接触噪声、高温和倒班与男性钢铁工人正常高值血压发生和高血压患病的关系
Relationships of exposures to noise, high temperature, and shift work with high-normal blood pressure and hypertension in male steel workers
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摘要:
目的 了解男性钢铁工人正常高值血压、高血压检出现状，分析接触噪声、高温和倒班对男性钢铁工人正常高值血压发生和高血压患病的影响。
方法 以唐山某钢铁集团2015年9月-2016年7月进行职业健康检查的全部男性在职职工为调查对象，进行问卷调查和体格检查，采用多因素无序多分类logistic回归模型，分析接触噪声、高温和倒班对男性钢铁工人正常高值血压发生和高血压患病的影响。
结果 本次调查共纳入研究对象7587人，男性钢铁工人正常高值血压检出率为42.9%，高血压患病率为32.8%。接触噪声、高温和倒班的男性钢铁工人血压分布不全相同（P < 0.001）。调整年龄、工龄、民族、婚姻状况、文化程度、家庭人均月收入、体质量指数、高血压家族史、吸烟、饮酒、食盐程度、体育锻炼等因素后，多因素无序多分类logistic回归分析结果显示：分别以从不接触噪声、高温和倒班的男性钢铁工人为参照，现在接触噪声、高温和倒班的男性钢铁工人正常高值血压发生风险，即OR及其95%CI值分别为从不接触者的1.27（1.12~1.44）倍、1.22（1.07~1.39）倍、1.20（1.03~1.40）倍，高血压患病风险（OR及其95%CI）分别为从不接触者的1.29（1.12~1.49）倍、1.34（1.16~1.56）倍和1.28（1.08~1.53）倍；曾经倒班的男性钢铁工人正常高值血压发生、高血压患病风险分别是从不倒班者的1.26（1.03~1.55）倍和1.36（1.09~1.71）倍；曾经接触高温的男性钢铁工人高血压患病风险是从不接触者的1.87（1.37~2.56）倍；曾经接触噪声者正常高值血压发生风险是从不接触者的1.56（1.11~2.20）倍。
结论 接触噪声、高温和倒班的男性钢铁工人正常高值血压的发生和高血压患病风险均高于不接触者。
Abstract:Objective To detect the positive rates of high-normal blood pressure and hypertension in male steel workers, and assess the effects of occupational exposures to noise, high temperature, and shift work on prevalence of high-normal blood pressure and hypertension.
Methods Male workers of an iron and steel group in Tangshan, who attended occupational health physical examination in September 2015-July 2016, completed questionnaires and received physical measurements. The relationships of exposures to noise, high temperature, and shift work with prevalence of high-normal blood pressure and hypertension were assessed using multinomial lo gistic regression models.
Results A total of 7 587 male steel workers were enrolled in the study. The positive rates of high-normal blood pressure and hypertension were 42.9% and 32.8%, respectively. The distribution of blood pressure was different in the male steel workers with exposures to noise, high temperature, and shift work (P < 0.001). After adjusted for age, seniority, ethnic group, marital status, educational level, family monthly income per capita, body mass index, hypertension family history, smoking, drinking, salt consumption, and physical exercise, the multinomial logistic regression analysis results showed that with the male steel workers without exposures to noise, high temperature, and shift work as reference, the OR values (95%CI) of high-normal blood pressure of those with current exposures were 1.27 (1.12-1.44), 1.22 (1.07-1.39), and 1.20 (1.03-1.40), respectively; the OR values (95%CI) of hypertension of those with current exposures were 1.29 (1.12-1.49), 1.34 (1.16-1.56), and 1.28 (1.08-1.53), respectively. The OR values (95%CI) of high-normal blood pressure and hypertension were 1.26 (1.03-1.55) and 1.36 (1.09-1.71) for those with former exposure to shift work versus those without, respectively; the OR value (95%CI) of hypertension was 1.87 (1.37-2.56) for those with former exposure to high temperature versus those without; the OR value (95%CI) of high-normal blood pressure was 1.56 (1.11-2.20) for those with former exposure to noise versus those without.
Conclusion The male steel workers exposed to noise, high temperature, and shift work may have higher risks of normal highnormal blood pressure and hypertension than those not exposed to these factors.
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