天津市某钢管制造企业噪声作业工人职业健康状况分析

Analysis on occupational health status of noise exposure workers in a steel pipe manufacturing enterprise in Tianjin

[背景]生产性噪声作为常见的职业病危害因素之一,对我国职业人群的健康影响尤为突出,钢管制造业噪声污染普遍存在,其噪声作业工人的健康状况值得关注。[目的]分析天津市某钢管制造企业噪声环境和噪声作业工人健康状况,为工人职业健康防护提供依据。[方法]收集2019年该企业职业危害因素检测资料及2333名噪声作业工人职业健康体检资料,对作业场所职业危害因素水平及分布情况进行分析。根据工人纯音听力测试结果将高频段3、4、6 kHz任一频率听阈≥40 dB者纳入高频听损组,将<40 dB者纳入听力正常组,采用t检验和χ^2检验对两组职工心电图、肝功能、血压、血脂、血糖等体检指标的差异进行统计学分析。[结果]2333名噪声作业工人中男性2327人,女性6人,平均年龄为(37.16±6.34)岁,平均噪声接触工龄为(10.96±5.57)年。该企业职工接触噪声级为80.0~102.5 dB(A),393个噪声作业岗位中227个岗位(占比57.76%)是单纯噪声暴露岗位,其余岗位与物理因素(高温)或化学毒物(硫化氢、粉尘、有机溶剂)等同时暴露。128个噪声作业岗位(占比32.57%)的噪声强度和5个岗位的粉尘浓度超出职业接触限值,其他危害因素检测结果符合职业接触限值要求。2333名受检工人中高频听损检出率为38.45%,随年龄和噪声接触工龄的增加,高频听损检出率增加(χ^2趋势=222.48,31.13,P<0.01)。高频听损组总胆固醇偏高检出率(35.90%)、甘油三酯偏高检出率(45.04%)和脂肪肝患病率(65.89%)均高于听力正常组(P<0.05)。此外,高频听损组血糖偏高检出率(11.82%)、血压偏高检出率(17.06%)及心电图异常率(18.06%)亦高于听力正常组(P<0.05),其中,高频听损组心电图异常类型主要是ST-T改变和窦性心动过缓,且检出率均高于听力正常组(P<0.05)。[结论]该钢管制造企业噪声污染广泛存在,对噪声作业工人听力和非听觉系统的健康影响不容忽视。

[Background]Productive noise,as one of the common occupational hazards,has a particularly prominent impact on the health of occupational populations in China.Noise pollution is widespread in the steel pipe manufacturing industry,and the health of noise-exposed workers is worthy of attention.[Objective]The study investigates noise levels of a steel pipe manufacturing enterprise in Tianjin and health status of the noise-exposed workers,and provides evidence for the enterprise to carry out occupational health protection work.[Methods]The monitoring results of occupational hazard factors of the enterprise and the occupational health examination data of 2333 noise-exposed workers in 2019 were retrieved,and the levels and distributions of occupational hazard factors in the workplace were analyzed.According to pure-tone hearing test results,the workers with a high-frequency hearing threshold≥40 dB in any frequency of 3,4,and 6 kHz were included in the highfrequency hearing loss group,and the workers with a high-frequency hearing threshold<40 d B were included in the normal hearing group.The differences in electrocardiogram(ECG),liver function,blood pressure,blood lipid,and blood glucose between the two groups were analyzed by t-test and chi-square test.[Results]Among the 2333 noise-exposed workers,there were 2327 males and 6 females.The average age was(37.16±6.34)years,and the average noise exposure working age was(10.96±5.57)years.The reported workplace sound pressure level was 80.0-102.5 dB(A),227 out of the 393 noise-exposed workplaces(57.76%)were noise-only workplaces,and the remaining workplaces were additionally exposed to physical factors(high temperature)or chemicals(such as hydrogen sulfide,dust,and organic solvents).The noise levels of 128 workplaces(32.57%)and the dust concentrations of 5 workplaces exceeded the corresponding occupational exposure limits,and the test results of other hazard factors met the requirements of relevant occupational exposure limits.The detection rate of highfrequency hearing loss in the 2333 workers was 38.45%,and increased with age and years of noise exposure(χ^2trend=222.48,31.13,P<0.01).The detection rates of high total cholesterol(35.90%)and high triglycerides(45.04%)and the prevalence rate of fatty liver(65.89%)in the high-frequency hearing loss group were higher than those in the normal hearing group(P<0.05).In addition,the detection rates of hyperglycemia(11.82%)and hypertension(17.06%)and the abnormal rate of ECG(18.06%)in the high-frequency hearing loss group were also higher than those in the normal hearing group(P<0.05).The abnormal types of ECG in the high-frequency hearing loss group were mainly ST-T changes and sinus bradycardia,and the detection rates of both types were higher than those in the normal hearing group(P<0.05).[Conclusion]Noise pollution is widespread in the selected steel pipe manufacturing enterprise and may have remarkable impacts on the auditory and non-auditory system health of noise-exposed workers.