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首页> 外文期刊>Occupational and environmental medicine >Respiratory health surveillance in a toluene di-isocyanate production unit, 1967-97: clinical observations and lung function analyses.
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Respiratory health surveillance in a toluene di-isocyanate production unit, 1967-97: clinical observations and lung function analyses.

机译：甲苯二异氰酸酯生产单元的呼吸健康监测，1967-97年：临床观察和肺功能分析。

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摘要

OBJECTIVES: To characterise irritant and allergic airway responses and assess changes in forced vital capacity (FVC) and forced expiratory volume in 1 second (FEV1) relative to exposure to toluene di-isocyanate (TDI). METHODS: Employees (n = 313) ever assigned to a TDI production unit for > or = 3 months (1967-92) were identified from personnel records along with 158 frequency matched referents without known exposure to TDI. Reports made during visits to the occupational clinic of incidents related to exposure to TDI and annual periodic examination results (questionnaire, physical findings, and spirometry) were abstracted and assessed relative to industrial hygiene estimates of exposure to TDI. RESULTS: Mean 8 hour time weighted average estimates of TDI concentrations ranged from 9.9 ppb in jobs with potentially high exposure during the early years of plant operations to 0.5 ppb in jobs with potentially low exposure in more recent years. The corresponding rates of visits to the clinic due to incidents of exposure to TDI (including both irritant and allergic airway responses) declined from 20.5 to 1.0 visits per 100 years of employment at the unit. The annual incidence of asthma induced by TDI declined from 1.8% before 1980 to 0.7% afterwards. Neither cross sectional nor longitudinal analyses of FVC and FEV1 showed significant dose-response findings relative to exposure to TDI across the total exposed population. Among cases of occupational asthma there was an apparent initial decline in FEV1 within 2 years of first reporting symptoms, but not an accelerated rate of decline in follow up tests from 4-30 years after induction of asthma. CONCLUSIONS: Occurrences of both asthma induced by TDI and irritant airway responses due to exposure to TDI were found in this cohort, but there was no relation between cumulative exposure to TDI and irreversible airflow obstruction as assessed by spirometry.
机译：目的：表征刺激性和过敏性气道反应，并评估相对于甲苯二异氰酸酯（TDI）在1秒内的强制肺活量（FVC）和强制呼气量（FEV1）的变化。方法：从人员记录中识别出曾被分配到TDI生产单位超过或等于3个月（1967-92年）的雇员（n = 313），以及158名频率已知的TDI对象，而他们没有已知的TDI暴露。抽取和访问与TDI接触有关的事件和年度定期检查结果（问卷，体格检查和肺活量测定）的职业诊所期间的报告，并根据TDI接触的工业卫生估计进行评估。结果：TDI浓度的8小时平均加权平均估计值范围从工厂运营初期可能处于高暴露水平的作业中的9.9 ppb到最近几年可能处于低暴露水平的作业中的0.5 ppb。由于单位暴露于TDI（包括刺激性和过敏性气道反应）导致的门诊就诊率从每100年使用20.5次降到了1.0次。 TDI诱发的哮喘的年发病率从1980年之前的1.8％下降到此后的0.7％。 FVC和FEV1的横断面分析或纵向分析均未显示出相对于总暴露人群中TDI暴露而言显着的剂量反应结果。在职业性哮喘病例中，FEV1在首次报告症状后的2年内有明显的初始下降，但从诱发哮喘后4-30年的随访测试中没有下降的加速速率。结论：在该队列研究中发现了由TDI引起的哮喘和由于暴露于TDI引起的刺激性气道反应的发生，但是通过肺活量测定法评估，累积暴露于TDI与不可逆气流阻塞之间没有关系。

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