冷烫液引发职业性哮喘1例报告

我们对从事理发职业接触冷烫液而引发职业性哮喘的1例病例进行了诊断.现报告如下.     

聚氨脂致职业性哮喘1例报告

目的　了解生产过程中使用聚氨脂可导致职业性哮喘情况。方法　现场职业卫生学调查、支气管激发试验和职业病诊断综合分析。结果　患者工作时接触聚氨脂,作业场所缺少必要的职业病防治措施,现场支气管激发试验阳性。结论　用人单位及患者职业病防护意识差,最终导致职业性哮喘的发生。     

聚氨酯致职业性哮喘1例报告

1　临床资料患者 ,男性 ,4 3岁 ,某热电厂电工。 1999年11月始从事供热管道安装。当焊接供热水管时 ,接触聚氨酯 (ＭＤＩ)保温层 ,致使其中ＭＤＩ有时燃烧或气化。每日接触 1次或数次 ,每次 10～60ｍｉｎ。 2 0 0 0年 6月 8日因接触ＭＤＩ气化气味时 ,突感胸闷 ,呼吸困难 ,哮喘不止 ,急送医院。入院查体 :一般情况尚可 ,口唇发绀 ,血压为16/10 75ｋＰａ ,双肺均闻及哮鸣音 ,心率 80次 /ｍｉｎ ,律正。胸部Ｘ射线透视心肺未见异常。既往体健 ,无哮喘史 ,家族中无过敏体质患者或支气管哮喘患者。当即给予吸氧 ,静脉注射氨茶碱 ,氟美松等 ,症…     

25例职业性哮喘临床分析

本文对10种毒物所致的25例职业性哮喘临床资料进行了初步分析。按病因不同分为毒性炎性哮喘和过敏性哮喘。前者无特异性,后者有明显的免疫球蛋白变化——IgE、IgG、IgM增高,C_3正常。其肺功能的改变主要是阻塞性通气功能障碍、小气道阻塞、1秒率下降。     

现场激发试验诊断职业性哮喘1例

根据患者的临床表现、职业接触史、现场劳动卫生学调查资料,结合特异性实验室指标之一的职业型(现场)支气管激发试验结果(阳性),依据《职业性哮喘诊断标准》(GBZ 57-2002),将某塑胶厂1名成品质检工诊断为职业性哮喘,具体情况报告如下。1病例简介及现场调查患者,女性,40岁,2001年3月开始在某塑胶厂从事成品收卷质检工作。入厂前为当地农民,其住宅距厂约300 m,无哮喘发作史。自2001年5月始反复出现咳嗽、气急等症状,曾先后到杭州、上海及当地多家医院诊治。临床检查示:血IgE 229 I U/ml(正常<87 I U/ml);气道反应性激发试验阳性,气道脉冲…     

职业性哮喘的流行病学特点及其可能致喘机制

近年流行病学研究普遍认为，在世界范围内，哮喘，尤其是职业性哮喘（occupational asthma，OA）的发病率有逐年增高的趋势，OA占职业病的比重也将逐渐增高。这与工业发展、工业人口增多、人们物质生活水平的提高以及环境污染等因素有关。随着我国加入WTO及世界经济日益全球化，各工业国的公司也纷纷涌入我国，工业化进程日进千里。因此，提高对于OA的认识和增强防范，对于保护工人的身体健康和提高工作效率及促进经济发展、维护社会稳定具有重要意义。     

双镍稳定剂致职业性哮喘两例报告

双镍稳定剂致职业性哮喘两例报告济南市职业病防治院（２５００１３）于永红，孙少秋济南塑料三厂卫生室李春随着农业大棚、地膜技术的推广，塑料薄膜的需求量不断增加。在塑料薄膜生产过程中，要使用含镍化合物做稳定剂。现将我们收治的双镍稳定剂致职业性哮喘两例报告如...     

1例异氰酸酯类化学物致职业性哮喘报告

目的 探讨1例异氰酸酯类化学物致职业性哮喘(occupational asthma, OA,变应性哮喘)病例,为该类职业病防治提供参考。方法 结合自述材料、临床资料、现场职业卫生学调查等分析该病例发病原因。结果 该病例为中年男性,长期接触异氰酸酯等化学物,2014年下半年始反复出现咳嗽、气喘,多于闻刺激性气体后发作,发作时自己可闻及哮鸣音,每予药物治疗可缓解,被当地医院诊断为支气管哮喘。结论 本病例依照标准诊断为异氰酸酯所致职业性哮喘,异氰酸酯类化学物是主要致喘物,需引起足够重视。     

顺铂致职业性哮喘一例报告

报告了一例护士因接触化疗药物顺铂,导致职业性哮喘。分析明确了顺铂为致敏原,并探讨了发病机理,诊断及治疗。     

职业型支气管激发试验诊断TDI职业性哮喘一例报告

职业型支气管激发试验诊断ＴＤＩ职业性哮喘一例报告北京市劳动卫生职业病防治研究所（朝外东大桥北，１０００２０）袁忠孝，洪屹ＴＤＩ，又名二异氰酸甲苯酯，用于制造聚氨酯树脂及其它泡沫塑料，是常见的化学致敏物。本文报道通过职业型支气管激发试验确诊为ＴＤＩ职业...     

重症职业性中暑6例分析

对6例重症中暑病人进行分析。其中5例为热射病,早期表现为过高热、多脏器损伤,后期有脑功能损伤的后遗症;1例为热痉挛、热衰竭混合型,表现为肌肉痉挛、血压下降。经治疗后,病情很快好转。     

Correlation between different measures of occupational exposure to formaldehyde

Data on exposure to formaldehyde from a cohort study of 26,561 workers first employed between 1934 and 1965 in 10 US plants producing or using formaldehyde were used to compare the classification of workers by different estimates of exposure, including duration of employment, duration of exposure, level for job with highest 8-hour time-weighted average exposure, estimated highest peak exposure, cumulative exposure, and average exposure. Measures of duration (employment and exposure) were highly correlated, as were average exposure and highest 8-hour time-weighted average exposure. Moderate correlations were seen between cumulative exposure and either average, highest 8-hour time-weighted average exposure, peak, or duration of exposure, between average and peak exposure, and between highest job and peak exposure. Average exposure, however, showed little correlation with duration of employment, duration of exposure, or peak exposures. The degree of similarity of these estimates of exposure also varied by plant. These results indicate that various measures of exposure rank subjects differently along an exposure gradient and that selection of an inappropriate measure could mute exposure-response gradients. Investigators should use several exposure measures in analyses whenever the mechanism of action is poorly understood in order to avoid false-negative findings.     

甲醛对职业接触工人健康效应的流行病学调查

目的探讨甲醛对职业接触工人的健康影响及早期损害的监测指标。方法应用横断面调查的方法,研究甲醛对接触组和对照组工人的自觉症状、神经行为功能、情绪状况、外周血生化指标和微核率等的影响。结果自觉症状方面,暴露组中流泪、流涕、疲乏无力、记忆力减退、腹痛的出现率较对照组高,两者差异有显著性(P<0.05);神经行为功能测试方面,两组工人的数字跨度、错误打点率和有力-好动等项的差异有统计学意义(P<0.05);外周血生化指标和微核发生率方面,两组工人的总蛋白、球蛋白及A/G差异有显著性(P<0.05)。结论甲醛会导致接触工人神经行为和情绪、精神状态改变,刺激症状明显,其中神经行为功能改变可考虑作为接触甲醛早期损害的监测指标。     

三聚氰胺树脂生产工厂甲醛接触水平调查

目的 调查三聚氰胺甲醛树脂(MF)生产工厂的甲醛接触水平.方法 用UMEX 100和3M 3500采样器分别采集MF生产工艺不同车间的空气样品,分别测定甲醛和其他挥发性有机物的时间加权平均浓度(TWA).结果 MF生产工艺的全流程,反应、干燥和球磨车问的甲醛4 h TWA分别为:8.80(4.26～15.85)、3.12(2.91～3.49)和1.87(1.78～1.95)mg/m3,均超过国家标准;其他挥发性有机物如苯、苯乙烯等的浓度低于检测限.结论 MF生产车间以甲醛污染为主,超标严重.     

Malignant melanomas of the nasal cavity after occupational exposure to formaldehyde.

Formaldehyde is a well known nasal carcinogen in rodents, but so far there has been no convincing evidence that workers occupationally exposed to formaldehyde have an increased risk of nasal cancer. In this study three cases of malignant melanoma of the nasal mucosa in persons occupationally exposed to formaldehyde for a long time are presented. The occurrence of such a rare tumour in patients with significant exposure to a known carcinogen warrants further investigation.     

甲醛对职业人群健康效应的影响

探讨甲醛对职业人群健康效应的影响。横断面调查研究甲醛对暴露人群的神经行为功能和血液系统等的损伤。结果表明甲醛刺激作用明显,对暴露组工人神经行为、肝功能均有一定影响,且DNA断裂损伤明显。其中神经行为功能改变和DNA断裂可考虑为其早期损害的敏感监测指标。     

DNA-protein crosslinks and p53 protein expression in relation to occupational exposure to formaldehyde

Background: Formaldehyde (FA) is classified as a probable human carcinogen. Aims: To examine DNA protein crosslinks (DPC) and p53, which are generally known to be involved in carcinogenesis, in peripheral blood lymphocytes of workers exposed to FA. Methods: DPC and p53 ("wild type" and mutant) were examined in peripheral blood lymphocytes of 186 workers exposed to FA (mean years of exposure = 16) and 213 unexposed workers. Every worker completed a questionnaire on demographic data, occupational and medical history, smoking, and hygiene. Results: The adjusted mean level of DPC in the exposed and the unexposed workers differed significantly. Adjustment was made for age, sex, years of education, smoking, and origin. Exposure to FA increased the risk of having a higher level of pantropic p53 above 150 pg/ml (OR 1.6, 95% CI 0.8 to 3.1). A significant positive correlation was found between the increase of pantropic p53 protein and mutant p53 protein, as well as between pantropic p53 >150 pg/ml and mutant p53 protein. In the exposed group a significantly higher proportion of p53 >150 pg/ml was found among workers with DPC >0.187 (55.7%) (0.187 = median level of DPC) than among workers with DPC ⩽0.187 (33.3%). The risk of having pantropic p53 protein >150 pg/ml was determined mainly by levels of DPC. Workers with DPC above the median level had a significantly higher risk of having pantropic p53 >150 pg/ml (adjusted OR 2.5, 95% CI 1.2 to 5.4). Conclusions: Results suggest that DPC and mutation in p53 may represent steps in FA carcinogenesis and a possible causal relation between DPC and mutation in p53. These biomarkers can be applied in the assessment of the development of cancer due to FA exposure.     

Respiratory symptoms and pathophysiological effects of occupational exposure to formaldehyde and wood dust

The hazards of exposure to formaldehyde have been widely discussed in recent years on account of the health complaints of exposed persons. Both domestic and occupational exposure to formaldehyde is common. In the present study the effects of formaldehyde alone and in combination with wood dust, another nasal irritant, on the upper and lower respiratory tract have been investigated. The effects were correlated with the duration and degree of exposure. Discomfort from both the upper and lower airways was more frequent in the exposed group than in the unexposed group. Nasal obstruction among the exposed subjects in general could not be detected by rhinomanometric measurements, but, for the group exposed to formaldehyde alone and with a history of nasal blocking, there was significant nasal mucosal swelling. The nasal mucociliary clearance was significantly delayed, and the sense of smell was significantly reduced in the exposed groups when they were compared with the referents. Spirometry showed a significantly decreased forced vital capacity in the exposed groups. There were no signs in this investigation that duration of exposure or level of exposure to formaldehyde would have any influence on the severity of symptoms or the impairment of physiological conditions.     

Imputation of individual cancer cases to occupational causes

OBJECTIVES: Many potential occupational causes of cancer have been documented. Imputation of an individual cancer to occupational or other causes is, however, difficult. A method based on the Bayes theorem is proposed for assessing causal relationships at the individual level. METHODS: Causality assessment, dealing with four types of persons defined by exposure and the occurrence of cancer, was linked with imputation, only dealing with persons who have cancer and were exposed. Imputation was then formulated using the Bayes theorem, relating epidemiologic information regarding causes, a patient's exposure history, and the posterior odds that the cancer was caused by a suspected occupational exposure. Data needed to apply a Bayesian method were defined in terms of relative risks, proportion of people exposed in populations, and the frequency of a positive relevant characteristic for persons without cancer. A relevant characteristic was defined using a formal consensus between experts. The method was then illustrated with cases of mesothelioma and lung cancer in possible relation to asbestos. RESULTS: Experts defined the relevant characteristics as being qualification of occupational exposure, intensity of exposure, latency, disease characteristics, and presence of causal agent in the body. Application to mesothelioma and lung cancer cases illustrated the potential usefulness of the method. CONCLUSIONS: The importance of occupational exposure in the formulation of imputation underscores the need for available and reliable data sources on occupational exposures. The proposed method could become a powerful tool for the expert assessment of causes of cancer cases, provided data become available in individual files and the literature.