河南省男性煤矿工人粉尘暴露与高血压发病风险的关联研究

Association between dust exposure and the risk of hypertension of male coal miners in Henan Province

目的探讨粉尘暴露与男性煤矿工人高血压发病的关联。方法采用回顾性队列研究的方法,于2006年1月建立河南省某煤业集团高血压队列。以某煤业集团2006—2017年入矿的所有男性煤矿工人中接触粉尘的掘进工、采煤工、辅助工、混合工4个工种职工作为暴露组,以不接触粉尘的行政后勤部门职工作为对照组。纳入标准为工龄>1年;职业史变动明确,且完整可查;职业健康监护档案完整,诊断可靠。排除标准为进入队列前已明确诊断为高血压的煤矿工人;有严重心、肝、肾疾病及恶性肿瘤者。最终纳入12 647名研究对象(暴露组11 663名;对照组984名)。随访时间为2006年1月至2017年12月,共随访89 259.75人年。采用问卷调查和身体测量方法收集一般人口学特征、职业暴露史和职业健康监护等信息。采用Cox比例风险回归模型分析粉尘暴露与煤矿工人高血压发病风险的关联。结果随访期间,新发高血压2 549例,发病密度为2 855.71/10万人年。暴露组高血压发病密度为2 967.58/10万人年,对照组为1 643.85/10万人年。多因素Cox比例风险回归模型结果显示,调整了婚姻情况、年龄、吸烟、饮酒及体重指数的影响后,与对照相比,粉尘暴露组煤矿工人的高血压发病风险HR(95%CI)值为1.692(1.410~2.032);进一步分析发现,与行政后勤类工种相比,掘进工、采煤工、辅助工的高血压发病风险HR(95%CI)值分别为1.629(1.345~1.973)、1.677(1.374~2.046)、1.782(1.677~1.374)。结论粉尘暴露可能增加煤矿工人高血压的发病风险。

Objective To explore the association between dust exposure and the incidence of hypertension in male coal miners.Methods Using the method of retrospective cohort study,a hypertension cohort of colliery in Henan Province was established in January 2006.From 2006 to 2017,all the male coal miners in a colliery who were exposed to dust were selected into the exposure group including tunneling,mining,auxiliary and combining workers,and workers from administrative logistics departments who were not exposed to dust were selected into the control group.The eligible participants should satisfy following conditions:working more than one year,with clear and complete record of occupation change,and with complete archives and reliable diagnosis of occupational health surveillance.The exclusion criteria of participants were with hypertension at the baseline of study or with heart,liver,kidney diseases and malignant tumors.A total of 12 647 participants were enrolled in this study(11 663 in the exposure group and 984 in the control group).The follow-up period was from January 2006 to December 2017,with a total follow-up of 89 259.75 person-years.Questionnaires and physical measurements were used to collect general demographic characteristics,occupational exposure history and occupational health surveillance data of all participants.The Cox proportional hazards regression model was used to estimate the association between the dust exposure and the incidence of hypertension.Results During the follow-up period,2 549 new-onset hypertension patients were identified with an incidence density of hypertension about 2 855.71 per 100 000 person-years.The incidence density of hypertension was 2 967.58 per 100 000 person-years in the exposure group,and 1 643.85 per 100 000 person-years in the control group.The results of multivariate Cox proportional hazards regression model showed that after the adjustment of marriage,age,smoking,alcohol drinking and body mass index,the risk of hypertension was higher in the exposure group compared with the control group(HR=1.692,95%CI:1.410-2.032).Further analysis showed that compared with workers from administrative logistics departments,the risk of hypertension in tunneling,mining and auxiliary working was 1.629(1.345-1.973),1.677(1.374-2.046)and 1.782(1.475-2.151),respectively.Conclusion Dust exposure may increase the risk of hypertension in male coal miners.