成都市某单位粉尘接尘工人健康损害的危险因素及预防对策

Risk factors and preventive measures of health damage among dust exposed workers in an enterprise of Chengdu City

目的探讨粉尘对接尘工人健康损害的危险因素及预防对策。方法以成都市某单位2014年的467名粉尘作业人员(接尘组)与280名非粉尘作业人员(对照组)为研究对象,对比两组人员的高仟伏胸片检查结果,采用多因素logistic回归分析粉尘作业人员健康损害的危险因素,并制定针对性预防对策,于2015年实施。比较该单位2014与2015年接尘工人高仟伏胸片结果异常率。结果 2014年接尘组高仟伏胸片结果异常率为16.06%(75/467),显著高于对照组6.43%(P<0.05)。高仟伏胸片结果异常主要表现为肺纹理增多、肺阴影、疑似肺结核与尘肺。接尘组用力肺活量(FVC)、第1秒末用力呼气量(FEV_(1.0))、第1秒肺活量占用力肺活量的比例(FEV_(1.0)/FVC)分别为(3 678.56±118.94)ml、(2 869.55±102.47)ml、(78.01±9.11)%,均低于对照组(P<0.01)。接尘组年龄≥35岁、工龄≥5 a、每天吸烟≥15支者所占比例分别为61.03%、74.95%、55.25%,均高于对照组(P<0.05)。2015年该单位接尘工人的高仟伏胸片异常率为5.71%,低于2014年的16.06%(P<0.05)。实施预防对策后2015年接尘作业人员的FVC、FEV_(1.0)、(FEV_(1.0)/FVC)%分别为(3 867.57±104.66)ml、(3 159.80±105.87)ml、(81.70±8.53)%,均高于实施前(P<0.01)。结论粉尘对接尘工人的健康损害检出率较高,对年龄稍大(≥35岁)、长工龄(≥5 a)接尘作业工人进行个人监护措施并及时更换岗位、积极倡导戒烟,有助于改善该部分人群的肺功能,降低身体损害风险。

[Objective] To explore the risk factors and preventive measures for health damage of dust exposed workers.[Methods]A total of 467 dust exposed workers（dust-exposed group）and 280 non-dust exposed workers（control group）in an enterprise of Chengdu City in 2014 were selected as study objects,and the high-kV chest radiograph of the two groups were compared. Multivariate logistic regression was used to analyze the risk factors of health damage in dust exposed workers,to develop preventive measures. After the measures were implemented in 2015,the abnormal high rate of high-kV chest radiographs in 2014 and 2015 were compared.[Results] The abnormal high rate of high-kV chest radiograph in dust-exposed group was 16.06%（75/467）,which was higher than that in control group（6.43%）significantly（P〈0.05）. The abnormal results of high-kV chest radiograph were mainly manifested as increased lung markings,lung shadow,suspected pulmonary tuberculosis and pneumoconiosis. The forced vital capacity（FVC）,the forced expiratory volume in the first second（FEV1.0）,the ratio of one-second forced expiratory volume to forced vital capacity（FEV1.0/FVC %） in dust-exposed group was respectively（3 678. 56 ± 118. 94） ml,（2 869.55±102.47）ml and（78.01±9.11）%,which were lower than those in control group（P〈0.05）. The proportion of workers who were over 35 years old,had the working age longer than 5 years and smoked more than 15 cigarettes per day in dust-exposed group was respectively 61.03%,74.95% and 55.25%,which were higher than those in control group（P〈0.05）. The abnormal rate of high-kV chest radiograph in dust exposed workers in 2015 was 5.71%,which was lower than that in 2014（16.06）significantly（P〈0.05）. After the implementation of preventive measures in 2015,the FVC,FEV1.0 and FEV1.0/FVC% in dust exposed workers was respectively（3 867.57±104.66）ml,（3 159.80±105.87）ml and（81.70±8.53）%,which were higher than those before the implementation（P〈0.01）.[Conclusion]The detection rate of health damage among dust exposed workers is high. To carry out the personal surveillance measures,appropriately replace position,and actively advocate smoking cessation among the dust exposed workers who are elderly（≥35 years old）and have longer working age（≥5 years）are helpful for improving their lung function and reducing the risk of health damage.