烟草作业环境中工人过敏性呼吸系统损害的调查

目的 调查分析烟草粉尘对接尘工人过敏性呼吸系统损害及其可能致病因素。方法 对某卷烟厂进行劳动卫生学调查和真菌污染状况调查，同时对130名接尘工人和112名对照工人进行呼吸系统症状询问调查、胸部X线检查、肺通气功能测定及黑根霉特异性IgE抗体水平的测定、黑根霉抗原皮肤点刺试验和鼻粘膜抗原激发试验。结果 卷烟厂各车间粉尘浓度超过国家标准，各个车间检测出8个种属的霉菌，其含量明显高于对照现场，其中主要为黑根霉和姻曲霉。接尘工人咳嗽、咯痰、胸闷、气短、鼻塞、流鼻涕等症状阳性率明显高于对照工人，肺通气功能指标异常率明显高于对照工人，并且11．4％的男性工人和11．7％的女性工人检出有过敏性鼻炎，4名男性工人(5．7％)X线检查发现肺部有点状阴影。黑根霉特异性IgE抗体试验阳性率高达31．2％，皮肤点刺试验阳性率达11．5％，鼻粘膜抗原激发试验阳性率为4．6％。结论 烟草作业现场中存在的霉菌和粉尘与接尘工人呼吸系统损害有关，真菌污染是导致接尘工人过敏性呼吸系统损害的原因之一。

Investigation of allergic respiratory system injury in workers exposed to tobacco working environment

Objective To investigate and analyse the allergic respiratory system injury in tobacco working environment and the hazardous factors.Method Investigation of industrial hygiene and mildew were conducted in a factory of tobacco.At the same time,the investigation of respiratory symptoms,the chest X-ray examination,the lung function test,the measurement of Rhizopus nigricans specific IgE antibody,the skin prick test and the nose challenge test of Rhizopus nigricans antigen were also carried out in 130 workers exposed to dust and 112 control workers.Result The concentration of dust in tobacco factory workrooms was higher than China national standard,and eight kinds of mildew measured from workroom were much higher than those in the control environment.Rhizopus nigricans and A fumigatus were the leading mildews.The rates of respiratory symptoms(cough,expectoration,chest tightness,dyspnea,snivel)and the abnormal rates of lung function in the workers exposed to dust were much higher than those in the control workers.There were 11.4% male and 11.7% female workers with allergic rhinitis and 4(5.7%)male workers with nodular opacities in lung.The rate of positive specific IgE antibody to Rhizopus nigricans was 31.2%;The rate of positive skin prick test was 11.5% and the rate of positive nose antigen challenge test was 4.6%.Conclusion The mildew and dust of tobacco environment were related to injury of respiratory system.The pollution of fungi was the factor of allergic respiratory system injury.