株洲市硬质合金生产企业工人肺功能状况调查
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摘要
目的了解株洲市硬质合金生产企业作业工人肺功能现状,探索硬质合金粉尘对作业工人肺功能的影响,对硬质合金生产企业工人在岗职业健康检查项目设置进行初步探讨。方法 2016年选取湖南省株洲市2家硬质合金生产企业的426名作业工人作为研究对象,通过问卷调查收集作业工人的基本信息、职业史等;对作业工人进行肺功能检查。按照接尘与不接尘分为暴露组与对照组,暴露组根据暴露粉尘性质分为烧结前、烧结及烧结后两组,了解株洲市硬质合金生产企业各工种肺功能现状。结果暴露组与对照组肺功能检查结果均在正常值范围内;控制抽烟、年龄及工龄等混杂因素,与对照组相比,暴露组肺通气功能指标VC/预计值、FVC/预计值、FEV_1/预计值均显著下降(分别t=-5.69,P<0.001;t=-6.54,P<0.001;t=-6.24,P<0.001);FEV_1/FVC值显著增高(t=8.068,P<0.001),暴露组MEF_(25%)/预计值显著增高(t=2.79,P=0.005),MEF_(50%)/预计值、MMEF/预计值与对照组相比,差异无统计学意义(t=-0.98,P=0.327;t=0.815,P=0.416)。烧结及烧结后工种与烧结前工种作业工人肺小气道功能指标相比较,MEF_(25%)/预计值、MEF_(50%)/预计值和MMEF/预计值均显著升高(分别t=-2.177,P=0.030;t=-2.038,P=0.042;t=-2.321,P=0.021)。结论硬质合金生产企业钨钴粉尘及硬质合金粉尘可导致肺通气功能指标改变;肺小气道功能指标或可成为硬质合金粉尘早期肺损伤的敏感指标;肺小气道功能检查应作为在岗职业健康检查必检项目。
Objective To investigate the pulmonary function of workers in cemented carbide production enterprises in Zhuzhou City,to explore the effect of cemented carbide dust on lung function of the workers,and to preliminarily discuss the setting of occupational health check items for in-service workers in cemented carbide production enterprises.MethodsFour hundred and twenty-six in-service workers selected from two cemented carbide production enterprises in Zhuzhou City,Hunan Province in 2016 served as the research subjects.All the workers’general information and history of occupation were collected through a questionnaire survey,and then their lung function was examined.All the workers were divided into the exposure group and the control group according to exposure and non-exposure to dust.The exposure group was subgrouped into the before sintering group and the sintering and after sintering group according to the properties of exposed-dust.We surveyed the current status of lung function of workers in each type of work in the two cemented carbide production enterprises in Zhuzhou City.ResultsLung function test results of the exposure group and the control group were within the normal range.After smoking,age and length of service and other mixed factors were controlled,pulmonary ventilation function indexes,VC/estimated value,FVC/estimated value and FEV_1/expected value in the exposure group were significantly decreased compared with the control group(t=-5.69,P<0.001;t=-6.54,P<0.001;t=-6.24,P<0.001),while FEV_1/FVC values(t=8.068,P<0.001)and MEF_(25%)/estimated value(t=2.79,P=0.005)were significantly increased.No statistically significant difference was found in MEF_(50%)/estimated value and MMEF/estimated value between the exposure group and the control group(t=-0.98,P=0.327;t=0.815,P=0.416).Compared with the workers engaging in jobs before sintering,pulmonary small airway function indexes,MEF_(25%)/predicted value,MEF_(50%)/expected value and MMEF/predicted value in the workers engaging in sintering and jobs after sintering were significantly increased(t=-2.177,P=0.030;t=-2.038,P=0.042;t=-2.321,P=0.021).ConclusionsTungsten cobalt dust and cemented carbide dust in the carbide production enterprises can lead to changes in the indicators of lung ventilation function.Pulmonary small airway function indicators may be sensitive indexes of early lung injury induced by cemented carbide,and pulmonary small airway function should serve as the necessary inspection items in the occupational health examination during the service.
Objective To investigate the pulmonary function of workers in cemented carbide production enterprises in Zhuzhou City,to explore the effect of cemented carbide dust on lung function of the workers,and to preliminarily discuss the setting of occupational health check items for in-service workers in cemented carbide production enterprises.MethodsFour hundred and twenty-six in-service workers selected from two cemented carbide production enterprises in Zhuzhou City,Hunan Province in 2016 served as the research subjects.All the workers’general information and history of occupation were collected through a questionnaire survey,and then their lung function was examined.All the workers were divided into the exposure group and the control group according to exposure and non-exposure to dust.The exposure group was subgrouped into the before sintering group and the sintering and after sintering group according to the properties of exposed-dust.We surveyed the current status of lung function of workers in each type of work in the two cemented carbide production enterprises in Zhuzhou City.ResultsLung function test results of the exposure group and the control group were within the normal range.After smoking,age and length of service and other mixed factors were controlled,pulmonary ventilation function indexes,VC/estimated value,FVC/estimated value and FEV_1/expected value in the exposure group were significantly decreased compared with the control group(t=-5.69,P<0.001;t=-6.54,P<0.001;t=-6.24,P<0.001),while FEV_1/FVC values(t=8.068,P<0.001)and MEF_(25%)/estimated value(t=2.79,P=0.005)were significantly increased.No statistically significant difference was found in MEF_(50%)/estimated value and MMEF/estimated value between the exposure group and the control group(t=-0.98,P=0.327;t=0.815,P=0.416).Compared with the workers engaging in jobs before sintering,pulmonary small airway function indexes,MEF_(25%)/predicted value,MEF_(50%)/expected value and MMEF/predicted value in the workers engaging in sintering and jobs after sintering were significantly increased(t=-2.177,P=0.030;t=-2.038,P=0.042;t=-2.321,P=0.021).ConclusionsTungsten cobalt dust and cemented carbide dust in the carbide production enterprises can lead to changes in the indicators of lung ventilation function.Pulmonary small airway function indicators may be sensitive indexes of early lung injury induced by cemented carbide,and pulmonary small airway function should serve as the necessary inspection items in the occupational health examination during the service.
引文
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[2]李志辉.硬质合金粉尘暴露对作业工人肺功能及血尿生物指标的影响[D].北京:中国疾病预防控制中心,2016.
[3]Ruokonen EL,Linnainmaa M,Seuri M,et al.A fatal case of hardmetal disease[M].Scand J Work Environ Health,1996,22(1):62-65.
[4]郑劲平,高怡.肺功能检查实用指南[M].北京:人民卫生出版社,2009:63-67.
[5]贺正一.简明临床肺功能测定与应用[M].北京:科学技术文献出版社,2010:37-40.
[6]刘忠玉,张庆蓉,刘健额.硬质合金粉尘对作业工人肺功能的影响[J].预防医学文献信息,2002,8(4):420.
[7]马伏生,邹世渠.硬质合金粉尘对工人小气道通气功能的影响[J].中华劳动卫生职业病杂志,1995,13(2):97-98.
[8]Meyer-Bisch C,Pham QT,Mur JM,et al,Respiratory hazards in hard metal workers:a cross sectional study[J].Br J Ind Med,1989,46(5):302-309.