烟草作业环境所致过敏性呼吸系统损害的研究

Study on Hypersensitive Respiratory Diseasesin Tobacco Processing Workers

目的 探讨烟草作业环境对接尘工人过敏性呼吸系统的损害。方法 对烟草作业环境进行了真菌学调查 ,并对 130名接尘工人及 112名不接触尘毒的对照工人进行了呼吸系统症状的询问调查、胸部X射线检查、肺通气功能测定及烟曲霉特异性IgE抗体的测定 ,并用烟曲霉抗原对接尘工人进行皮肤针刺试验及鼻粘膜激发试验。结果 烟草作业环境真菌总数量及各种属数量均明显高于对照现场 ,其优势菌种为烟曲霉和黑根霉。接尘工人的咳嗽、咯痰、气短、胸闷、鼻塞、流鼻涕、过敏性鼻炎等症状的阳性率明显高于对照工人。其中 ,接尘组男、女工人鼻塞阳性率分别达 2 5 7% ,2 6 7% ,流鼻涕阳性率达 30 0 % ,2 5 0 % ,过敏性鼻炎阳性率达 11 4 % ,11 7%。胸部X射线检查发现 4名男性工人 (占接尘组男工人总数的 5 7% )肺部有点状阴影。肺通气功能各项指标异常率均高于对照工人。烟曲霉特异性IgE抗体试验阳性率高达 6 5 2 %。接尘工人的皮肤针刺试验和鼻粘膜激发试验的阳性率分别达 11 5 % ,4 6 %。结论 烟草作业现场中存在的真菌和粉尘与接尘工人呼吸系统损害有关 ,尤其是真菌的污染可能是导致接尘工人过敏性呼吸系统损害的原因。

Objective To study the respiratory system injury in tobacco processing environment.Methods Environmental Fungal survey was conducted in the tobacco processing environment.Investigation of respiratory symptoms,chest X ray examination and pulmonary function test were also carried out for 130 tobacco processing workers and 112 control workers.At the same time,specific IgE antibody to A.fumigayus was analyzed by ELISA.Besides,skin prick test and nose stimulating test were taken in tobacco processing workers.Results The numbers and categories of fungi in tobacco processing environment were much more than those in the control environment. A.fumigayus and Rhizopus nigricans were the leading strains of fungi.Workers with respiratory symptoms(cough,sputum,dyspnea,chest tightness,nasal obstruction,snivel and allergic rhinitis)in the tobacco processing environment were more than those in the control ones.Especially,the percentages of nasal obstruction in male and female workers were 25 7% and 26 7% respectively,while for snivel,30 0% and 25 0%,and for allergic rhinitis,11 4% and 11 7% respectively.4 abnormal chest X ray were found in male tobacco processing workers.Abnormal rates for pulmonary function in the tobacco processing workers were higher than those in the control workers.Positive rate of specific IgE antibody to A.fumigayus was 65 2%. Meanwhile, positive rates of skin prick test and nose stimulating test in tobacco workers were 11 5% and 4 6% respectively.Conclusions A.fumigayus may be the pathogens of occupational respiratory diseases in tobacco processing workers.