唐山市某钢铁厂高温作业工人膳食营养状况调查

Nutrition survey of workers with occupational heat exposure in a steel plant in Tangshan

[目的]调查和分析唐山市某钢铁厂高温作业工人的膳食摄入情况及体内营养素水平。[方法]采用整群随机抽样方法,调查唐山市某钢铁厂高温作业工人226人。根据高温环境测定结果将工人岗位分为高温作业Ⅲ级和Ⅳ级;对工人进行一般状况调查、体格检查、膳食状况调查、体内营养素水平检测和评价。[结果]体重正常、超重、肥胖和消瘦的工人分别占调查工人总数的52.2%、29.6%、15.9%和2.2%。钢铁厂高温作业工人每日摄入的食物以谷薯类为主,占食物摄入总量的32.8%;其次为蔬菜类、水果类、畜禽肉类、大豆及坚果类、蛋类、油类、奶及奶制品类、水产类和盐类,分别占食物摄入总量的26.1%、18.1%、8.3%、5.3%、4.0%、2.3%、1.8%、1.0%和0.3%。工人对水、抗坏血酸、核黄素、维生素A、钾、钙、硒的摄入低于高温作业建议摄入量(均P<0.05),分别占高温作业建议摄入量的32.5%~49.4%、56.7%~78.5%、52.2%~70.6%、51.0%、76.6%~89.1%、64.6%、95.9%;Ⅳ级高温作业工人水的摄入量高于Ⅲ级高温作业工人(P<0.05)。高温作业工人的抗坏血酸、钾、钠、维生素A、锌、核黄素、铁、钙的缺乏率分别为95.6%、57.1%、42.0%、41.1%、38.5%、31.9%、31.0%、26.1%。Ⅳ级高温作业工人的核黄素、钾、钠、钙、铁、锌的体内缺乏率高于Ⅲ级高温作业工人(均P<0.05)。[结论]钢铁厂高温作业工人水、抗坏血酸、核黄素、维生素A、钾、钙、硒的摄入不足;95.6%工人体内抗坏血酸缺乏,维生素A、钾、钠的体内缺乏率均在40%以上。需要对高温作业工人进行营养指导以改善其膳食结构,并根据高温作业等级进行工间液体补充。

[Objective] To investigate and analyze the dietary intake and nutrition level of workers exposed to heat stress in a steel plant in Tangshan.[Methods] A total of 226 workers with occupational heat exposure were selected from a steel plant in Tangshan by cluster random sampling method, and were classified into grade Ⅲ and grade Ⅳ heat stress groups according to the detection results of workplace temperature. The general information, physical examination data, surveyed dietary information, nutritional levels were collected or estimated.[Results] The workers with normal weight,overweight, obesity, and marasmus accounted for 52.2%, 29.6%, 15.9%, and 2.2% of the total surveyed workers, respectively. The daily intake of the steel workers was dominated by grain which accounted for 32.8% of the total intake. Vegetables, fruits, meat, beans and nuts, eggs, oil, milk and dairy products, aquatic products, and salt accounted for 26.1%, 18.1%, 8.3%, 5.3%, 4.0%, 2.3%, 1.8%, 1.0%, and 0.3% of the total food intake, respectively. The intakes of water, ascorbic acid, riboflavin, vitamin A, potassium, calcium, and selenium were lower than the recommended intakes for workers with occupational heat exposure（Ps 0.05）, accounting for 32.5%-49.4%, 56.7%-78.5%, 52.2%-70.6%, 51.0%, 76.6%-89.1%, 64.6%, and 95.9% of corresponding recommended intakes. The water intake of grade Ⅳ heat stress workers was higher than that of grade Ⅲ heat stress workers（P〈0.05）. The deficiency rates of ascorbic acid, potassium, sodium, vitamin A, zinc, riboflavin, iron, and calcium of the workers were 95.6%, 57.1%, 42.0%, 41.1%, 38.5%, 31.9%, 31.0%, and 26.1%, respectively. The deficiency rates of riboflavin, potassium, sodium, calcium, iron, and zinc in the grade Ⅳ heat stress workers were higher than those of the grade Ⅲ heat stress workers（P〈0.05）.[Conclusion] Water, ascorbic acid, riboflavin, vitamin A, potassium, calcium, and selenium intakes are deficient in the steel workers with occupational heat exposure. Specifically, 95.6% of the workers lack ascorbic acid and more than 40% of the workers lack vitamin A, potassium, and sodium. It is necessary to improve dietary structure of heat stress exposed workers by proper nutrition guidance and provide liquid supplement during work according to heat stress work classification.