低浓度酸气(雾)对鼻粘膜和肺功能的慢性职业损害  

Study on the Chronic Damage to Nosal Mucosa and Lung Function Low Concentrations Occupational Exposure of Acid Mists

作　　者：刘卓宝 王培安[1,2] 邵薇娟 杨文草[1,2] 殷国华 

机构地区：[1]上海市预防医学研究院 [2]上海市第四人民医院

出　　处：《中国工业医学杂志》1999年第2期71-74,共4页Chinese Journal of Industrial Medicine

摘　　要：目的探索低浓度下单一和混合性酸气（雾）对鼻粘膜和肺功能慢性损害的特点及剂量效应关系。方法以车间作业工人呼吸带酸气（雾）平均浓度低于国家最高容许浓度（ＭＡＣ）的上海市１８家工厂７６６名接触氢氟酸（ＨＦ）、铬酸（ＣｒＯ３）、三酸（Ｈ２ＳＯ４，ＨＮＯ３，ＨＣｌ）及ＨＦ混合三酸和ＣｒＯ３混合三酸作业工人为接触组，１７４名不接触酸气的健康人员为对照组，统一行系统体检和肺功能测定。结果接触组３０１６％（２３１／７６６）作业工人有不同程度鼻粘膜糜烂（２２５例）、溃疡（３例）和中隔穿孔（３例），２９５１％（１８５／６２７）出现小气道阻塞（１６７例）及不同程度肺功能减退（１８例）。５组酸气接触组鼻粘膜、肺功能损害检出率均显著高于对照组（Ｐ＜００５～００１）。铬酸与三酸的低浓度酸气（雾）混合接触，对鼻粘膜损害有明显协同作用（Ｐ＜０００１），损害发生与工龄呈正相关关系（ｒｓ＝０８９２）。结论长期接触现行卫生标准下的５种酸气（雾）有明显鼻粘膜和肺小气道功能损害作用，对安全限值尚须进一步研究，鼻粘膜和肺小气道功能损害是检测低浓度酸气（雾）职业危害的客观指标。To explore the effect of the five acid mists(hydrofluric acid,chromic acid and hydrochloric acid,sulfuric acid,nitric acid(three acids)on nosal mucosa below maximun allowable concentration(MAC)in the workplace and the dose effect relationship,a case control study was conducted in 18 factories of Shanghai.Total 766 workers were enrolled as exposed group,while 174 healthy office staffs as control.All the subjects were given physical and lung function examination with the same standards.The result showed that 30 16%(231 in 766)of exposed workers had nosal damage such as mucosal erosion(225),ulcer(3)and septal perforation(3);29 51%(185 in 627)workers developed respiratory damages such as decreased lung functions(18)and small airway obstruction(167),both damage incidences were significantly higher than that of control group(P<0 05～0 01).The mixed exposure to chromic acid and “three acids” showde synergistic action on nosal mucosal damage(P<0 001)which was positively correlated with the working periods(r s=0 892).About 1/5 and 1/3 workers developed small airway obstruction under the exposure level at 1/6 MAC of chromium trioxide and less than MAC of hydrochoric acid respectively.The conclusion seems that the damages on nosal mucosa and lung function may be a objective clinical manifestation to low concentrations of acid mists,and the current MAC seems not so safe.

关 键 词：低浓度酸气 鼻粘膜 肺功能 职业损害 

分 类 号：R135.14[医药卫生—劳动卫生] R995[医药卫生—公共卫生与预防医学]