烟草尘和噪声暴露与作业人员血清胆红素关系
Serum bilirubin in workers exposed to tobacco dust and noise
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摘要:
背景 烟草尘和噪声暴露可增加作业人员患心血管疾病的风险，但对作业人员血清胆红素水平的影响研究甚少。
目的 分析烟草尘和噪声联合作用对作业人员血清胆红素浓度的影响。
方法 选取武汉市某大型卷烟厂824名在职人员为研究对象，依据现场职业病危害因素状况，将研究对象分为对照组（149人）、烟草尘接触组（198人）、噪声接触组（299人）和烟草尘噪声联合接触组（178人），收集四组人群的一般情况资料，采集四组人群的血液样本，检测其血清胆红素浓度。采用卡方检验对四组人群的计数资料进行比较；采用方差分析对四组人群的计量资料进行比较；以对照组为参考类别，采用广义线性回归模型分析三组接害人群与对照组人群血清胆红素浓度的关联性。
结果 对照组、烟草尘接触组、噪声接触组、烟草尘噪声联合接触组作业人员血清间接胆红素浓度异常率分别为6.04%（9/149）、12.63%（25/198）、13.38%（40/299）和17.42%（31/178），呈明显的递增趋势（
P <0.05），烟草尘噪声组血清间接胆红素异常率明显高于烟草尘组或噪声组（P <0.05），烟草尘组、噪声组、烟草尘噪声组血清间接胆红素浓度均明显高于对照组（P <0.05），分别为对照组的1.833、1.774、1.634倍。结论 烟草尘、噪声作业可使卷烟厂作业人员血清总胆红素浓度升高，主要为间接胆红素浓度，烟草尘、噪声联合接触的作业人员血清间接胆红素异常率较高。
Abstract:Background Exposure to tobacco dust or noise is associated with the risk of cardiovascular disease in workers, but there are few studies on their effects on workers' serum bilirubin levels.
Objective To analyze the effects of combined exposure to tobacco dust and noise on workers' serum bilirubin levels.
Methods We selected 824 employees from a large cigarette factory in Wuhan. According to the status of occupational hazards on site, we divided the participants into a control group (
n =149), a tobacco dust exposure group (n =198), a noise exposure group (n =299), and a tobacco dust and noise combined exposure group (n =178). We collected general information of the participants. We collected blood samples and measured serum bilirubin. We used chi-square test to compare between-group categorical indicators. We used analysis of variance to compare measurement data. Taking the control group as the reference category, we used generalized linear regression model to analyze serum bilirubin concentration across the three exposure groups and the control group.Results The abnormal rates of serum indirect bilirubin concentrations in the control group, the tobacco dust exposure group, the noise exposure group, and the tobacco dust and noise combined exposure group were 6.04% (9/149), 12.63% (25/198), 13.38% (40/299), and 17.42% (31/178), respectively, showing a clear increasing trend (
P <0.05). The mean concentrations of indirect bilirubin in the tobacco dust and noise combined exposure group were significantly higher than that in the tobacco dust and the noise groups (P <0.05). The serum indirect bilirubin concentrations in the tobacco dust exposure group, the noise exposure group, and the tobacco dust and noise combined exposure group were 1.833, 1.774, and 1.634 times higher than those of the control group (P <0.05).Conclusion Occupational exposure to tobacco dust or noise may associate with elevated serum total bilirubin concentration in cigarette factory workers, mainly indirect bilirubin concentration. Serum indirect bilirubin anomaly is higher among workers simultaneously exposed to tobacco dust and noise.
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