韩冬柏, 刘晓宇, 李娜, 许春杰, 郭春月, 尹素凤, 武建辉, 胡泊. 职业性噪声暴露对石油工人甲襞微循环的影响[J]. 环境与职业医学, 2020, 37(4): 348-353. DOI: 10.13213/j.cnki.jeom.2020.19833
引用本文: 韩冬柏, 刘晓宇, 李娜, 许春杰, 郭春月, 尹素凤, 武建辉, 胡泊. 职业性噪声暴露对石油工人甲襞微循环的影响[J]. 环境与职业医学, 2020, 37(4): 348-353. DOI: 10.13213/j.cnki.jeom.2020.19833
HAN Dong-bai, LIU Xiao-yu, LI Na, XU Chun-jie, GUO Chun-yue, YIN Su-feng, WU Jian-hui, HU Bo. Effect of occupational noise exposure on nailfold microcirculation of petroleum workers[J]. Journal of Environmental and Occupational Medicine, 2020, 37(4): 348-353. DOI: 10.13213/j.cnki.jeom.2020.19833
Citation: HAN Dong-bai, LIU Xiao-yu, LI Na, XU Chun-jie, GUO Chun-yue, YIN Su-feng, WU Jian-hui, HU Bo. Effect of occupational noise exposure on nailfold microcirculation of petroleum workers[J]. Journal of Environmental and Occupational Medicine, 2020, 37(4): 348-353. DOI: 10.13213/j.cnki.jeom.2020.19833

职业性噪声暴露对石油工人甲襞微循环的影响

Effect of occupational noise exposure on nailfold microcirculation of petroleum workers

  • 摘要: 背景

    在我国,噪声是石油工人作业场所中存在的主要职业有害因素之一,长期接触可能会引发微循环功能障碍,进而引发多种心脑血管疾病。

    目的

    探讨职业性噪声暴露对石油工人甲襞微循环的影响。

    方法

    以2018年5-10月某石油企业参加职业健康体检的工人为研究对象,共1 104名石油工人纳入本次调查,涉及的岗位有注水岗、外输岗、井下作业岗、电气焊岗、加热岗和化验岗等。通过面对面询问的方式进行问卷调查,内容包括:性别、年龄、文化程度等社会人口学资料,吸烟、饮酒和体育锻炼等生活行为习惯,工龄、倒班和噪声接触史等职业因素。测量调查对象身高、体重。由经过培训的研究员采集甲襞微循环图像和视频数据,采用双人盲法诊断甲襞微循环障碍;根据是否连续暴露于噪声每天8 h或每周40 h噪声暴露等效声级≥ 80 dB(A)1年及以上者判定石油工人是否接触噪声。采用多因素logistic回归模型分析职业性噪声暴露对石油工人甲襞微循环的影响。

    结果

    1 104名石油工人年龄范围为19~64岁,男性占66.2%。石油工人甲襞微循环障碍发生率为33.8%,噪声组甲襞微循环障碍发生率(42.4%)高于对照组(21.4%)(P < 0.001)。不同性别、年龄、体重指数(BMI)、吸烟、饮酒、体育锻炼、工龄和倒班的石油工人甲襞微循环障碍发生率不同(P < 0.05),其中,男性、BMI ≥ 28.0 kg·m-2、吸烟、饮酒、无体育锻炼和倒班的石油工人甲襞微循环障碍发生率高于各自的参照组,差异有统计学意义(P < 0.05)。工龄20~30年的石油工人甲襞微循环障碍发生率最低(28.1%)。调整性别、年龄、BMI、吸烟、饮酒、体育锻炼和倒班后,多因素logistic回归结果显示:接触噪声的石油工人甲襞微循环障碍发生的风险是不接触噪声的2.50倍(95%CI为1.86~3.36)。

    结论

    噪声可能是石油工人甲襞微循环障碍的重要危险因素。

     

    Abstract: Background

    In China, noise is one of the major occupational harmful factors in the workplace of petroleum workers, and long-term exposure to noise can cause microcirculation disorder and further several cardiovascular diseases.

    Objective

    This study explores the effects of occupational noise exposure on nailfold microcirculation in petroleum workers.

    Methods

    A total of 1 104 petroleum workers who received annual occupational health examination of a petroleum company from May to October 2018 were enrolled for this study. The workstations of the petroleum workers included water injection, external transport, underground operation, electrical welding, heating, and laboratory. Socio-demographic characteristics (such as sex, age, and education level), lifestyle behaviors (such as smoking, drinking, physical exercise), and occupational factors (such as seniority, shift work, and history of noise exposure) were collected through a questionnaire survey interviewed face-to-face. Height and body weight were also measured. Nailfold microcirculation images and videos were recorded by trained researchers, and two independent physicians provided blinded diagnostic evaluations on nailfold microcirculation. The petroleum workers were divided into a noise group and a control group based on whether they were continuously exposed to noise for 1 year or more8 h per day or 40 h per week equivalent sound pressure level ≥ 80 dB (A). A multi-factor logistic regression model was used to analyze the effect of occupational noise exposure on nailfold microcirculation in the petroleum workers.

    Results

    Of the 1 104 participants, the range of age was 19-64 years, and most were male (66.2%). The prevalence rate of nailfold microcirculation disorder in the petroleum workers was 33.8%. The prevalence rate of nailfold microcirculation disorder was higher in the noise group than in the control group (42.4% vs 21.4%, P < 0.001). The prevalence rates of nailfold microcirculation disorder were different among the petroleum workers of different sex, age, body mass index (BMI), smoking, drinking, physical exercise, seniority, and shift work groups (P < 0.05). The prevalence rates of nailfold microcirculation disorder were higher in male, BMI ≥ 28.0 kg·m-2, smoking, drinking, non-physical exercise, and shift work groups than in their respective reference groups (P < 0.05). The prevalence rate of nailfold microcirculation disorder was the lowest in the group of 20-30 years of working age (28.1%). After adjusting for sex, age, BMI, smoking, drinking, physical exercise, and shift work, the multi-factor logistic regression results showed that the OR (95%CI) of nailfold microcirculation disorder was 2.50 (1.86-3.36) for those with noise exposure versus those without.

    Conclusion

    Noise may be an important risk factor of nailfold microcirculation disorder of petroleum workers.

     

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