京藏铁路列车乘务人员高原习服调查研究
Altitude Acclimatization of Coach Attendants Serving Beijing-Tibet Railway
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摘要:
目的 通过跟踪监测高原列车乘务人员相关生理指标变化,分析乘务人员高原适应性及影响因素,为高原乘务人员的健康监护及指定作业方式提供依据。 方法 随机对一列京藏线列车98 名乘务人员全程监测血氧饱和度(SaO2)、眼压、眼底情况及Lake Louise 急性高原病(AMS)自评评分。 结果 车厢内氧分压及乘务员血氧饱和度与海拔高程呈负相关性,94 人发生不同程度AMS,在岗时间短及劳动强度大的人群AMS 较明显(P<0.05),83 人出现视网膜静脉扩张,21 人出现视乳头充血水肿。 结论 现行列车富氧措施不能完全防止AMS 的发生;在岗时间及劳动强度均对乘务员高原适应性有影响;视网膜血管改变可作为AMS 重要指征。 Abstract:Objective To assess the high altitude adaptability of railway coach crew members and its influencing factors by monitoring their physiological parameters, and to provide reference for future occupational health supervision and work arrangement guidance. Methods Pulse oximeter, tonometer, fundus photography, and Lake Louise self-assessment questionnaires were performed on 98 randomly selected coach attendants during the entire journey to examine saturation oxygen (SaO2), intraocular pressure, fundus conditions, and occurrence of acute mountain sickness (AMS). Results The oxygen partial pressures of the coach compartments and the blood oxygen pressures of the attendants were negatively correlated with altitude. In the 98 studied subjects, AMS was presented in varying degrees in 94 attendants, and the AMS scores were obviously higher for the attendants with shorter on-duty hours and higher workload (P<0.05). Moreover, 83 subjects presented retinal vascular engorgement and 21 subjects presented retinal hemorrhage and papilledema. Conclusion Existing coach oxygen-rich measures cannot sufficiently prevent occurrence of AMS. Both on-duty hours and workload may affect coach attendants' altitude adaptation. Retinal vascular changes can be used as an important indicator of AMS in railway coach attendants.
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