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。

Early change of pulmonary ventilation in new coal miners

Objective To study the early effects of coal dust on lung function in new underground coal miners. Methods Two hundred and eighty-seven male miners were selected from new employees at the Xuzhou Mining Group Company as study group,and 132 male students at a mining technical school were selected as control.Data collection included:individual demographic parameters,family medical history,occupational history,and smoking history,measurement of dust concentrations in work areas,and lung function tests.This prospective cohort study took place over 3 years during which time total dust and respirable dust concentrations in the new coal miners' work areas were measured twice each month.For both miner and student groups,FVC and FEV 1 were tested initially before dust exposure,and then 15 times over the 3 years. Results The average total dust and respirable dust concentrations in the miners' work areas were 23.8 mg/m 3 and 8.9 mg/m 3 respectively,which greatly exceeded national health criteria.During the first year of dust exposure,the miners's average FVC was higher than that of the controls(5.19 L vs 4.92 L, P <0.01).During the 2nd and 3rd year the difference in average FVC between miners and control group was not significant(5.14 L vs 5.12 L, P > 0.05) .Before dust exposure,the miners' FEV 1 was significantly higher than that of the control group(4.48 L vs 4.28 L).In the miners group,FEV 1 declined rapidly during the first year following dust exposure(from 4.48 L to 4.25 L),and in the 2nd and the 3rd year the average FEV 1 of the miners was significantly lower than that of controls(4.34 Lvs 4.56 L, P < 0.01) ,although there were some fluctuations during the follow-up period.Overall,the average FEV 1 of miners group showed a significant decline during the study.There were significant correlations between FVC or FEV 1 and age,height,weight,and smoking.The three-year total loss of FVC and FEV 1 in smoking miners(154 ml,184 ml) were greater than in non-smoking miners(83 ml,91 ml). Conclusion There are apparent effects of coal dust on lung function in new underground coal miners,with FEV 1 being more impacted than FVC.Smoking may aggravate the effect of dust exposure on reducing lung function.