engleski

Lung function impairment in cement workers

AIM In order to get more information about the characteristics of chronic lung disease in cement workers sensitive tests with respect to lung mechanical properties were studied. METHODS A cross-sectional survey of chronic lung disease in 76 randomly selected cement workers and 31 maintenance workers was carried out in two cement plants in Croatia. A standardised questionnaire was used to obtain a detailed history concerning health, smoking habit and occupation. A chest radiogram was taken in all cases. Lung volumes were measured by spirography and body-plethysmography, compliance of the lungs (CL) by the oesophageal catheter method and diffusing capacity of the lung (DLCO) by the single-breath method. The mean values of total and respirable cement dust concentration were considerably higher of MAC (97.1 mg/m3, 8.2mg/m3, respectively). Individual exposure was calculated based on workers' tasks. RESULTS In our group of cement workers there were only minor abnormalities on routine lung function tests and chest x-ray. The more directly exposed cement packers had significantly (P less than 0.05) higher airway resistance (Raw) and slightly decreased diffusing capacity than the less exposed cement loaders. There were non-significant differences in routine spirometry and in airway resistance between cement workers and controls. The static pressure/volume curves showed that the static elastic recoil pressure tended to be decreased at a given percentage of predicted total lung capacity in exposed workers. Static compliance was increased in 51 (65%) of cement workers ; in the 16 other workers CLstat was within normal limits and 9 had slightly decreased static lung compliance. Frequency dependence of compliance revealed an uneven distribution of ventilation in cement workers. CONCLUSION. The study points out that the introduction of tests of lung mechanics can improve the diagnosis of early lung disease in cement workers. The results revealed that the basic pathophysiological change in some cases of chronic broncho-pulmonary disease in cement workers was obstructive bronchitis or peribronchial fibrosing alveolitis, which may be accompanied with emphysema. To prevent lung function impairment in cement workers respirable dust levels should be monitored regularly and the excessive levels should be reduced by engineering control and by process enclosure.

cement dust; workers; functional tests; lung

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