铝作业工人执行功能变化及其影响因素

Evaluation of executive function of aluminum workers and its risk factors

目的分析职业接触铝对作业工人执行功能损害的影响因素。方法采用方便抽样方法,选择172名铝作业工人为研究对象,根据其血铝水平分为低、中、高水平组。采用《连线测验问卷》(TMT)评价其执行功能,并分析其影响因素。结果研究对象血铝水平中位数和第25、75百分位数[M(P_(25),P_(75))]为23.71(13.14,38.27)μg/L,低、中、高水平组人群血铝水平M(P_(25),P_(75))分别为9.84(2.60,13.18)、23.18(19.45,28.23)和45.02(38.23,62.52)μg/L。随着血铝水平的升高,研究对象TMT-A、TMT-B和TMT总的耗时数及其异常率均升高(P值均<0.05)。二分类logistic回归分析结果显示,中水平组人群TMT-B、TMT总的耗时数异常的风险分别是低水平组的2.59和2.98倍(P值均<0.05),高水平组人群TMT-A、TMT-B和TMT总的耗时数异常的风险分别是低水平组的7.77、11.04和9.74倍(P值均<0.05);工龄越长者,TMT-B耗时数和TMT总耗时数异常的风险越高(P值均<0.05);文化程度越高者,TMT-A耗时数和TMT总耗时数异常的风险越低(P值均<0.05)。结论职业性铝接触可损害作业工人的执行功能,呈剂量-效应关系;血铝水平和工龄是其执行功能损害的危险因素,文化程度是其执行功能损害的保护因素。

Objective To evaluate the risk factors of occupational aluminum exposure on workers'executive function.Methods A total of 172 aluminum-exposed workers were selected by convenient sampling method.According to the blood aluminum concentration,the subjects were divided into low-,medium-,and high-level groups.The trail making test(TMT)was used to evaluate the executive function and its risk factors of the subjects.Results The median and 25th and 75th percentiles[M(P_(25),P_(75))]of blood aluminum was 23.71(13.14,38.27)μg/L.The M(P_(25),P_(75))of blood aluminum levels in low-,medium-and high-level groups were 9.84(2.60,13.18),23.18(19.45,28.23)and 45.02(38.23,62.52)μg/L,respectively.The total time and abnormality rate of TMT-A,TMT-B and TMT in this study increased with the increasing blood aluminum levels(all P<0.05).The results of binary logistic regression analysis showed that the abnormal risks of total time on TMT-B and TMT in the medium-level group were 2.59 and 2.98 times respectively(both P<0.05),and the abnormal risks of total time on TMT-A,TMT-B and TMT in the high-level group were 7.77,11.04 and 9.74 times respectively compared with the low-level group(all P<0.05).The longer the length of service,the higher the abnormal risk of total time on TMT-B and TMT(both P<0.05).The higher the education level,the lower the risk of abnormal risk of total time on TMT-A and TMT(both P<0.05).Conclusion Occupational aluminum exposure may impair the executive function of workers with a dose-effect relationship.Blood aluminum level and length of employment are risk factors and education level is a protective factor for the executive function of workers.