矽尘接尘工人在岗期间肺功能和胸部尘肺样改变状况及其影响因素  

Status and influencing factors of pulmonary function and pneumoconiosis-like changesat chestamong silica-exposed workers while on duty

作　　者：王科霖[1] 米兆娟[1] 嵇平钟 王艳梅 谭强 WANG Ke-lin;MI Zhao-juan;JI Ping-zhong;WANG Yan-mei;TAN Qiang(Department of Occupational Health and Radiation Protection,The Center for Disease Prevention and Control of Yantai,Yantai 264003,China;不详)

机构地区：[1]烟台市疾病预防控制中心职业卫生与辐射防护科,山东烟台264003 [2]河南大学护理与健康学院,河南开封475004 [3]佛山市职业病防治所,广东佛山528000

出　　处：《工业卫生与职业病》2021年第4期274-277,293,共5页Industrial Health and Occupational Diseases

基　　金：佛山市医学类科技攻关项目(2017AB002561)。

摘　　要：目的了解矽尘接尘工人在岗期间肺功能和胸部尘肺样改变状况,分析其影响因素,为企业职业卫生管理工作提供参考依据。方法收集中国疾病预防控制信息系统中某市2015-2019年职业健康检查个案卡数据,采用SPSS 18.0软件进行统计分析。结果2015-2019年某市参加在岗期间职业健康检查的矽尘接尘工人共15281人次。其中,限制性通气功能障碍的检出率为3.00%;胸部尘肺样改变的检出率为0.99%。胸部尘肺样改变的工人肺功能指标FVC、FEV_(1)和FEV_(1)/FVC值均明显低于X射线胸片未见异常者(P<0.05)。多因素logistic回归分析结果显示,行业和经济类型是矽尘接尘工人出现限制性通气功能障碍的影响因素,金属冶炼压延加工和非金属制品业,私有制和外商企业工人发生肺功能异常的风险较大。行业、经济类型、年龄和工龄为工人胸部尘肺样改变的影响因素,金属冶炼压延加工和采矿业,私有制和集体所有制,工龄≥14 a,年龄>35岁工人发生胸部尘肺样改变的风险较大。结论企业不仅要关注矽尘接尘工人的胸部尘肺样改变,也应关注他们的肺功能改变,尤其是金属冶炼压延加工和非金属制品业的企业,及时发现在岗工人呼吸系统的早期改变,加强防护措施的落实和管理,从而预防尘肺病的发生。Objective To investigate the status and related influencing factors of pulmonary and pneumoconiosis-like changes at chest among silica-exposed workers while on duty,and to provide evidencefor administration work of occupational health in enterprise.Methods According to China information system for diseases control and prevention,case reports of occupational medical examination from 2015 to 2019 in a citywere collected,and analyzedwith SPSS 18.0.Results From 2015 to 2019,15281 silica-exposed workers were reported among the workers who received occupational medical examination in a city.Among these workers,the prevalence of restrictive pulmonary dysfunction were 3.00%,the detection rate of pneumoconiosis-like changes at chestwas 0.99%.FVC,FEV_(1) and FEV_(1)/FVC were significantly lower in the workers with the pneumoconiosis-like changes at chest than that of the normal ones(P<0.05).The industry and economy-ownedtype of were the main influence factors on pulmonary function.The higher prevalence of pulmonary dysfunction was foundin metal smelting and processing industries and non-metallic products industry of privately-owned and foreign investedenterprises.The industry,economy-ownedtype,age and length of service were the main influence factors on the pneumoconiosis-like changes at chest.The higher prevalence of the pneumoconiosis-like changes at chest among workers older than 35 years and having been serving for more than 14 years in metal smelting and processing industries and mining industries of privately-owned and collective ownership enterprises.Conclusions The enterprises should pay attention not only to pneumoconiosis-like changes at chest among silica-exposed workers,but also to emergence of pulmonary dysfunction among them,especially workers in metal smelting and processing industries and non-metallic products industry,in order to find early abnormal changes on the respiratory system among silica-exposed workers while on duty,strengthen implementation and management of preventive measure,and prevent emergen

关 键 词：矽尘 胸部尘肺样改变 肺功能 

分 类 号：R135.2[医药卫生—劳动卫生]