烟草作业环境所致过敏性呼吸系统损害的研究

目的 探讨烟草作业环境对接尘工人过敏性呼吸系统的损害。方法 对烟草作业环境进行了真菌学调查，并对130名接尘工人及112名不接触尘毒的对照工人进行了呼吸系统症状的询问调查、胸部X射线检查、肺通气功能测定及烟曲霉特异性IgE抗体的测定，并用烟曲霉抗原对接尘工人进行皮肤针刺试验及鼻粘膜激发试验。结果 烟草作业环境真菌总数量及各种属数量均明显高于对照现场，其优势菌种为烟曲霉和黑根霉。接尘工人的咳嗽、咯痰、气短、胸闷、鼻塞、流鼻涕、过敏性鼻炎等症状的阳性率明显高于对照工人。其中，接尘组男、女工人鼻塞阳性率分别达25．7％，26．7％，流鼻涕阳性率达30．0％，25．0％，过敏性鼻炎阳性率达11．4％，11．7％。胸部X射线检查发现4名男性工人(占接尘组男工人总数的5．7％)肺部有点状阴影。肺通气功能各项指标异常率均高于对照工人。烟曲霉特异性IgE抗体试验阳性率高达65．2％。接尘工人的皮肤针刺试验和鼻粘膜激发试验的阳性率分别达11．5％，4．6％。结论 烟草作业现场中存在的真菌和粉尘与接尘工人呼吸系统损害有关，尤其是真菌的污染可能是导致接尘工人过敏性呼吸系统损害的原因。     

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。     

羽毛作业工人中变应疾病分析

对１２５名接工人和９７名非接尘人员作流行病学调查,以三种抗原皮内试验,结合血清ｇＥ测定,进行变应疾病诊断。结果显示,接尘组变应疾病的发病率显著高于对照组（Ｐ〈０．０１）,变应性支气管炎的发生与接尘时间及粉尘浓度呈正相关（Ｐ〈０．０１和０．０５）。认为职业性接触羽秘尘损害的靶器官,主要为呼吸系统的变态反应。皮肤试验可做为职业性变应疾病的诊断指标。     

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     

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。     

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。     

卷烟厂制丝车间粉尘对工人呼吸系统损害的调查分析

为探讨烟草粉尘对呼吸系统的损害作用 ,我们对某卷烟厂制丝车间的生产环境和接尘工人的健康状况进行调查。1　对象与方法1 .1　对象　选择某卷烟厂制丝车间接尘工龄 5年以上的 2 30名工人为调查对象 ,其中男 91人 ,年龄 2 4～ 43岁 (平均37岁 ) ,工龄 5～ 2 6年 (平均 1 4年 ) ;女性 1 39人 ,年龄 2 3～ 45岁 (平均 35岁 ) ,工龄 5～ 2 8年 (平均 1 5年 )。1 .2　方法　 1作业场所粉尘监测 :粉尘浓度测定使用 C- 型粉尘采样器采样 ,采用滤膜重量法测定 ;粉尘分散度使用滤膜溶解 -投影法测定 ;粉尘中游离 Si O2含量采用红外分光光度计法测…     

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。     

棉纺女工呼吸系统损害的调查研究

目的 探讨棉尘对棉纺女工呼吸系统的损害。方法 对棉纺厂各车间工序进行劳动卫生学和空气中细菌、真菌污染状况调查,并对302名棉纺女工及64名对照女工呼吸系统症状进行询问调查、X线胸片检查及班前班后肺功能的测定。结果 棉纺各车间工序空气中微生物污染严重,尤以前纺车间为重。接尘女工呼吸系统症状阳性率均显著高于对照女工（P＜0．01）,86名棉纺女工中X线胸片异常者20例,占拍片人数的23．3％。肺功能FVC、FEV1.0、FEE25～75各指标班前班后下降值均较对照组明显。接尘女工肺功能FEV1.0异常急性改变率为52．2％,对照女工为9．4％,差异有显著性（P＜0．01）。前纺车间女工呼吸系统症状阳性率及肺功能FEV1.0异常急性改变率明显高于络筒和织布车间。结论 棉纺女工出现呼吸系统症状阳性率增高及肺功能急性下降,可能与车间空气中微生物污染程度有关。     

烟草尘对呼吸系统危害的调查分析

烟草尘对呼吸系统危害的调查分析周烨李琴贞刘家驹（芜湖市卫生防疫站２４１０００）为了解烟草尘对烟厂工人的危害程度，以便提出改进措施，我们进行了烟草尘对呼吸系统职业危害的调查。１对象与方法１．１对象选择某卷烟厂制丝车间工人２１６人（男１１５人，女工１０１...     

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.     

Allergen and dust exposure as determinants of work-related symptoms and sensitization in a cohort of flour-exposed workers; a case-control analysis

OBJECTIVES: To estimate the incidence of specific IgE sensitization and allergic respiratory symptoms among UK bakery and flour mill workers; and to examine the roles of flour aeroallergen and total dust exposures in determining these outcomes. METHODS: A cohort of 300 new employees, without previous occupational exposure to flour, were followed prospectively for a median (range) of 40 (1-91) months. Cases-defined as those developing work-related symptoms or a positive skin prick test to flour or alpha-amylase during follow up--were compared with controls, matched for duration of employment. Exposures to flour aeroallergen and total inhalable dust were estimated using a questionnaire and personal sampling techniques. RESULTS: Incidence rates for work-related eye/nose and chest symptoms were 11.8 and 4.1 cases per 100 person years (py), respectively. Fewer employees developed positive skin prick tests to flour (2.2 cases per 100 py) or alpha-amylase (2.5 cases per 100 py). Positive skin tests to occupational allergens were more common among those with new work-related symptoms. There were clear relationships between the risks of developing work-related symptoms or a positive skin prick test and three categories of estimated exposure to total dust or flour aeroallergen. Atopic employees were more likely to develop a positive skin prick test-but not work-related symptoms. These findings were unaffected by age, sex or cigarette smoking. CONCLUSIONS: In this population, many work-related symptoms which develop after first employment in modern UK bakeries or flour mills were not accompanied by evidence of IgE sensitization to flour or alpha-amylase. Although average dust exposures were within current occupational standards, the risks of development of upper and lower respiratory symptoms and of specific sensitization were clearly related to total dust and/or flour aeroallergen exposure. The incidence of work-related chest symptoms in the presence of a positive skin test to flour or alpha-amylase in this setting was approximately 1 case per 100 py.     

Respiratory health of cigar factory workers

OBJECTIVES: To determine whether occupational exposure to raw tobacco causes respiratory or allergic diseases, an excess of respiratory symptoms, a decrease in lung function, or parenchymal changes in chest radiography among Finnish cigar workers. METHODS: This cross sectional study included all Finnish cigar workers (n = 106) exposed to raw tobacco and also a group of unexposed matched referents. Data were collected with a self administered questionnaire, flow volume spirometry, measurements of diffusing capacity of the lung for carbon monoxide, chest radiography and skin prick tests. A questionnaire was also sent to former workers of the factory. RESULTS: There were no significant differences between the groups in the prevalence of respiratory symptoms and chest radiography findings. Nine of 102 tobacco workers had pulmonary fibrosis of at least 1/0 (according to the International Labour Organisation (ILO) 1980 classification) and the corresponding figure was five for the referents. The tobacco workers tended to have a low forced vital capacity (FVC), and they had impaired forced expiratory volume in 1 second and lower means of the maximal expiratory flow at 25% of the FVC significantly more often than the referents. Diffusing capacity tended to be lower among the referents. The referents more often had atopy and earlier atopic diseases than the exposed workers. These results indicate the possibility of selection among the exposed workers. CONCLUSIONS: No excess of prevalence of respiratory symptoms in the tobacco workers was found. According to the questionnaire episodes of allergic alveolitis may have occurred in the cigar factory workers. However, in the absence of impairments in lung function and radiological changes it was not possible to distinguish humidifier fever and allergic alveolitis. In exposure conditions that include humidification of the air humidifier, fever and allergic alveolitis constitute a risk for tobacco workers. No effects were shown of exposure to tobacco dust on lung function.       

Immunological and respiratory changes in tobacco workers

BACKGROUND: Tobacco workers develop respiratory changes following occupational exposure to tobacco dust. METHODS: This study investigated 102 tobacco workers as well as a group of 30 matched control workers. Immunological testing, symptom questionnaire, and lung function measurements were performed in all workers. RESULTS: Increased total IgE was found in 12.7% of tobacco workers but in none of the controls (P < 0.05). Increased specific IgE (tobacco allergen) was recorded in 26.7% of tobacco workers with positive skin tests to tobacco extract but in none of the controls (P < 0.05). Regression analysis of ventilatory tests in female tobacco workers indicated a significant association of FEF75 to employment and smoking among workers with positive skin tests to tobacco. There were, however, no other associations between positive immunologic findings and lung function abnormalities and symptoms. CONCLUSIONS: Our study found increased immunological reactions in the tobacco workers. However, with the possible exception of lung function at low lung volume in female workers, these reactions do not appear to contribute significantly to the symptoms and lung function abnormalities seen in these workers. Am. J. Ind. Med. 45:76-83, 2004.     

Lung function, atopy, specific hypersensitivity, and smoking of workers in the enzyme detergent industry over 11 years.

A study of 2800 workers employed in three factories of the two major manufacturers of enzymatic products in the United Kingdom covering 11 years of operation from 1969 to 1980 showed that 2344 workers had sufficient lung function data to meet the operational criteria and these were analysed in three separate groups by factory locations. Spirometry and prick tests for specific skin reactions to standardised enzyme were performed at six monthly intervals for the first six years of the study and then annually. Factory enzyme dust and total dust measurements were made to determine the degree of dust exposure of the subjects. The lung function of the factory groups was analysed for the effects of working in the detergent industry, the degree of exposure to enzymes, skin prick test positivity to enzymes, atopicity, and smoking. The 4.5% of workers who had experienced respiratory effects from enzymes were analysed separately. Exposure to the enzyme allergen has had no significant long term effect on the lung function of the detergent workers. A higher proportion of atopics than non-atopics became skin test positive to the allergen and more smokers than non-smokers were sensitised. The overall lung function of detergent workers showed 39 ml/year loss in FEV1 on the 11 year longitudinal study and 51 ml/year loss on the lateral (cross sectional) analysis with better lung function in the south east than the north west of England. In the development of the methodology for the study several potential problems were discovered that could remain unrecognised in a cross sectional analysis performed in isolation.     

Lung function, atopy, specific hypersensitivity, and smoking of workers in the enzyme detergent industry over 11 years

A study of 2800 workers employed in three factories of the two major manufacturers of enzymatic products in the United Kingdom covering 11 years of operation from 1969 to 1980 showed that 2344 workers had sufficient lung function data to meet the operational criteria and these were analysed in three separate groups by factory locations. Spirometry and prick tests for specific skin reactions to standardised enzyme were performed at six monthly intervals for the first six years of the study and then annually. Factory enzyme dust and total dust measurements were made to determine the degree of dust exposure of the subjects. The lung function of the factory groups was analysed for the effects of working in the detergent industry, the degree of exposure to enzymes, skin prick test positivity to enzymes, atopicity, and smoking. The 4.5% of workers who had experienced respiratory effects from enzymes were analysed separately. Exposure to the enzyme allergen has had no significant long term effect on the lung function of the detergent workers. A higher proportion of atopics than non-atopics became skin test positive to the allergen and more smokers than non-smokers were sensitised. The overall lung function of detergent workers showed 39 ml/year loss in FEV1 on the 11 year longitudinal study and 51 ml/year loss on the lateral (cross sectional) analysis with better lung function in the south east than the north west of England. In the development of the methodology for the study several potential problems were discovered that could remain unrecognised in a cross sectional analysis performed in isolation.     

Sensitization to green coffee bean (GCB) and castor bean (CB) allergens among dock workers

Summary Dock workers (n = 218) occupationally exposed to green coffee beans (GCB) were studied, using a specific questionnaire for allergic symptoms and skin tests for common and occupational allergens. Thirty-one workers (14.3%) complained of allergic symptoms of the eye, nose and bronchial system at the workplace. The prick tests, using both commercial allergens and specific extracts prepared from the most common types of coffee and their corresponding sacks, confirmed a sensitization in 21 workers (9.6%). A positive skin reaction to castor beans (CB) was found in nearly all these cases; in ten workers there was also a positive reaction to GCB allergens and in 14 cases prick tests were positive to extracts of sacks. There was a good concordance between prick tests and specific IgE for CB (95.0%) and also, but to a lesser extent, for GCB. The authors concluded that there is a significant risk of sensitization to CB and GCB allergens in dock workers occupied in handling green coffee bean, despite the fact that the exposure is not continuous. CB emerged as a common contaminant of GCB from various countries. For effective prevention, a modification of the methods of transport is required to avoid CB contamination to other products. Eliminating environmental dust during shipping operations is the most important preventive measure and it can be achieved by the use of containers, as some exporting countries are already doing.     

Factors relating to the development of respiratory symptoms in coffee process workers.

After several cases of occupational asthma had been reported in a coffee processing factory in England, 197 coffee workers representing 80% of the production workforce were studied to determine the factors affecting the development of work related respiratory symptoms of wheeze, cough, and dyspnoea. Two computer administered questionnaires concerning the presence of respiratory symptoms and the occurrence of work related respiratory symptoms were used. Workers underwent skin prick testing to green coffee bean extract (GCB) and 11 common inhalant allergen extracts and bronchial provocation testing with methacholine. The presence of specific immunoglobulin E (IgE) antibodies to GCB and castor bean extract (CAB) were determined by a radioallergosorbent test (RAST). The prevalence of work related respiratory symptoms was 12.7%, bronchial hyperresponsiveness 30%, atopy 54%, positive GCB skin prick test 14.7%, positive GCB RAST 14%, and positive CAB RAST 14.7%. None of the workers was sensitised to fungi present in the factory and the numbers of certain species of fungi, despite being greater than may be found out of doors or in an uncontaminated indoor environment, were fewer than are generally associated with the presence of work related respiratory symptoms among agricultural workers. Storage mites were not isolated. Green coffee bean extract and CAB RAST were significantly correlated using the McNemar test but there was limited allergenic cross reactivity in RAST inhibition studies of the two extracts. The only factors that were significantly and independently associated with work related symptoms were CAB RAST and duration of employment. Bronchial hyperresponsiveness was not independently associated with work related respiratory symptoms. The significant independent associations of bronchial hyperresponsiveness included GCB RAST, duration of employment, and resting forced expiratory volume in one second. Exposure to CAB, a highly potent antigen, may be overriding the effects of other factors such a GCB, atopy, bronchial hyperresponsiveness, and smoking. This study suggests that CAB contamination remains a potential problem in the coffee processing industry and all efforts to eliminate it from the working environment should continue.     

Factors relating to the development of respiratory symptoms in coffee process workers

After several cases of occupational asthma had been reported in a coffee processing factory in England, 197 coffee workers representing 80% of the production workforce were studied to determine the factors affecting the development of work related respiratory symptoms of wheeze, cough, and dyspnoea. Two computer administered questionnaires concerning the presence of respiratory symptoms and the occurrence of work related respiratory symptoms were used. Workers underwent skin prick testing to green coffee bean extract (GCB) and 11 common inhalant allergen extracts and bronchial provocation testing with methacholine. The presence of specific immunoglobulin E (IgE) antibodies to GCB and castor bean extract (CAB) were determined by a radioallergosorbent test (RAST). The prevalence of work related respiratory symptoms was 12.7%, bronchial hyperresponsiveness 30%, atopy 54%, positive GCB skin prick test 14.7%, positive GCB RAST 14%, and positive CAB RAST 14.7%. None of the workers was sensitised to fungi present in the factory and the numbers of certain species of fungi, despite being greater than may be found out of doors or in an uncontaminated indoor environment, were fewer than are generally associated with the presence of work related respiratory symptoms among agricultural workers. Storage mites were not isolated. Green coffee bean extract and CAB RAST were significantly correlated using the McNemar test but there was limited allergenic cross reactivity in RAST inhibition studies of the two extracts. The only factors that were significantly and independently associated with work related symptoms were CAB RAST and duration of employment. Bronchial hyperresponsiveness was not independently associated with work related respiratory symptoms. The significant independent associations of bronchial hyperresponsiveness included GCB RAST, duration of employment, and resting forced expiratory volume in one second. Exposure to CAB, a highly potent antigen, may be overriding the effects of other factors such a GCB, atopy, bronchial hyperresponsiveness, and smoking. This study suggests that CAB contamination remains a potential problem in the coffee processing industry and all efforts to eliminate it from the working environment should continue.