不同工种水泥作业工人尘肺高仟伏X线胸片小阴影及肺门、肺纹理形态学研究
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摘要
目的
水泥为人工合成的硅酸盐,原料是石灰石、粘土和高炉矿渣。水泥尘肺属硅酸盐尘肺,在水泥的生产工艺流程中,各种粉尘的成分和浓度差别很大,所致X线胸片的影像变化各有其不同特点,水泥尘肺(cement pneumoconiosis)是由于长期吸入水泥生产过程中所产生的粉尘而引起的尘肺。
生产性粉尘是水泥生产作业的主要职业危害。由于水泥生产工艺复杂,接尘工人在生产的不同工艺阶段所接触的粉尘成分不尽相同,因此,水泥尘肺的发生除了与粉尘浓度、工龄和个体因素有关外,与水泥的化学组成也有密切关系。水泥尘肺存在着发病率低,发病工龄长,病情进展缓慢的特点,其发病时间一般在接触水泥粉尘20年以上,由于成品水泥的SiO_2含量较低,加之水泥尘肺的发病特点,早期文献资料认为水泥生产原料对机体的危害程度大于水泥成品,而水泥成品不会导致尘肺。90年代初,国内开展了大规模的水泥尘肺普查工作,证实了水泥生产过程中接触不同工艺阶段生产性粉尘的接尘工人均可罹患尘肺。
国内外水泥尘肺的发病率远低于煤工尘肺及矽肺,病例数相对较少,对水泥尘肺的X线胸片的影像学分析和研究一直未能深入,对水泥尘肺工人X线胸片特征的描述也过于笼统。本研究着眼于水泥生产中主要工艺阶段的职业性危害,对生料粉尘、熟料粉尘、成品水泥粉尘所致的水泥尘肺X线胸片的小阴影、肺门、肺纹理的影像学表现进行比较分析,阐明三种生产性粉尘所致尘肺X线胸片表现的差别及特点,以期为水泥尘肺的诊断和鉴别诊断提供影像学依据。
方法
选取辽宁工源水泥集团的尘肺现患病人及疑似尘肺者作为研究对象,经质量控制后得到样本498人,包括三个工种:(1)生料工种(2)熟料工种(3)成品工种。
依据GBZ1-2002《工业企业卫生设计标准》对检测点空气中粉尘进行测定。粉尘浓度、游离SiO_2含量、分散度的测定按GB5748-85《作业场所空气中粉尘测定方法》进行。使用北京产IFC-2型防爆粉尘采样仪在各个工种的工作岗位进行采样测定。采用美国GE Proteus XP-50型800mAX光机,摄取高仟伏胸片。
由3名取得职业病诊断资格的执业医师根据国家《尘肺病诊断标准》(GBZ70-2002),参照标准片集体阅片。
按期别分别比较生料、熟料、成品三个工种胸片显示的小阴影密集度及不同形态小阴影的出现率及肺门、肺纹理的改变率。
结果
各工种所接触粉尘浓度以成品工为最高,在50.84～59.70mg/m~3之间,其次是生料工所接触的粉尘浓度,在33.90～34.66mg/m~3之间。熟料工所接触的粉尘浓度在三个工种中最低,在13.79～16.81mg/m~3之间。各工种工作场所粉尘中游离二氧化硅含量历年均值以生料工种为最高,达6.08%,熟料工种工作场所游离二氧化硅含量为4.32%,含量最低的是成品工种,为1.81%,均低于10%。
在各期研究对象中,生料工高仟伏胸片的小阴影平均密集度要显著高于成品工,总体来看,生料工、熟料工、成品工胸片所示小阴影的平均密集度呈递减趋势。
我们在阅片过程中发现不规则小阴影早期多在左中肺野出现,而后向下或向上扩展,至Ⅱ期时可布满全肺野,有u影出现,左肺较右肺为甚,未见有小阴影聚集。各工种胸片均见圆形小阴影和不规则小阴影,生料工胸片p影、q影所占肺区数高于同期别的熟料工和成品工,成品工胸片的s影、t影所占肺区数要高于同期别的生料工。
各工种肺门和肺纹理的改变在0~+和Ⅱ期时比较无显著意义,在Ⅰ期Ⅰ~+时,肺门和肺纹理的改变生料工较熟料工及成品工严重。
结论
1.同期别各工种水泥作业工人尘肺高仟伏X线胸片上,生料工胸片所示小阴影平均密集度最高,其次为熟料工,再次为成品工。
2.各工种高仟伏X线胸片均有圆形小阴影和不规则小阴影出现,生料工胸片圆形小阴影占优势。成品工胸片不规则小阴影占优势。熟料工胸片显示随期别晋升,圆形小阴影的优势逐渐被不规则小阴影所取代。
3.生料工与熟料工高仟伏X线胸片所示肺门、肺纹理的改变在尘肺Ⅰ期和Ⅰ~+时较成品工严重。
Objective
Cement is synthetic silicate,it's raw material are limestone and clay,and the blast furnace slag.Cement pneumoconiosis is classified as silicate pneumoconiosis.In cement production process,the concentration and composition of all kinds of dust are great different,which caused the different characteristics on chest X-ray image changes.Cement pneumoconiosis is due to long-term inhalation of productive dust in cement production process and the dust produced the pneumoconiosis.
Productive dust is the main occupational hazards in cement production operations. Because the cement production process is complex,dust in the production process is different,the dust that the workers contact in different phases are not the same, therefore,the cement of pneumoconiosis is not only relate with dust concentration and the job seniority and individual factors,but also relate with the chemical composition of cement.Cement pneumoconiosis has the characteristics of low incidence,long job seniority of disease,slow progression of the disease,the average time from contacting with cement powder to falling ill is more than 20 years,due to the end product has low content of free SiO_2,and the characteristics of cement pneumoconiosis,early literature thought of the cement production raw material has greater damage than cement products,and cement products would not cause pneumoconiosis.In the early 1990s, China launched large-scale cement pneumoconiosis census,which confirmed that all kinds workers contact dust particles are suffering from pneumoconiosis in different stages of cement production process.
The incidence of domestic and overseas cement pneumoconiosis is lower than coal miner's pneumoconiosis and pneumoconiosis,and the number of cases of pneumoconiosis is relatively less than aforementioned two type of pneumoconiosis,the imaging analysis and research of cement pneumoconiosis chest X-ray has failed to penetrate deeply,the description of the characteristics of cement pneumoconiosis chest X-ray is too general.Our research mainly focuses on the occupational hazards in principal cement production technology process,have analyzed the imaging findings of small opacities and hilus pulmonis and pulmonary markings of cement pneumoconiosis on high-thousand-volt chest X-ray caused by raw cement material dust and ready cement materials dust and the end cement product dust,moreover we clarify the difference and characteristics on chest X-ray of the pneumoconiosis caused by the three kinds of dust,so as to provide imageology evidences for imaging diagnosis and differential diagnosis of cement pneumoconiosis.
Methods
We select the workers who suffered cement pneumoconiosis and suspected cement pneumoconiosis of Liaoning Gongyuan cement group as the research object,and have 498 samples after quality controlling,including three worker type:(1) raw materials workers(2) ready materials workers(3) end product workers.
According to the GBZ1-2002 "the standard design of industrial enterprises",we tasted the dust in air of the operating point.We tested the dust concentration and the free SiO_2 content and the dispersity of the dust according to the national standard GB5748-85,the determination method of dust in workplaces.In the testing,we have the sampling measurement jobs by IFC-2 dust sampling instrument which produced in Beijing,and take the high-thousand-volt chest X-ray by American GE Proteus XP - 50 type 800mA X-ray machine.
The radiography are analyzed by three doctors who has obtained qualification of occupational disease diagnosis according the pneumoconiosis disease diagnosis standard(GBZ70-2002).Compared the concentration of the small opacities and the frequency of different small opacities and the rate of changing of hilus pulmonis and pulmonary markings in high-thousand-volt chest X-ray according to the three worker type of raw materials workers and ready materials workers and end product workers respectively.
Results
The highest concentration of contacting dust of three worker types is the dust in end product workplaces,which ranged from 50.84 to 59.70 mg/m~3,followed by the dust concentration in raw materials workplaces,which ranged from 33.90 to 34.66 mg/m~3,the dust concentration of ready materials workers contacted is lowest,ranged from 13.79 to 16.81 mg/m~3.The free SiO_2 contend of raw materials workplaces is highest in the three types workers' workplace over the years,reaches 6.08%.The free SiO_2 contend of ready materials workers' workplace is 4.32%,and the lowest free SiO_2 contend appears at end product workers' workplace,which is 1.81%,all these value of free SiO_2 contend are less than 10%.
In all kinds of objects,the average concentration of small opacities in high thousand volts X-ray radiography of raw materials workers is significantly higher than end product workers'.Over all,the average concentration of small opacities of raw materials workers' and ready materials workers' and end product workers' appears a decrease progressively tendency.
We find that the irregular small opacities appear at the left-middle lung field early period mostly,and then extend to lower lung field or to upper lung field,it can cloud all the lung field atⅡperiod pneumoconiosis,this moment,we can find "u" type small opacities,the left lung are more serious than the right lung,and we have not find accumulative small opacities.The round small opacities and irregular small opacities are appear on all kinds of radiography in this study,the number of lung area that "p" opacities and "q" opacities appear of raw materials workers' radiography is more than the number of ready materials workers' and end product workers' of the same pneumoconiosis period,and the "s" opacities and the "t" opacities in end product workers' radiography are more than the raw materials workers'.
The changes of hilus pulmonis and pulmonary markings of all kinds of workers' radiography have not significant difference in 0+ andⅡperiod.InⅠandⅠ~+period, the changes of hilus pulmonis and pulmonary markings of raw materials workers' are more serious than ready material workers' and end product workers'.
Conclusion
1 The average concentration of small opacities on high-thousand-volts chest X-ray of each kinds cement pneumoconiosis worker in the same period,the highest is the raw material worker's,and the second is the ready materials worker's,then is the end product worker's.
2 Small round opacities and small irregular opacities appear in all kinds workers' high-thousand-volts chest X-ray,and the round small opacities are dominant in raw materials workers' radiography.The irregular small opacities are dominant in end product workers' radiography.The dominant of round small opacities are replaced by the irregular small opacities gradually in ready materials workers' radiography along of the promoting of pneumoconiosis' period.
3 The changes of hilus pulmonis and pulmonary markings in high thousand volts X-ray radiography of raw materials workers' and ready materials workers' are more serious than end product workers' inⅠandⅠ+pneumoconiosis period.
水泥为人工合成的硅酸盐,原料是石灰石、粘土和高炉矿渣。水泥尘肺属硅酸盐尘肺,在水泥的生产工艺流程中,各种粉尘的成分和浓度差别很大,所致X线胸片的影像变化各有其不同特点,水泥尘肺(cement pneumoconiosis)是由于长期吸入水泥生产过程中所产生的粉尘而引起的尘肺。
生产性粉尘是水泥生产作业的主要职业危害。由于水泥生产工艺复杂,接尘工人在生产的不同工艺阶段所接触的粉尘成分不尽相同,因此,水泥尘肺的发生除了与粉尘浓度、工龄和个体因素有关外,与水泥的化学组成也有密切关系。水泥尘肺存在着发病率低,发病工龄长,病情进展缓慢的特点,其发病时间一般在接触水泥粉尘20年以上,由于成品水泥的SiO_2含量较低,加之水泥尘肺的发病特点,早期文献资料认为水泥生产原料对机体的危害程度大于水泥成品,而水泥成品不会导致尘肺。90年代初,国内开展了大规模的水泥尘肺普查工作,证实了水泥生产过程中接触不同工艺阶段生产性粉尘的接尘工人均可罹患尘肺。
国内外水泥尘肺的发病率远低于煤工尘肺及矽肺,病例数相对较少,对水泥尘肺的X线胸片的影像学分析和研究一直未能深入,对水泥尘肺工人X线胸片特征的描述也过于笼统。本研究着眼于水泥生产中主要工艺阶段的职业性危害,对生料粉尘、熟料粉尘、成品水泥粉尘所致的水泥尘肺X线胸片的小阴影、肺门、肺纹理的影像学表现进行比较分析,阐明三种生产性粉尘所致尘肺X线胸片表现的差别及特点,以期为水泥尘肺的诊断和鉴别诊断提供影像学依据。
方法
选取辽宁工源水泥集团的尘肺现患病人及疑似尘肺者作为研究对象,经质量控制后得到样本498人,包括三个工种:(1)生料工种(2)熟料工种(3)成品工种。
依据GBZ1-2002《工业企业卫生设计标准》对检测点空气中粉尘进行测定。粉尘浓度、游离SiO_2含量、分散度的测定按GB5748-85《作业场所空气中粉尘测定方法》进行。使用北京产IFC-2型防爆粉尘采样仪在各个工种的工作岗位进行采样测定。采用美国GE Proteus XP-50型800mAX光机,摄取高仟伏胸片。
由3名取得职业病诊断资格的执业医师根据国家《尘肺病诊断标准》(GBZ70-2002),参照标准片集体阅片。
按期别分别比较生料、熟料、成品三个工种胸片显示的小阴影密集度及不同形态小阴影的出现率及肺门、肺纹理的改变率。
结果
各工种所接触粉尘浓度以成品工为最高,在50.84～59.70mg/m~3之间,其次是生料工所接触的粉尘浓度,在33.90～34.66mg/m~3之间。熟料工所接触的粉尘浓度在三个工种中最低,在13.79～16.81mg/m~3之间。各工种工作场所粉尘中游离二氧化硅含量历年均值以生料工种为最高,达6.08%,熟料工种工作场所游离二氧化硅含量为4.32%,含量最低的是成品工种,为1.81%,均低于10%。
在各期研究对象中,生料工高仟伏胸片的小阴影平均密集度要显著高于成品工,总体来看,生料工、熟料工、成品工胸片所示小阴影的平均密集度呈递减趋势。
我们在阅片过程中发现不规则小阴影早期多在左中肺野出现,而后向下或向上扩展,至Ⅱ期时可布满全肺野,有u影出现,左肺较右肺为甚,未见有小阴影聚集。各工种胸片均见圆形小阴影和不规则小阴影,生料工胸片p影、q影所占肺区数高于同期别的熟料工和成品工,成品工胸片的s影、t影所占肺区数要高于同期别的生料工。
各工种肺门和肺纹理的改变在0~+和Ⅱ期时比较无显著意义,在Ⅰ期Ⅰ~+时,肺门和肺纹理的改变生料工较熟料工及成品工严重。
结论
1.同期别各工种水泥作业工人尘肺高仟伏X线胸片上,生料工胸片所示小阴影平均密集度最高,其次为熟料工,再次为成品工。
2.各工种高仟伏X线胸片均有圆形小阴影和不规则小阴影出现,生料工胸片圆形小阴影占优势。成品工胸片不规则小阴影占优势。熟料工胸片显示随期别晋升,圆形小阴影的优势逐渐被不规则小阴影所取代。
3.生料工与熟料工高仟伏X线胸片所示肺门、肺纹理的改变在尘肺Ⅰ期和Ⅰ~+时较成品工严重。
Objective
Cement is synthetic silicate,it's raw material are limestone and clay,and the blast furnace slag.Cement pneumoconiosis is classified as silicate pneumoconiosis.In cement production process,the concentration and composition of all kinds of dust are great different,which caused the different characteristics on chest X-ray image changes.Cement pneumoconiosis is due to long-term inhalation of productive dust in cement production process and the dust produced the pneumoconiosis.
Productive dust is the main occupational hazards in cement production operations. Because the cement production process is complex,dust in the production process is different,the dust that the workers contact in different phases are not the same, therefore,the cement of pneumoconiosis is not only relate with dust concentration and the job seniority and individual factors,but also relate with the chemical composition of cement.Cement pneumoconiosis has the characteristics of low incidence,long job seniority of disease,slow progression of the disease,the average time from contacting with cement powder to falling ill is more than 20 years,due to the end product has low content of free SiO_2,and the characteristics of cement pneumoconiosis,early literature thought of the cement production raw material has greater damage than cement products,and cement products would not cause pneumoconiosis.In the early 1990s, China launched large-scale cement pneumoconiosis census,which confirmed that all kinds workers contact dust particles are suffering from pneumoconiosis in different stages of cement production process.
The incidence of domestic and overseas cement pneumoconiosis is lower than coal miner's pneumoconiosis and pneumoconiosis,and the number of cases of pneumoconiosis is relatively less than aforementioned two type of pneumoconiosis,the imaging analysis and research of cement pneumoconiosis chest X-ray has failed to penetrate deeply,the description of the characteristics of cement pneumoconiosis chest X-ray is too general.Our research mainly focuses on the occupational hazards in principal cement production technology process,have analyzed the imaging findings of small opacities and hilus pulmonis and pulmonary markings of cement pneumoconiosis on high-thousand-volt chest X-ray caused by raw cement material dust and ready cement materials dust and the end cement product dust,moreover we clarify the difference and characteristics on chest X-ray of the pneumoconiosis caused by the three kinds of dust,so as to provide imageology evidences for imaging diagnosis and differential diagnosis of cement pneumoconiosis.
Methods
We select the workers who suffered cement pneumoconiosis and suspected cement pneumoconiosis of Liaoning Gongyuan cement group as the research object,and have 498 samples after quality controlling,including three worker type:(1) raw materials workers(2) ready materials workers(3) end product workers.
According to the GBZ1-2002 "the standard design of industrial enterprises",we tasted the dust in air of the operating point.We tested the dust concentration and the free SiO_2 content and the dispersity of the dust according to the national standard GB5748-85,the determination method of dust in workplaces.In the testing,we have the sampling measurement jobs by IFC-2 dust sampling instrument which produced in Beijing,and take the high-thousand-volt chest X-ray by American GE Proteus XP - 50 type 800mA X-ray machine.
The radiography are analyzed by three doctors who has obtained qualification of occupational disease diagnosis according the pneumoconiosis disease diagnosis standard(GBZ70-2002).Compared the concentration of the small opacities and the frequency of different small opacities and the rate of changing of hilus pulmonis and pulmonary markings in high-thousand-volt chest X-ray according to the three worker type of raw materials workers and ready materials workers and end product workers respectively.
Results
The highest concentration of contacting dust of three worker types is the dust in end product workplaces,which ranged from 50.84 to 59.70 mg/m~3,followed by the dust concentration in raw materials workplaces,which ranged from 33.90 to 34.66 mg/m~3,the dust concentration of ready materials workers contacted is lowest,ranged from 13.79 to 16.81 mg/m~3.The free SiO_2 contend of raw materials workplaces is highest in the three types workers' workplace over the years,reaches 6.08%.The free SiO_2 contend of ready materials workers' workplace is 4.32%,and the lowest free SiO_2 contend appears at end product workers' workplace,which is 1.81%,all these value of free SiO_2 contend are less than 10%.
In all kinds of objects,the average concentration of small opacities in high thousand volts X-ray radiography of raw materials workers is significantly higher than end product workers'.Over all,the average concentration of small opacities of raw materials workers' and ready materials workers' and end product workers' appears a decrease progressively tendency.
We find that the irregular small opacities appear at the left-middle lung field early period mostly,and then extend to lower lung field or to upper lung field,it can cloud all the lung field atⅡperiod pneumoconiosis,this moment,we can find "u" type small opacities,the left lung are more serious than the right lung,and we have not find accumulative small opacities.The round small opacities and irregular small opacities are appear on all kinds of radiography in this study,the number of lung area that "p" opacities and "q" opacities appear of raw materials workers' radiography is more than the number of ready materials workers' and end product workers' of the same pneumoconiosis period,and the "s" opacities and the "t" opacities in end product workers' radiography are more than the raw materials workers'.
The changes of hilus pulmonis and pulmonary markings of all kinds of workers' radiography have not significant difference in 0+ andⅡperiod.InⅠandⅠ~+period, the changes of hilus pulmonis and pulmonary markings of raw materials workers' are more serious than ready material workers' and end product workers'.
Conclusion
1 The average concentration of small opacities on high-thousand-volts chest X-ray of each kinds cement pneumoconiosis worker in the same period,the highest is the raw material worker's,and the second is the ready materials worker's,then is the end product worker's.
2 Small round opacities and small irregular opacities appear in all kinds workers' high-thousand-volts chest X-ray,and the round small opacities are dominant in raw materials workers' radiography.The irregular small opacities are dominant in end product workers' radiography.The dominant of round small opacities are replaced by the irregular small opacities gradually in ready materials workers' radiography along of the promoting of pneumoconiosis' period.
3 The changes of hilus pulmonis and pulmonary markings in high thousand volts X-ray radiography of raw materials workers' and ready materials workers' are more serious than end product workers' inⅠandⅠ+pneumoconiosis period.
引文
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6 郭晓华,黄瑞田,张绪琴,孙文军,毛延铭.水泥粉尘接触者病理与x线诊断.中华劳动卫生职业病杂志.1994;12(1):51
7 张绪琴,郭晓华,周彦坤,孙文军.接触水泥粉尘工人尸检病理研究.中华劳动卫生职业病杂志.1992;10(3):140-143
8 张绪琴,郭晓华,周彦坤,孙文军,毛延铭.对水泥尘肺中“水泥小体”的研究.中国工业医学杂志.1992;5(1):5-7
9 Masoud Neghab,Alireza Choobineh.Work-related respiratory symptoms and ventilatory disorders among employees of a cement industry in Shiraz,Iran.Occup Health.2007;49:273-278
10 Carlsten C,Deroos A J,Kaufman J D,et al.Cell Markers,Cytokines,and Immune Parameters in Cement Mason Apprentices.American College of Rheumatology.2007;57:147-153
11 Ayse Ormana,Ahmet Kahramanb,Hamdullah C,et al.Plasma malondialdehyde and erythrocyte glutathione levels in workers with cement dust-exposure silicosis.Toxicology.2005;207:15-20
12 Julius Mwaiselage,Bente Moen,Magne Bratveit.Acute respiratory health effects among cement factory workers in Tanzania:an evaluation of a simple health surveillance tool.Int Arch Occup Environ Health.2006;79:49-56
13 Mwaiselage J,Bratveit M,Moen BE,et al.Respiratory symptoms and chronic obstructive pulmonary disease among cement factory workers.Scand J Work Environ Health. 2005;31:316-323.
14 李志容,陈跃成,刘创中.水泥尘肺23例发病情况分析.职业与健康.2003;19(11):20-21
15 李卓敏,和俊礼.水泥作业工人108例X线胸片表现分析.职业与健康.2002;18(8):27-28
16 Kun-Il Kim,Chang Won Kim,Min Ki Lee,et al.Imaging of Occupational Lung Disease.Radiographics.2001;21:1370-1391
17 Julius mwaiselage,Magne Bratveit,Bente Moen,et al.Variability in Dust exposure in a cement factory in Tanzania.Ann.occup.Hyg.2005;49:511-519
18 Semin Chong,Kyung Soo Lee,Myung Jin Chung,et al.Pneumoconiosis:Comparison of imaging and pathologic findings.Radiographics.2006;26:59-77
19 Hisao Shida,Keizo Chi(?)yotani,Koichi Honma,et al.Radiologic and pathologic characteristics of mixed dust pneumoconiosis.Radiographics.1996;16:483-498
20 Hnizdo E,Vallyathan V.Chronic obstructive pulmonary disease due to occupational exposure to silica dust:a review of epidemiological and pathological evidence.Occup Environ Med 2003;60:237-243
21 Park R,Rice F,Stayner L,et al.Exposure to crystalline silica,silicosis,and lung disease other than cancer in diatomaceous earth industry workers:a quantitative risk assessment.Occup Environ Med 2002;59:36-43
22 郭晓华,孙福全.Ⅲ期水泥尘肺的病理学研究.中华劳动卫生职业病杂志.1999;17(1):30-32
23 Sun J,Weng D,Jin C,et al.The value of high resolution computed tomography in the diagnostics of small opacities and complications of silicosis in mine machinery manufacturing workers,compared to radiography.J Occup Health.2008;50:400-5.
24 王勤.矽肺的X线表现分析.中国煤炭工业医学杂志.2006;9(10):1047-1048
25 刘艺翠,阴祖国,王琪.可疑尘肺22例的高、低仟伏X线摄影分析.职业与健康.2007;23(22):2043-2044
26 李尚朝.25例水泥尘肺分析报告.职业医学.1998;25(1):60-61
1 李尚朝,陈亚珍.水泥生产性粉尘作业危害调查.职业与健康.2005;21(13):329-331
2 魏远驯.水泥呼吸性粉尘与尘肺的剂量反应关系.实用预防医学.2006;13(4):967-968
3 袁伟明,付红,宣志强等.水泥作业工人的职业暴露和吸烟对肺通气功能和胸部X线影像的影响.职业与健康.2006;22(5):321-323
4 孙丙坤,周翠玉.许昌市部分水泥作业工人职业危害的调查.工业卫生与职业病.2007;33(5):304-305
5 郭晓华,孙福全.Ⅲ期水泥尘肺的病理学研究.中华劳动卫生职业病杂志.1999;17(1):30-32
6 王炳森.水泥尘肺及其水泥小体.中华劳动卫生职业病杂志.1996;14(6):5
7 施瑾,周泽深.混凝土搅拌工水泥尘肺一例报告.环境与职业医学.2007:24(4):462-463
8 郭晓华,黄瑞田,张绪琴,孙文军,毛延铭.水泥粉尘接触者病理与x线诊断.中华劳动卫生职业病杂志.1994;12(1):51
9 张绪琴,郭晓华,周彦坤,孙文军.接触水泥粉尘工人尸检病理研究.中华劳动卫生职业病杂志.1992;10(3):140-143
10 张绪琴,郭晓华,周彦坤,孙文军,毛延铭.对水泥尘肺中“水泥小体”的研究.中国工业医学杂志.1992;5(1):5-7
11 Masoud Neghab,Alireza Choobineh.Work-related respiratory symptoms and ventilatory disorders among employees of a cement industry in Shiraz,Iran.Occup Health.2007;49:273-278
12 CARLSTEN C,DE ROOS J A,KAUFMAN J D,et al.Cell Markers,Cytokines,and Immune Parameters in Cement Mason Apprentices.American College of Rheumatology.2007;57(1):147-153
13 Ays,Ormana E,Ahmet Kahramanb,et al.Plasma malondialdehyde and erythrocyte glutathione levels in workers with cement dust-exposure silicosis.Toxicology.2005;207:15-20
14 Julius Mwaiselage,Bente Moen,Magne Bratveit.Acute respiratory health effects among cement factory workers in Tanzania:an evaluation of a simple health surveillance tool.Int Arch Occup Environ Health.2006;79(1):49-56
15 Mwaiselage J,Bratveit M,Moen BE,et al.Respiratory symptoms and chronic obstructive pulmonary disease among cement factory workers.Scand J Work Environ Health.2005Aug;31(4):316-23.
16 李志容,陈跃成,刘创中.水泥尘肺23例发病情况分析.职业与健康.2003;19(11):20-21
17 李卓敏,和俊礼.水泥作业工人108例X线胸片表现分析.职业与健康.2002;18(8):27-28
18 Kun-Il Kim,Chang Won Kim,Min Ki Lee,et al.Imaging of Occupational Lung Disease.Radiographics.2001;21(6):1370-1391
19 JULIUS MWAISELAGE,MAGNE BRATVEIT,BENTE MOEN,et al.Variability in Dust Exposure in a Cement Factory in Tanzania.Ann.occup.Hyg.2005;49(6):511-519
20 Semin Chong,Kyung Soo Lee,Myung Jin Chung,et al.Pneumoconiosis:Comparison of Imaging and Pathologic Findings.Radiographics.2006;26(1):59-77
21 Hisao Shida,Keizo Chi(?)yotani,Koichi Honma,et al.Radiologic and Pathologic Characteristics of Mixed Dust pneumoconiosis.Radiographics.1996;16:483-498
22 Hnizdo E,Vallyathan V.Chronic obstructive pulmonary disease due to occupational exposure to silica dust:a review of epidemiological and pathological evidence.Occup Environ Med 2003;60:237-243
23 Park P,Rice F,Stayner L,et al.Exposure to crystalline silica,silicosis,and lung disease other than cancer in diatomaceous earth industry workers:a quantitative risk assessment.Occup Environ Med 2002;59:36-43
24 Bergdahl A,Tore Eriksson,Hedlund U,et al.Increased mortality in COPD among construction workers exposed to inorganic dust.Eur Respir J 2004;23:402-406.
25 余晨,李德鸿.ILO国际尘肺X射线影像分类法.工业卫生与职业病.2005;31(4):264-268
2 孙丙坤,周翠玉.许昌市部分水泥作业工人职业危害的调查.工业卫生与职业病.2007;33(5):304-305
3 Bergdahl A,Eriksson K,Hedlund U,et al.Increased mortality in COPD among construction workers exposed to inorganic dust.Eur Respir J 2004;23:402-406.
4 王炳森.水泥尘肺及其水泥小体.中华劳动卫生职业病杂志.1996;14(6):5
5 施瑾,周泽深.混凝土搅拌工水泥尘肺一例报告.环境与职业医学.2007:24(4):462-463
6 郭晓华,黄瑞田,张绪琴,孙文军,毛延铭.水泥粉尘接触者病理与x线诊断.中华劳动卫生职业病杂志.1994;12(1):51
7 张绪琴,郭晓华,周彦坤,孙文军.接触水泥粉尘工人尸检病理研究.中华劳动卫生职业病杂志.1992;10(3):140-143
8 张绪琴,郭晓华,周彦坤,孙文军,毛延铭.对水泥尘肺中“水泥小体”的研究.中国工业医学杂志.1992;5(1):5-7
9 Masoud Neghab,Alireza Choobineh.Work-related respiratory symptoms and ventilatory disorders among employees of a cement industry in Shiraz,Iran.Occup Health.2007;49:273-278
10 Carlsten C,Deroos A J,Kaufman J D,et al.Cell Markers,Cytokines,and Immune Parameters in Cement Mason Apprentices.American College of Rheumatology.2007;57:147-153
11 Ayse Ormana,Ahmet Kahramanb,Hamdullah C,et al.Plasma malondialdehyde and erythrocyte glutathione levels in workers with cement dust-exposure silicosis.Toxicology.2005;207:15-20
12 Julius Mwaiselage,Bente Moen,Magne Bratveit.Acute respiratory health effects among cement factory workers in Tanzania:an evaluation of a simple health surveillance tool.Int Arch Occup Environ Health.2006;79:49-56
13 Mwaiselage J,Bratveit M,Moen BE,et al.Respiratory symptoms and chronic obstructive pulmonary disease among cement factory workers.Scand J Work Environ Health. 2005;31:316-323.
14 李志容,陈跃成,刘创中.水泥尘肺23例发病情况分析.职业与健康.2003;19(11):20-21
15 李卓敏,和俊礼.水泥作业工人108例X线胸片表现分析.职业与健康.2002;18(8):27-28
16 Kun-Il Kim,Chang Won Kim,Min Ki Lee,et al.Imaging of Occupational Lung Disease.Radiographics.2001;21:1370-1391
17 Julius mwaiselage,Magne Bratveit,Bente Moen,et al.Variability in Dust exposure in a cement factory in Tanzania.Ann.occup.Hyg.2005;49:511-519
18 Semin Chong,Kyung Soo Lee,Myung Jin Chung,et al.Pneumoconiosis:Comparison of imaging and pathologic findings.Radiographics.2006;26:59-77
19 Hisao Shida,Keizo Chi(?)yotani,Koichi Honma,et al.Radiologic and pathologic characteristics of mixed dust pneumoconiosis.Radiographics.1996;16:483-498
20 Hnizdo E,Vallyathan V.Chronic obstructive pulmonary disease due to occupational exposure to silica dust:a review of epidemiological and pathological evidence.Occup Environ Med 2003;60:237-243
21 Park R,Rice F,Stayner L,et al.Exposure to crystalline silica,silicosis,and lung disease other than cancer in diatomaceous earth industry workers:a quantitative risk assessment.Occup Environ Med 2002;59:36-43
22 郭晓华,孙福全.Ⅲ期水泥尘肺的病理学研究.中华劳动卫生职业病杂志.1999;17(1):30-32
23 Sun J,Weng D,Jin C,et al.The value of high resolution computed tomography in the diagnostics of small opacities and complications of silicosis in mine machinery manufacturing workers,compared to radiography.J Occup Health.2008;50:400-5.
24 王勤.矽肺的X线表现分析.中国煤炭工业医学杂志.2006;9(10):1047-1048
25 刘艺翠,阴祖国,王琪.可疑尘肺22例的高、低仟伏X线摄影分析.职业与健康.2007;23(22):2043-2044
26 李尚朝.25例水泥尘肺分析报告.职业医学.1998;25(1):60-61
1 李尚朝,陈亚珍.水泥生产性粉尘作业危害调查.职业与健康.2005;21(13):329-331
2 魏远驯.水泥呼吸性粉尘与尘肺的剂量反应关系.实用预防医学.2006;13(4):967-968
3 袁伟明,付红,宣志强等.水泥作业工人的职业暴露和吸烟对肺通气功能和胸部X线影像的影响.职业与健康.2006;22(5):321-323
4 孙丙坤,周翠玉.许昌市部分水泥作业工人职业危害的调查.工业卫生与职业病.2007;33(5):304-305
5 郭晓华,孙福全.Ⅲ期水泥尘肺的病理学研究.中华劳动卫生职业病杂志.1999;17(1):30-32
6 王炳森.水泥尘肺及其水泥小体.中华劳动卫生职业病杂志.1996;14(6):5
7 施瑾,周泽深.混凝土搅拌工水泥尘肺一例报告.环境与职业医学.2007:24(4):462-463
8 郭晓华,黄瑞田,张绪琴,孙文军,毛延铭.水泥粉尘接触者病理与x线诊断.中华劳动卫生职业病杂志.1994;12(1):51
9 张绪琴,郭晓华,周彦坤,孙文军.接触水泥粉尘工人尸检病理研究.中华劳动卫生职业病杂志.1992;10(3):140-143
10 张绪琴,郭晓华,周彦坤,孙文军,毛延铭.对水泥尘肺中“水泥小体”的研究.中国工业医学杂志.1992;5(1):5-7
11 Masoud Neghab,Alireza Choobineh.Work-related respiratory symptoms and ventilatory disorders among employees of a cement industry in Shiraz,Iran.Occup Health.2007;49:273-278
12 CARLSTEN C,DE ROOS J A,KAUFMAN J D,et al.Cell Markers,Cytokines,and Immune Parameters in Cement Mason Apprentices.American College of Rheumatology.2007;57(1):147-153
13 Ays,Ormana E,Ahmet Kahramanb,et al.Plasma malondialdehyde and erythrocyte glutathione levels in workers with cement dust-exposure silicosis.Toxicology.2005;207:15-20
14 Julius Mwaiselage,Bente Moen,Magne Bratveit.Acute respiratory health effects among cement factory workers in Tanzania:an evaluation of a simple health surveillance tool.Int Arch Occup Environ Health.2006;79(1):49-56
15 Mwaiselage J,Bratveit M,Moen BE,et al.Respiratory symptoms and chronic obstructive pulmonary disease among cement factory workers.Scand J Work Environ Health.2005Aug;31(4):316-23.
16 李志容,陈跃成,刘创中.水泥尘肺23例发病情况分析.职业与健康.2003;19(11):20-21
17 李卓敏,和俊礼.水泥作业工人108例X线胸片表现分析.职业与健康.2002;18(8):27-28
18 Kun-Il Kim,Chang Won Kim,Min Ki Lee,et al.Imaging of Occupational Lung Disease.Radiographics.2001;21(6):1370-1391
19 JULIUS MWAISELAGE,MAGNE BRATVEIT,BENTE MOEN,et al.Variability in Dust Exposure in a Cement Factory in Tanzania.Ann.occup.Hyg.2005;49(6):511-519
20 Semin Chong,Kyung Soo Lee,Myung Jin Chung,et al.Pneumoconiosis:Comparison of Imaging and Pathologic Findings.Radiographics.2006;26(1):59-77
21 Hisao Shida,Keizo Chi(?)yotani,Koichi Honma,et al.Radiologic and Pathologic Characteristics of Mixed Dust pneumoconiosis.Radiographics.1996;16:483-498
22 Hnizdo E,Vallyathan V.Chronic obstructive pulmonary disease due to occupational exposure to silica dust:a review of epidemiological and pathological evidence.Occup Environ Med 2003;60:237-243
23 Park P,Rice F,Stayner L,et al.Exposure to crystalline silica,silicosis,and lung disease other than cancer in diatomaceous earth industry workers:a quantitative risk assessment.Occup Environ Med 2002;59:36-43
24 Bergdahl A,Tore Eriksson,Hedlund U,et al.Increased mortality in COPD among construction workers exposed to inorganic dust.Eur Respir J 2004;23:402-406.
25 余晨,李德鸿.ILO国际尘肺X射线影像分类法.工业卫生与职业病.2005;31(4):264-268