吸烟对煤矿接尘工人呼吸系统影响的探讨

为探讨吸烟对煤矿接尘工人呼吸系统的影响,我们对某煤矿接尘工人进行了吸烟情况的调查分析。１对象与方法１．１对象调查对象为接尘工龄１年以上的１５８０例男性工人（接尘组）,年龄平均５０．７±１０．９岁,接尘工龄平均１８．５±３．４年。另选择同一单位非接尘男...     

锡冶炼工接尘工龄与尘肺病发病情况相关分析

目的 了解锡冶炼工尘肺病的发病情况,并分析其与接尘工龄之间的关系,为进一步研究与制定锡冶炼工尘肺病的防治对策提供科学依据.方法 收集广西某冶炼厂锡冶炼车间385名冶炼工人的体格检查和诊断资料,运用寿命表法分析接尘工龄与尘肺病的关系.结果 385名锡冶炼接尘工人中,有9例尘肺病患者,患病率为2.34％;接尘后13～18年是该厂锡冶炼工人尘肺病发病的高峰期,在此期间患病率迅速升高;锡冶炼工人接尘工龄与尘肺病累积患病率之间呈高度正相关[相关系数(r) =0.933,P＜0.05],回归方程为y=0.003x-0.012.结论 锡冶炼工接尘工龄与尘肺病累计患病率关系密切,在该厂现有劳动条件下,若想把尘肺病的患病率控制在1％左右,工人的接尘工龄以不超过7年为宜.     

粉尘接触水平与脱尘矿工尘肺发病关系的研究

本文应用寿命表方法，对革金矿脱尘矿工粉尘接触水平与尘肺发病关系进行了研究，结果表明：随累积接尘量的增高，脱尘矿工尘肺患病率及累积患病率均依次递增，且差异显著（Ｐ〈０．０５或Ｐ〈０．０１）；累积拦尘量与尘肺患病之间存在剂量反应关系，若控制该职业人群尘肺累积发病率不超过５％，则作业场所空气中粉尘浓度就为３．５ｍｇ／ｍ＾３左右。     

煤矿与铁矿脱尘后尘肺的调查分析

采用典型抽样的方法，对煤矿及铁矿脱尘后尘肺的分布及进展情况进行了描述性研究。结果表明目前尘肺的发病情况已明显改变，新发病例以脱尘后尘肺为主，其实际接尘工龄较短，而发病工龄及发病年龄较长，晋期率、结核合并率及ＰＭＦ发病率均低于现职尘肺。由于今后社会上可能出现大量脱尘后尘肺患者，因此加强对脱尘工人，尤其是轮换制工人的管理有着重要意义。     

某矿晚发型矽肺病例调查

[目的]了解某矿接尘工人晚发型矽肺的患病情况，为更好地做好健康监护工作提供科学依据。[方法]2000年12月对某矿现有矽肺病人进行回顾性调查。[结果]245名矽肺患者中，离尘后发病的107例，占43．67％。其中，现有Ⅰ期病人86例，Ⅱ期病人19例，Ⅲ期病人2例；接尘工龄平均19．78年(4．7～42年)，发病至脱尘时间平均8．27年(1～32．4年)；初次诊断矽肺时(发病)年龄平均50．79岁，其中45～59岁占81．31％；运搬、手锤、风钻、爆破、支柱等矿山坑内作业工种合计占88．77％，20世纪50～60年代开始接尘的占81．31％；肺结核合并率为13．08％。[结论]该矿接尘工人离尘后发生矽肺的较多，大都从事主要工种，接尘工人离尘后应定期安排健康检查。     

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。     

螺旋CT结合呼吸门控对接尘工人肺部形态与功能关系的研究

目的 探讨呼吸门控下定量CT对接尘工人早期病变的诊断价值。方法 接尘工人62例（接尘3－28年）及对照组54例，在50％肺活量（50％VC）状态下行全肺螺旋CT扫描，在10％VC、90％VC呼吸水平下于隆突层和隆突上、下各5cm处行高分辨CT（HRCT）扫描。用定量指标分析结果，并与临床肺功能检测进行对照。结果 62例接尘工人中有9例在CT上可见肺气肿的表现。接尘工人的10％VC、90％VC时的定量指标与对照组的差异均有显著性（P＜0．05），并且随着接尘工龄的增加，其定量指标与对照组的差异呈梯度增加。结论 呼吸门控定量CT是接尘工人早期病变的灵敏、准确、客观的检查方法，其对小气道病变的诊断优于临床肺功能检测。     

两邻近煤矿尘肺病情差异的影响因素分析

为探讨影响煤工尘肺发病的主要因素,选择尘肺病情不同的两个邻近无烟煤矿进行了调查研究,分别比较了两煤矿尘肺工种工龄患病率,多重断面的尘肺患病率和工种别人年发病率,并用寿命表法分析两煤矿不同工种、不同入矿年代接尘工人按工龄累积的尘肺发病概率,结果表明,影响两煤矿煤工尘肺肺病情差异的因素主要是接尘量和粉尘中游离SiO_2含量,建议在修订我国粉尘最高容许浓度卫生标准时,宜将两者密切结合,把游离SiO_2含量分级更细些为好。     

衢州市退伍工程兵晚发性矽肺流行病学调查分析

目的 了解退伍工程兵在脱尘后的矽肺发病情况。方法采用调查表的方式对每位退伍工程兵逐个进行询问调查，并结合民政部门的档案资料进行统计分析。结果在162名退伍工程兵健康检查中，检出晚发性矽肺患者11人，其平均年龄为41．5岁，平均接尘工龄为5．01年，平均脱尘年限为15．83年，检出率为6．79％；以1955年至1965年入伍的工程兵为主，占总退伍工程兵患矽肺人数的49．38％。结论该地区退伍工程兵患晚发性矽肺特征有脱尘时间较长，接尘工龄在5年左右，发病年龄有增长趋势。     

824名煤矿脱尘工人尘肺病现状调查

调查显示,824名煤矿脱尘工人的尘肺患病率较高,占尘肺总数的37.40%;按不同接尘年代分组,晚发尘肺患病数及尘肺晋期人数比较,50年代接尘组高于60年代及70年代以后接尘组(P<0.01);不同作业工龄及工种的煤矿脱尘工人晚发性尘肺发病率及尘肺晋期率无明显差异(P>0.05)。     

British data on coal miners'' pneumoconiosis and relevance to US conditions.

OBJECTIVES. The current primary federal dust standard for US underground coal miners of 2 mg/m3 respirable dust is based on British epidemiological information on exposure-response derived in 1969. Since then, much new information has become available. This paper reviews and compares the available information as it relates to the US mining situation. METHODS. Recent exposure-response information on pneumoconiosis and dust exposure derived by British researchers was employed to estimate working-life risks of pneumoconiosis for miners exposed to 2 mg/m3. RESULTS. It is estimated that close to 9% of underground coal miners who work for 40 years in a 2 mg/m3 environment would develop pneumoconiosis (category 1 or greater). Progressive massive fibrosis would develop in 0.7%. CONCLUSIONS. There are unresolved questions relating to the validity of extrapolating findings on British mines and miners to the US and also in predicting disease levels at the low end of the dust exposure spectrum. Given the data available, current information suggests miners who are employed for a working life-time at the current federal dust limit of 2 mg/m3 are still at risk of developing pneumoconiosis.     

煤矿新工人早期肺通气功能的变化

目的　研究煤矿粉尘对新工人肺通气功能的早期影响。方法　选择徐州矿务集团新招收的男性工人2 87人为矿工组,选择该集团技工学校在校男生132人为对照组。调查内容包括个人基本资料、家族疾病史、职业史、吸烟史、作业场所粉尘浓度、肺通气功能随访测定。前瞻性队列调查为期3年,每半个月测定作业场所的总粉尘和呼吸性粉尘浓度;定期测定两组人群的用力肺活量(FVC)和第一秒用力呼气量(FEV1)。结果　矿工作业场所的总粉尘平均浓度为2 3.8mg/m3 ,呼吸性粉尘平均浓度为8.9mg/m3 ,均超过国家卫生标准。接尘第1年,矿工组FVC(5 .19L)高于对照组(4.92L) ,差异有统计学意义(P <0 .0 1) ,第2年和第3年的差异均无统计学意义(P >0 .0 5 )。接尘前矿工组FEV1[(4.4 8±0 .4 9)L]高于对照组[(4.2 8±0 .4 8)L];接尘1年时FEV1下降至4 .2 5L ;第2年和第3年FEV1(4.34L)低于对照组(4.5 6L) ,差异有统计学意义(P <0 .0 1)。矿工组FEV1呈下降趋势。矿工吸烟者3年中的FVC、FEV1损失量(15 4、184ml)高于不吸烟者(83、91ml)。FVC、FEV1与年龄、身高和体重存在一定相关。结论　粉尘对煤矿新工人的早期肺通气功能有明显影响,FEV1下降比FVC更为明显;吸烟可加重粉尘对肺通气功能的损害。     

重庆煤矿尘肺发病规律研究

为探索重庆煤矿尘肺发病规律，对重庆1986年在册的47038名接尘工人进行了回顾性调查。结果显示，重庆煤矿尘肺患病率为13．0％．平均发病工龄为20年，平均发病年龄为46岁，尘肺死亡率为24．5％，平均死亡年龄为58．2岁，大块纤维化患病率为1．6％；尘肺的发生与工人接触高合矽量、高浓度粉尘有关；重庆煤矿粉尘中游离SiO2，平均含量为8．5％，尘肺病例以煤矽肺和煤肺为多，矽肺病例相对较少；防尘工作重点应放在采煤工作面。     

煤工尘肺预期发病工龄寿命表法研究

目的 研究煤工尘肺预期发病工龄。方法 收集整理某局1960－1995年期间的8291份接尘工人健康检查资料,分别计算不同时间的尘肺累积发病数,队列寿命表法求得矿工预期发病工龄。结果 煤矿工人的接尘工龄与累积患病率的概率单位之间呈正相关（r=0.98,P=0.0001),煤工尘肺的发病率随工龄的增加而增高,预期发病工龄随工龄的增加而缩短。结论 煤矿工人的尘肺发病工龄约为15年左右,在目前煤矿粉尘浓度水平的条件下,若想把尘肺患病率控制在1％左右,各工种的工人接尘期限以不超过6年为宜。     

Lung retention and clearance of shipyard arc welders

Summary The amount of welding fume lung contaminants was measured in 42 shipyard arc welders. The subjects were divided into four groups according to the exposure time which varied from 1 to 40 years. A new measuring method, based on magnetic properties of fume iron retained in the lungs, was used to evaluate the amount of lung contaminants. The average alveolar deposition rate seemed to be from 20 to 40 mg per year, typical alveolar retention after 5 years of continuous exposure was 200 mg and the clearance rate ranged from 10 to 20 % per year.The interindividual variation in the amount of lung dust was high, the geometric standard deviation varying between 2 and 3. The results were compared with post mortem studies of coal miners. Retention rate of welding fumes seemed to be lower than that of coal mine dust but the clearance rate was about the same.     

2003至2008年某矿务集团煤工尘肺发病情况分析

目的 分析某煤矿2003至2008年尘肺病检出情况,探讨该矿尘肺发病特点,为尘肺病的防治提供科学依据.方法 收集1949年以来井下粉尘监测数据及2003至2008年的健康监护资料和尘肺诊断资料,分析尘肺发病情况,根据不同年代的粉尘接触水平结合工种和工龄推算安全总粉尘累积剂量.结果 2003至2008年该矿务集团在岗工人职业性健康监护率呈逐年提高趋势,共新检出煤工尘肺病例296例,总检出率为0.57%,平均年检出率为0.32%;Ⅰ期煤工尘肺268例,占全部病例的90.59%,87.20%(258例)的煤工尘肺患者为采掘工;新发病例的接尘工龄最短为3年,最长38年;每年总粉尘累积剂量为86.1～4926.0mg/m3.用百分位数法(第99%百分位数)推算煤矿井下工人每年安全总粉尘累积剂量为120.6 mg/m3.结论 尘肺病防治的重点工种是采掘工,在现有工作条件下井下采掘作业工龄不应超过13年.

Abstract：

Objective Analyzed associations among the incidence of coal workers' pneumoconiosis from 2003 to 2008, jobs, exposure years and cumulative total dust exposure levels(CTE ) and found the current characteristics of the mine incidence of pneumoconiosis disease. Methods collected the health care information of the new diagnosed pneumoconiosis of underground mine workers from 2003 to 2008 and the dust monitoring data of underground mine from 1949 and estimated the personnel cumulative total dust exposure levels (CTE); analyzed the incidence features of the new diagnosed pneumoconiosis. Results The rates of health surveillance of workers were gradually improved from 2003 to 2008 and 296 new coal workers pneumoconiosis were diagnosed. The total incidence was 0.57%, and the average annual rate was 0.32%. Among the new diagnosed cases, phase I accounted for 90.5% and the 87.2% from coal mine drillers. The shortest exposure period was 3 years and the longest was 38 years, and the cumulative total dose of dust was varied between 86. 1 and 4926 mg/m3 per year. The total dust accumulated limited dose was calculated by the percentile method to prevent 99% of miners from pneumoconiosis, which was 120.6 mg/m3 per year, so we suggested that the exposure years should be shorter than 13 years under the current working conditions. Conclusions Preventive coal workers' pneumoconiosis should be focused on mine drillers and their limited exposure years should be within 13 years.     

An investigation into the relationship between coal workers' pneumoconiosis and dust exposure in U.S. coal miners.

The National Study of Coal Workers' Pneumoconiosis (NSCWP) is a large, continuing epidemiologic study of the respiratory health of U.S. coal miners. By using information from the study, prevalence of coal workers' pneumoconiosis (CWP) was related to indexes of dust exposure obtained from research and compliance sampling data. Clear relationships between prevalences of both simple CWP and progressive massive fibrosis (PMF) and estimated dust exposure were seen. Additional effects independently associated with coal rank (% carbon) and age were also seen. Logistic model fitting indicated that between 2% and 12% of miners exposed to a 2-mg/m3 dust environment in bituminous coal mines would be expected to have Category 2 or greater CWP after a 40-yr working life; PMF would be expected for between 1.3% and 6.7%. The risks for anthracite miners appeared to be greater. There was a suggestion of a background level of abnormality, not associated with dust exposure, but increasing with age. Although there are certain weaknesses in the data used to derive these exposure estimates, the results are in general agreement with, but somewhat greater than, some recent findings for British coal miners.     

不同煤种呼吸性粉尘与尘肺病患病风险的剂量-反应关系分析

目的 探讨无烟煤、烟煤、褐煤呼吸性粉尘与尘肺病累计患病率的剂量-反应关系,为科学制定职业卫生标准提供依据。方法 对9处国有煤矿采煤工人的接尘和尘肺病患病情况进行调查研究,以寿命表法分别计算出无烟煤、烟煤、褐煤呼尘累计接尘量对应的累计患病率,利用线性回归方程进行单侧区间统计控制,得到呼尘接触浓度限值。结果 9处煤矿共21 000名采煤工人纳入研究,其中无烟煤、烟煤、褐煤煤矿采煤工人尘肺病检出率分别为11.27%、21.32%、6.00%,平均接尘工龄为20.12、22.88、25.21年。无烟煤、烟煤、褐煤煤矿采煤工人呼尘累计接尘量与尘肺病累计患病率的剂量-反应关系分别为线性回归方程y=5.788x-16.043（R²=0.949）、y=5.679x-16.837（R²=0.904）、y=6.465x-19.573（R²=0.944）。当接尘30年尘肺累计患病率≤1%时,以安全系数为1.2计算,三者呼尘接触浓度限值分别为1.7、2.3、3.9 mg/m³。结论 不同煤种的尘肺病检出率、平均接尘工龄、呼尘接触浓度限值均不同,在煤尘累计接尘量相似情况下,煤的挥发分越低（含碳量越高）,累计患病率越高（无烟煤 > 烟煤 > 褐煤）。建议按照不同煤种分别制定国家职业卫生煤尘标准。     

Pneumoconiosis and advanced occupational lung disease among surface coal miners--16 states, 2010-2011

Coal workers' pneumoconiosis (CWP) is a chronic occupational lung disease caused by long-term inhalation of dust, which triggers inflammation of the alveoli, eventually resulting in irreversible lung damage. CWP ranges in severity from simple to advanced; the most severe form is progressive massive fibrosis (PMF). Advanced CWP is debilitating and often fatal. To prevent CWP, the Coal Mine Health and Safety Act of 1969 established the current federal exposure limit for respirable dust in underground and surface coal mines. The Act also established a surveillance system for assessing prevalence of pneumoconiosis among underground coal miners, but this surveillance does not extend to surface coal miners. With enforcement of the exposure limit, the prevalence of CWP among underground coal miners declined from 11.2% during 1970-1974 to 2.0% during 1995-1999, before increasing unexpectedly in the last decade, particularly in Central Appalachia. Exposure to respirable dust is thought to be less in surface than underground coal miners. Although they comprise 48% of the coal mining workforce, surface coal miners have not been studied since 2002. To assess the prevalence, severity, and geographic distribution of pneumoconiosis among current surface coal miners, CDC obtained chest radiographs of 2,328 miners during 2010-2011 through the Coal Workers' Health Surveillance Program of the National Institute for Occupational Safety and Health (NIOSH). Forty-six (2.0%) of 2,257 miners with >1 year of surface mining experience had CWP, including 37 who had never worked underground. Twelve (0.5%) had PMF, including nine who had never worked underground. A high proportion of the radiographs suggested silicosis, a disease caused by inhalation of crystalline silica. Surface coal mine operators should monitor worker exposures closely to ensure that both respirable dust and silica are below recommended levels to prevent CWP. Clinicians should be aware of the risk for advanced pneumoconiosis among surface coal miners, in addition to underground coal miners, to facilitate prompt disease identification and intervention.     

脱尘矿工肺通气功能损害及其影响因素的调查分析

本文对３２６名脱尘矿工和６９名不接触尘毒的健康工人分别进行了肺通气功能测定，并对影响脱尘矿工肺通气功能损害的因素进行了分析，结果表明：无论是肺通气功能的实测值、实测值占预计值的百分比，还是肺通气的异常率，或是最大呼气流速容量曲线的比较分析，均显示脱尘矿工的肺气功能损害较对照工人为严重。多因素分析结果表明：接尘起始年代、慢性支气管炎对脱尘工人肺通气功能损害的影响尤为明显。即接尘起始年代越早或有慢性支