耐火陶瓷纤维对作业工人肺小气道功能的影响  

Effects of refractory ceramic fibers on workers' small airway function

作　　者：谷一硕 马文军[1] 朱晓俊[2] 王鸿飞[2] 肖培[2] 陈娟[1] 岑亚财 李涛[2] 

机构地区：[1]北京大学公共卫生学院,北京100191 [2]中国疾病预防控制中心职业卫生与中毒控制所,北京100050

出　　处：《中国工业医学杂志》2017年第6期410-414,424,共6页Chinese Journal of Industrial Medicine

基　　金：北京市自然科学基金资助项目(编号:7152104)

摘　　要：目的探讨耐火陶瓷纤维对作业工人肺小气道功能的影响。方法选择从事耐火陶瓷纤维生产和加工的77名作业工人作为接触组,80名不接触耐火陶瓷纤维和其他职业有害因素的工人作为对照组。接触组分别按纤维计数浓度≤0.5 f/ml、>0.5 f/ml,按总粉尘质量浓度≤5 mg/m^3、>5 mg/m^3各分为低、高两个接触水平;按纤维计数浓度分组,低接触组62人、高接触组15人;按总粉尘质量浓度分组,低接触组47人、高接触组30人。测定研究对象肺小气道通气功能,最大呼气中期流量(MMEF)、用力呼气50%肺活量的瞬间流量(V_(50))和用力呼气75%肺活量呼气流速(V_(25)),均以实测值占预计值的百分比表示。应用方差分析、卡方检验和非条件Logistic回归模型分析不同接触特征、接触时间对作业工人肺小气道功能的影响及可能的危险因素。结果作业工人V_(50)%、V_(25)%和MMEF%水平随纤维计数浓度接触水平的增高而降低,但差异无统计学意义(P>0.05);V_(25)%、MMEF%异常的检出率随纤维接触水平升高而增加,并呈线性趋势关系(P趋势<0.05)。总粉尘高接触组V_(50)%、V_(25)%和MMEF%水平明显低于总粉尘低接触组和对照组(P<0.05),V_(50)%、V_(25)%和MMEF%异常率均明显高于总粉尘低接触组和对照组(P<0.05)。小气道功能障碍在总粉尘高接触组的检出率为33.3%,高于对照组(10.0%)和总粉尘低接触组(8.5%)(P<0.05)。工人肺小气道功能障碍与其总粉尘接触水平有关(OR=2.115,P<0.05),与接触纤维计数浓度、工龄和吸烟状态无关(P>0.05)。结论接触耐火陶瓷纤维可以导致作业工人肺小气道功能降低,总粉尘接触浓度较高的作业环境可以显著增加作业工人小气道功能障碍的发生率。Objective To explore the effects of refractory ceramic fibers （RCFs） on workers＇ small airway function. Methods This study enrolled 77 manufacturing and processing workers as the exposure group and another 80 workers neither exposed to RCFs nor other occupational toxicants as the control group. Low and high exposure subgroups were divided by the number concentration of fiber≤0.5 f/ml, 〉0.5 f/ml and by the gravimetric concentration of total dust ≤5 mg/m3, 〉5 mg/mz. According to the actual exposure level of fiber, 62 exposed workers were classified as low fiber exposure level, 15 exposed work- ers were classified as high fiber exposure level. According to the actual exposure level of total dust, 47 exposed workers were classified as low total dust exposure level, 30 exposed workers were classified as high total dust exposure levek All subjects accepted pulmonary function test. Maximal mid expiratory flow （ MMEF）, forced expiratory flow after 50% of the FVC has been exhaled （ Vs0 ）, forced expiratory flow after 75% of the FVC has been exhaled （ V25 ） were measured as small airway function indicators. Analyses of variance, chi-square tests, and unconditioned logistic regression analyses were used to analysis positive rates of small airway dysfunction and influence factors of RCFs workers with different exposure features and difference exposure years. Results Mean values of V50%, V25 %, and MMEF% were increased along with the fiber exposure level, but there were no statistically significant difference （P〉0.05）. Abnormal rates of V25% and MMEF% showed a positive linear relationship with the fiber exposure level （Ptrend 〈0. 05 ） . Compared with the control group and low total dust exposure level group, high total dust exposure level group had significantly lower mean values of V50%, V25%, and MMEF% （P〈0. 05） and correspondingly had significant higher abnormal rates of V50%, V25%, and MMEF% （P〈0. 05）. High total dust exposure level group （33.3%） also had significant h

关 键 词：耐火陶瓷纤维 肺小气道功能 总粉尘质量浓度 纤维计数浓度 

分 类 号：R135.2[医药卫生—劳动卫生]