宦佳萍, 韩笑, 高丹, 赵丹, 宋静, 王林平, 张慧芳, 牛侨, 路小婷. 职业铝暴露和饮酒种类及其交互作用对工人认知功能的影响[J]. 环境与职业医学, 2022, 39(7): 763-768, 774. DOI: 10.11836/JEOM21474
引用本文: 宦佳萍, 韩笑, 高丹, 赵丹, 宋静, 王林平, 张慧芳, 牛侨, 路小婷. 职业铝暴露和饮酒种类及其交互作用对工人认知功能的影响[J]. 环境与职业医学, 2022, 39(7): 763-768, 774. DOI: 10.11836/JEOM21474
HUAN Jiaping, HAN Xiao, GAO Dan, ZHAO Dan, SONG Jing, WANG Linping, ZHANG Huifang, NIU Qiao, LU Xiaoting. Effects of occupational aluminum exposure, types of alcohol consumption, and their interaction on cognitive function of workers[J]. Journal of Environmental and Occupational Medicine, 2022, 39(7): 763-768, 774. DOI: 10.11836/JEOM21474
Citation: HUAN Jiaping, HAN Xiao, GAO Dan, ZHAO Dan, SONG Jing, WANG Linping, ZHANG Huifang, NIU Qiao, LU Xiaoting. Effects of occupational aluminum exposure, types of alcohol consumption, and their interaction on cognitive function of workers[J]. Journal of Environmental and Occupational Medicine, 2022, 39(7): 763-768, 774. DOI: 10.11836/JEOM21474

职业铝暴露和饮酒种类及其交互作用对工人认知功能的影响

Effects of occupational aluminum exposure, types of alcohol consumption, and their interaction on cognitive function of workers

  • 摘要: 背景 职业铝暴露与认知功能障碍密切相关,且饮酒与认知功能障碍也密切相关。

    目的 探讨饮酒种类对职业铝暴露工人认知功能的影响。

    方法 于2019年7—8月采用整群抽样的方法选取某地区某铝厂电解铝车间工人及同地区某厂某维修车间工人,最终共纳入181名年龄为23~56岁的作业工人。采集静脉血,采用电感耦合等离子体质谱法测定血浆铝浓度。根据血铝水平中位数和工种将研究对象分为低暴露组和高暴露组。采用该厂职工医院职工健康体检表收集研究对象的基本情况。采用北京版蒙特利尔认知评估量表评估工人认知功能。采用logistic回归分析血浆铝浓度与认知障碍、饮酒种类(白酒、红酒、啤酒)与认知障碍之间的关系,采用非条件logistic回归拟合血浆铝浓度和饮酒种类的相乘交互作用模型以及相加交互作用模型,并计算表计算交互作用超额相对危险度(RERI)和交互作用归因比(AP)。

    结果 研究对象血铝浓度MP25P75)为40.01(25.05,60.56)µg·L−1,低、高暴露组血铝浓度MP25P75)分别为25.16(17.13,34.78)、60.56(47.40,68.53)µg·L−1。调整饮酒种类、饮酒、年龄、接铝工龄、文化程度、婚姻状况、吸烟因素后,高暴露组的工人在注意力、语言表达、总体认知功能方面出现异常的风险OR及其95%CI分别是低暴露组工人的4.295(1.912~9.648)倍、5.687(1.355~23.867)倍、2.720(1.225~6.040)倍;此外,调整血铝水平、饮酒总量、年龄、接铝工龄、文化程度、婚姻状况和吸烟因素后,饮白酒者注意力出现异常的风险OR及其95%CI是不饮白酒者的2.613(1.054~6.837)倍;饮啤酒者视空间与执行功能、语言表达、延迟回忆、总体认知功能出现异常的风险OR及其95%CI是不饮啤酒者的3.165(1.285~7.797)倍、17.898(1.590~201.480)倍、3.118(1.215~8.003)倍、3.824(1.736~8.423)倍。饮白酒与血浆铝浓度对注意力领域存在相加交互作用RERI(95%CI)为1.745(1.394~2.097),AP(95%CI)为0.415(0.201~0.630)和相乘交互作用(OR=3.591,95%CI:1.393~9.255)。在注意力领域损害个体中归因于饮白酒和血浆铝浓度交互作用所引起的认知功能损害占41.5%。饮啤酒与血浆铝浓度之间在总体认知功能领域存在相加交互作用RERI(95%CI)为5.955(0.562~11.328),AP(95%CI)为0.829(0.577~1.081)和相乘交互作用(OR=42.174,95%CI:5.469~325.252)。在总体认知功能损害个体中归因于饮啤酒和血浆铝浓度交互作用所引起的认知功能损害占82.9%。

    结论 职业铝暴露工人的注意力、语言表达、总体认知功能与血铝浓度密切相关,且血铝水平分别与饮白酒、啤酒对作业工人认知功能损害存在交互作用。

     

    Abstract: Background Occupational aluminum exposure is closely related to cognitive impairment, and alcohol consumption is also closely related to cognitive dysfunction.

    Objective To explore the effects of types of alcohol consumption on cognitive function of occupational aluminum exposed workers.

    Methods A total of 181 workers aged from 23 to 56 years were selected by cluster sampling method in an electrolytic aluminum workshop of an aluminum plant in a region and in a maintenance workshop of another plant in the same region from July to August, 2019. Venous blood was collected, and plasma aluminum concentration was determined by inductively coupled plasma mass spectrometry. The study subjects were divided into low and high exposure groups based on the median blood aluminum level and type of work. Their basic information was collected by occupational health examination. Workers' cognitive function was assessed using the Montreal Cognitive Assessment Scale-Beijing Edition. Logistic regression was used to analyze the association between plasma aluminum concentration and cognitive impairment, and between the types of alcohol consumption (including Baijiu, red wine, and beer) and cognitive impairment, Unconditional logistic regression was used to fit multiplicative interaction model as well as additive interaction model of plasma aluminum concentration and the types of alcohol consumption, and to calculate the relative excess relative risk due to interaction (RERI) and attributable proportion due to interaction (AP).

    Results The M (P25, P75) concentrations of plasma aluminum were 40.01 (25.05, 60.56) µg·L−1 in the total study subjects, 25.16 (17.13, 34.78) µg·L−1 in the low exposure group and 60.56 (47.40, 68.53) µg·L−1 in the high exposure group. After adjusting the type of alcohol consumption, drinking, age, duration of exposure to aluminum, education, marital status, and smoking, the odds ratios for impairments of attention, language expression, and overall cognitive function in the high exposure group were 4.295 (95%CI: 1.912-9.648), 5.687 (95%CI: 1.355-23.867), and 2.720 (95%CI: 1.225-6.040) times of the low exposure group respectively. Besides, after adjusting blood aluminum concentration, total alcohol consumption, age, duration of exposure to aluminum, education, marital status, and smoking, the risk of attention impairment of the Baijiu drinkers was 2.613 (95%CI: 1.054 to 6.837) times of the non-Baijiu drinkers; the risks of impairment of visuospatial abilities and execution functions, language expression, delayed recall, and overall cognitive function of the beer drinkers were 3.165 (95%CI: 1.285-7.797), 17.898 (95%CI: 1.590-201.480), 3.118 (95%CI: 1.215-8.003), and 3.824 (95%CI: 1.736-8.423) times of the non-beer drinkers. There were both additive RERI (95%CI): 1.745 (1.394-2.097), AP (95%CI): 0.415 (0.201-0.630) and multiplicative (OR=3.591, 95%CI: 1.393-9.255) interactions between Baijiu intake and plasma aluminum concentration levels on the attention domain. The cognitive impairment attributed to the interactive effects of drinking Baijiu and plasma aluminum concentration in individuals with attention impairment accounted for 41.5%. There were both additive RERI (95%CI): 5.955 (0.562-11.328), AP (95%CI): 0.829 (0.577-1.081) and multiplicative (OR=42.174, 95%CI: 5.469-325.252) interactions between beer drinking and plasma aluminum concentration on the overall cognitive function. Among the individuals with overall cognitive impairment, the cognitive impairment caused by the interaction of beer drinking and plasma aluminum concentration accounted for 82.9%.

    Conclusion Occupation aluminum exposed workers' attention, language expression, and overall cognitive function are closely related to their plasma aluminum concentration. Plasma aluminum concentrations have interactions with Baijiu and beer consumption on cognitive impairment of workers.

     

/

返回文章
返回