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目的研究广州市接触粉尘作业对劳动者肺通气功能的影响,并探讨肺通气功能与胸片在评估生产性粉尘对接触工人健康监护中的作用。方法随机抽取广州市700名接触粉尘工龄4年或以上工人进行肺通气功能测定及胸片检查,同时抽取年龄、性别均与接触组匹配的不接尘工人700名作为对照组。对两组人群作肺通气功能比较,并对接触组的肺通气功能及胸片结果进行比较分析。结果接触组FEV1占预计值百分比、FEV1/FVC两项指标均高于对照组,差异有统计学意义(P<0.05);经Kappa检验,接触组FVC、FEV1两项肺通气功能检测结果和胸片检查结果的吻合系数分别为0.036、-0.042(P均>0.05),经Mc Nemar检验,两种诊断方法吻合度弱,肺通气功能检测阳性率高于胸片;FVC与FEV1异常率具有一致性,吻合系数为0.623(P<0.01)。结论接触粉尘者肺通气功能损伤的发生概率比未接触粉尘者大;肺通气功能检查更能在疾病早期发现异常,而胸片可对肺部实质性损害提供证据,两者可综合应用于粉尘作业的健康监护评价中。
Objective To study the impact of dust exposure on laborer pulmonary ventilation in Guangzhou city and to explore the role of lung ventilation and chest radiograph in assessing the role of productive dust in the health monitoring of exposed workers. Methods A total of 700 laborers aged 4 years or over who were exposed to dust in Guangzhou City were enrolled in this study. Lung function tests and chest radiography were performed. Meanwhile, 700 unsanctioned workers whose age and gender were matched with those of the contact group were selected as control group. The two groups of people for lung ventilation function comparison, and the contact group of pulmonary ventilation and chest X-ray results were compared. Results The percentage of FEV1 in the exposure group and FEV1 / FVC in the exposure group were significantly higher than those in the control group (P <0.05). The results of Kappa test, FVC and FEV1 in lung exposure group and chest The coincidence coefficients of the two diagnostic methods were weaker than those of the other two diagnostic methods. The positive rates of pulmonary ventilation were higher than those of the chest radiographs. The abnormal rates of FVC and FEV1 were consistent The anastomosis coefficient was 0.623 (P <0.01). Conclusions The incidence of pulmonary ventilatory damage in contact with dust is higher than that in non-exposed dust. The examination of lung ventilation function is more likely to be abnormal in the early stages of the disease, while the chest radiograph may provide evidence of substantial lung damage, both of which can be applied to dust Occupational health monitoring evaluation.