焦炉工人神经行为改变及其影响因素研究

Research on Neurobehavioral Change of Coke Oven Workers and Its Influencing Factors

[目的]探讨焦炉作业环境对焦炉工人神经行为的影响及其影响因素。[方法]选取某焦化厂198名焦炉作业工人为暴露组(炉底工23人,炉侧工85人,炉顶工90人);该厂气防员等非焦化作业工人145名为对照组。高效液相色谱法测定作业环境中的B(a)P和尿1-羟基芘浓度。调查表采集个人信息。采用WHO推荐的神经行为核心测试组合(NCTB)对研究对象的情感状态和神经行为功能进行测试。[结果]炉顶、炉侧、炉底暴露组和对照组作业环境的B(a)P浓度分别为(0.21±0.02)、(0.05±0.005)、(0.02±0.01)和(0.01±0.00)μg/m^3,工人尿1-羟基芘浓度分别为(10.47±3.72)、(3.80±2.45)、(1.86±2.19)和(1.62±1.91)μmol/mol肌酐。炉顶工人紧张-焦虑、愤怒-敌意、有力-好动、慌乱-迷惑、平均反应时间、最快反应时间、最慢反应时间、数字跨度(顺序)、数字跨度(倒序)、数字跨度(总体)、提转捷度(非习惯用手)、数字译码、视觉记忆、目标追踪(正确数)和目标追踪(总数)15项行为得分与对照组相比差异有统计学意义(P<0.05);炉侧工人愤怒-敌意、有力-好动、数字跨度(顺序)、数字跨度(倒序)、数字跨度(总体)、数字译码、目标追踪(正确数)和目标追踪(总数)8项行为得分与对照组相比差异有统计学意义(P<0.05);炉底工人平均反应时间行为得分与对照组相比差异有统计学意义(P<0.05)。多元线性回归分析显示,尿1-羟基芘水平与紧张-焦虑、慌乱-迷惑、平均反应时间、数字跨度(顺序)、数字跨度(倒序)、数字跨度(总体)、数字译码和目标追踪总数8项行为得分呈负相关;与有力-好动得分呈正相关。年龄、工龄、吸烟、饮酒、文化程度和夜班等因素分别与焦炉工人相应神经行为得分相关。[结论]焦炉作业环境可导致焦炉工人神经行为改变,与外暴露水平有关。尿1-羟基芘、年龄、工龄、吸烟、饮酒、文化程度和夜班为焦炉工人神经行为改变的主要影响因素。

[ Objective ] To explore the influence of working at coke oven on the neurobehavioral change of the workers and its influencing factors. [ Methods ] Altogether 198 coke oven workers were selected as exposure groups （ including 23 workers at oven bottom, 85 at oven side and 90 at oven top ）, and 145 workers of this plant never worked at coke oven such as water treatment workers were selected as control group. Levels of B （ a ）P in the working environment and urinary 1-hydroxypyrene of the workers were determined using high pressure liquid chromatography. Personal information was collected by questionnaire. Profiles of mood state and neurobehavioral of the objectives were tested and studied using ＂neurobehavioral core test battery＂（ NCTB ）recommended by WHO. [ Results ] The B （ a ） P concentrations of the working environment of oven top group, oven side group, oven bottom group and control group were （ 0.21 ± 0.02 ）, （ 0.05 ± 0.005 ）, （ 0.02 ± 0.01 ） and （ 0.01 ± 0.00 ） μg/m^3 respectively. The urinary 1-hydroxypyrene concentration of the workers were （ 10.47 ± 3.72 ）, （ 3.80 ± 2.45 ）, （ 1.86 ±2.19 ） and （ 1.62 ± 1.91 ） μmol/molCr respectively. Scores of 15 mood and neurobehavioral indicators including tension-anxiety （ POMST ）, anger-hostility （ POMSA ）, vigor-activity （ POMSV ）, confusion-bewilderment （ POMSC ）, average simple reaction time （ SRT ）, fastest simple reaction time （ SRTF ）, slowest simple reaction time（ SRTS ）, forward digital span（ DSPF ）, backward digital span（ DSPB ）, digital span（ DSP ）, Santa Ana with non-habitual hand （ SANN ）, digit symbol test （ DSY ）, Benton visual retention （ BVR ）, correct pursuit aiming （ PAC ） and pursuit aiming （ PA ） in the oven top group were significantly different from control group （ P 〈 0.05 ）. Scores of 8 indicators（ POMSA, POMSV, DSPF, DSPB, DSP, DSY, PAC and PA ）in the oven side group were significantly different from control group（ P〈0.05 ）. Score of the SRT in oven bottom group was significantly different from control group（ P〈0.05 ）. Multiple linear regression analysis indicated that urinary 1-hydroxypyrene levels were negatively correlated with 8 neurobehavioral scores （ POMST, POMSC, SRT, DSPF, DSPB, DSP, DSY and PA ）, but positively correlated with POMSV. The scores of the neurobehavioral test in coke oven workers were related with age, length of service, smoking, alcohol, education and night shift. [ Conclusion ] Coke oven workers＇ working environment could lead to their neurobehavioral changes, which was related with the level of environmental exposure. Urinary 1-hydroxypyrene, age, length of service, smoking, alcohol, education and night shift were the main factors for the neurobehavioral changes of coke oven workers.