自报职业二氧化硫暴露对高血压发病影响的巢式病例对照研究

A nested case-control study on association between self-reported occupational sulfur dioxide exposure and hypertension

  • 摘要:
    背景 目前职业二氧化硫(SO2)暴露对高血压发病风险的证据十分有限,且环境SO2暴露对高血压发病影响的研究结论仍不一致。
    目的 分析自报职业SO2暴露与高血压发病风险的关联及SO2暴露年限与高血压发病风险的剂量-反应关系。
    方法 基于金昌队列,采用巢式病例对照研究设计,以随访新发确诊高血压患者841例为病例组,分别以非职业因素限制和职业因素限制选取对照组进行1∶1个体匹配,前者以年龄±2岁、性别相同、工龄±2年、家庭住址为同一街道为匹配条件,后者在前者基础上职业限制为相同车间,最终前者纳入对照717例,后者纳入对照488例。采用统一调查问卷收集研究对象的一般人口学特征、生活行为习惯、糖尿病史、高血压家族史、SO2职业暴露情况(自报有无SO2职业暴露史及SO2暴露年限)等信息;应用条件logistic回归模型分析职业SO2暴露与高血压发病的关联强度及SO2暴露年限与高血压发病风险的剂量-反应关系。
    结果 在非职业因素限制巢式病例对照研究中,自报有职业SO2暴露人群的高血压发病风险OR值为2.39(95%CI:1.68~3.39);而在限制职业因素后,自报有职业SO2暴露人群的高血压发病风险OR值为1.48(95%CI:1.04~2.12)。随着SO2暴露年限从1~9年、10~19年、20~29年及30年及以上增加:在非职业因素限制巢式病例对照研究中,高血压发病风险OR值依次为1.85(95%CI:0.68~5.08)、1.46(95%CI:0.58~3.67)、1.64(95%CI:1.00~2.67)、4.95(95%CI:2.63~9.31);在职业因素限制巢式病例对照研究中,高血压发病风险OR值依次为0.98(95%CI:0.40~2.41)、1.84(95%CI:0.72~4.70)、1.37(95%CI:0.82~2.29)、2.44(95%CI:1.37~4.35)。经 \chi ^2 趋势性检验,两组职业SO2暴露年限和高血压发病风险之间均存在剂量-反应关系(P趋势<0.05)。
    结论 自报职业SO2暴露与人群高血压发病风险具有一定关联,且随着暴露年限的增加,发病风险增大。

     

    Abstract:
    Background Current evidence on whether occupational sulfur dioxide (SO2) exposure affects the risk of hypertension is still limited, and the research results of the effect of environmental SO2 exposure on risk of hypertension remain inconsistent.
    Objective To analyze the association between self-reported occupational exposure to SO2 and the risk of hypertension, and the potential dose-response relationship between the years of exposure to SO2 and the risk of hypertension.
    Methods Based on the Jinchang cohort, a nested case-control study design was adopted. A total of 841 newly diagnosed hypertension patients were followed up as the case group, and the control group was selected with 1∶1 individual matching based on non-occupational factors and occupational factors, respectively. The former matching conditions included age ±2 years old, same gender, working age ±2 years, and home address in the same sub-district. The latter was limited to working in the same workshop on the basis of the former conditions. Finally, the former included 717 controls and the latter included 488 controls. A unified questionnaire was used to collect general demographic characteristics, lifestyle habits, history of diabetes, family history of hypertension, and information on occupational exposure to SO2 (self-reported history of occupational exposure to SO2 and years of exposure to SO2). Conditional logistic regression model was used to analyze the association between occupational exposure to SO2 and hypertension, and the dose-response relationship between the years of SO2 exposure and the risk of hypertension.
    Results In the nested case-control study matching with the non-occupational factors, the OR of hypertension in workers with self-reported occupational exposure to SO2 was 2.39 (95%CI: 1.68-3.39); while when matching with the occupational factors, the OR of hypertension in workers with self-reported occupational exposure to SO2 was 1.48 (95%CI: 1.04-2.12). The results of the dose-response relationship showed that as the SO2 exposure years increased from 1-9 years, 10-19 years, 20-29 years, and 30 years and above, in the nested case-control study matching with non-occupational factors, the ORs of hypertension were 1.85 (95%CI: 0.68-5.08), 1.46 (95%CI: 0.58-3.67), 1.64 (95%CI: 1.00-2.67), and 4.95 (95%CI: 2.63-9.31), respectively; in the nested case-control study matching with occupational factors, the ORs of hypertension were 0.98 (95%CI: 0.40-2.41), 1.84 (95%CI: 0.72-4.70), 1.37 (95%CI: 0.82-2.29), and 2.44 (95%CI: 1.37-4.35), respectively. The two dose-response relationships were positive by χ2 trend test (Ptrend<0.05).
    Conclusion Self-reported occupational exposure to SO2 is associated with the risk of hypertension in the study population, and the hypertension risk increases with the increase of SO2 exposure years.

     

/

返回文章
返回