【摘要】：目的:通過對某大型石油化工企業(yè)苯接觸作業(yè)工人職業(yè)健康檢查結(jié)果的統(tǒng)計分析,了解長期低濃度苯接觸對作業(yè)工人健康狀況的影響,進(jìn)一步探討長期低濃度苯接觸對作業(yè)工人健康損害的早期敏感指標(biāo),為加強(qiáng)對苯接觸作業(yè)工人的健康監(jiān)護(hù)和改善現(xiàn)有防護(hù)措施提供理論依據(jù)。方法:對某大型石油化工企業(yè)苯生產(chǎn)裝置和苯分析實驗室進(jìn)行現(xiàn)場職業(yè)衛(wèi)生學(xué)調(diào)查,監(jiān)測其作業(yè)場所空氣中苯濃度;選取307名長期低濃度苯接觸的作業(yè)工人作為接觸組,選擇同企業(yè)不接觸苯的314名作業(yè)工人作為對照組,對其進(jìn)行職業(yè)健康檢查,結(jié)合現(xiàn)場檢測和職業(yè)健康檢查結(jié)果,比較和分析長期低濃度苯接觸對作業(yè)工人白細(xì)胞計數(shù)、中性粒細(xì)胞計數(shù)、紅細(xì)胞計數(shù)、血小板計數(shù)、血紅蛋白含量、肝功能、B超、心電圖及胸片等檢查結(jié)果的影響。結(jié)果:苯接觸組作業(yè)工人所在崗位作業(yè)場所空氣中的苯濃度均低于國家職業(yè)接觸限值;接觸組作業(yè)工人血象中白細(xì)胞計數(shù)和中性粒細(xì)胞減少的發(fā)生率均高于對照組(P0.01),差異有統(tǒng)計學(xué)意義;白細(xì)胞計數(shù)、中性粒細(xì)胞計數(shù)、紅細(xì)胞計數(shù)、血小板計數(shù)減少的發(fā)生率在性別方面比較,差異無統(tǒng)計學(xué)意義;接觸組作業(yè)工人的白細(xì)胞計數(shù)、中性粒細(xì)胞計數(shù)、血小板計數(shù)、血紅蛋白減少的發(fā)生率隨工齡的增加有上升趨勢,其中白細(xì)胞計數(shù)的降低趨勢明顯(趨勢χ2=4.105,P0.05),存在時間-效應(yīng)關(guān)系。接觸組不同崗位作業(yè)工人的血象、肝功能、心電圖、腹部B超、胸片等指標(biāo)異常率間相比,差異無統(tǒng)計學(xué)意義;接觸組與對照組的肝功能、心電圖、腹部B超、胸片等各項指標(biāo)的異常率間相比,差異無統(tǒng)計學(xué)意義(P0.05);苯濃度、性別、接觸苯的工齡均為白細(xì)胞計數(shù)減少的危險因素,其中接苯工齡是影響白細(xì)胞計數(shù)減少的主要因素。結(jié)論:長期低濃度苯接觸對作業(yè)工人血常規(guī)中的白細(xì)胞計數(shù)、中性粒細(xì)胞計數(shù)有一定的影響,白細(xì)胞計數(shù)、中性粒細(xì)胞計數(shù)是監(jiān)測苯對人體早期職業(yè)健康損害作用的敏感指標(biāo);企業(yè)應(yīng)進(jìn)一步加強(qiáng)對低濃度苯作業(yè)工人的健康監(jiān)護(hù)并對防護(hù)設(shè)施持續(xù)改進(jìn)。
[Abstract]:Objective: to investigate the effects of benzene exposure on occupational health status of workers exposed to benzene in a large petrochemical enterprise. In order to provide theoretical basis for strengthening health monitoring of workers exposed to benzene and improving existing protective measures, the early sensitive indexes of health damage to workers exposed to benzene for a long time were discussed. Methods: the benzene production plant and benzene analysis laboratory of a large petrochemical enterprise were investigated in the field of occupational hygiene to monitor the benzene concentration in the air of the workplace, 307 workers exposed to benzene for a long time were selected as the exposure group. 314 workers who were not exposed to benzene in the same enterprise were selected as the control group, and their occupational health examination was carried out. Combined with the results of field and occupational health examination, the white blood cell count of workers exposed to benzene for a long time was compared and analyzed. The effect of neutrophil count, erythrocyte count, platelet count, hemoglobin content, liver function, B ultrasound, electrocardiogram and chest radiography. Results: the concentration of benzene in the air of the workers in the benzene exposure group was lower than the national occupational exposure limit. The incidence of leukocyte count and neutropenia in the exposure group was higher than that in the control group (P0.01), the difference was statistically significant, the white blood cell count, neutrophil count, erythrocyte count, The incidence of thrombocytopenia was not significantly different between men and women. The white blood cell count, neutrophil count, platelet count in exposed workers, The incidence of hemoglobin decrease increased with the increase of working time, and the white blood cell count decreased obviously (蠂 2 + 4. 105% P 0.05), and there was a time-effect relationship. There was no significant difference in abnormal rate of blood, liver function, electrocardiogram, abdominal B-ultrasound and chest radiography between the exposed workers in different positions, and the liver function, electrocardiogram, abdominal B-ultrasound in the contact group and the control group. There was no significant difference between the abnormal rates of chest radiographs (P0.05); benzene concentration, sex, exposure to benzene were the risk factors of leukocyte count reduction, among which benzene exposure was the main factor affecting leukocyte count reduction. Conclusion: Long-term exposure to benzene at low concentration has a certain effect on the leukocyte count and neutrophil count in the blood routine of workers. The leukocyte count and neutrophil count are sensitive indicators for monitoring the effect of benzene on the early occupational health injury of workers. Enterprises should further strengthen the health care of workers exposed to low-concentration benzene and continue to improve the protective facilities.
【學(xué)位授予單位】：新疆醫(yī)科大學(xué)
【學(xué)位級別】：碩士
【學(xué)位授予年份】：2016
【分類號】：R131

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