职业紧张与工作条件对男性警察糖尿病发病影响前瞻性研究  

Effects of occupational stress and working conditions on diabetes mellitus in male police officers: a prospective cohort study

作　　者：张利新[1] 于浩[2] 罗晓燕[3] 刘金川[2] 岳松[4] 陈曦[2] 杨昆[1] 汤乃军[2] 

机构地区：[1]天津医科大学公共卫生学院毒理学教研室,天津300070 [2]天津医科大学公共卫生学院劳动卫生与环境卫生学系 [3]天津医科大学公共卫生学院流行病与卫生统计学系 [4]天津市公安医院物检科

出　　处：《中国公共卫生》2015年第2期164-168,共5页Chinese Journal of Public Health

基　　金：天津市科技支撑计划重点项目(08ZCGYSF01500)

摘　　要：目的 探讨职业紧张与工作条件对男性警察糖尿病（DM）发病的影响。方法 采用前瞻性队列研究方法,以天津市6 075名男性警察为研究对象,调查其DM危险因素、职业紧张水平及工作条件,跟踪随访队列DM发病情况,采用多因素Cox回归分析职业紧张与工作条件对警察DM发病的影响。结果 2008—2011年对队列人群进行定期随访,随访中位时间为2.61年,随访期间发现DM患者179例（3.1%）;交警DM发病风险明显高于其他警种,HR值及其95%CI为2.89（2.12~3.93）;相对于适度职业紧张组,具有缺乏职业紧张、高度职业紧张的警察DM发病的HR值及其95%CI为3.12（1.81~5.38）、1.97（1.34~2.91）;相对于适度紧张反应组,具有中度紧张反应、高度紧张反应的警察DM发病的HR值及其95%CI为1.66（1.12~2.44）、2.57（1.34~4.92）;将危险因素重新定义并采用Cox回归分析发现,具有缺乏职业紧张、中度职业紧张、高度职业紧张、中度紧张反应和高度紧张反应的交警人群相对于其他警察DM发病的HR值及其95%CI分别为4.62（2.39~8.90）、2.44（1.65~3.60）、3.30（2.20~4.94）、3.11（1.93~5.03）、4.48（1.83~10.98）。结论 职业紧张和工作条件在影响警察DM发病过程中起着重要作用,交警和缺乏、中度、高度职业紧张和中度、高度紧张反应是其独立危险因素。Objective To investigate the effects of occupational stress and working conditions on diabetes mellitus （DM） in male police officers. Methods Totally 6 075 police offices in Tianjin municipality were recruited for a pro- spective cohort study on risk factors of DM. DM cases were screened during the period of the follow-up. Cox proportional hazard regression analysis was used to calculate the hazard ratios（HR） of DM predicted by occupational stress status and working conditions. Results During the follow-up period of 2.61 years （median） from 2008 to 2011,179 （ 3.1% ） per- sons developed DM among the participants. The risk of DM for traffic police was significantly higher than other police （HR = 2.89,95% confidence interval [ 95% CI] ： 2. 12 - 3.93 ）. Compared to the police with moderate occupational stress ,the HR of DM for the police officers without the stress or with high occupational stress were 3.12（95% CI： 1.81 - 5.38 ） and 1.97 （ 95 % CI = 1.34 - 2. 91 ） ; compared to the police with appropriate occupational stress reaction, the HR for the police officers with moderate or high occupational stress reaction were 1.66 （ 95% CI： 1.12 - 2.44 ） and 2.57 （ 95% CI： 1.34 -4.92 ）, respectively. After redefined the risk factors, the results of Cox regression showed that the HR （95 % CI） of DM for the traffic police without occupational stress, with moderate or high occupational stress, with moderate or high occupational stress reaction were 4. 62 （ 2. 39 - 8.90 ）, 2.44 （ 1.65 - 3.60 ）, 3.30 （ 2. 20 - 4. 94 ）, 3. 11 （ 1.93 - 5.03）, and 4. 48 （ 1.83 - 10. 98 ） compared to other police officers, respectively. Conclusion Occupational stress and working conditions play an important role in the incident of DM in police officers and being a traffic police, without occu- pational stress, with moderate or high occupational stress, and with moderate or high occupational stress reaction are independent risk factors of DM.

关 键 词：警察 糖尿病(DM) 职业紧张 工作条件 前瞻性队列研究 

分 类 号：R161.7[医药卫生—公共卫生与预防医学]