二甲基甲酰胺职业暴露对作业工人健康影响分析
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摘要
目的探讨二甲基甲酰胺(Dimethylformamide,DMF)职业暴露对作业工人身体健康的影响,提出DMF职业危害的防护措施,预防相关职业病的发生。方法选取2018年南通市7家存在DMF危害因素的企业213名在岗工人作为接触组,对该组工人进行职业健康检查,同时选取2018年261名不接触有毒有害因素的行政和后勤人员作为对照组,对其进行常规健康检查。计数资料的比较采用卡方检验,以P<0.05为差异有统计学意义。结果两组人群中血压、血常规、尿常规、心电图异常率差异无统计学意义(P>0.05)。接触组肝功能异常率和肝功能检出值高于对照组,其中ALT、AST、GGT异常率差异有统计学意义(P<0.05)。接触组肝脏B超脂肪肝检出率高于对照组,差异有统计学意义(P<0.05)。接触组不同工龄间,肝功能异常率和脂肪肝异常率差异无统计学意义(P>0.05)。结论 DMF职业暴露可造成人体肝脏损害。建议加大监管部门对企业的监管力度,改善企业的通风设置,加强劳动者的防护措施,定期职业健康检查,切实保护劳动者的健康。
Objective This study aimed at putting forward protective measures against dimethylformamide(DMF)occupational hazards to prevent occupational diseases through the investigation on the effects of DMF exposure on physical health of workers. Methods The exposure group consisted of 213 onduty workers selected from 7 enterprises with DMF hazards in 2018 in Nantong City and the control group included 261 administrative and support service personnel who were not exposed to toxic and harmful factors in 2018. Occupational health examination was conducted for the exposure group and routine health examination was done for the control group. The results of the physical examination were collated and statistically analyzed with α <0.05 level. Results There were no statistically significant differences in blood pressure, blood routine, urine routine and electrocardiogram between the two groups(P>0.05). The abnormal rate of liver function and the detected value of liver function in the exposure group were higher than that in the control group, and the differences of alanine amiotransferase(ALT), aspartate aminotransferase(AST) and γ-glutamyl transpeptadase(GGT) were statistically significant(P<0.05). The positive rate of fatty liver in the exposure group was higher than that in the control group and the differences were statistically significant(P<0.05). There were no statistically significant differences in the rates of abnormal liver function and the positive rates of fatty liver among different age workers in the exposure group(P>0.05). Conclusion Occupational exposure to DMF could cause the liver damages in human body. It is suggested that supervision departments should tighten the supervision over enterprises, improve the ventilation settings, strengthen the protective measures of workers,and conduct regular occupational health examinations to effectively protect the workers.
Objective This study aimed at putting forward protective measures against dimethylformamide(DMF)occupational hazards to prevent occupational diseases through the investigation on the effects of DMF exposure on physical health of workers. Methods The exposure group consisted of 213 onduty workers selected from 7 enterprises with DMF hazards in 2018 in Nantong City and the control group included 261 administrative and support service personnel who were not exposed to toxic and harmful factors in 2018. Occupational health examination was conducted for the exposure group and routine health examination was done for the control group. The results of the physical examination were collated and statistically analyzed with α <0.05 level. Results There were no statistically significant differences in blood pressure, blood routine, urine routine and electrocardiogram between the two groups(P>0.05). The abnormal rate of liver function and the detected value of liver function in the exposure group were higher than that in the control group, and the differences of alanine amiotransferase(ALT), aspartate aminotransferase(AST) and γ-glutamyl transpeptadase(GGT) were statistically significant(P<0.05). The positive rate of fatty liver in the exposure group was higher than that in the control group and the differences were statistically significant(P<0.05). There were no statistically significant differences in the rates of abnormal liver function and the positive rates of fatty liver among different age workers in the exposure group(P>0.05). Conclusion Occupational exposure to DMF could cause the liver damages in human body. It is suggested that supervision departments should tighten the supervision over enterprises, improve the ventilation settings, strengthen the protective measures of workers,and conduct regular occupational health examinations to effectively protect the workers.
引文
[1]李陆明,王明龙,孙晓楼,等.二甲基甲酰胺作业工人肝肾损害和尿中甲基甲酰胺含量的关系[J].中华劳动卫生职业病杂志,2004,22(3):270-271.
[2]张万里,王国胜,陈翔.职业性暴露二甲基甲酰胺工人的血清胃动素、胃泌素和血管活性肽水平研究[J].浙江预防医学,2014,26(4):345-348.
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[4]高海萍,陆春花,单利玲,等.职业性急性二甲基甲酰胺中毒2例调查分析[J].职业卫生与应急救援,2018,36(5):468-470.
[5]赵娴静,赵允武.二甲基甲酰胺作业工人肝胆脾肾B超影像学改变[J].浙江实用医学,2015,20(4):273-274.
[6]陈惠清,李荣宗,李小亮,等.1例二甲基甲酰胺致职业性慢性中毒性肝病调查[J].中国职业医学,2014,41(3):356-360.
[7]徐胜,姜荣明,朱旭.二甲基甲酰胺累积接触量与肝损伤累积发病的关系[J].职业与健康,2016,32(12):1620-1622.
[8]黄沪涛,张平,李克勇,等.二甲基甲酰胺中毒对机体健康损害的研究进展[J].职业卫生与应急救援,2018,36(5):398-441.
[9]黄志鹏,郭如意,苏智军.二甲基甲酰胺致中毒性肝病的发病机制和临床诊治进展[J].肝脏,2012,17(2):134-136.
[10]Senoh H,Aiso S,Arito H,et al.Carcinogenicity and chronic toxicity after inhalation exposure of rats and mice to N,N-dimethylformamide[J].J Occup Health,2004,46(6):429-439.
[11]仇芳芳,吴超,曹毅,等.2012年杭州市某区二甲基甲酰胺(DMF)职业暴露人群体检资料分析[J].中国初级卫生保健,2014,28(6):93-94.
[12]朱宗铭.二甲基甲酰胺作业人员职业健康检查分析[J].工业卫生与职业病,2014,40(1):50-51.
[13]李德鸿,赵金垣,李涛.中华职业医学[M].北京:人民卫生出版社,2019:847-850.
[14]金莉,龚丽文,陈海婴,等.江西省加油站职工职业健康及个人防护用品使用现状调查[J].公共卫生与预防医学,2014,25(2):38-40.
[2]张万里,王国胜,陈翔.职业性暴露二甲基甲酰胺工人的血清胃动素、胃泌素和血管活性肽水平研究[J].浙江预防医学,2014,26(4):345-348.
[3]毛叶挺,单利玲.二甲基甲酰胺致慢性中毒性肝病1例报告[J].中国工业医学杂志,2016,29(4):316-320.
[4]高海萍,陆春花,单利玲,等.职业性急性二甲基甲酰胺中毒2例调查分析[J].职业卫生与应急救援,2018,36(5):468-470.
[5]赵娴静,赵允武.二甲基甲酰胺作业工人肝胆脾肾B超影像学改变[J].浙江实用医学,2015,20(4):273-274.
[6]陈惠清,李荣宗,李小亮,等.1例二甲基甲酰胺致职业性慢性中毒性肝病调查[J].中国职业医学,2014,41(3):356-360.
[7]徐胜,姜荣明,朱旭.二甲基甲酰胺累积接触量与肝损伤累积发病的关系[J].职业与健康,2016,32(12):1620-1622.
[8]黄沪涛,张平,李克勇,等.二甲基甲酰胺中毒对机体健康损害的研究进展[J].职业卫生与应急救援,2018,36(5):398-441.
[9]黄志鹏,郭如意,苏智军.二甲基甲酰胺致中毒性肝病的发病机制和临床诊治进展[J].肝脏,2012,17(2):134-136.
[10]Senoh H,Aiso S,Arito H,et al.Carcinogenicity and chronic toxicity after inhalation exposure of rats and mice to N,N-dimethylformamide[J].J Occup Health,2004,46(6):429-439.
[11]仇芳芳,吴超,曹毅,等.2012年杭州市某区二甲基甲酰胺(DMF)职业暴露人群体检资料分析[J].中国初级卫生保健,2014,28(6):93-94.
[12]朱宗铭.二甲基甲酰胺作业人员职业健康检查分析[J].工业卫生与职业病,2014,40(1):50-51.
[13]李德鸿,赵金垣,李涛.中华职业医学[M].北京:人民卫生出版社,2019:847-850.
[14]金莉,龚丽文,陈海婴,等.江西省加油站职工职业健康及个人防护用品使用现状调查[J].公共卫生与预防医学,2014,25(2):38-40.