三硝基甲苯所致白内障患病情况调查
Prevalence of Cataract Induced by Trinitrotoluene
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摘要:
目的 对三硝基甲苯(trinitrotoluene,TNT)致白内障的患病情况进行调查,探讨TNT 白内障临床特点及发病与工种和工龄的关系,并对晶状体摄影留档。 方法 对某厂452 例TNT 作业工人,常规外眼检查后复方托品酰胺滴眼3 次至双眼瞳孔散大7~8 mm,用裂隙灯显微镜观察晶状体,同时用裂隙灯显微镜对患者进行晶状体摄影。诊断及分级使用GBZ 45-2010《职业性三硝基甲苯白内障诊断标准》。 结果 452 名作业人员中,符合TNT 白内障观察对象标准者185 例;确诊TNT 白内障者132 例,根据TNT 不同分期,壹期97 例、贰期27 例、叁期8 例,TNT 白内障总患病率为29.20%,晶状体混浊检出率为70.13%(317/452)。随着工龄的增长,TNT 白内障患病率逐渐升高,工龄分布以工作25年以上者为最高,且各工龄段的白内障检出率差异有统计学意义(χ2=80.60,P< 0.01)。TNT 白内障的岗位分布以混药工最高,其患病率的性别差异无统计学意义。 结论 TNT 白内障患病率与工种关系密切,且随工龄的增加和接触TNT时间延长而升高。晶状体摄影能够作为确诊重要证据,可更好的帮助职业病诊断工作者准确地完成职业性三硝基甲苯白内障诊断。 Abstract:Objective To survey the prevalence of cataract induced by trinitrotoluene(TNT), describe the clinical characteristics of TNT cataract, assess the relationship of its occurrence with job title and length service, and also record lens photography at the same time. Methods TNT-exposed workers(n=452) in a factory were invited to a regular external eye examination. Followed by applying the compound tropicamide drops three times till pupils dilating to 7-8 mm, lens were observed and photographed with a slit lamp microscope. Diagnosis and classification of cataract were followed the Diagnostic criteria of occupational trinitrotoluene cataract(GBZ 45-2010). Results Among the 452 workers investigated, 185 cases required clinic observation and 132 cases were diagnosed with TNT cataract, including 97 cases at stage I, 27 cases at stage II, and 8 cases at stage III, with a total prevalence rate of 29.20%. The positive rate of lens opacity was 70.13%(317/452). With the length of service grew, the prevalence rate of TNT cataract also increased. Specifically, the highest prevalence rate was found in the group with greater than 25 years of length of service and in the mixing task group. There were differences by length of service(χ2=80.60, P< 0.01). No statistical difference was found by gender. Conclusion The prevalence of TNT cataract is closely related to job titles and rises with the increasing of length of service and the duration of TNT exposure in the selected factory. Lens photographs provide important evidence to accurately diagnose TNT cataract.
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