铬接触人员鼻部损害的健康调查与健康管理实施的探讨

Health investigation and health management to the chromium-exposed workers' nasal damage

目的探讨六价铬对作业人员鼻部损害的情况及对其实施健康管理的必要性。方法按铬盐接触时间将76名作业工人分为T1组(接触时间小于5年)、T2组(接触时间5～10年)、T3组(接触时间10～20年)、T4组(接触时间大于20年),并以该厂行政、后勤无毒接触史32人为对照组,分别采用健康问卷调查和体检的方式反映铬对鼻部损害的情况,结果作统计学分析。结果接触组中鼻部异常症状如鼻痒、喷嚏、鼻塞、嗅觉减退等发生率明显高于对照组,差异有统计学意义(P<0.05),且鼻痒、喷嚏、鼻塞症状多见于T1组;嗅觉减退症状多见于T4组;接触组中鼻部异常体征如鼻黏膜充血、肿胀、干燥、鼻黏膜糜烂等检出率明显高于对照组,差异有统计学意义(P<0.05)。其中以鼻黏膜充血、肿胀及鼻中隔黏膜糜烂最为多见,鼻中隔黏膜糜烂多见于T3、T4组。结论铬对作业人员的鼻部损害是明确的,并随接触时间延长而加重。应加强对作业环境的治理,降低铬浓度,加强个人防护知识教育,提高自我保健意识,相比之下,个性化、系统化的健康管理系统的建立显得尤为重要。

Objective To investigate the hexavalent chromium Cr（VI）of the operating staff nasal damage and its need for the implementation of health management.Methods According to the chromate contacting time,76 workers were divided into T1 group（contact time 〈5 years）,T2 group（contact time 5-10 years）,T3 group（contact time 10-20 years）,T4 group（contact time〉 20 years）,and the 32 administrative support staffs of non-exposure to Cr were as the control group.We used the health questionnaires and physical examination of the chromium to reflect the damage to the nose,the results was done with the statistical analysis.Results The contact groups,nasal symptoms such as abnormal nasal itching,sneezing,stuffy nose,dry nose,nose burning sensation,decreased sensity of smell were significantly higher than the control group（P〈0.05）,and nasal itching,sneezing,stuffy nose symptoms were particularly prevalent in the T1 group;decreased sensity of smell was more common in T4 group;in contact the group nas...更多al abnormal signs such as nasal congestion,swelling,dry,nasal mucosa erosion were significantly higher than the control group（P〈0.05）.Among them,nasal congestion,swelling and nasal septum mucosa erosions were the most commen symptoms,mucosal erosion of nasal septum was particularly prevalent in the T3 and T4 group.Conclusion The nasal damage of the operating staff of contacting-Cr（VI）is clear,and with the extension of contact time the damage is increasing.Operating environment should be strengthened and the concentration of chromium should be reduced,and we should strengthen education,personal safety protection,and enhance the awareness of self-care,at the same time,the personalized,systematic health management system is especially important.