哮喘联盟

   摘要
   背景：木尘是职业性哮喘的一个常见病因，而在家具和木材加工过程中有潜在高浓度的木尘暴露。
   目的：本研究旨在探索与家具和木材加工工作环境相关的非肿瘤性呼吸系统疾病的证据。
   方法：本系统综述根据PRISMA声明（《系统综述和荟萃分析优先报告的条目》）进行操作。文献根据SIGN（苏格兰学院院际指南网）和MERGE（评估研究指南和证据的方法）标准进行分级，数据则根据研究结局进行分级。
   结果：初步搜索了1,328篇文献，其中55篇纳入本综述。A级（MERGE或SIGN >2++）研究14项。除1篇文献外，其余均描述了高浓度木尘暴露的工人较低或无暴露工人，呼吸道症状风险增加。有5项研究证实，木尘暴露与哮喘具有剂量效应关系；3项研究证实，木尘暴露与哮喘相关。1项荟萃分析证实，木尘暴露工人哮喘的相对风险为1.5 (95% CI: 1.25 - 1.87)。2项研究证实，暴露的人群肺功能阻塞性通气功能障碍更严重(FEV1/ FVC < 0.7)。1项研究证实，高浓度木尘暴露且抽烟的女性FEV1 下降更严重。经测定，职业相关的呼吸道症状与木尘特异性免疫球蛋白E(IgE)阳性无关。
   结论：在高浓度木尘暴露的环境中工作，与呼吸道症状和哮喘发病风险显著增加有关。但是，木尘暴露导致肺功能受损的证据不足。而该环境下的工人，其呼吸道疾病的患病率与致病原因，仍需进一步研究。

（杨冬 审校）
Occup Med (Lond). 2015 Oct 18. pii: kqv149. [Epub ahead of print]
 

Asthma in furniture and wood processing workers: a systematic review.
 

Wiggans RE1, Evans G2, Fishwick D3, Barber CM3.
 

Abstract
BACKGROUND:Wood dust is a common cause of occupational asthma. There is potential for high exposure to wood dust during furniture and wood manufacturing processes.
AIMS:To evaluate the evidence for non-neoplastic respiratory ill health associated with work in the furniture and wood manufacturing sector.
METHODS:A systematic review was performed according to PRISMA guidelines. Articles were graded using SIGN (Scottish Intercollegiate Guideline Network) and MERGE (Methods for Evaluating Research Guidelines and Evidence) criteria, with data grouped by study outcome.
RESULTS:Initial searches identified 1328 references, from which 55 articles were included in the review. Fourteen studies were graded A using MERGE or >2++ using SIGN. All but one paper describing airway symptoms reported an increased risk in higher wood dust exposed workers in comparison to lower or non-exposed groups. Five studies reporting asthma examined dose response; three found a positive effect. The relative risk for asthma in exposed workers in the single meta-analysis was 1.5 (95% CI 1.25-1.87). Two studies reported more obstructive lung function (forced expiratory volume in 1 s [FEV1]/forced vital capacity < 0.7) in exposed populations. Excess longitudinal FEV1 decline was reported in female smokers with high wood dust exposures in one study population. Where measured, work-related respiratory symptoms did not clearly relate to specific wood immunoglobulin E positivity.
CONCLUSIONS:Work in this sector was associated with a significantly increased risk of respiratory symptoms and asthma. The evidence for wood dust exposure causing impaired lung function is less clearly established. Further study is required to better understand the prevalence, and causes, of respiratory problems within this sector.
 

Occup Med (Lond). 2015 Oct 18. pii: kqv149. [Epub ahead of print]