酶(ALT)等10项生化指标,并进行比较;同时测定生产环境中TNT浓度。结果接触组甘胆酸(CG)、肌酐(Cr)、尿酸(UA)3项指标的均值与对照组相比明显增高,差异有统计学意义;白蛋白(ALB)、甘油三酯(Tg)2项指标的均值与对照组相比明显降低,差异有统计学意义。结论长期接触TNT可导致作业人员部分血清生化指标的改变,主要为CG、Cr、UA增高,ALB、Tg降低。     

敌敌畏对外呼吸功能和生化免疫影响

本文研究接触敌敌畏对工人肺功能的急慢性影响和生化免疫指标的改变.以农药厂47名接触敌敌畏(浓度1—4mg/m~3)的工人和16名行政管理人员分别作为接触和对照组的研究对象,并以机电厂30名无生产性粉尘、毒物接触而劳动强度相仿,年龄和身高与接触组接近的作为观察接触组工人班前、班后肺功能急性改变的厂外对照组。结果如下:接触组和对照组全血胆碱酯酶活力分别为2.75±0.42和3.11±0.20μmol/0.02ml.肺功能的慢性影响研究可见,接触组FEV_1、FEV_1/FVC%和FEF_(?)-(?)%的实测值/预期值(O/E%)明显低于对照(P<0.05);急性影响观察发现,接触组工人班后的FEV_1和FEF_(?)-75%比班前显著降低(>7%),P<0.01.有1例班前、班后FEV_1降低绝对值达700ml以上,降低>20%.接触组血清总胆固醇为142.50±30.31mg%,明显低于对照的166.16±65.23mg%,P<0.05;血清碱性磷酸酶活性和IgM 水平显著高于对照。作者认为:接触有机磷工人除胆碱酯酶受抑外,可能存在其它系统的影响和损害.     

铝电解作业工人肺通气功能改变

为探讨铝电解作业氧化铝粉尘等有害因素对工人肺通气功能的早期影响,我们对某电解铝厂铝作业工人进行了肺通气功能测定及现场劳动卫生学调查。结果显示铝作业工人呼吸系统疾病显著增加,肺通气功能为小气道阻塞性改变,ＦＥＶ１均值随工龄延长、累计接尘量增加和吸烟量增加而显著下降,ＦＥＶ１异常率明显增加。接触组内ＦＥＶ１异常与有害因素之间Ｌｏｇｉｓｔｉｃ回归分析结果表明,工龄和吸烟量是造成肺通气功能损伤的重要因素,     

对苯二甲酸作业人群尿液离子水平的变化

探讨对苯二甲酸（ＴＰＡ）作业人群尿液离子水平的变化。方法留取２２４名ＴＰＡ作业工人和１１４名对照组工人当日工前工后尿样。对尿ｐＨ、Ｎａ＋、Ｃｌ－、Ｃａ２＋、ＮＨ４＋、ＰＯ４３－和ＳＯ４２－进行测定分析。结果接触组尿Ｎａ＋、Ｃｌ－、Ｃａ２＋和ＳＯ４２－离子浓度显著高于对照组（Ｐ＜００１）,同时ＮＨ４＋与尿ＴＰＡ负荷存在明显的剂量依赖关系;指标聚类分析表明,尿ＴＰＡ水平与尿ＮＨ４＋水平相关系数最大（ｒ＝０２４０５,Ｐ＜００１）,提示ＴＰＡ可能是导致尿ＮＨ４＋离子排泄增加的原因。结论由于ＮＨ４＋长期排泄过多,会导致机体负氮平衡,因此似可以尿ＮＨ４＋作为接触ＴＰＡ的早期生物学监测指标。     

Biochemical Changes Associated with Chloracne in Workers Exposed to Tetrachlorazobenzene and Tetrachlorazoxybenzene

In 1976 and 1977 workers on two linked plants producing theherbicide Diuron and its precursor 3,4-dichloraniline (DCA)developed mild chloracne. One year later review of the resultsof serial liver function tests, together with lipid profilesin some of the workers, revealed a higher than expected incidenceof abnormalities. A controlled biochemical investigation anda follow-up study were made of the work-force on the two plants.There were no significant abnormalities of liver function inthe DCA/Diuron workers. However, there was a statistically significantincrease in their mean tri-glyceride values which was greaterin those who had chloracne. Mean cholesterol levels were alsohigher. As a result of a combined programme of improved occupationalhygiene and personal health care the lipid values returned tonormal. ⁰Requests for reprints should be addressed to: Dr D. A. Scarisbrick, Health and Safety Executive, Employment Medical Advisory Service, Sovereign House, 40 Silver Street, Sheffield, SI 2ES.     

低浓度三氯乙烯对接触者免疫功能的影响

[目的]观察低浓度三氯乙烯(TCE)接触对人体体液免疫与细胞免疫功能的影响。[方法]测定作业环境空气中的TCE浓度。以48名接触TCE的工人及45名非接触TCE的工人为测试对象,测定尿中TCA浓度和血清中的IgG、IgA、IgM、IgE及外周血T淋巴细胞亚群。接触TCE的工人按尿中TCA浓度分为2组:低暴露组(≤50mg/L)和高暴露组(>50mg/L)。[结果]①低暴露组和高暴露度组IgM分别为(1.22±0.35)g/L和(1.27±0.58)g/L与对照组IgM(1.48±0.61)g/L相比,IgM水平下降,差异有显著性(P<0.05)。②低暴露组和高暴露度组IgG和IgA水平有下降的趋势。③对照组、低暴露组及高暴露组的CD3 分别为(81.28±9.17)%,(71.26±13.23)%和(61.80±12.33)%;CD4 分别为(70.27±13.82)%,(39.61±10.22)%和(36.28±7.29)%;CD8 分别为(31.48±11.95)%,(50.87±12.80)和(46.20±9.17)%。低暴露组及高暴露组CD3 、CD4 及CD4 /CD8 均低于对照组(P<0.01);CD8 高于对照组(P<0.01)。[结论]低浓度三氯乙烯可抑制接触者的体液免疫和细胞免疫功能。     

高频作业工人神经行为功能改变的观察

目的探讨神经行为功能检测在高频辐射职业危害中的应用价值。方法采用ＷＨＯ神经行为核心测试组合中４项神经行为功能测试方法，观察工业高频电磁场对作业工人神经行为的影响。结果高频作业工人各项指标得分均显著低于对照组，并与作业工人神经衰弱的检出结果有一定的关系。结论神经行为功能的改变为高频电磁场对人体不良影响的重要方面。     

对苯二甲酸接触工人尿酶及微球蛋白的变化

选择１２７名ＴＰＡ作业工人进行动式个体采样,并留取１２７名ＴＰＡ作业工人当日工前工后尿样和７０名对照工人的工前尿。对尿样中γ谷氨酰转肽酶（ＧＧＴ）、碱性磷酸酶（ＡＬＰ）、乳酸脱氢酶（ＬＤＨ）、Ｎ乙酰βＤ氨基葡糖苷酶（ＮＡＧ）活性以及尿ＴＰＡ、α１微球蛋白（α１ＭＧ）、β２微球蛋白（β２ＭＧ）水平进行分析。结果显示,ＴＰＡ接触组尿ＧＧＴ、ＡＬＰ、ＬＤＨ、ＮＡＧ活性以及尿α１ＭＧ、β２ＭＧ水平与对照组相比无显著差别,而５～ｍｍｏｌ／ｍｏｌ．Ｃｒ尿ＴＰＡ负荷组工人尿β２ＭＧ与对照组相比有明显升高（Ｐ＜００５）,尿β２ＭＧ与尿ＴＰＡ负荷量呈现一定的剂量依赖关系。尿ＴＰＡ水平对尿酶活性、α１ＭＧ均未产生明显影响。不同累积接尘量和不同工龄的工人尿酶和微球蛋白无明显差异。提示ＴＰＡ对肾实质可造成一过性可逆性影响,尚不能说明肾实质受到器质性损伤。     

低浓度1-溴丙烷对接触者神经系统的影响

[目的]观察低浓度1-溴丙烷(1-BP)接触对人外周神经系统和中枢神经系统功能的影响。[方法]以25名1-BP接触工人为接触组(其中男性17人)和25名非接触工人为对照组(其中男性17人),使用问卷调查收集研究对象的年龄、性别和吸烟、饮酒状况及教育程度等信息,测定1-BP接触的时间加权平均浓度(TWA),进行神经传导速度和神经行为学检查。[结果]接触组女性和暴露组女性相比,一般情况中除年龄(接触组女性年龄低于对照组,P<0．05)外,其他方面差别均无显著性;接触组男性和暴露组男性一般情况差别均无显著性。1-BP接触浓度的TWA平均值80．4(2．0-384．9)mg/m3;男性接触组与其对照组相比,运动神经传导速度减慢,末端潜伏期延长,简明情绪量表(profile of mood states,PMOS)表中紧张焦虑项得分增高,视觉记忆项得分降低,差异有显著性(P<0．05);女性接触组与其对照组各项比较差别均未见统计学意义(P>0．05)。[结论]低浓度1-BP暴露能对男性接触者外周神经传导速度和神经行为产生影响。     

镉接触工人心血管功能研究

[目的 ]探讨镉接触对工人血压、心电图的影响及可能的作用机制 ,以保护作业工人的健康。 [方法 ]以某冶炼厂镉接触工人 86名为接触组 ,以邻近地区无镉接触史的健康工人 10 6名为对照组 ,对其血压、心电图及相关生化指标进行测定。数据经方差分析、趋势卡方检验和logistic多元回归分析 ,并计算基准剂量 (Benchmarkdose ,BMD)。 [结果 ]镉接触组工人收缩压、舒张压、高血压患病率显著高于对照组 (P <0 0 5 ) ,高血压患病率随尿镉水平增加而升高 ,有明显的剂量 反应关系 ,并得出基准剂量 2 98μg/gCr。血浆血管紧张素II、尿钠 /钾比值也随尿镉水平增高而增高。镉对高血压患病率的影响与肾功能损害与否没有显著联系。Logistic多元回归分析发现体质指数、吸烟、镉接触年限、尿镉 ,是影响高血压患病率的主要因素。接触组工人心室电压无明显改变 ,心率低于对照组 ,QRS间期和QT间期延长 ,T波及ST段改变、心动过缓等异常发生率也显著高于对照组。 [结论 ]长期接触镉可对作业工人心血管功能产生影响 ,导致血压升高 ,这可能与镉影响肾素 血管紧张素 醛固酮系统和 /或体内钾钠平衡有关。且镉可引起心电图的改变 ,可能主要是影响心室内传导。     

Withdrawal Symptoms in Workers Exposed to Nitroglycerine

Several reports during the last few years have described chest pain and sudden death in workers exposed to nitroglycol in combination with nitroglycerine. A report is given here of nine persons suffering from chest pain (including one sudden death) after exposure to nitroglycerine alone. The pains occurred between 30 and 65 hours after termination of the exposure. The differential diagnosis from angina pectoris is discussed.     

铅接触工人心律反应变化初探

对蓄电池厂和工业陶瓷厂铅接触工人进行自主神经系统功能心电图测试和问卷调查，对照组为公司非铅接触人员组成。测试项目包括：ＶａｌｓａｌｖａＭａｎｏｅｕｖｒｅ心律反应，深呼吸时心律变化，即心律反应。测试值结果显示年龄增长与测试值间呈高度负相关（Ｐ＜０．０００１），表明年龄是影响自主神经功能的重要因素，年龄相近的接触组与对照组间测试差异均无显著性（Ｐ＞０．０５），接触组测试值与接触指标间未见显著相关关系（Ｐ＞０．０５），未观察到铅接触与自主神经功能下降有直接关系的证据。     

2005年包头市某棉纺厂噪声对女工听力影响调查

[目的]探讨噪声对纺织女工听力的影响.[方法]2005年对包头市某棉纺厂女工使用国产ND-2型精密声级计测定各车间噪声强度,使用国产AM-1型声级计测量女工听力.听损评价以人为单位,高频听损以坏耳为准,低频听损以好耳为准.[结果]各车间随噪声强度的增大女工听损人数增多,尤其是90 dB(A)至95 dB(A),阳性数骤增,两者间差异有统计学意义(P＜0.01);随工龄的延长,女工听力损伤增多,组间差异有统计学意义(P＜0.05).[结论]环境噪声导致女工听力损伤,应加强环境噪声的治理与控制.     

Acute and Chronic Changes in Pulmonary Functions among Indian Textile Workers

An epidemiological study was carried out in three textile millsof Ahmedabad. A total of 214 cotton dust exposed and 184 controlsubjects were examined for pulmonary function tests. Pulmonaryfunction tests included forced vital capacity and forced expiratoryvolume in one second. The pulmonary function tests were carriedout before starting the shift and after 7 hours of exposureon a vitalograph spirometer. The study shows that among thecotton dust exposed workers byssinotics behave distinctly andshow the maximum acute and chronic changes in pulmonary functions.It seems that the effect of cotton dust exposure on the byssinoticsubjects is more predominant than the effect of smoking. Requests for reprints should be addressed to: J. R. Parikh, National Institute of Occupational Health, Ahmedabad-380016, India     

Hypothyroidism in Textile Workers

Four cases of overt hypothyroidism, three of whom were men intheir early forties, had occurred over a period of 6 years ata textile factory where thiourea and resorcinol were used inthe finishing departments. A follow-up survey of 189 men and48 women (44 per cent of employees) revealed 12 new cases ofvarying grades of hypothyroidism, categorized after the systemproposed by Evered¹. These included a case of mild hypothyroidismin a male worker, who subsequently received thyroid hormonereplacement therapy as a hospital out-patient. A full occupationalhygiene survey was carried out to determine possible sourcesof exposure to thiourea and resorcinol. Although we were unableto demonstrate a statistically significant occurrence of biochemicallyand immunologically detectable disturbances in thyroid functionamong this workforce, we did note that three of the originalindex cases and several of those workers with varying degreesof minor dysfunction in the follow-up study seemed to clusterin locations where exhausted fumes could accumulate. Requests for reprints should be addressed to: Mrs A. L. Wright, Occupational Medicine and Hygiene Laboratories, Health and Safety Executive, 403 Edgware Road, London NW2 6LN, UK     

Respiratory Abnormalities in Workers Exposed to Grain Dust

Survey of 68 grain elevator agents in Southern Manitoba disclosed that 75% had respiratory symptoms. Chronic cough and sputum, and dyspnea associated with exposure to grain dust were common. These symptoms were reported in more than half of the smokers and ex-smokers and in more than one quarter of the nonsmokers. Twenty-seven percent of the subjects also developed systemic symptoms of “grain fever” after exposure to grain dust. Lung function tests demonstrated abnormal spirometric results in 37%, while estimation of the “closing volume” demonstrated abnormality in 42.5% of the subjects, even after the values have been standardized for smoking habit. The high prevalence of respiratory symptoms and abnormal lung function among these subjects indicated that exposure to grain dust was an important etiologic factor in their development. Hypersensitivity to grain dust was found in eight subjects by prick skin testing and in six subjects by precipitin test. There was no significant correlation between the presence of positive skin or precipitin test and clinical disease.     

TOCP对作业工人淋巴细胞NTE活性的影响

测定60例TOCP作业工人的淋巴细胞NTE活性,结果表明,该酶活性的降低可在一定程度上反映近期TOCP接触水平,因而可以做为有机磷作业工人的一项监测指标;但对岗位多变或已经脱离TOCP接触的迟发性神经病患者,淋巴细胞NTE活性测定无显著意义。