某地区职业病危害因素接触人群的血清胆红素影响因素分析

Analysis of the influencing factors of serum bilirubin in workers exposed to occupational hazards factors in a urban area

目的探讨接触职业病危害因素对职业人群血清胆红素的影响。方法于2019年4月,采用整群抽样方法,选取2017年7月至2019年3月乌鲁木齐市接触职业病危害因素5433人作为研究对象,通过问卷调查和实验室检查获取数据,以单因素χ^(2)检验和Wilcoxon带符号秩和进行检验,并以logistic回归进行多因素分析。结果随年龄增大血清胆红素降低,男性高于女性,汉族高于维吾尔族,未婚高于已婚,差异有统计学意义(P<0.01)。接触职业病危害因素种类不同血清胆红素存在差异,差异有统计学意义(P<0.01);血清总胆红素和直接胆红素异常率为27.60%(1499/5433)、58.20%(3162/5433);多因素logistic回归分析结果表明,接触粉尘化学因素、物理因素是影响血清素胆红素的危险因素(P<0.01)。谷丙转氨酶(ALT)和谷草转氨酶(AST)异常与血清胆红素增高具有一致性。结论接触职业病危害因素可引起血清胆红素升高及肝功转氨酶异常,应加强工作场所职业病危害的防控和职业健康监护工作。

Objective To investigate the effect of exposure to occupational hazard factors on serum bilirubin in workers.Methods In April 2019,using cluster sampling method 5433 workers exposed to occupational hazard factors from July 2017 to March 2019 were screened out by questionnaire and laboratory test,the date of serum bilirubin were used by the logistic regression analysis of single factor card test and wilcoxon band symbol rank and test.Results The bilirubin decreases with age,is higher in male than in female,the han is higher than the uygur,and the unmarried workers is higher than the married one,there was significant difference in the levels of bilirubin between different genders,ages,ethnic groups and marriages(P<0.01).There were statistically significant differences in bilirubin among the occupational hazard factors(P<0.01),the bilirubin level is highest in the exposure to physical factors,followed by chemical factors and dust.The multivariate logistic regression analysis showed that the dust was the main factor affecting bilirubin(ORdusr/TBIL=2.080,95%CI:1.542~2.807,P<0.01).Abnormal alanine aminotransferase(ALT)and alanine aminotransferase(AST)are consistent with elevated bilirubin.Conclusion Exposure to occupational hazard factors may lead to elevated serum bilirubin and abnormal liver function transaminase,the prevention and control of occupational hazards and cccupational health monitoring should be strengthened.