Exposure to metal fume and infectious pneumonia
Exposure to metal fume and infectious pneumonia
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DOI：
10.1093/aje/kwf188
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发表时间：
2003-02-01
影响因子：
5
通讯作者：
Coggon, D
中科院分区：
文献类型：
--
作者：
Palmer, KT;Poole, J;Coggon, D
为了验证吸入金属烟雾可逆地增加对肺炎的易感性的假设，作者进行了一项病例对照研究。年龄在20-64岁之间，在1996-1999年期间在英国西米德兰兹郡的11家医院住院的社区获得性肺炎患者接受了有关其终生职业史、金属烟雾暴露和潜在混杂因素的采访。类似的信息也收集自同一家医院的非呼吸系统疾病的对照组。对于病例，暴露的时间相对于他们的疾病发作（平均在访谈前6个月）。对照组的暴露史在访谈前6个月删失。525例病例和1,122例对照完成了访谈（应答率分别为74%和99%）。肺炎与前一年报告的金属烟雾职业暴露有关（调整后的比值比（OR）= 1.6，95%置信区间（CI）：1.1，2.4），但在早期则无关（OR = 1.1）。大叶性肺炎和近期暴露于亚铁烟雾的风险最高（OR = 2.3，95%CI：1.2，4.3）。这种关联并不特异于任何一种微生物。这些发现支持了亚铁和可能的其他金属烟雾可逆地易患传染性肺炎的假设。研究现在应侧重于根本机制和预防。
To test the hypothesis that inhalation of metal fume reversibly increases susceptibility to pneumonia, the authors conducted a case-control study. Men aged 20-64 years, admitted to 11 hospitals in West Midlands, England, with community-acquired pneumonia during 1996-1999 were interviewed about their lifetime occupational history, exposure to metal fume, and potential confounding factors. Similar information was collected from controls admitted to the same hospitals with nonrespiratory illness. For cases, exposures were timed relative to the onset of their illness (on average, 6 months before interview). Exposure histories for controls were censored 6 months before interview. Interviews were completed by 525 cases and 1,122 controls (response rates of 74% and 99%). Pneumonia was associated with reported occupational exposure to metal fume in the previous year (adjusted odds ratio (OR) = 1.6, 95% confidence interval (CI): 1.1, 2.4) but not in earlier periods (OR = 1.1). The risk was highest for lobar pneumonia and recent exposure to ferrous fume (OR = 2.3, 95% CI: 1.2, 4.3). The association was not specific to any one microorganism. These findings support the hypothesis that ferrous and possibly other metal fumes reversibly predispose to infectious pneumonia. Research should now focus on the underlying mechanisms and prevention.