秦盛, 杨永忠, 郑子薇, 陈圆煜, 李超, 陈哲, 王娇娇, 王涵, 李晶, 王洁, 武建辉. 职业高温暴露与钢铁工人血脂异常的相关性[J]. 环境与职业医学, 2021, 38(6): 593-599. DOI: 10.13213/j.cnki.jeom.2021.20543
引用本文: 秦盛, 杨永忠, 郑子薇, 陈圆煜, 李超, 陈哲, 王娇娇, 王涵, 李晶, 王洁, 武建辉. 职业高温暴露与钢铁工人血脂异常的相关性[J]. 环境与职业医学, 2021, 38(6): 593-599. DOI: 10.13213/j.cnki.jeom.2021.20543
QIN Sheng, YANG Yongzhong, ZHENG Ziwei, CHEN Yuanyu, LI Chao, CHEN Zhe, WANG Jiaojiao, WANG Han, LI Jing, WANG Jie, WU Jianhui. Correlation between occupational high temperature exposure and dyslipidemia in steel workers[J]. Journal of Environmental and Occupational Medicine, 2021, 38(6): 593-599. DOI: 10.13213/j.cnki.jeom.2021.20543
Citation: QIN Sheng, YANG Yongzhong, ZHENG Ziwei, CHEN Yuanyu, LI Chao, CHEN Zhe, WANG Jiaojiao, WANG Han, LI Jing, WANG Jie, WU Jianhui. Correlation between occupational high temperature exposure and dyslipidemia in steel workers[J]. Journal of Environmental and Occupational Medicine, 2021, 38(6): 593-599. DOI: 10.13213/j.cnki.jeom.2021.20543

职业高温暴露与钢铁工人血脂异常的相关性

Correlation between occupational high temperature exposure and dyslipidemia in steel workers

  • 摘要: 背景

    钢铁工人所处的高温环境使钢铁工人更容易患慢性疾病,高温暴露对疾病的影响越来越受到人们的关注。

    目的

    研究高温累积暴露量与钢铁工人血脂异常之间的关系,为制订钢铁工人血脂异常的防控措施提供科学依据。

    方法

    采用现况研究,选取2017年4—6月参加职业健康体检的唐山市某钢铁集团的6 107名一线在职工人为研究对象,其中5 977人参与了体检问卷调查,应答率为97.87%。排除年龄>60岁,问卷调查资料不全和生化指标检测资料缺失者,最终5 807名钢铁工人纳入研究,有效回收率为95.09%。通过问卷调查、体格检查、实验室检查和作业场所职业暴露数据监测等方法收集数据。高温暴露数据来源于企业根据GBZ/T 189.7—2007《工作场所物理因素测量第7部分:高温》测量的高温作业场所历年高温检测报告。根据黑球湿球温度指数和高温工种的工作年限计算高温累积暴露量(CEM)。运用限制性立方样条(RCS)模型结合logistic回归模型探讨高温累积暴露量与钢铁工人血脂异常之间的剂量-反应关系。

    结果

    5 807名研究对象中,血脂异常检出率为38.11%。在调整了相关混杂因素后RCS模型结果显示高温累积暴露量与血脂异常之间存在线性剂量-反应关系(总体关联性检验χ2=11.88,P=0.002 6;非线性检验χ2=1.70,P=0.192 9)。多因素logistic回归分析结果显示,调整年龄、性别、人均收入、教育程度、高血压家族史、吸烟状况、饮酒状况、阻止高血压膳食方案(DASH)评分、睡眠时间、体力活动水平、高血压、糖尿病、体重指数(BMI)、肝酶代谢、高尿酸血症、倒班、噪声暴露、粉尘暴露、CO暴露等混杂因素后,以累积暴露量 < 477.97℃·年组为参照组,高温累积暴露量为653.04~℃·年、782.82~℃·年组的工人血脂异常患病风险分别是参照组的1.362倍(OR=1.362,95%CI:1.086~1.709)和1.333倍(OR=1.333,95%CI:1.048~1.694)。

    结论

    高温累积暴露量和钢铁工人血脂异常之间呈线性剂量-反应关系,高温累积暴露量增加则钢铁工人血脂异常患病风险增大。

     

    Abstract: Background

    The occupational high temperature environment makes steel workers more susceptible to chronic diseases, and the influence of high temperature on diseases is attracting more and more attention.

    Objective

    This study evaluates the relationship between cumulative high temperature exposure and dyslipidemia, providing a scientific basis for the prevention and control of dyslipidemia in steel workers.

    Methods

    A cross-sectional study was adopted to select 6 107 front-line employees of a steel group in Tangshan with occupational health examination reports from April to June 2017. Among them, 5 977 workers participated in the physical examination and questionnaire survey, and the response rate was 97.87%. After excluding those aged >60 years and with incomplete questionnaire data and biochemical data, 5 807 steel workers were finally included in the study, and the effective recovery rate was 95.09%. Data were collected through questionnaire survey, physical examination, laboratory examination, and surveillance plan of occupational exposure in workplace. High temperature exposure data were derived from the workplace high temperature test reports following the Measurement of physical agents in workplace Part 7: high temperature (GBZ/T 189.7—2007). The cumulative exposure measurement (CEM) of high temperature was calculated based on wet-bulb global temperature and the working time schedule related to high temperature exposure. Restricted cubic spline (RCS) and mutiple logistic regression model were used to explore the relationship between cumulative high temperature exposure and dyslipidemia.

    Results

    Among the 5 807 steel workers, the prevalence of dyslipidemia was 38.11%. After adjusting for selected confounders, the results of the RCS model showed a linear dose-response relationship between cumulative high temperature exposure and dyslipidemia (χ2=11.88, P=0.002 6 for overall association test; χ2=1.70, P=0.192 9 for nonlinear test). After adjusting for age, sex, income per capita, education, family history of hypertension, smoking, alcohol drinking, dietary approaches to stop hypertension (DASH) score, sleeping time, physical activity level, hypertension, diabetes, body mass index (BMI), hyperuricemia, shift work, and exposures to noise, dust, and CO, the results of multiple logistic regression model showed that compared with the steel workers with CEM exposure < 477.97℃ ·year, the risks of dyslipidemia of the steel workers with CEM exposure >653.04 and >782.82℃ ·year were 1.362 (OR=1.362, 95%CI: 1.086-1.709) and 1.333 (OR=1.333, 95%CI: 1.048-1.694) times higher.

    Conclusion

    There is a linear dose-response relationship between cumulative high temperature exposure and dyslipidemia of steel workers. As the cumulative exposure to high temperature increases, the risk of dyslipidemia in steel workers increases.

     

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