某市苯系物接触工人职业性苯中毒的特征调查及危险因素分析

Investigation on characteristics and risk factors of occupational benzene poisoning among workers exposed to benzene series in a city

目的对某市苯系物接触工人职业性苯中毒的特征进行调查并分析其危险因素。方法以2018年1月-12月某市13 748名在职苯系物接触工人为研究对象,收集其人口学资料、职业史及职业健康检查结果。观察职业性苯中毒病例与非职业性苯中毒病例的特征差异,采用非条件logistic回归法分析职业性苯中毒的危险因素。结果 13 748名在职苯系物接触工人的白细胞计数、血小板计数、中性粒细胞计数、红细胞计数、血红蛋白平均表达水平均符合《血细胞分析参考区间》的偏低限值标准.符合严重偏低限值标准的人数,占比较低(0.06%~0.18%);符合偏低限值标准的人数,占比较高(6.66%~9.80%)。13 748名在职苯系物接触工人中,检出职业性苯中毒314例(2.28%),其中312例为慢性轻度苯中毒,2例为中度苯中毒,无重度苯中毒病例。职业性苯中毒病例中接苯工龄越高(3~10 a、>10 a)、私有企业、企业规模越小(中、小型企业)、涉苯一线作业人员病例数占比高于非职业性苯中毒病例(P<0.05)。经logistic分析可知,接苯工龄为3~10 a和>10 a、小型企业、涉苯一线作业人员均是苯系物接触工人职业性苯中毒的独立危险因素。结论虽然该市苯系物接触工人职业性苯中毒病例的检出比例不高,但接触工人职业性苯中毒病例的相关血常规指标异常检出比例较高,应针对上述危险因素加强防控,降低职业性苯中毒的发生风险。

Objective To investigate and analyze the characteristics and risk factors of occupational benzene poisoning in workers exposed to benzene series in a city.Methods From January to December 2018,a total of 13748 on-the-job workers exposed to benzene series in a city were selected as research subjects, and demographic information, occupational history and occupational health examination results were collected. To observe the characteristic difference between occupational and non-occupational benzene poisoning cases, the risk factors of occupational benzene poisoning were analyzed by non-conditional logistic regression. Results The white blood cell count, platelet count, neutrophil count, red blood cell count and average hemoglobin expression level of 13,748 on-the-job benzene series exposed workers exposed to benzene series all met the lower limit standard of reference interval for Blood cell analysis. The number of people meeting the standard of severely low limit is relatively low(0.06%~0.18%);the number of people who met the lower limit standard accounted for a relatively high proportion(6.66%~9.80%).Among 13,748 on-the-job benzene series exposed workers, 314 cases(2.28%)of occupational benzene poisoning were detected, including 312 cases of chronic mild benzene poisoning, 2 cases of moderate benzene poisoning, and no cases of severe benzene poisoning. Among the cases of occupational benzene poisoning, the proportion of cases withhigh exposure years(3-10 years, >10 years),andtheproportion of cases working inprivate enterprisesand inmedium and small enterprises,and the proportion of cases of benzene related front-line workers were higher than that of non-occupational benzene poisoning(P<0.05). According to Logistic analysis, Benzene exposure workers with a working age of 3-10 a and >10 a, small enterprises, benzene related front-line workersall are independent risk factors of occupational benzene poisoning in workers exposed to benzene series. Conclusions Although thecitydetection rate of occupational benzene poisoning cases in the workers exposed to benzene series is not high, the abnormal detection rate of blood routine indexes related to occupational benzene poisoning in the workers exposed to benzene series is high, so prevention and control measurementshould be strengthened to reduce the risk of occupational benzene poisoning.