高原铁路修建工人健康状况调查

A study of high altitude environment affecting on worker's health du ring the constructing Qinghai-Xizang railway

目的 研究高原作业环境对作业工人健康的影响。方法 采用队列研究方法 ,研究习服期、初上高原和在高原工作 90d不同时期高原反应、血压、血象和氧化指标的变化情况。结果 初上高原有 83 .3 %的人出现程度不等的高原反应 ,以头痛最多。血压异常检出率随着海拔高度和停留时间而增高 ,与平原对照组的差异有显著性 (P <0 .0 1) ,90d组高血压检出率为 41.7% ,以舒张压升高明显 ,与其他 3组相比 ,差异均有显著性 (P <0 .0 1)。初上高原组WBC、RBC明显增加 ,Hb在 90d左右才明显增加 ,与平原对照组相比 ,差异均有显著性 (P <0 .0 1)。习服期组丙二醛 (MDA)明显增加 ,且随着海拔高度和停留时间而增加 ,90d组过氧化氢酶 (CAT)、谷胱甘肽过氧化物酶 (GSH Px)、超氧化物歧化酶 (SOD)活力明显增加 ,分别为 (2 2 2 .3 6± 3 6.52 )× 10 3U/L、(158.49± 14 .42 )U/L、(45.74±8.3 1)NU/ml ,与对照组 [分别为 (110 .17± 3 3 .81)× 10 3U/L、(10 8.3 6± 2 5.2 6)U/L、(3 2 .2 8± 7.45)NU/ml]的差异均有显著性 (P <0 .0 1)。结论 高原作业环境可使作业工人血压异常 ,以舒张压升高为主 ;可导致WBC、RBC、Hb增高 ;可使体内氧化活动增强 ;并可引起头痛、头晕。

ObjectiveTo study high altitude environmen t affecting on worker's health MethodsUsing the cohort study,the altitude reaction was investigated and the WBC,RBC,Hb and oxygenation indexes were measured on workers in several periods, namely,acclimatization per iod,initially arrived high altitude and resident 90 days. ResultsThe 83.3% of men had altitude reactions with different kinds at initial ly arrived high altitude.The headache was the most.The rate of abnormal blood pr essure increased with altitude and resident time( P <0.01).The rate of 90 day 's group was 41.7%.The rise of diastole pressure was obvious( P <0.01).As th e beginning of arrived highland,the increase of WBC,RBC were significant( P <0 .01).The increase of Hb appeared only in 90 day's group.The level of malondiald ehyde(MDA) obviously increased during acclimatization period and increased with altitude and resident time( P <0.01).The activity of catalase(CAT),glutathione peroxidase(GSH-Px),superoxide dismutase(SOD) increased significantly in 90 day 's group[(222.36±36.52)×10 3U/L,(158.49±14.42)U/L,(45.74±8.31)NU/ml respe ctively]( P <0.01). ConclusionThe high altitude envir onment may result in the abnormal blood pressure,the rise of diastolic pressure was important.It lead to the increase of WBC,RBC,Hb.It initiated activity of oxy genation reaction.The symptoms of headache,dizziness,loss of appetite and insomn ia appeared as working in high altitude environment.