职业性高温暴露对男性钢铁工人肾功能的影响
Effects of occupational high temperature exposure on renal function in male steel workers
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摘要:
目的 探讨职业性高温暴露对男性钢铁工人肾功能异常的影响，为男性钢铁工人肾功能异常的防治提供理论依据。
方法 以某钢铁集团2015年10月-2016年5月进行职业健康检查的4 992名男性钢铁工人作为研究对象，采用面对面调查方式收集工人的社会人口学特征、生活方式、职业性高温接触史等，并采集血样检测血肌酐，根据血肌酐估算肾小球滤过率，判断肾功能是否异常。采用χ2检验、多因素非条件logistic回归和限制性立方样条模型，分析职业性高温暴露及暴露年限对男性钢铁工人肾功能异常的影响。
结果 共4 400人纳入分析。在控制了年龄、文化程度、人均月收入、食盐摄入、吸烟、饮酒、体育锻炼各因素后， < 50岁的男性钢铁工人职业性高温暴露对肾功能异常有影响（P < 0.05），OR（95% CI）为1.85（1.16~2.95）。限制性立方样条分析结果显示：高温暴露年限与肾功能异常有关（χ2=8.45，P < 0.05），且呈非线性关系（χ2=5.44，P < 0.05）；高温暴露年限低于20.5年时，肾功能异常风险呈逐渐增加的趋势，到20.5年以后呈下降趋势。
结论 < 50岁的男性钢铁工人职业性高温暴露对肾功能异常有影响，且高温暴露年限与肾功能异常呈先增加后减少的非线性关系。
Abstract:Objective To assess the effects of occupational high temperature exposure on abnormal renal function in male steel workers, and to provide a theoretical basis for protection of rental function of this occupational group.
Methods A total of 4 992 male steel workers from a steel group who received occupational health examination from October 2015 to May 2016 were selected as study subjects. A face-to-face questionnaire survey was conducted to collect demographic characteristics, lifestyle, and occupational high temperature exposure history. Blood samples were also collected to detect serum creatinine and calculate glomerular filtration rate adjusted by serum creatinine to estimate renal function. The effects of exposure to occupational high temperature and exposure years on abnormal renal function were analyzed by chi-square test, multiple logistic regression model, and restricted cubic spline model.
Results A total of 4 400 workers were included in the analysis. After controlling age, educational level, per capita monthly in come, salt intake, smoking, alcohol consumption, and physical exercise, occupational high temperature exposure affected abnormal renal function in the male workers aged < 50 years (OR=1.85, 95%CI:1.16-2.95, P < 0.05). Restricted cubic spline model analysis results showed that high temperature exposure duration was associated with abnormal renal function (χ2=8.45, P < 0.05), showing a nonlinear dose-response relationship (χ2=5.44, P < 0.05). The risk of abnormal renal function increased gradually for < 20.5 years of occupational high temperature exposure, and decreased for >20.5 years.
Conclusion Of the male steel workers aged < 50 years, occupational high temperature exposure may induce abnormal renal function, and there is a nonlinear dose-response relationship of high temperature exposure duration with abnormal renal function, showing a first-increasing-then-decreasing trend.
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