职业性铝暴露对视空间建构能力的影响研究

Effect of occupational aluminum exposure on the visuospatial construction ability

目的探讨铝作业工人视空间建构能力与铝暴露的关系,为铝作业工人职业损害的早期防护提供依据。方法采用整群抽样方法抽取山西省某铝厂442名作业工人为调查对象,收集人口学信息和职业史;采用电感耦合等离子体质谱法检测血铝浓度;采用蒙特利尔认知评估量表(MoCA)中文版的复制立方体测试(CCT)评估视空间建构能力;采用多因素logistic回归模型分析视空间建构能力与血铝浓度的关联。结果调查铝作业工人442人,均为男性,年龄为(43.40±7.31)岁,工龄为(22.64±8.35)年,血铝浓度均值为33.87μg/L。视空间建构能力受损206人,占46.61%;其中血铝浓度>33.87μg/L 127人,占61.65%;受教育年限6~<10年190人,占92.23%;电解工118人,占57.28%;轮班114人,占55.34%;睡眠质量很好123人,占59.71%。多因素logistic回归分析结果显示,血铝浓度>33.87μg/L(OR=2.490,95%CI:1.531~4.052)、受教育年限≥6年(OR:0.075~0.246,95%CI:0.015~0.622)、工种为非电解工(OR=0.838,95%CI:0.425~0.987)、轮班(OR=1.179,95%CI:1.078~1.435)和睡眠质量很好(OR=0.104,95%CI:0.012~0.896)与视空间建构能力受损存在统计学关联。结论作业工人视空间建构能力受损与铝暴露相关。

Objective To examine the correlation between visuospatial construction ability and occupational aluminum ex⁃posure among aluminum workers,so as to provide the evidence for early protection of occupational injury among alumi⁃num workers.Methods A total of 442 workers in an aluminum factory in Shanxi Province were selected using a clus⁃ter sampling method,and participants'demographic features and occupational history were collected.The blood alumi⁃num concentration was measured using inductively coupled plasma mass spectrometry(ICP-MS),and the visuospatial con⁃struction ability was evaluated with the Cube Copying Test(CCT)of the Chinese version of the Montreal Cognitive As⁃sessment(MoCA).The correlation between the visuospatial construction ability and blood aluminum concentration was ex⁃amined using a multivariable logistic regression model.Results A total of 442 aluminum workers were enrolled,and all participants were male,with a mean age of(43.40±7.31)years,labor service duration of(23.64±8.35)years and a mean blood aluminum concentration of 33.87μg/L.Of all participants,there were 206 workers with impaired visuospa⁃tial construction ability(46.61%),including 127 workers with blood aluminum concentrations of>33.87μg/L(61.65%);190 workers with educational duration of 6 to 9 years(92.23%),118 electrolytic aluminum workers(57.28%),114 work⁃ers with work shifts(55.34%),and 123 workers with a very good sleep quality(59.71%).Multivariable logistic regres⁃sion analysis revealed that blood aluminum concentrations of>33.87μg/L(OR=2.490,95%CI:1.531-4.052),educational duration of 6 years or more(OR:0.075-0.246,95%CI:0.015-0.622),work type as a non-electrolytic aluminum worker(OR=0.838,95%CI:0.425-0.987),work shift(OR=1.179,95%CI:1.078-1.435)and a very good sleep quality(OR=0.104,95%CI:0.012-0.896)significantly correlated with impaired visuospatial construction ability among aluminum work⁃er.Conclusion Impaired visuospatial construction ability correlates with occupational aluminum exposure among alumi⁃num workers.