發(fā)布時(shí)間：2018-03-15 08:10

  本文選題：尿砷　切入點(diǎn)：職業(yè)砷暴露　出處：《昆明醫(yī)科大學(xué)》2016年碩士論文　論文類型：學(xué)位論文

【摘要】：[目的]通過(guò)對(duì)個(gè)舊某錫冶煉廠在職砷作業(yè)人群尿砷含量的檢測(cè),了解職業(yè)性砷暴露工人尿砷水平。同時(shí)通過(guò)對(duì)現(xiàn)場(chǎng)勞動(dòng)衛(wèi)生學(xué)和職業(yè)人群的調(diào)查,結(jié)合尿砷檢測(cè)結(jié)果,分析尿砷的影響因素,為探討職業(yè)性砷暴露人群的保護(hù)措施提供線索。[方法]選擇個(gè)舊某錫冶煉廠砷暴露工人作為研究對(duì)象,采集一次班后尿,采用濕法消化-氫化物發(fā)生-原子熒光光度法進(jìn)行尿砷水平的檢測(cè)；同時(shí)在現(xiàn)場(chǎng)采用面對(duì)面問(wèn)卷調(diào)查的方式收集調(diào)查對(duì)象的一般人口學(xué)特征、生活習(xí)慣、最近三天膳食營(yíng)養(yǎng)素?cái)z入情況等資料。采用Epidata3.1軟件,將調(diào)查結(jié)果由專人雙錄入,建立的數(shù)據(jù)庫(kù)經(jīng)一致性檢驗(yàn)后,將數(shù)據(jù)導(dǎo)入SPSS20.0軟件進(jìn)行數(shù)據(jù)分析,經(jīng)過(guò)多因素Logistic回歸分析,探討尿砷的影響因素。[結(jié)果](1)本次調(diào)查發(fā)現(xiàn)119例該錫冶煉廠工人尿砷含量中位數(shù)為268.34μg/L,男女尿砷含量中位數(shù)分別為274.97μ g/L、250. 01μ g/L,男女尿砷水平差異沒(méi)有統(tǒng)計(jì)學(xué)意義(P0.05)。(2)單因素分析發(fā)現(xiàn),尿砷水平與年齡、工齡不相關(guān)(P0.05),尿砷在不同年齡、工齡之間差異無(wú)統(tǒng)計(jì)學(xué)意義(P0.05)；各車(chē)間工人尿砷差異無(wú)統(tǒng)計(jì)學(xué)意義(P0.05)；但尿砷在不同民族之間差異具有統(tǒng)計(jì)學(xué)意義(P0.05),進(jìn)一步兩兩比較分析知,哈尼族尿砷含量高于漢族及其他少數(shù)民族,并且差異具有統(tǒng)計(jì)學(xué)意義(P0.05)；其他民族之間尿砷含量差異無(wú)統(tǒng)計(jì)學(xué)意義(P0.05)；不同文化程度之間尿砷水平差異無(wú)統(tǒng)計(jì)學(xué)意義(P0.05)。(3)尿砷含量與工人BMI之間呈負(fù)相關(guān)(rs=-0.734,P0.001),即尿砷隨著B(niǎo)MI值的升高而降低。尿砷在不同BMI分組之間差異具有統(tǒng)計(jì)學(xué)意義(χ2=108.973,P=0.000)；經(jīng)兩兩比較知,BMI正常的工人尿砷高于BMI超重工人尿砷,且尿砷水平差異有統(tǒng)計(jì)學(xué)意義(P=0.006)；其他組工人尿砷差異沒(méi)有統(tǒng)計(jì)學(xué)意義(P0.05)。(4)工人的吸煙量、飲酒量與其尿砷水平不相關(guān)。吸煙組與不吸煙組尿砷水平差異無(wú)統(tǒng)計(jì)學(xué)差異(P0.05)；飲酒組與不飲酒組尿砷水平差異沒(méi)有統(tǒng)計(jì)學(xué)意義(P0.05)；不同飲茶頻率、飲茶種類工人尿砷水平差異無(wú)統(tǒng)計(jì)學(xué)意義(P0.05)。(5)經(jīng)進(jìn)一步Logistic回歸分析知,影響尿砷水平的因素有年齡、飲用綠茶、每日食肉量、近三天蛋白質(zhì)總攝入量、近三天膳食纖維總攝入量、近三天維生素C總攝入量、近三天煙酸總攝入量；飲用綠茶、近三天膳食纖維總攝入量、近三天煙酸總攝入量促進(jìn)尿砷排泄；年齡、每日食肉量、近三天蛋白總攝入量、近三天維生素C總攝入量不促進(jìn)尿砷排泄。(6)調(diào)查對(duì)象文化程度普遍偏低,砷毒性認(rèn)識(shí)嚴(yán)重匱乏,并且砷毒性相關(guān)知識(shí)獲取渠道窄,形式單一。(7)臨床表現(xiàn)以類神經(jīng)癥和皮膚損害為主,并與尿砷超標(biāo)有關(guān)系。[結(jié)論](1)尿砷水平與年齡、工齡、吸煙量、飲酒量等無(wú)關(guān),尿砷在不同性別、年齡、工齡、文化程度之間差異無(wú)統(tǒng)計(jì)學(xué)意義；(2)不同民族之間尿砷水平不同,哈尼族尿砷高于漢族,并且差異有統(tǒng)計(jì)學(xué)意義；BMI與尿砷水平呈負(fù)相關(guān),不同BMI分組尿砷水平不同,BMI正常者尿砷高于BMI異常者；(3)膳食營(yíng)養(yǎng)素的攝入如每天蛋白質(zhì)、膳食纖維素、煙酸的攝入量增加將可促進(jìn)尿砷的排泄,改善接砷作業(yè)者的營(yíng)養(yǎng)狀況可以在一定程度上減少砷對(duì)機(jī)體的危害；(4)慢性職業(yè)砷暴露會(huì)引起機(jī)體的健康損害,尤其是皮膚損害具有特異性,并且尿砷含量越高,皮損表現(xiàn)越明顯；(5)無(wú)論作業(yè)環(huán)境砷濃度是否超過(guò)國(guó)家標(biāo)準(zhǔn),均應(yīng)加強(qiáng)接砷人群尿砷監(jiān)測(cè),發(fā)現(xiàn)高危人群,及時(shí)調(diào)離接砷崗位；定期進(jìn)行作業(yè)場(chǎng)所環(huán)境監(jiān)測(cè)并組織接砷工人進(jìn)行職業(yè)健康體檢,及早發(fā)現(xiàn)職業(yè)性健康損害的存在,及早脫離作業(yè)崗位、及早治療；改善作業(yè)人群營(yíng)養(yǎng)狀況如增加蛋白質(zhì)、膳食纖維素、煙酸等的攝入,可以促進(jìn)體內(nèi)砷的排泄,同時(shí)加強(qiáng)鍛煉,提高體質(zhì)；應(yīng)積極開(kāi)展健康促進(jìn)措施,提高企業(yè)主管對(duì)砷毒性的防護(hù)的認(rèn)識(shí),做好現(xiàn)場(chǎng)通風(fēng)、排毒,履行用人單位的職責(zé),加強(qiáng)砷相關(guān)的職業(yè)病預(yù)防知識(shí)的宣傳,拓寬作業(yè)人員對(duì)砷毒性知識(shí)的獲取渠道,提高作業(yè)人員對(duì)砷毒性的認(rèn)識(shí),加強(qiáng)自我防護(hù)。
[Abstract]:[Objective] through the detection of Gejiu Tin Smelter in workers exposed to arsenic arsenic in urine, urine arsenic exposure levels of workers to understand the occupation of arsenic. At the same time through the survey in the labor hygiene and occupation groups, combined with urinary arsenic detection results, analysis of influencing factors of urinary arsenic, protective measures to investigate the occupation of arsenic exposure people to provide clues. Methods] Gejiu Tin smelter workers exposed to arsenic as the research object, collecting a class of urine, by wet digestion hydride generation detection of urine arsenic level atomic fluorescence spectrophotometry; at the same time, general demographic characteristics, face-to-face questionnaire survey used at the site living habits, the last three days of dietary intake data. Using Epidata3.1 software, the result of investigation by hand for double entry and establishment of the database through the consistency test, the data into SPSS2 0 software was used for data analysis by multivariate Logistic regression analysis, to explore the influencing factors of urine arsenic results.] (1) the survey found that 119 cases of the tin smelter workers median urinary arsenic content was 268.34 g/L, urine arsenic content medians were 274.97 g/L, 250.01 g/ L, gender differences in urine arsenic levels were not statistically significant (P0.05). (2) single factor analysis showed that urinary arsenic levels and age, not related to age (P0.05), urinary arsenic in different age, there was no significant difference between the length of service (P0.05); the workshop workers urinary arsenic had no significant difference (P0.05); but in the urine arsenic the differences between different ethnic groups has statistical significance (P0.05, 22) further comparative analysis, the arsenic content in urine was higher than that of the Hani nationality Han nationality and other ethnic minorities, and the difference was statistically significant (P0.05); there was no significant difference between the content of arsenic in urine of other nationalities (P0.05) ; there was no significant difference of urine arsenic level between different cultural level (P0.05). (3) there was a negative correlation between urinary arsenic content and workers BMI (rs=-0.734, P0.001), the urine arsenic with the increase of BMI value of urine arsenic decreased. The difference was statistically significant between BMI group (2= 108.973, P=0.000) by comparison; 22, BMI normal urine arsenic BMI is higher than that of overweight workers workers urinary arsenic, and there were statistically significant differences in the level of urinary arsenic (P=0.006); the other group of workers of arsenic in urine was not statistically significant difference (P0.05). (4) the amount of smoking workers, not related to alcohol intake and the urinary arsenic levels was not statistically. The difference between the smoking group and non-smoking group urine arsenic level (P0.05); drinking group and alcohol group differences in urinary arsenic levels was not statistically significant (P0.05); different tea frequency, the type of tea workers urinary arsenic levels showed no significant difference (P0.05). (5) after further Logistic regression Analysis of knowledge, influence factors of urinary arsenic levels were age, drinking Green Tea, daily meat intake, nearly three days of total protein intake, nearly three days of total dietary fiber intake, vitamin C intake for nearly three days, nearly three days of total niacin intake; drinking Green Tea, nearly three days of total dietary fiber intake, nearly three days of nicotinic acid total intake promotes urinary arsenic excretion; age, daily meat intake, nearly three days of total protein intake, nearly three days of total intake of vitamin C does not promote urinary excretion of arsenic. (6) respondents generally lower educational level, lack of understanding of arsenic toxicity, and toxicity of arsenic related knowledge acquisition channel is narrow, single form (7). The clinical manifestations of neural disease and skin damage, and urinary arsenic exceed the standard relationship. Conclusion: (1) urinary arsenic levels and age, age, smoking, alcohol consumption and irrelevant, urinary arsenic in different gender, age, age, culture degree difference between no statistical significance Yi; (2) the levels of urinary arsenic among different ethnic groups, Hani urinary arsenic is higher than the Han nationality, and the difference was statistically significant; BMI was negatively correlated with urinary arsenic levels and urinary arsenic levels in different BMI group, normal BMI abnormal urinary arsenic is higher than that of BMI; (3) the dietary intake of nutrients such as protein every day, dietary fiber, niacin intake increases will promote urinary arsenic excretion, improve the nutritional status of arsenic operators can reduce arsenic harm to the body to a certain extent; (4) health damage will induce chronic occupation of arsenic exposure, especially with specific skin damage, and the higher the urine arsenic content. The lesions showed more obvious; (5) whether arsenic concentration exceeded the national standard working environment should be strengthened, arsenic urinary arsenic monitoring, found that the high risk population, promptly removed arsenic jobs; regular workplace environmental monitoring and industrial organization of arsenic 浜鴻繘琛岃亴涓氬仴搴蜂綋媯，

本文編號(hào)：1615164