电焊作业工人黄斑视觉功能损害的危险因素分析  

The Influence of risk factors on visual performance in of phototoxic maculopathy in occupational welders

作　　者：李清韬[1] 张新芳[1] 

机构地区：[1]湖北民族学院附属民大医院眼科,恩施445000

出　　处：《中华劳动卫生职业病杂志》2014年第10期759-761,共3页Chinese Journal of Industrial Hygiene and Occupational Diseases

摘　　要：目的 探讨影响电焊作业工人黄斑视觉功能损害发生的相关危险因素.方法 选择2010年8月-2013年12月本地电焊作业的工厂中专职电焊工86例172眼作为研究对象.眼部检查：包括最佳矫正视力、90 D前置镜眼底检查、眼底彩照和OCT检查,光损伤性黄斑病变的诊断以OCT的检查结果为准.将受试者按年龄、防护程度、工龄和工作时间分组,比较各组间光损伤性黄斑病变的检出率.再将受试者随机分为叶黄素干预组和安慰剂对照组,检测最佳矫正视力、黄斑色素密度值、对比敏感度及眩光敏感度.结果 （1）光损伤性黄斑病变总发病率为32.0％,与年龄无相关性（统计学结果）.（2）防护习惯不同各组间光损伤性黄斑病变的发生率分别是21.4％,36.7％,53.6％,采用严格防护者,检出率低于其他两组,非专业防护者检出率最高,三组间差别有统计学意义.（3）随着工龄和每天工作时间的延长,光损伤性黄斑病变的发生率逐渐提高,差别有统计学意义.（4）叶黄素干预组在最佳矫正视力、MPOD和对比敏感度及眩光敏感度方面,显著优于安慰剂对照组.结论 电焊工人中黄斑光损伤的危险相关因素是工龄、工作时间、防护习惯和叶黄素的是否辅助使用,所以应该在这些方面加强.Objective To investigate the Influence of risk factors that cause the phototoxic maculopathy by welding arc in occupational welders.Methods We examined randomly a group of 86 male occupational welders 172 eyes from some local metal manufacturing enterprise from August 2010 to December 2013.The ophthalmologic examination which the participants underwent thorough including the best visual acuity,fundus examination by the supplementary lens,fundus photography,and the high definition optical coherence tomography （OCT） scan.All participants of this study underwent thorough the medicine examined by a specialist of occupational who prior to the OCT.All the subjects were divided into groups according to age,protection degrees,length of service,operating time.The incidences of phototoxic maculopathy were compared within groups.The subjects was divided randomly into the lutein group and the placebo group.The examination including the best visual acuity,serum lutein concentrations,macular pigmentoptical density （MPOD）,Contrast and glare Sensitivity.Results （1）The total incidence of phototoxic maculopathy is 32.0％.（2）The incidences of phototoxic maculopathy in the strict protection group,the randomed protective group and the nonprofessional protection group were respectively 21.4％,36.7％,53.6％.The incidence in the strict protection group was lower than the other two groups,the incidence was the highest in the nonprofessional protection group,and the difference was statistically significant.（3） The longer length of service,and operating time,the more incidence of phototoxic maculopathy develop.（4） The lutein group prior to the placebo group at the best visual acuity,serum lutein concentrations,macular pigmentoptical density（MPOD）,Contrast and glare Sensitivity.Conclusion The risk factors of phototoxic maculopathy in male occupational welders are the length of service,operating time,protection degrees and the lutein assistantly.The incidence of phototoxic maculopathy occurs regardless of age.

关 键 词：光损伤性黄斑病变 电焊弧光 职业危险 

分 类 号：R135.92[医药卫生—劳动卫生]