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目的探索低浓度下单一和混合性酸气（雾）对鼻粘膜和肺功能慢性损害的特点及剂量效应关系。方法以车间作业工人呼吸带酸气（雾）平均浓度低于国家最高容许浓度（ＭＡＣ）的上海市１８家工厂７６６名接触氢氟酸（ＨＦ）、铬酸（ＣｒＯ３）、三酸（Ｈ２ＳＯ４，ＨＮＯ３，ＨＣｌ）及ＨＦ混合三酸和ＣｒＯ３混合三酸作业工人为接触组，１７４名不接触酸气的健康人员为对照组，统一行系统体检和肺功能测定。结果接触组３０１６％（２３１／７６６）作业工人有不同程度鼻粘膜糜烂（２２５例）、溃疡（３例）和中隔穿孔（３例），２９５１％（１８５／６２７）出现小气道阻塞（１６７例）及不同程度肺功能减退（１８例）。５组酸气接触组鼻粘膜、肺功能损害检出率均显著高于对照组（Ｐ＜００５～００１）。铬酸与三酸的低浓度酸气（雾）混合接触，对鼻粘膜损害有明显协同作用（Ｐ＜０００１），损害发生与工龄呈正相关关系（ｒｓ＝０８９２）。结论长期接触现行卫生标准下的５种酸气（雾）有明显鼻粘膜和肺小气道功能损害作用，对安全限值尚须进一步研究，鼻粘膜和肺小气道功能损害是检测低浓度酸气（雾）职业危害的客观指标。
Objective To explore the characteristics and dose-response relationship of single and mixed acid gas (fog) to chronic damage of nasal mucosa and lung function under low concentration. Methods A total of 766 workers exposed to hydrofluoric acid (HF), chromic acid (CrO3) and tricarboxylic acid (H2SO4) in 18 factories in Shanghai were tested with the average concentration of respiratory acid gas (fog) of workers in workshop was lower than the national maximum allowable concentration HNO3, HCl) and HF mixed triacid and CrO3 mixed triacid workers were used as the exposure group, and 174 healthy people without acid gas were taken as the control group. The physical examination and pulmonary function tests were conducted in a unified way. Results In the contact group, 3016% (231/766) workers had different degrees of nasal mucosal erosion (225 cases), ulcers (3 cases) and septal perforation (3 cases), 2951% (185/627) Road obstruction (167 cases) and varying degrees of lung dysfunction (18 cases). The nasal mucosa in 5 groups of acid-gas exposure group were significantly higher than those in control group (P <005-001). Chromic acid mixed with low concentration of acid (mist) of triacid has obvious synergetic effect on nasal mucosal damage (P <0001), and the incidence of injury is positively correlated with the length of service (rs = 0892). Conclusions Long-term exposure to the five kinds of acid gas (fog) under the current health standards has significant nasal mucosal and pulmonary small airway dysfunction, the safety limits need to be further studied, nasal mucosa and pulmonary function impairment is the detection of low concentrations of acid gas (Fog) Objective indicators of occupational hazards.