Abstract：Objective To investigate the pulmonary function of workers in cemented carbide production enterprises in Zhuzhou City, to explore the effect of cemented carbide dust on lung function of the workers, and to preliminarily discuss the setting of occupational health check items for in-service workers in cemented carbide production enterprises. Methods Four hundred and twenty-six in-service workers selected from two cemented carbide production enterprises in Zhuzhou City, Hunan Province in 2016 served as the research subjects. All the workers’ general information and history of occupation were collected through a questionnaire survey, and then their lung function was examined. All the workers were divided into the exposure group and the control group according to exposure and non-exposure to dust. The exposure group was subgrouped into the before sintering group and the sintering and after sintering group according to the properties of exposed-dust. We surveyed the current status of lung function of workers in each type of work in the two cemented carbide production enterprises in Zhuzhou City. Results Lung function test Results of the exposure group and the control group were within the normal range. After smoking, age and length of service and other mixed factors were controlled, pulmonary ventilation function indexes, VC/estimated value, FVC/estimated value and FEV1/expected value in the exposure group were significantly decreased compared with the control group(t=-5.69,P<0.001;t=-6.54,P<0.001;t=-6.24,P<0.001), while FEV1/FVC values(t=8.068,P<0.001) and MEF25%/estimated value(t=2.79,P=0.005) were significantly increased. No statistically significant difference was found in MEF50%/estimated value and MMEF/estimated value between the exposure group and the control group (t=-0.98,P=0.327;t=0.815,P=0.416). Compared with the workers engaging in jobs before sintering, pulmonary small airway function indexes, MEF25%/predicted value, MEF50%/expected value and MMEF/predicted value in the workers engaging in sintering and jobs after sintering were significantly increased(t=-2.177, P=0.030; t=-2.038, P=0.042; t=-2.321, P=0.021). Conclusions Tungsten cobalt dust and cemented carbide dust in the carbide production enterprises can lead to changes in the indicators of lung ventilation function. Pulmonary small airway function indicators may be sensitive indexes of early lung injury induced by cemented carbide, and pulmonary small airway function should serve as the necessary inspection items in the occupational health examination during the service.
[1] 刘尚军,李西西,罗英男,等.硬金属粉尘职业暴露危害的研究进展[J].实用预防医学,2016,23(4):509-513. [2] 李志辉. 硬质合金粉尘暴露对作业工人肺功能及血尿生物指标的影响[D].北京:中国疾病预防控制中心,2016. [3] Ruokonen EL,Linnainmaa M, Seuri M, et al. A fatal case of hard-metal disease[M].Scand J Work Environ Health,1996,22(1):62-65. [4] 郑劲平,高怡.肺功能检查实用指南[M].北京:人民卫生出版社,2009:63-67. [5] 贺正一. 简明临床肺功能测定与应用[M]. 北京:科学技术文献出版社,2010:37-40. [6] 刘忠玉,张庆蓉,刘健额. 硬质合金粉尘对作业工人肺功能的影响[J]. 预防医学文献信息,2002,8(4):420. [7] 马伏生,邹世渠. 硬质合金粉尘对工人小气道通气功能的影响[J].中华劳动卫生职业病杂志,1995,13(2):97-98. [8] Meyer-Bisch C,Pham QT,Mur JM, et al, Respiratory hazards in hard metal workers: a cross sectional study[J].Br J Ind Med,1989, 46(5):302-309.
2018, Vol. 25 
