广州城区空气污染职业暴露肺功能变化及其影响因素探讨  

Study on lung function change and its impact factors in occupational exposure to air pollution in Guangzhou urban

作　　者：郑湘毅 何喜子 黎俊勇 徐春生[3] 阮劲 谭健 

机构地区：[1]广州市番禺疗养院,广州511490 [2]广州市番禺区石碁人民医院 [3]南方医科大学珠江医院

出　　处：《中国医师杂志》2014年第12期1642-1644,1648,共4页Journal of Chinese Physician

基　　金：2013年番禺区科技计划资助项目（2013-Z03-65）

摘　　要：目的 探讨吸烟与空气污染职业暴露对肺功能影响差异及其变化规律.方法 选取98名番禺区环卫人员,按吸烟与否分为吸烟环卫组、非吸烟环卫组.同时选取番禺疗养院体检健康人群为对照组,采用COPD评估测试量表（CAT）、问卷调查、肺功能检测方法,进行统计学分析.结果 （1）非吸烟环卫组第1秒用力呼气容积（FEV1％）、第1秒用力呼气容积/用力肺活量（FEV1/FVC）、用力呼气50％肺活量的瞬间流量（FEF50％）、用力呼气75％肺活量的瞬间流量（FEF75％）、最大呼气中期流量（MMEF）均低于非吸烟普通组（P＜0.01）.（2）非吸烟环卫组FEF50％、FEF75％、MMEF异常率均高于非吸烟普通组（P＜0.01）.（3）无论吸烟与否,环卫组FEF50％、FEF75％异常率均高于普通组（P＜0.01）.（4）非吸烟环卫组的FEV1％、FEV1/FVC异常率与非吸烟普通组对比,差异均无统计学意义（P＞0.05）.（5）非吸烟环卫组、吸烟普通组的“中等”评分的例数均多于非吸烟普通组（P＜0.01）.结论 空气污染职业暴露和吸烟均可导致小气道损伤,以后者更为明显,长期处于空气污染职业暴露的环卫工人有必要进行定期监测肺功能.增加体能锻炼,有利于全民提高肺运动耐力.Objective To explore influence and variation of smoking and occupational exposure to air pollution on lung function.Methods Ninety eight sanitation staffs from Panyu District were divided into smoking and non-smoking sanitation groups; and all subject accepted the Chronic Obstructive Pulmonary Disease Assessment Test （CAT） scales,questionnaires,lung function test,and data statistical analysis.Healthy people accepted health examination from Guangzhou Panyu medical health center were used as the control group.Results （1） Forced expiratory volume in the first second （FEV1％）,forced expiratory volume in the first second/ forced vital capacity（FEV1/FVC）,maximal expiratory flow in 50％ vital capacity （FEF50％）,maximal expiratory flow in 75％ vital capacity （FEF75％）,maximal mid-expiratory flow （MMEF） of non-smoking sanitation group was significantly lower than non-smoking healthy group （P ＜ 0.01）.（2） Abnormal rates of FEF50％,FEF75％,and MMEF of non-smoking sanitation group were significantly higher than non-smoking healthy group （P ＜ 0.01）.（3） Abnormal rates of FEF50％,and FEF75％ of sanitation group were significantly higher than healthy group with or without smoking.（4） Abnormal rates of FEV1％ and FEV1/FVC did not have significant difference between non-smoking sanitation group and non-smoking healthy group,but had significant difference between non-smoking and smoking healthy groups.It means smoking and occupational exposure had different impacts on pulmonary function.（5） ＂ Moderate＂ score of nonsmoking sanitation group and smoking healthy group were significantly higher than non-smoking healthy group by P =0.049 and P =0.001,respectively.Conclusions Occupational exposure to air pollution and smoking can lead to small airway damage,which was not as obvious as pulmonary function changes.It is necessary to regularly monitor lung function for sanitation staffs who risk occupational exposure to air pollution.Increasing physical exercise would benefi

关 键 词：空气污染 吸烟 职业暴露 呼吸功能试验 问卷调查 

分 类 号：R131[医药卫生—劳动卫生]