高原旅客列车客运乘务员职业健康状况评价

Occupational health status in crew on plateau passenger trains

目的评价高原旅客列车客运乘务员频繁往返高原17个月后的职业健康状况。方法对248名乘务员的3次体检结果资料进行分析评价,主要评价指标包括收缩压、舒张压、血氧饱和度、右心室流出道、右心室内径(左右径)、右肺下动脉干横径、动脉干横径与气管径比值、肺活量、实测值/预期值、红细胞、血红蛋白、红细胞压积等。结果与高原心脏病、高原红细胞增多症等相关的主要生理指标发生了一定的代偿性变化。岗前和第2次岗间体检各项指标比较中,血压、血氧饱和度、右心室流出道、右肺下动脉干横径、右肺下动脉干横径与气管横径比值、室间隔厚度、肺活量、实测值/预期值、血红蛋白指标比较差异有统计学意义;血氧饱和度、心电图、肺活量、实测值/预期值、红细胞压积在第2次体检中的异常发生率分别为4.84%、3.23%、14.92%、8.87%和20.97%,均高于第1次岗间体检。结论在目前的交路和高原工作强度下,高原值乘17个月后,乘务员的健康状况基本良好。

Objective To evaluate occupational health status of crew on highland passenger trains after 17-month frequent round-trips.Methods Data of three physical examinations for 248 crew members of the trains were analyzed and evaluated, including their systolic and diastolic blood pressure, blood oxygen saturation, fight ventrieular outflow tract, right ventricular diameter （left and right track）, transverse diameter of the arterial stem in lower part of the fight lung, ratio of transverse diameter of the arterial stem to that of the trachea, vital capacity （measured value/expected value）, red blood cell count, hemoglobin level, hematocrit, and so on.Results Compensatory changes in major physiological indices related to high-altitude heart disease and high-altitude polyeythemia could be observed in the crew on highland passenger trains. Statistically significant difference in blood pressure, blood oxygen saturation, right ventricular outflow tract, transverse diameter of the arterial stem in lower part of the fight lung, ratio of transverse diameter of the arterial stem and that of the trachea, interventricular septal thickness, vital capacity （measured value/expected value） and hemoglobin level were all observed in the second on-job physical examinations, as compared with the pre-job examination. Proportions of abnormal blood oxygen saturation, Electrocardiograms （ECG）, vital capacity （measured value/expected value） and hematocrit in the crew at the second on-job examinations were 4.84 percent, 3.23 percent, 14.92 percent, 8.87 percent, and 20.97 percent, respectively, which were all higher than those at the first on-job examination. Conclusions Crew of the highland passenger trains still kept healthy after 17-month duty under present transportation and highland work-intensity.