Pneumoconiosis
Pneumoconiosis
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DOI：
10.1111/j.1742-1241.1957.tb00647.x
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发表时间：
1957-02
影响因子：
2.6
通讯作者：
W. R. James
中科院分区：
文献类型：
--
作者：
W. R. James
在人的一生中，每个人都会吸入一些灰尘。在农村条件下，大气粉尘污染很轻微，但在那些生活在烟雾缭绕的城市的人的肺部，发现了许多微小的粉尘堆积。在这些条件下滞留的灰尘几乎不会造成解剖学上的损害，而且，就目前所知，它不会影响健康。肺尘埃沉着病一词不用于指这种肺部状态。城市大气污染可能是肺癌和支气管炎的易感因素，但这种可能性的讨论超出了本文的范围。在某些工业过程中，空气中可能会充满大量的灰尘。几个世纪以来，人们已经知道，从事其中一些过程的工人容易患上肺损伤。Doig(1949)给出了危险行业的全面清单。尘肺病一词通常是指因在工作中吸入有害粉尘而导致的健康状况不佳。阅读文献表明，根据作者的经验，尘肺病这个术语有时有特殊的含义。放射科医生认为这是一种能够产生特征性X光改变的肺部异常，而病理学家认为这是由于吸入粉尘的影响而导致的肺解剖改变。出于立法目的，议会使用病理学标准将肺尘埃沉着病定义为“因二氧化硅粉尘、石棉粉尘或其他粉尘引起的肺纤维化，并包括称为粉尘网状的情况”(“国家保险(工伤)法”，1946、57、3)的经验表明，工业中遇到的一些粉尘相对无害，而其他粉尘则可能导致迅速致命的肺部疾病。据观察，锯木厂、水泥厂和石灰石采石场的工人可以在尘土飞扬的条件下忍受多年，而不会感染肺病。相比之下，接触富含游离二氧化硅的粉尘(二氧化硅)的职业存在严重的健康不良风险。有趣的是，含有以硅酸盐形式化学结合的硅(Si)的粉尘通常比那些含有作为二氧化硅的游离二氧化硅的粉尘危害小得多。除了少数例外，可以证明，随着粉尘中二氧化硅含量的增加，患严重尘肺病的风险也会增加。
IN THE COURSE of a lifetime everyone inhales some dust. Under rural conditions atmospheric dust contamination is slight, but in the lungs of those who live in smoky cities, many minute accumulations of dust are found. The dust retained under these conditions causes little or no anatomical damage and, so far as is known, results in no disturbance of health. The term pneumoconiosis is not used in reference to such lung states. It is possible that urban atmospheric pollution may predispose to lung cancer and bronchitis, but a discussion of this possibility is outside the scope of the present paper. In some industrial processes the air may become heavily laden with dust. It has been known for centuries that workmen engaged in some of these processes are liable to develop lung damage. A comprehensive list of the hazardous industries is given by Doig (1949). The term pneumoconiosis is usually reserved for a condition of ill-health resulting from the inhalation of harmful dusts at work. Perusal of the literature shows that special meanings are sometimes attached to the term pneumoconiosis according to the experience of the author. The radiologist regards it as a lung abnormality capable of producing characteristic x-ray changes, and the pathologist considers it as an alteration of pulmonary anatomy due to the effects of inhaled dust. For legislative purposes, Parliament has used pathological criteria in defining pneumoconiosis as " fibrosis of the lungs due to silica dust, asbestos dust or other dust and includes the condition known as dust reticulation" (National Insurance (Industrial Injuries) Act, 1946, 57, 3)' Experience has shown that some dusts encountered in industry are relatively harmless whilst others may cause rapidly fatal lung disease. It has been observed that workmen in sawmills, cement works and limestone quarries may tolerate dusty conditions for many years without contracting lung disease. In contrast, occupations involving exposure to dusts rich in free silica (Si02) carry a serious risk of ill-health. It is of interest that dusts containing silicon (Si) chemically combined as silicates are in general much less harmful than those which contain , free' silica as silicon dioxide. With few exceptions, it can be shown that the risk of serious pneumoconiosis increases with a rise in the silica content of the dust.