煤矿工人神经行为特征及影响因素
Characteristics and influencing factors of neurobehavioral function of coal miners
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摘要:
目的 煤矿工人井下作业环境及倒班等对其生理、心理均会产生影响，但对其神经行为功能影响的报道较少见。本项目拟通过神经性为核心测试组合（NCTB）了解煤矿工人神经行为功能的分布特征，并分析其影响因素，为进行职业危害的早期干预提供依据。
方法 2017年4-6月选取山西省某国有煤矿652名男性工人为研究对象，包括地面、井下一线、井下辅助三大类作业岗位。通过问卷调查收集研究对象基本信息，采用WHO推荐的NCTB评价煤矿工人的情感状态和行为功能，采用卡方检验、协方差分析和多元方差分析对工人神经行为改变的相关因素进行分析。
结果 煤矿工人情感得分除"有力-好动"得分处于中间偏上水平外，其余5项得分均较低。行为功能测试结果显示，工人平均反应时间为（0.50±0.16）s；数字跨度顺序平均复述（11.72±2.20）个数字序列，正确率较高，倒序平均复述（5.50±2.42）个数字序列，正确率较低；数字译码为90s中正确（45.34±19.57）个；视觉记忆正确率约为65.9%；提转捷度习惯用手和非习惯用手得分接近；正确打点数约占目标追踪总数的61.5%，错误打点数占总打点数比例较高（38.5%）。多元方差分析结果显示，不同作业场所可对疲惫-惰性、提转捷度（习惯用手和非习惯用手）、视觉记忆和目标追踪（正确打点数）产生影响，井下作业工人疲惫-惰性和提转捷度评分高于地面工人，而视觉记忆和目标追踪（正确打点数）评分低于地面工人（均P < 0.05）；倒班作业者5项情感状态（除有力-好动外）的得分均高于非倒班作业者，在5项行为功能（数字跨度倒序和总分、视觉记忆、正确打点数和打点总数）的得分低于非倒班作业者（均P < 0.05）。工人的年龄大、工龄长、文化水平低、睡眠质量差、月收入低和高血压患病都可能对其部分情感状态或行为功能产生消极影响（均P < 0.05）。
结论 煤矿工人神经行为功能呈现较低水平，不同作业场所的煤矿工人神经行为功能存在差异，倒班对工人神经行为功能多方面均有影响；工人的年龄、工龄、文化程度、睡眠质量及高血压状况也可能是煤矿工人神经行为功能改变的影响因素。
Abstract:Objective Underground working environment and shift work may have adverse physical and mental health effects in coal miners, but few studies report the effects on neurobehavioral function. This study aims to understand the distribution characteristics and influencing factors of neurobehavioral function of coal miners in different workplaces through Neurobehavioral Core Test Battery (NCTB), and provide evidence for early intervention of occupational hazards.
Methods A total of 652 male coal miners from a state-owned coal mine in Shanxi Province were selected from April to June 2017 and divided into three groups (ground group, underground front-line group, and underground auxiliary group) according to assigned workplaces. The basic information of coal miners was collected through questionnaires, and profile of mood state (POMS) and neurobehavioral function of coal miners were evaluated by WHO NCTB. Chi-square test, covariance analysis, and multivariate analysis of variance were used to analyze the factors of neurobehavioral changes.
Results Except PMOSV score above average, the other five PMOS subscale scores were at low level. The results of behavior function test showed that the average simple reaction time was (0.50±0.16) s; the subjects scored higher in recalling digit span in forward order (11.72±2.20) than in backward order (5.50±2.42); in 90 s, 45.34±19.57 correct digit symbol occurred; the correct rate of Benton Visual Retention (BVR) was 65.9%; the scores of Santa Ana Preferred Hand (SANP) and Santa Ana Non-preferred Hand (SANN) were close; correct and wrong dot numbers accounted for 61.5% and 38.5% of total pursuit aiming score respectively. The results of multivariate analysis of variance showed that workplace affected the scores of POMSF, Santa Ana Manual Dexterity (SANP and SANN), BVR, and pursuit aiming (correct dot number); compared to the ground workers, the scores of POMSF, and Santa Ana Manual Dexterity in the underground workers were higher, while the scores of BVR and pursuit aiming (correct dot number) were lower (P < 0.05); the scores of POMS (except vigor-activity) in the shift workers were all higher than those of the non-shift workers, while the scores of five behavioral functions (backward and total score of digital span, BVR, correct dot number, and total dot number) were lower than those of the non-shift workers (P < 0.05). There were also negative effects on the scores of selected POMS or behavioral functions among workers who were older, or had longer length of service, lower education level, poor quality of sleep, lower monthly income, and hypertension (P < 0.05).
Conclusion There are differences in neurobehavioral function of coal miners in different workplaces, and shift work has influences on many aspects of neurobehavioral function; age, length of service, education level, quality of sleep, and hypertension are also possible influencing factors of neurobehavioral function changes of coal miners.
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