【摘要】：目的以鋼鐵工人為研究對(duì)象,采用回顧性隊(duì)列研究分析倒班與高血壓的關(guān)系,探討開始倒班年齡、倒班年限與高血壓關(guān)聯(lián)程度的劑量-反應(yīng)關(guān)系,從而為鋼鐵企業(yè)工時(shí)制度的建立提供科學(xué)依據(jù)。方法2014年8月至2015年11月,以某鋼鐵企業(yè)進(jìn)行職業(yè)健康體檢的工人作為研究對(duì)象,采用回顧性隊(duì)列研究方法分析倒班與高血壓的關(guān)系。觀察時(shí)間從第一位工人入廠1971年3月起至2015年11月,根據(jù)入廠時(shí)倒班與否分為倒班組和白班組。資料收集包括面對(duì)面問(wèn)卷調(diào)查及職業(yè)健康檔案資料的摘錄,內(nèi)容包括工人的社會(huì)人口學(xué)特征、生活飲食習(xí)慣、高血壓個(gè)人病史和家族史、工作情況以及職業(yè)有害因素的暴露情況等,同時(shí)測(cè)量血壓。采用Epi Data3.1建庫(kù),SPSS19.0、SAS9.1.3進(jìn)行統(tǒng)計(jì)分析。應(yīng)用χ2檢驗(yàn)比較年齡、性別、民族等在倒班和白班兩組間的構(gòu)成;倒班及倒班類型與高血壓關(guān)系的單因素分析應(yīng)用χ2檢驗(yàn),倒班與高血壓關(guān)系的多因素分析應(yīng)用傾向性評(píng)分分層法和多因素Cox回歸;倒班高溫、倒班噪聲的聯(lián)合作用與高血壓的關(guān)系以及退出倒班后對(duì)高血壓的影響應(yīng)用Cox回歸分析;應(yīng)用基于限制性立方樣條的Cox、Logistic回歸模型分析開始倒班年齡、倒班年限與高血壓關(guān)聯(lián)程度的劑量-反應(yīng)關(guān)系。結(jié)果1本研究共收集問(wèn)卷7314份,剔除不合格問(wèn)卷303份,共7011人進(jìn)入研究隊(duì)列,觀察人年為105269.4人年,平均隨訪15.0年。進(jìn)入隊(duì)列年齡為16歲~42歲,平均(22.1±4.0)歲,工齡為1年~43年,平均(15.0±9.6)年,鋼鐵工人高血壓的發(fā)病密度為16.61‰。倒班與白班兩組間年齡、性別、吸煙、飲酒、父親和母親高血壓史、高溫噪聲暴露的構(gòu)成比較,差異有統(tǒng)計(jì)學(xué)意義(P0.05)。兩組間文化程度、民族、婚姻狀況、食鹽情況和體育鍛煉的構(gòu)成比較,差異無(wú)統(tǒng)計(jì)學(xué)意義(P0.05)。2倒班組發(fā)生高血壓的風(fēng)險(xiǎn)為白班組的1.540倍(95%CI:1.381-1.719),歸因危險(xiǎn)度(AR)為5.43‰,歸因危險(xiǎn)度百分比(AR%)為35.06%,人群歸因危險(xiǎn)度(PAR)為3.57‰,人群歸因危險(xiǎn)度百分比(PAR%)為21.49%。3四班三運(yùn)轉(zhuǎn)發(fā)生高血壓的風(fēng)險(xiǎn)為白班的1.601倍(95%CI:1.433-1.790)。4與單純白班相比較,單純倒班、倒班高溫聯(lián)合組、倒班噪聲聯(lián)合組發(fā)生高血壓的風(fēng)險(xiǎn)RR(95%CI)分別為1.599(1.309-1.958)、1.922(1.567-2.357)和1.602(1.429-1.831),差異均有統(tǒng)計(jì)學(xué)意義(P0.05),單純高溫、噪聲組發(fā)生高血壓的風(fēng)險(xiǎn)RR(95%CI)分別為1.087(0.853-1.386)和1.112(0.863-1.432),差異無(wú)統(tǒng)計(jì)學(xué)意義(P0.05)。5開始倒班年齡與高血壓之間的關(guān)聯(lián)程度呈非線性劑量反應(yīng)關(guān)系(χ2=12.30,P0.05)。6倒班年限與高血壓之間的關(guān)聯(lián)程度呈非線性劑量反應(yīng)關(guān)系(χ2=8.15,P0.05),與倒班1年相比較,于15年時(shí)高血壓發(fā)生的風(fēng)險(xiǎn)開始有統(tǒng)計(jì)學(xué)意義。7倒班年限為1~10年時(shí),隨著離開倒班崗位時(shí)間的延長(zhǎng)高血壓發(fā)生的風(fēng)險(xiǎn)RR值降低,當(dāng)?shù)拱嗄晗薮笥诘扔?0年時(shí)發(fā)現(xiàn)同樣結(jié)果。結(jié)論1倒班為高血壓發(fā)生的一個(gè)獨(dú)立危險(xiǎn)因素。2倒班者中發(fā)生的高血壓有35.06%可歸因于倒班;鋼鐵工人中發(fā)生的高血壓有21.49%可歸因于倒班。3將倒班年限控制在15年內(nèi)可降低高血壓的發(fā)生風(fēng)險(xiǎn)。4隨著退出倒班崗位時(shí)間的延長(zhǎng),發(fā)生高血壓的風(fēng)險(xiǎn)下降。
[Abstract]:Objective To study the relationship between shift and hypertension by retrospective cohort study to study the relationship between shift and hypertension, and to provide scientific basis for the establishment of man-time system of iron and steel enterprise. Methods From August 2014 to November 2015, a retrospective cohort study was used to analyze the relationship between the shift and hypertension. The observation time was from March 1971 to November 2015 from the first worker to the factory, and it was divided into the reverse group and the white shift group according to whether the shift was in the factory. The data collection includes a face-to-face questionnaire and an excerpt from the occupational health profile, which includes the social and demographic characteristics of the worker, the life eating habits, the personal history of the hypertension, the family history, the working condition, and the exposure of the occupational harmful factors, while measuring the blood pressure. Statistical analysis was performed using Epi Data3.1 built-in, SPSS19.0, SAS9.1.3. The two groups, such as age, sex, and ethnic group, were used to test the composition of the two groups in the shift and the white shift. The single-factor analysis of the relationship between the shift and the shift and the hypertension was applied to the multi-factor analysis of the relationship between the shift and the hypertension, and the stratified and multi-factor Cox regression was applied to the multi-factor analysis of the relationship between the shift and the hypertension. Cox regression was used to analyze the effect of combined action of high-temperature and reverse-shift noise on hypertension and the effect of withdrawal on hypertension. Cox and Logistic regression model based on restricted cubic spline were used to analyze the start-up age. Dose-response relationship between the degree of shift and the degree of association of hypertension. Results A total of 7314 questionnaires were collected in this study, and 303 of the non-conforming questionnaires were rejected. The total number of 7011 persons was enrolled in the study cohort, with the observation of 105269.4 in human year and the average follow-up of 15.0 years. The age of the access to the cohort was 16 to 42 years. The average age (22.1 to 4.0) was from 1 to 43 years, with an average of 15.0 (9.6) years. The incidence of hypertension among the steel workers was 16.61%. The difference of age, sex, smoking, drinking, father and mother's hypertension and high-temperature noise exposure was statistically significant (P0.05). The risk of hypertension was 1.540 times (95% CI: 1.381-1.719), and the attributable risk (AR) was 5.43%. The percentage of attributable risk (AR%) was 35.06%, the population attributable risk (PAR) was 3.57%, and the percentage of the population attributable risk (PAR%) was 21.49%. The risk of hypertension was 1.601 times (95% CI: 1.433-1.790) in the white class. The RR (95% CI) of hypertension was 1.599 (1.309-1.958), 1.922 (1.567-2.357) and 1.602 (1.429-1.831), respectively. There was no statistical significance (P0.05). The association between the shift age and the hypertension was the non-linear dose-response relationship (Sup2 = 12.30, P0.05). The degree of association between the shift and the hypertension was the non-linear dose-response relationship (Sup2 = 8.15, P0.05). The risk of hypertension at 15 years started to be statistically significant.7-10 years, the risk of increasing the risk of hypertension with the time of leaving the shift post was reduced, and the same result was found when the shift number was greater than or equal to 10 years. Conclusion 1.1-shift is an independent risk factor in the occurrence of hypertension, and 35.06% of the hypertension in the shift group can be attributed to the shift. The high blood pressure in the steel workers is 21.49%, which can be attributed to the shift. The risk of high blood pressure can be reduced within 15 years. The risk of high blood pressure is reduced with the extension of the time of withdrawal.
【學(xué)位授予單位】：華北理工大學(xué)
【學(xué)位級(jí)別】：碩士
【學(xué)位授予年份】：2016
【分類號(hào)】：R544.1

【相似文獻(xiàn)】

相關(guān)期刊論文 前10條

1 陳紀(jì)剛，韋星，猶學(xué)筠，，烏正　，沈安麗;上海輪胎橡膠行業(yè)癌癥的回顧性隊(duì)列研究[J];腫瘤;1995年04期

2 肖建華,肖全華,沈艷梅,伍應(yīng)華;某化工廠惡性腫瘤死亡的回顧性隊(duì)列研究[J];中國(guó)職業(yè)醫(yī)學(xué);2001年05期

3 孫強(qiáng)國(guó),鄧文彥,萬(wàn)松泉,張紅娣,張紅;橡膠工人惡性腫瘤回顧性隊(duì)列研究[J];職業(yè)醫(yī)學(xué);1992年03期

4 穆世惠,羅素瓊,楊華忠,張昌義,張紅芬;大姚縣農(nóng)村疾病死亡回顧性隊(duì)列研究[J];現(xiàn)代預(yù)防醫(yī)學(xué);1998年01期

5 猶學(xué)筠,陳紀(jì)剛,韋星;十二家橡膠廠腫瘤死亡的回顧性隊(duì)列研究[J];中國(guó)工業(yè)醫(yī)學(xué)雜志;1994年01期

6 曲成毅;;回顧性隊(duì)列研究(講座)[J];山西醫(yī)學(xué)院學(xué)報(bào);1982年03期

7 高玉堂，彭靖，鄭葦，朱錫麟，金凡，汪仲賢;關(guān)于肺癌與肺結(jié)核聯(lián)系性的回顧性隊(duì)列研究[J];腫瘤;1995年03期

8 張文昌;高賢章;;福州橡膠廠作業(yè)工人癌死亡回顧性隊(duì)列研究[J];福建醫(yī)學(xué)院學(xué)報(bào);1988年02期

9 范正鵬,來(lái)匡逮,張文魁,文濤,關(guān)寧,常泉爽,黃力,孫本志;化工工人接觸一氧化碳與惡性腫瘤死亡關(guān)系的回顧性隊(duì)列研究[J];職業(yè)醫(yī)學(xué);1991年04期

10 李劍虹;任澤萍;陳波;米生權(quán);李保蒿;李劍華;董建群;;成人超重和肥胖10年回顧性隊(duì)列研究[J];中國(guó)慢性病預(yù)防與控制;2012年06期

相關(guān)會(huì)議論文 前1條

1 易建生;楊秀桉;唐紅;;××鉆探工程有限公司鉆井作業(yè)員工身體健康狀況3年回顧性隊(duì)列研究[A];第六屆預(yù)防醫(yī)學(xué)學(xué)術(shù)交流會(huì)論文集[C];2009年

相關(guān)碩士學(xué)位論文 前1條

1 劉亞靜;倒班對(duì)鋼鐵工人高血壓影響的回顧性隊(duì)列研究[D];華北理工大學(xué);2016年

本文編號(hào)：2504689