摘要
目的阐明职业性三氯乙烯(TCE)药疹样皮炎职业流行病学特征,为其防治与研究提供资料。方法用专用调查表对广东省1988～2001年发病的150例职业性TCE药疹样皮炎病例进行回顾性调查,同时收集这些发病事故的调查资料,用Excel建立数据库,SPSS10.0进行统计处理。结果这组病例的临床表现和发病特点与药疹皮炎极其相似,表现为剥脱性皮炎、重症多形红斑、大疱性表皮坏死松解症或多形红斑。其发病均因接触TCE,但与接触浓度无明显关系;潜伏期均小于3个月;××市3年调查,接触TCE新工人的发病率仅为0.045%;激素治疗有效,病后再接触可再发病,斑贴试验阳性等。引起发病的TCE含量在95%以上,产地也不同,全分析未发现相同杂质;全部病例没有发现接触甲醛、甲胺磷等能引起药疹样皮炎的化学品;大部分病例发疹前2个月没有服过任何药物;美国和日本等地已有21例相似的病例报道。因接触TCE的新工人多和临床医师和管理人员提高了对本病的认识,使广东多发。结论本组病例都由职业性接触TCE引起,与药疹样皮炎相似,属免疫增强损伤。称为“职业性TCE药疹样皮炎”;其流行病学特点均与职业性TCE接触明显相关。
Objective To clarify the epidemiological characteristics of occupational medicamentosa-like dermatitis induced by trichloroethylene （OMLDT）, and to provide data for its prevention, treatment and research. Methods With special questionnaires, an occupational epidemiological retrospective survey on 150 cases of OMLDT, which happened in Guangdong province from 1988 to 2001, was carried out. Data base related to the disease was established with Excel and analyzed with SPSS 10.0. Results The characteristics of the occurrence and clinical manifestations of these cases were very similar to drug eruptions, showing exfoliative dermatitis, erythema multiforme, Stevens-Johnson syndrome, or toxic epidermal necrolysis. All of these cases had been exposed to trichloroethylene （TCE）, but without significant dose-dependent relations found between exposure levels and the occurrence of the disease. Latent period of these cases were shorter than 3 months, According to a 3-year survey in a certain city, the incidence of OMLDT in TCE exposed new workers was only 0. 045%. It was shown that hormone was useful to counteract the disorder, that re-exposure to TCE could cause recurrence, and that patch-tests in some patients were positive. The purities of TCE used by these cases were all higher than 95%, and TCE used in different factories were made in different countries. Total analysis on the components of TCE used by the patients did not show the same impurity existed, All cases did not contact to chemicals which could cause dermatitis such as formaldehyde and methamidophos. Most of the cases had not received medication within 2 months before the appearance of rash. There were 21 similar cases reported in the USA and Japan. The reasons why the disorders recently concentrated in Guangdong were that a great number of new workers were exposed to TCE, and that physicians and managers had increased knowledge about OMLDT. Conclusion All of these 150 cases were caused by occupational TCE exposure. They were similar to drug eruption dermatitis, and caused by immunoenhancement, Therefore, this disease is named as OMLDT. Its epidemiological characteristics are obviously related to occupational exposure to TCE.
出处
《中国职业医学》
CAS
北大核心
2006年第5期333-336,共4页
China Occupational Medicine
基金
广东省重点科技攻关项目(编号9622056-05)
广东省卫生系统"五个一科教兴医工程"重点项目(编号1996-186)
关键词
三氯乙烯
职业接触
药疹样皮炎
职业流行病学
Trichloroethylene
Occupational exposure
Medicamentosa-like dermatitis
Occupational epidemiology
