A cross-sectional study of early effects on the lung in workers exposed to indium, a suspected strong inducer of pneumoritis

为了阐明铟(In)对呼吸系统的影响，于2003年12月和2004年2月在2家铟-锡氧化物陶瓷靶材(ITO Target)制造厂和2家铟回收厂进行了横断面研究。研究对象为112名男性接铟工人(接铟工人，平均接铟时间为70.3mos)、40名男性既往接铟工人(已接工，平均接铟时间：71.7mos，接铟后平均接铟时间：74.1mos)和104名男性参照工。其中在岗女工9名，离岗女工2名，转诊女工25名，其中在岗职工、离岗职工和参照职工的血清浓度几何均数(In-S)分别为6.87、2.96和0.52mgg/L。吸烟者“冬外咳”、非吸烟者“冬咳”、“冬痰”患病率明显高于对照工人。肺活量测定指标无明显差异。INTE…的患病率高分辨率计算机断层扫描(HRCT)检查6个肺野的病变在离岗工人中约占23%，但与对照工人相比差异无统计学意义。In-S与间质改变的患病率之间的剂量-反应关系尚不清楚。血清KL-6、SP-D和SP-A呈剂量依赖性升高，且在S和KL-6之间存在非常明显的剂量-效应和剂量-反应关系。部分曾接触In的工人在接触结束后150个月仍表现出较高的In-S和KL-6水平，提示In具有较强的诱发肺间质改变的潜能，血清中KL-6是反映肺间质改变的最合适指标。此外，即使在完成暴露后，In的影响似乎也会持续很长一段时间。根据这些研究结果，因In暴露而产生的健康风险在2004年被传达给工厂的管理人员和个别工人。建议采用健康风险管理方法，控制作业环境，保护对肺部的健康影响。较少

To clarify the effects of indium (In) on the respiratory system, a cross-sectional study was performed in 2 indium-tin oxide ceramics target (ITO target) manufacturing plants and 2 indium recycling plants in December 2003 and February 2004. The study subjects were 112 male indium-exposed workers (In workers, mean exposure duration : 70.3 mos), 40 male former exposed workers (ex-In workers, mean exposure duration : 71.7 mos, mean duration after indium exposure : 74.1 mos), and 104 male referent workers. Nine female In workers, 2 female former In workers, and 25 female referent workers were also surveyed.Geometric means of serum In concentration (In-S) in In workers, ex-In workers and referent workers were 6.87, 2.96 and 0.52 μg/L, respectively. Prevalence of "cough other than winter" in smokers and "cough in winter" and "phlegm in winter" in non-smokers were significantly higher in In workers than in referent workers. Indices of spirometry didn't show any differences. Prevalence of inte … More rstitial changes in 6 lung fields examined by high resolution computed tomography (HRCT) was ca. 23% in ex-In workers, but no statistical difference was seen between In workers and referent workers. Dose-response relationship between In-S and the prevalence of the interstitial changes was unclear. Serum KL-6, SP-D and SP-A increased dose-dependently and very sharp dose-effect and dose-response relationships were revealed between In-S and KL-6. Some ex-In workers showed high In-S and KL-6 even 150 months after finishing their In exposure job.In conclusion, it became clear that In had a strong potential to induce lung interstitial changes and KL-6 in serum was the most appropriate indicator of the interstitial changes. Furthermore, the effects of In seem to persist for a long time even after finishing the exposure.According to these study results, health risks due to In exposure were communicated to the managers of the plants and individual workers in 2004. Health risk management for control the workplace environment and protecting the health effects on the lung were also recommend. Less