哮喘联盟

   摘要
   背景：有机二异氰酸酯是引起职业性哮喘的常见原因，特别是汽车修理（MVR）工人。英国健康和安全实验室提供尿己二胺(UHDA)的筛查，后者是暴露于1,6-己二异氰酸酯(HDI)的一种生物标志物。英国工作相关和职业性呼吸道疾病计划监督局(SWORD)收集了1996年以来职业性哮喘的报告。
   目的：对HDI暴露趋势与SWORD报告的MVR工人由于异氰酸酯或喷漆工作导致哮喘发病率的趋势进行比较。
   方法：采用二元回归模型评估SWORD报告的UHDA水平和MVR工人工作相关性哮喘的趋势。趋势的方向和大小进行描述性比较。
   结果：从2006年到2014年，达到可检测水平的UHDA的尿标本中数目(比值比0.96；95%CI 0.94-0.98)和指导数值的最小变化(1.03; 1.00-1.06)显著下降。在同一时期，SWORD报道的由于异氰酸酯暴露或喷漆工作导致的哮喘病例显著减少(0.90; 0.86-0.94)，在MVR工人中存在不显著下降(0.94; 0.86-1.02)。
   结论：SWORD报告的HDI暴露与哮喘病例同时下降与风媒异氰酸酯暴露下降导致哮喘下降暂时一致。虽然这并不是两种趋势因果关系的直接证据，但具有提示性意义。

 

（苏欣 审校）
Occup Med (Lond). 2015 Dec;65(9):713-8. doi: 10.1093/occmed/kqv108. Epub 2015 Jul 25.
 

Isocyanate exposure and asthma in the UK vehicle repair industry.
 

Stocks SJ1, Jones K2, Piney M3, Agius RM4.
 

Abstract
BACKGROUND:Organic diisocyanates are a common cause of occupational asthma, particularly in motor vehicle repair (MVR) workers. The UK Health & Safety Laboratory provides screening for urinary hexamethylenediamine (UHDA), a biomarker of exposure to 1,6-hexamethylene diisocyanate (HDI). The UK Surveillance of Work-related and Occupational Respiratory Disease scheme (SWORD) has collected reports of occupational asthma since 1996.
AIMS:To compare trends in HDI exposure with trends in the incidence of work-related asthma attributed to isocyanates or paint spraying in MVR workers reported to SWORD.
METHODS:Two-level regression models were used to estimate trends in UHDA levels and work-related asthma in MVR workers reported to SWORD. The direction and magnitude of the trends were compared descriptively.
RESULTS:From 2006 to 2014, there was a significant decline in the number of urine samples with detectable levels of UHDA (odds ratio = 0.96; 95% confidence intervals 0.94-0.98) and minimal change in those over the guidance value (1.03; 1.00-1.06). Over the same period, there was a significant decline in all asthma cases attributed to isocyanates or paint spraying reported to SWORD (0.90; 0.86-0.94) and a non-significant decline among MVR workers (0.94; 0.86-1.02).
CONCLUSIONS:The simultaneous decrease in HDI exposure and incident cases of asthma reported to SWORD is temporally consistent with a reduction in exposure to airborne isocyanate leading to a reduction in asthma. Although this is not direct evidence of a causal relationship between the two trends, it is suggestive.
 

Occup Med (Lond). 2015 Dec;65(9):713-8. doi: 10.1093/occmed/kqv108. Epub 2015 Jul 25.