發(fā)布時間：2019-06-01 08:09

【摘要】：目的探討鋼鐵工人主要職業(yè)有害因素倒班、高溫、噪聲、粉塵、CO和鋼鐵工人2型糖尿病(T2DM)患病率間是否存在關(guān)聯(lián)。方法采用現(xiàn)況研究的方法,選取2015年6月至2016年6月在某鋼鐵集團公司所屬醫(yī)院進行職業(yè)健康體檢和健康體檢的全部鋼鐵工人8564人,用于分析8379人。收集資料包括鋼鐵工人人口學(xué)特征、生活方式、個人病史及家族史、職業(yè)史。采用Epidata3.1建立數(shù)據(jù)庫。計數(shù)資料使用率或構(gòu)成比表示,單因素分析采用χ2檢驗。多因素統(tǒng)計分析方法采用多因素非條件logistic回歸進行,篩選出鋼鐵工人主要職業(yè)有害因素與T2DM患病率相關(guān)的因素。鋼鐵工人職業(yè)有害因素累積暴露量與T2DM患病率的劑量-反應(yīng)關(guān)系分析選擇限制性立方樣條進行,并在SAS9.4軟件中繪制出反應(yīng)累積暴露量和患病風(fēng)險的限制性立方樣條圖。采用雙側(cè)檢驗,檢驗水準α=0.05。結(jié)果1鋼鐵工人中倒班人群66.4%;暴露高溫人群53.1%;暴露噪聲人群54.9%;暴露粉塵人群59.7%;暴露一氧化碳人群47.8%。2職業(yè)有害因素單因素分析結(jié)果顯示:倒班、粉塵、一氧化碳與T2DM患病率差異具有統(tǒng)計學(xué)意義(P0.05)。高溫、噪聲與T2DM患病率差別無統(tǒng)計學(xué)意義(P0.05)。3職業(yè)有害因素多因素非條件logistic模型分析結(jié)果顯示:在只調(diào)整一般因素的情況下,以相應(yīng)非暴露人群為對照,倒班、粉塵、CO暴露人群T2DM患病風(fēng)險比非暴露人群高,分別是非暴露人群的1.372倍(95%CI:1.198~1.571)、1.340倍(95%CI:1.180~1.522)、1.346倍(95%CI:1.192~1.520)。在調(diào)整一般因素及其它職業(yè)有害因素時,以相應(yīng)非暴露人群為對照,得到與只調(diào)整一般因素類似的結(jié)果,倒班、粉塵、CO暴露人群T2DM患病風(fēng)險比非暴露人群高,分別是非暴露人群的1.379倍(95%CI:1.204~1.578)、1.338倍(95%CI:1.177~1.520)、1.278倍(95%CI:1.127~1.448),高溫、噪聲與糖尿病患病率無相關(guān)性。因此倒班、粉塵、CO均為T2DM患病的危險因素,而高溫、噪聲與糖尿病患病率無相關(guān)性。4對5562個暴露倒班人群進行限制性立方樣條分析。調(diào)整一般因素和職業(yè)有害因素,倒班年限與T2DM關(guān)聯(lián)強度有統(tǒng)計學(xué)意義(χ2=18.68,P0.0001)且呈線性相關(guān)(χ2=0.51,P=0.4739)。T2DM患病風(fēng)險隨著倒班年限持續(xù)增加而增加。5對5105個暴露粉塵人群進行限制性立方樣條分析。調(diào)整一般因素和職業(yè)有害因素,粉塵累積暴露量與T2DM關(guān)聯(lián)強度有統(tǒng)計學(xué)意義(χ2=27.22,P0.0001)且呈非線性相關(guān)(χ2=4.88,P0.0001)。開始增加,T2DM患病風(fēng)險隨著粉塵累積暴露量持續(xù)增加而增加。6對4060個暴露CO人群進行限制性立方樣條分析。調(diào)整一般因素和職業(yè)有害因素,CO累積暴露量與T2DM關(guān)聯(lián)強度有統(tǒng)計學(xué)意義(χ2=46.56,P0.0001)且呈線性相關(guān)(χ2=0.40,P=0.6526)。T2DM患病風(fēng)險隨著CO累積暴露量持續(xù)增加而增加。結(jié)論1倒班、粉塵、CO與T2DM患病率有關(guān),是糖尿病的危險因素。2 T2DM的患病風(fēng)險隨著倒班年限、粉塵累積暴露量、CO累積暴露量的增加呈增加趨勢。
[Abstract]:Objective to investigate the relationship between shift, high temperature, noise, dust, CO and the prevalence of type 2 diabetes mellitus (T2DM) in iron and steel workers. Methods from June 2015 to June 2016, 8564 iron and steel workers who underwent occupational health examination and physical examination in the hospital of an iron and steel group company were selected to analyze 8379 iron and steel workers. The data included demographic characteristics, lifestyle, personal and family history and occupational history of iron and steel workers. Epidata3.1 is used to establish the database. The utilization rate or constituent ratio of counting data was expressed by single factor analysis. Multivariate statistical analysis was carried out by multivariate unconditional logistic regression to screen out the main occupational harmful factors related to the prevalence of T2DM in iron and steel workers. The dose-response relationship between the cumulative exposure of occupational harmful factors and the prevalence of T2DM in iron and steel workers was analyzed by restricted cubic splines, and the restricted cubic splines of response cumulative exposure and disease risk were drawn in SAS9.4 software. Using bilateral test, the test level 偽 = 0.05. Results 1the shift population of iron and steel workers was 66.4%, the high temperature exposed population was 53.1%, the noise exposed population was 54.9%, the dust exposed population was 59.7%, and the workers exposed to high temperature were 53.1%, 54.9% and 59.7%, respectively. The results of univariate analysis of occupational harmful factors in 47.8% of the exposed population showed that there was significant difference in the prevalence of shift, dust, carbon monoxide and T2DM (P 0.05). There was no significant difference in the prevalence of high temperature, noise and T2DM (P 0.05). 3 the results of multivariate unconditional logistic model analysis of occupational harmful factors showed that under the condition of only adjusting the general factors, the corresponding non-exposed population was taken as the control, and the shift was taken as the control. The risk of T2DM in dust and CO exposed population was 1.372 times (95%CI:1.198~1.571) and 1.340 times (95%CI:1.180~1.522) higher than that in non-exposed population, respectively. 1.346 times (95%CI:1.192~1.520). When adjusting the general factors and other occupational harmful factors, compared with the corresponding non-exposed population, the results were similar to those of only adjusting the general factors. The risk of T2DM in shift, dust and CO exposed population was higher than that in non-exposed population. 1.379 times (95%CI:1.204~1.578), 1.338 times (95%CI:1.177~1.520) and 1.278 times (95%CI:1.127~1.448) of non-exposed population, high temperature and noise were not correlated with the prevalence of diabetes mellitus. Therefore, shift, dust and CO were the risk factors of T2DM, but there was no correlation between high temperature, noise and the prevalence of diabetes mellitus. 4 restricted cubic splines analysis was performed in 5562 exposed shift people. After adjusting for general factors and occupational harmful factors, the correlation intensity between shift years and T2DM was statistically significant (蠂 ~ 2 鈮，

本文編號：2490120