某精密铸造企业粉尘接触人员健康状况

Health status of dust-exposed workers in a precision casting enterprise

目的了解精密铸造企业接触锆英砂、矽尘等作业人员健康状况，为制定防治措施提供依据。方法对某市精铸企业176名男性工人（接触含锆尘组18人、非锆尘组109人、无接尘组49人）进行职业健康检查、个人问卷以及职业卫生现场调查，对资料进行统计分析。结果该精铸企业主要职业病危害因素为粉尘和噪声。176人体检异常率为71．02％。接触含锆尘组限制性通气功能障碍、免疫球蛋白IgE增高、丙氨酸转移酶（ALT）增高、碱性磷酸酶（ALP）增高的检出率明显高于非锆尘组，差异均有统计学意义（P〈0．05）；且ALP增高的检出率明显高于无接尘组，差异有统计学意义（P〈0．05）。检出尘肺样改变15例（尘肺病11例，观察对象4例）。其中接触含锆尘组4例（尘肺病3例，观察对象1例），接触非锆尘组11例（尘肺病8例，观察对象3例）。两组尘肺样改变的检出率（20．22％、10．09％）没有明显差异。结论该企业粉尘危害严重。吸入含锆粉尘与呼吸系统损害，尤其是尘肺病的发生有关，可能引起免疫系统功能紊乱、肝功能损害。

Objective To investigate the health status of workers exposed to zircon sand and silica dust in a precision casting enterprise, and to provide a basis for the development of prevention and control measures. Methods Occupational health examination, questionnaire survey, and field investigation of occupational health were performed for 176 male workers （18 workers in the zirconium dust exposure group, 109 in the non- zirconium dust exposure group, and 49 in the non-dust exposure group） in a precision casting enterprise, and a statistical analysis was performed for the data obtained. Results Dust and noise were major hazard factors for occupational diseases in this enterprise. The abnormal rate of physical examination was 71.02%. Compared with the non-zirconium dust exposure group, the zirconium dust exposure group had significantly higher detection rates of restrictive ventilatory dysfunction, increased immunoglobulin IgE, increased alanine aminotransferase, and increased alkaline phosphatase （ALP） （P〈0.05） ; compared with the non-dust exposure group, the zirconium dust exposure group had a significantly higher detection rate of increased ALP（P〈0.05）. Of all workers, 15 were found to have pneumoconiosis-like changes （ 11 had pneumoconiosis and 4 needed observation）, among whom 4 were in the zirconium dust exposure group（3 had pneumoconiosis and 1 needed observation） and 11 were in the non-zirconium dust exposure group （8 had pneumoconiosis and 3 needed observation）. The detection rate of pneumoconiosis-like changes showed no significant differences between the two groups （20.22% vs 10.09%）. Conclusions There was a severe dust hazard in this enterprise. Inhalation of dust containing zirconium is associated with respiratory system injury, especially the development of pneumoconiosis, and it may also cause immune dysfunction and liver impairment.