异氰酸酯作业工人职业性支气管哮喘患病情况及其危险因素研究

The prevalence and risk factors of occupational asthma in workers exposed to isocyanate

【摘要】目的研究异氰酸酯作业工人职业性支气管哮喘患病情况及相关危险因素。方法采用横断面研究，选2011年3—6月某企业发泡车间429名异氰酸酯暴露工人为研究对象，通过问卷调查、体检、实验室检查调查职业性支气管哮喘患病率，检测受试者诱导痰中炎性细胞计数，多因素logistic回归分析其可能的危险因素。结果（1）共有366名资料完整者纳入本研究，最终11例诊断为异氰酸酯职业性支气管哮喘，患病率为3．0％。（2）异氰酸酯职业性支气管哮喘工人诱导痰中中性粒细胞计数明显增加[上班前为42．00（34．00，55．00）％，上班后为59．00（51．00，70．00）％；Z=2．940．P〈0．05]。（3）工龄（OR=3．096，P=0．025）、鼻炎（OR=1．901，P=0．008）是异氰酸酯职业性支气管哮喘致病的独立危险因素，采取防护措施（OR=0．074，P=0．015）是其保护因素。结论异氰酸酯接触可导致工人发生中性粒细胞性气道炎症，定期健康检查、采取有效防护措施能降低其职业性支气管哮喘患病率。

Objective To investigate the prevalence of occupational asthma, airway inflammation and analyze the risk factors for workers exposed to isocyanates. Methods A cross-sectional study was applied. Totally 429 isocyanates exposed workers were surveyed and the prevalence of occupational asthma and airway inflammation situation were examined by questionnaire, physical examination and laboratory tests. Multivariate logistic regression was applied to analyze the possible risk factors of isocyanate-induccd occupational asthma. Results （ 1 ） A total of 366 patients with complete data were included in the study, and finally 11 cases were diagnosed as isocyanate-induced occupational asthma with a prevaler^ce of 3.0%. （ 2 ） Neutrophil percentage in the induced sputum of occupational asthma increased significantly [ 42. 00% （ 34. 00% -55.00% ） before work and 59.00% （ 51.00% -70. 00% ） after work （ Z = - 2. 940. P 〈 0. 05 ） ]. （ 3 ） Length of service （ OR = 3. 096 ,P = 0. 025 ） and rhinitis （ OR = 1. 901, P = 0. 008 ） were independent dangerous factors, and protective measures （ OR = 0. 074, P = 0. 015 ） was protective factors to isocyanate- induced occupational asthma. Conclusions Neutrophilie inflammation can be triggered by isoeyanate exposure. Regular health examinations, effective proteetive measures can reduce the prevalence of isocyanate- induced occupational asthma.