2015—2019年张家港市铸造行业职工健康状况及其影响因素分析

Analysis on health status and influencing factors of workers in foundry industry in Zhangjiagang City from 2015-2019

目的了解张家港市铸造行业职工健康状况及其影响因素,为铸造行业职业病防控提供理论和决策依据。方法选取2015—2019年张家港市铸造行业698名接触铸造粉尘等职业病危害因素的职工,同时选择同企业无职业危害因素接触史293名职工作为对照组,依据职业健康监护技术规范进行相关的职业健康检查,并对结果进行统计分析。结果接害组与对照组比较,心电图异常率差异无统计学意义(P>0.05),血压异常率高于对照组(P<0.05);胸片异常率差异无统计学意义(P>0.05),肺功能异常率高于对照组(P<0.05)。肺功能异常的单因素分析结果显示,与工龄<5年相比,工龄≥15年的职工肺功能异常的风险增高(P<0.05);与心电图正常组相比,异常组职工肺功能异常的风险增高(P<0.05);与造型工段相比,清砂工段组职工肺功能异常的风险增高,铸造工段组职工肺功能异常的风险降低(均P<0.05)。肺功能多因素条件logistic回归分析显示,铸造行业接害工龄≥15年(OR=2.156,95%CI:1.136~4.094)、心电图异常(OR=2.328,95%CI:1.560~3.475)和清砂工段职工(OR=1.778,95%CI:1.166~2.711)发生肺功能异常的风险显著增加(均P<0.05)。结论铸造行业易导致作业人群血压和肺功能异常;工龄长(≥15年)和心电图异常的清砂工段职工肺功能异常率最高。

Objective To understand the health status and influencing factors of workers in foundry industry in Zhangjiagang City,provide theoretical and decision-making basis for the prevention and control of occupational diseases in foundry industry.Methods A total of 698 workers exposed to occupational hazards such as foundry dust were selected from the foundry industry in Zhangjiagang City from 2015-2019,at the same time,293 workers without exposure history of occupational hazards in the same enterprise were selected as the control group. According to the technical specifications of occupational health monitoring,the relevant occupational health examination was carried out, and the results were statistically analyzed. Results There was no statistically significant difference in the abnormal rate of electrocardiogram(ECG) in the exposure group and control group(P>0.05),the abnormal rate of blood pressure was higher than that in the control group(P<0.05). There was no statistically significant difference in the abnormal rate of chest X-ray in the exposure groupand control group(P>0.05),the abnormal rate of pulmonary function was higher than that in the control group(P<0.05). Univariate analysis of pulmonary dysfunction showed that the risk of abnormal pulmonary function in working age ≥15 years group increased as compared with working age <5 years group(P<0.05),the risk of abnormal pulmonary function in abnormal ECG group increased as compared with normal ECG group(P<0.05),the risk of abnormal pulmonary function in the sand cleaning section group increased as compared with the molding section group(P<0.05),and the risk of abnormal pulmonary function in the casting section group decreased as compared with the molding sec-tion group(P<0.05). Multivariate conditional logistic regression analysis of lung function showed that the risk of abnormal pulmonary function was significantly higher in the working age ≥15 years group( OR = 2. 156, 95 % CI : 1. 136-4. 094),abnormal ECG group(OR=2.328,95% CI:1.560-3.475) and sand cleaning section group(OR=1.778,95%CI:1.166-2.711)(all P<0.05). Conclusion Foundry industry is easy to lead to abnormal blood pressure and pulmonary function of workers. The abnormal rates of pulmonary function in workers with long working age (≥15 years) and abnormal ECG are the highest.