Cross-sectional silica exposure measurements at two Zambian copper mines of Nkana and Mufulira

We measured the quartz content of 20 bulk settled dust and 200 respirable dust samples in a cross-sectional dust exposure assessment that is part of an epidemiological study to ascertain the risk of nonmalignant respiratory diseases among Zambian copper miners. Dust samples were collected from the copper mines of Mopani Copper Mine plc (Mufulira and Nkana Mines). Analytical measurements employed NIOSH Method 0600 for gravimetric analysis of respirable dust and NIOSH Method 7500 for quartz analysis in bulk and respirable dust samples. The measured quartz content of respirable dust showed that 59% and 26% of Mufulira and Nkana Mine samples, respectively, were above the calculated U.S. Occupational Safety and Health Administration permissible exposure limit. The mean intensities of respirable dust exposure at Mufulira and Nkana were 0.992 mg/m3 (range 0-7.674) and 0.868 mg/m3 (range 0-6.944), respectively while the mean intensities of respirable quartz at Mufulira and Nkana were 0.143 mg/m3 (range 0-1.302) and 0.060 mg/m3 (range 0-0.317), respectively. These results indicate weak dust monitoring at these mines which may increase the risk of nonmalignant disease in many miners. Since Zambian mining regulations do not have crystalline silica exposure limits, these results accord with the recommendation that Zambian mining houses and the government establish crystalline silica analysis laboratory capacity and adopt dust mass concentration occupational exposure limits for more protective dust monitoring of workers.     

Assessment of potential biases in the application of MSHA respirable coal mine dust data to an epidemiologic study

Systematic errors in exposure data will result in biased estimates of the exposure-response relationship derived from epidemiologic analyses. Thus, adjustment of exposure data to account for identified errors may provide for a more accurate assessment of effect. In preparing to apply respirable coal mine dust exposure data collected by the Mine Safety and Health Administration (MSHA) to a study of the pulmonary status of underground coal miners, an assessment of potential systematic errors was undertaken. Potential errors stemming from adjustment of controls during sampling, concentration-dependent sampling, truncation of sampling results, identified sampling equipment problems, and a disproportionate number of low concentration samples in mine operator-collected samples were identified and evaluated. Methods to account for these errors and adjust mean exposures by mine, occupation, and year are given.     

Respirable coal dust exposure and respiratory symptoms in South-African coal miners: a comparison of current and ex-miners

OBJECTIVES: Dose-response associations between respirable dust exposure and respiratory symptoms and between symptoms and spirometry outcomes among currently employed and formerly employed South-African coal miners were investigated. METHODS: Work histories, interviews, and spirometry and cumulative exposure were assessed among 684 current and 212 ex-miners. RESULTS: Lower prevalences of symptoms were found among employed compared with ex-miners. Associations with increasing exposure for symptoms of phlegm and past history of tuberculosis were observed, whereas other symptom prevalences were higher in the higher exposure categories. Symptomatic ex-miners exhibited lower lung function compared to the nonsymptomatic. CONCLUSIONS: Compared with published data, symptoms rates were low in current miners but high in ex-miners. Although explanations could include the low prevalence of smoking and/or reporting/selection bias, a "survivor" and/or a "hire" effect is more likely, resulting in an underestimation of the dust-related effect.     

Relation between dust exposure and lung function in miners and ex-miners.

A sample of men working in the British coal industry in the 1950s has been followed up and examined 22 years later. The relations between lung function and individual cumulative exposure to respirable dust have been studied in 1867 men who were still working in the industry at the time of follow up and 2192 men who had left. Levels of forced expired volume in one second (FEV1), forced vital capacity (FVC), and FEV1/FVC ratio at follow up were found to be inversely related to exposure to respirable dust after allowing for other factors, even in men without pneumoconiosis. The magnitude of this estimated effect was equivalent to a loss of 228 ml FEV1 in response to an exposure of 300 gh/m3, a moderately high exposure for this group. Ex-miners aged under 65 had worse lung function than miners on average, suggesting that ill health had encouraged some of these men to leave the industry. Whereas a more severe response to dust exposure among ex-miners under 65 was suggested, this difference could easily have arisen by chance. The presence of symptoms of chronic bronchitis was associated with reduced levels of lung function, however, and, additionally, ex-miners under 65 with chronic bronchitis showed a more severe response of the FVC to dust exposure than miners without these symptoms. Among these ex-miners with chronic bronchitis a small group of men who had taken other jobs showed a much more severe effect of dust exposure on their lung function than the average, likely in heavily exposed men to contribute importantly to disability. Men in this group who had given up smoking showed and even more severe effect of dust exposure, equivalent to a loss of 940 ml FEV1 in response to an exposure of 300 gh/m3. These results indicate that exposure to respirable dust can occasionally cause severe respiratory impairment in the absence of progressive massive fibrosis. Dust exposure was related to a parallel reduction of FEV1 and FVC, implying that the pathology of dust induced lung damage differs form that induced by smoking. This pattern of abnormality was shown by some non-smokers, whereas smokers and ex-smokers apparently severely affected by dust showed a classic obstructive pattern of abnormality with pronounced reduction of the FEV1/FVC ratio.     

Relation between dust exposure and lung function in miners and ex-miners

A sample of men working in the British coal industry in the 1950s has been followed up and examined 22 years later. The relations between lung function and individual cumulative exposure to respirable dust have been studied in 1867 men who were still working in the industry at the time of follow up and 2192 men who had left. Levels of forced expired volume in one second (FEV1), forced vital capacity (FVC), and FEV1/FVC ratio at follow up were found to be inversely related to exposure to respirable dust after allowing for other factors, even in men without pneumoconiosis. The magnitude of this estimated effect was equivalent to a loss of 228 ml FEV1 in response to an exposure of 300 gh/m3, a moderately high exposure for this group. Ex-miners aged under 65 had worse lung function than miners on average, suggesting that ill health had encouraged some of these men to leave the industry. Whereas a more severe response to dust exposure among ex-miners under 65 was suggested, this difference could easily have arisen by chance. The presence of symptoms of chronic bronchitis was associated with reduced levels of lung function, however, and, additionally, ex-miners under 65 with chronic bronchitis showed a more severe response of the FVC to dust exposure than miners without these symptoms. Among these ex-miners with chronic bronchitis a small group of men who had taken other jobs showed a much more severe effect of dust exposure on their lung function than the average, likely in heavily exposed men to contribute importantly to disability. Men in this group who had given up smoking showed and even more severe effect of dust exposure, equivalent to a loss of 940 ml FEV1 in response to an exposure of 300 gh/m3. These results indicate that exposure to respirable dust can occasionally cause severe respiratory impairment in the absence of progressive massive fibrosis. Dust exposure was related to a parallel reduction of FEV1 and FVC, implying that the pathology of dust induced lung damage differs form that induced by smoking. This pattern of abnormality was shown by some non-smokers, whereas smokers and ex-smokers apparently severely affected by dust showed a classic obstructive pattern of abnormality with pronounced reduction of the FEV1/FVC ratio.     

Assessment of respirable dust and its free silica contents in different Indian coalmines

Assessment of respirable dust, personal exposures of miners and free silica contents in dust were undertaken to find out the associated risk of coal workers' pneumoconiosis in 9 coal mines of Eastern India during 1988-91. Mine Research Establishment (MRE), 113A Gravimetric Dust Sampler (GDS) and personal samplers (AFC 123), Cassella, London, approved by Director General of Mines Safety (DGMS) were used respectively for monitoring of mine air dust and personal exposures of miners. Fourier Transform Infra-red (FTIR) Spectroscopy determined free silica in respirable dusts. Thermal Conditions like Wet Bulb Globe Temperature (WBGT) index, humidity and wind velocity were also recorded during monitoring. The dust levels in the face return air of both, Board & Pillar (B&P) and Long Wall (LW) mining were found above the permissible level recommended by DGMS, Govt. of India. The drilling, blasting and loading are the major dusty operations in B&P method. Exposures of driller and loader were varied between, 0.81-9.48 mg/m3 and 0.05-9.84 mg/m3 respectively in B&P mining, whereas exposures of DOSCO loader, Shearer operator and Power Support Face Worker were varied between 2.65-9.11 mg/m3, 0.22-10.00 mg/m3 and 0.12-9.32 mg/m3 respectively in LW mining. In open cast mining, compressor and driller operators are the major exposed groups. The percentage silica in respirable dusts found below 5% in all most all the workers except among query loaders and drillers of open cast mines.     

Respirable dust exposures in U.S. surface coal mines (1982-1986)

Exposure of miners to respirable coal mine dust and to respirable quartz silica at surface coal mines in the United States during 1982-1986 were evaluated by job category using data collected by coal mine operators and Mine Safety and Health Administration (MSHA) inspectors. Average coal mine dust concentrations were usually well below the MSHA Permissible Exposure Limit (PEL) for all job categories, but at least 10% of the samples obtained from some coal preparation plant job areas and most drilling job areas had concentrations that exceeded the 2.0 mg/m3 limit. In contrast, a very high proportion of samples from surface mine driller areas exceeded the quartz PEL. Of all samples collected for highwall drill operators and helpers, 78% and 77%, respectively, were greater than the 0.1 mg/m3 quartz exposure limit (average concentrations were .32 and .36 mg/m3, respectively). Although MSHA compliance data may not be entirely adequate for assessing chronic exposure to quartz, these data and the results of other NIOSH studies nonetheless indicate excessive exposure to silica in a group of surface coal miners.     

Variability of exposure and estimation of cumulative exposure in a manually operated coal mine

This study aims at estimating variability in exposure to respirable dust and assessing whether the a priori grouping by job team is appropriate for an exposure-response study on respiratory effects among workers in a manually operated coal mine in Tanzania. Furthermore, estimated exposure levels were used to calculate cumulative exposure. Full-shift personal respirable dust samples (n = 204) were collected from 141 randomly chosen workers at underground and surface work sites. The geometric mean exposure for respirable dust varied from 0.07 mg m(-3) for office workers to 1.96 mg m(-3) for the development team. The analogous range of respirable quartz exposure was 0.006-0.073 mg m(-3). Variance components were estimated using random effect models. For most job teams the within-worker variance component was considerably higher than the between-worker variance component. For respirable dust the estimated attenuation of the linear exposure-response relationship was low (5.9%) when grouping by job team. Grouping by job team was considered appropriate for studying the association between current dust exposure and respiratory effects. Based on the estimated worker-specific mean exposure in the job teams, the arithmetic mean cumulative exposure for the 299 workers who participated in the epidemiological part of the study was 38.1 mg* yr m(-3) for respirable dust and 2.0 mg* yr m(-3) for quartz.     

Dust exposure during small-scale mining in Tanzania: a pilot study

Small-scale mining in developing countries is generally labour-intensive and carried out with low levels of mechanization. In the Mererani area in the northern part of Tanzania, there are about 15000 underground miners who are constantly subjected to a poor working environment. Gemstones are found at depths down to 500 m. The objectives of this pilot study were to monitor the exposure to dust during work processes, which are typical of small-scale mining in developing countries, and to make a rough estimation of whether there is a risk of chronic pulmonary diseases for the workers. Personal sampling of respirable dust (n = 15) and 'total' dust (n = 5) was carried out during three consecutive days in one mine, which had a total of 50 workers in two shifts. Sampling started immediately before the miners entered the shaft, and lasted until they reappeared at the mine entrance after 5-8 h. The median crystalline silica content and the combustible content of the respirable dust samples were 14.2 and 5.5%, respectively. When drilling, blasting and shovelling were carried out, the exposure measurements showed high median levels of respirable dust (15.5 mg/m(3)), respirable crystalline silica (2.4 mg/m(3)), respirable combustible dust (1.5 mg/m(3)) and 'total' dust (28.4 mg/m(3)). When only shovelling and loading of sacks took place, the median exposures to respirable dust and respirable crystalline silica were 4.3 and 1.1 mg/m(3). This study shows that the exposure to respirable crystalline silica was high during underground small-scale mining. In the absence of personal protective equipment, the miners in the Mererani area are presumably at a high risk of developing chronic silicosis.     

Prevalence of pneumoconiosis and its relationship to dust exposure in a cohort of U.S. Bituminous coal miners and ex-miners

Information on radiographic evidence of coal workers' pneumoconiosis (CWP) is presented for a group of 3,194 underground bituminous coal miners and ex-miners examined between 1985 and 1988. Prevalence of CWP was related to estimated cumulative dust exposure, age, and rank of coal. On the basis of these data, miners of medium to low rank coal, who work for 40 years at the current federal dust limit of 2 mg/m³, are predicted to have a 1.4% risk of having progressive massive fibrosis on retirement. Higher prevalences are predicted for less severe categories of CWP. Miners in high rank coal areas appear to be at greater risk than those mining medium and low rank coals. Ex-miners who said that they left mining for health-related reasons had higher levels of abnormality compared to current miners.     

Longitudinal and cross sectional analyses of exposure to coal mine dust and pulmonary function in new miners.

The association between exposure to dust and pulmonary function was studied by longitudinal and cross sectional analyses in a group of United States underground coal miners beginning work in or after 1970. Quantitative estimates of exposure to respirable coal mine dust were derived from air samples taken periodically over the entire study period. The cohort included 977 miners examined both in round 2 (R2) (1972-5) and round 4 (R4) (1985-8) of the National Study of Coal Workers' Pneumoconiosis. Multiple linear regression models were developed for both cross sectional (pulmonary function at R2 and R4) and longitudinal (change in pulmonary function between R2 and R4) analyses with exposure partitioned into pre-R2 and post-R2 periods and controlled for covariates including smoking history. The results indicate a rapid initial (at R2) loss of FVC and FEV1 in association with cumulative exposure of the order of 30 ml per mg/m3-years. Between R2 and R4 (about 13 years) no additional loss of function related to dust exposure was detected although the percentage of predicted FVC and FEV1 did decline over the period. After some 15 years since first exposure (at R4), a statistically significant association of cumulative exposure with FEV1 of about -5.9 ml per mg/m3-years was found. These results indicate a significant non-linear effect of exposure to dust on pulmonary function at dust concentrations present after regulations took effect. The initial responses in both the FVC and FEV1 are consistent with inflammation of the small airways in response to exposure to dust.     

Dust exposures at U.S. surface coal mines in 1982-1983

Exposures to British Mining Research Establishment corrected respirable dust and respirable quartz at U.S. surface coal mines during 1982-1983 were evaluated from coal mine operator and Mine Safety and Health Administration (MSHA) inspector samples. The average respirable quartz concentration from inspector samples ranged from .34-.49 mg/m3 for drilling jobs and .18 mg/m3 for bulldozer operators. For most other surface coal mine jobs, the average respirable quartz concentration was less than .1 mg/m3, and the average respirable dust concentration was less than 2 mg/m3. The results from the analysis of quartz exposures are consistent with epidemiological results for an increased silicosis risk among drillers. It is unclear, however, whether the MSHA samples provide a representative estimate of the average annual quartz concentration for drillers. Results suggest the need for a greater number of quartz samples to be taken on strip coal miners, particularly on drillers and bulldozer operators.     

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.     

Personal exposure to dust, endotoxin and crystalline silica in California agriculture

AIMS: The aim of this study was to measure personal exposure to dust, endotoxin and crystalline silica during various agricultural operations in California over a period of one year. METHODS: Ten farms were randomly selected in Yolo and Solano counties and workers were invited to wear personal sampling equipment to measure inhalable and respirable dust levels during various operations. The samples were analysed for endotoxin using the Limulus Amebocyte Lysate assay and crystalline silica content using X-ray diffraction. In total 142 inhalable samples and 144 respirable samples were collected. RESULTS: The measurements showed considerable difference in exposure levels between various operations, in particular for the inhalable fraction of the dust and the endotoxin. Machine harvesting of tree crops (Geometric mean (GM) = 45.1 mg/m3) and vegetables (GM = 7.9 mg/m3), and cleaning of poultry houses (GM = 6.7 mg/m3) showed the highest inhalable dust levels. Cleaning of poultry houses also showed the highest inhalable endotoxin levels (GM = 1861 EU/m3). Respirable dust levels were generally low, except for machine harvesting of tree crops (GM = 2.8 mg/m3) and vegetables (GM = 0.9 mg/m3). Respirable endotoxin levels were also low. For the inhalable dust fraction, levels were reduced considerably when an enclosed cabin was present. The percentage of crystalline silica was overall higher in the respirable dust samples than the inhalable dust samples. CONCLUSIONS: Considerable differences exist in personal exposure levels to dust, endotoxin and crystalline silica during various agricultural operations in California agriculture with some operations showing very high levels.     

Differential respirable dust related lung function effects between current and former South African coal miners

Dust-related dose-response decrements in lung function among coal miners have been reported in several studies, with varying magnitudes across populations. Few studies have compared differences between current and former coal miners. No studies on dose response relationships with lung function have been conducted in South African coal mines, one of the top three producers of coal internationally. The objectives of this study were (1) to describe the relationship between respirable dust exposure and lung function among current and former South African coal miners and to determine whether differential dust related effects were present between these employment categories; (2) to examine dust related dose response relationships, controlling for potential confounding by smoking and a history of tuberculosis (TB). Six hundred and eighty-four current and 188 ex-miners from three bituminous coal mines in Mpumalanga Province were studied. Interviews assessing work histories, smoking profiles and other risk factors were conducted. Work histories were also obtained from company records. Standardised spirometry was performed by trained technicians. Cumulative respirable dust exposure (CDE) estimates were constructed from company-collected sampling and measurements conducted by the researchers. Regression models examined the associations of CDE with per cent predicted FEV₁ and FVC, controlling for smoking, past history of TB and employment status. A statistically significant decline in FEV₁ of 1.1 and 2.2 ml/mg-year/m³ was found in representative 40-year-old, 1.7-m tall current and former miners, respectively. Significant differences were found between the highest and medium exposure categories. Ex-miners had a lower mean per cent predicted lung function than current miners for each cumulative exposure category, suggesting a healthy worker effect. Past history of TB contributed to 21 and 14% declines in per cent predicted FEV₁ and FVC, respectively. Thus, in this cohort, a dose-related decline in lung function was associated with respirable dust exposure, with a magnitude of effect similar to that seen in other studies and important differences between current and former employees. A healthy worker effect may have attenuated the magnitude of this relationship. TB was a significant contributor to lung function loss.     

Ventilatory function after exposure to various respirable hazards in a population of former coal miners

The ventilatory function of 406 male former coal miners who had presented at the Cook County Hospital occupational medicine clinic between January 1976 and April 1987 was studied to determine whether subsequent exposure to respiratory hazards after leaving the coal mines adversely affected lung function. The miners were divided into five exposure groups based on their exposure to respirable hazards. These were coal dust only, coal dust plus asbestos dust, coal dust plus silica dust, coal dust plus another respirable hazard and coal dust plus two other respirable dust exposures. Duration of employment in coal mines, race, smoking history, and mean age were not significantly different between the various exposure groups. No significant difference was found in the per cent of predicted forced expiratory volume in one second (FEV1), per cent of predicted forced vital capacity (FVC), and FEV1/FVC when the coal dust only group was compared with each of the other four exposure groups using ANOVA. Among former coal miners who present for a respiratory disability determination, therefore, exposure to respirable hazards subsequent to employment in coal mines is not associated with a statistically significant deterioration in ventilatory function.     

Ventilatory function after exposure to various respirable hazards in a population of former coal miners.

The ventilatory function of 406 male former coal miners who had presented at the Cook County Hospital occupational medicine clinic between January 1976 and April 1987 was studied to determine whether subsequent exposure to respiratory hazards after leaving the coal mines adversely affected lung function. The miners were divided into five exposure groups based on their exposure to respirable hazards. These were coal dust only, coal dust plus asbestos dust, coal dust plus silica dust, coal dust plus another respirable hazard and coal dust plus two other respirable dust exposures. Duration of employment in coal mines, race, smoking history, and mean age were not significantly different between the various exposure groups. No significant difference was found in the per cent of predicted forced expiratory volume in one second (FEV1), per cent of predicted forced vital capacity (FVC), and FEV1/FVC when the coal dust only group was compared with each of the other four exposure groups using ANOVA. Among former coal miners who present for a respiratory disability determination, therefore, exposure to respirable hazards subsequent to employment in coal mines is not associated with a statistically significant deterioration in ventilatory function.     

Evaluation of the approach to respirable quartz exposure control in U.S. coal mines

Occupational exposure to high levels of respirable quartz can result in respiratory and other diseases in humans. The Mine Safety and Health Adminstration (MSHA) regulates exposure to respirable quartz in coal mines indirectly through reductions in the respirable coal mine dust exposure limit based on the content of quartz in the airborne respirable dust. This reduction is implemented when the quartz content of airborne respirable dust exceeds 5% by weight. The intent of this dust standard reduction is to restrict miners' exposure to respirable quartz to a time-weighted average concentration of 100 μg/m(3). The effectiveness of this indirect approach to control quartz exposure was evaluated by analyzing respirable dust samples collected by MSHA inspectors from 1995 through 2008. The performance of the current regulatory approach was found to be lacking due to the use of a variable property-quartz content in airborne dust-to establish a standard for subsequent exposures. In one situation, 11.7% (4370/37,346) of samples that were below the applicable respirable coal mine dust exposure limit exceeded 100 μg/m(3) quartz. In a second situation, 4.4% (895/20,560) of samples with 5% or less quartz content in the airborne respirable dust exceeded 100 μg/m(3) quartz. In these two situations, the samples exceeding 100 μg/m(3) quartz were not subject to any potential compliance action. Therefore, the current respirable quartz exposure control approach does not reliably maintain miner exposure below 100 μg/m(3) quartz. A separate and specific respirable quartz exposure standard may improve control of coal miners' occupational exposure to respirable quartz.     

Exposure to silica and silicosis among tin miners in China: exposure-response analyses and risk assessment

OBJECTIVES—To investigate the risk of silicosis among tin miners and to investigate the relation between silicosis and cumulative exposure to dust (Chinese total dust and respirable crystalline silica dust).
METHODS—A cohort study of 3010 miners exposed to silica dust and employed for at least 1 year during 1960-5 in any of four Chinese tin mines was conducted. Historical total dust data from China were used to create a job exposure matrix for facility, job title, and calendar year. The total dust exposure data from China were converted to estimates of exposure to respirable crystalline silica for comparison with findings from other epidemiological studies of silicosis. Each worker''s work history was abstracted from the complete employment records in mine files. Diagnoses of silicosis were based on 1986 Chinese pneumoconiosis Roentgen diagnostic criteria, which classified silicosis as stages I-III—similar to an International Labour Organisation (ILO) classification of 1/1 or greater.
RESULTS—There were 1015 (33.7%) miners identified with silicosis, who had a mean age of 48.3 years, with a mean of 21.3 years after first exposure (equivalent to 11.0 net years in a dusty job). Among those who had silicosis, 684 miners (67.4%) developed silicosis after exposure ended (a mean of 3.7 years after). The risk of silicosis was strongly related to cumulative exposure to silica dust and was well fitted by the Weibull distribution, with the risk of silicosis less than 0.1% when the Chinese measure of cumulative exposure to total dust (CTD) was under 10 mg/m³-years (or 0.36 mg/m³-years of respirable crystalline silica), increasing to 68.7% when CTD exposure was 150 mg/m³-years (or 5.4 mg/m³-years of respirable crystalline silica). Latency period was not correlated to the risk of silicosis or cumulative dose of exposure. This study predicts about a 36% cumulative risk of silicosis for a 45 year lifetime exposure to these tin mine dusts at the CTD exposure standard of 2 mg/m³, and a 55% risk at 45 years exposure to the current United States Occupational Safety and Health Administration and Mine Safety and Health Administration standards of 0.1 mg/m³ 100% respirable crystalline silica dust.
CONCLUSIONS—A clear exposure-response relation was detected for silicosis in Chinese tin miners. The study results were similar to most, but not all, findings from other large scale exposure-response studies.


     

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。