金属加工液接触者班前班后肺功能变化研究  

Pulmonary function changing of workers exposed to metalworking fluids pre-and post-shift

作　　者：王长勇[1] 王林超 高衍新[3] 杜英林[3] 邹立海[3] WANG Changyong;WANG Linchao;GAO Yanxin;DU Yinglin;ZOU Lihai(Department of Occupational and Environmental Health,Tai’an Municipal Center for Disease Control and Prevention,Tai'an,Shandong 271000,China;Department of Health Administration,The 7th People’s Hospital of Jinan,Jinan,Shandong 250132,China;Division of Public Health,Shandong Center for Disease Control and Prevention,Jinan,Shandong 250132,China)

机构地区：[1]泰安市疾病预防控制中心职业与环境卫生科,山东泰安271000 [2]济南市第七人民医院健康管理科,山东济南250132 [3]山东省疾病预防控制中心公共卫生所,山东济南250014

出　　处：《职业卫生与应急救援》2022年第3期273-276,304,共5页Occupational Health and Emergency Rescue

基　　金：山东省医药卫生科技发展计划项目(2011HZ054)。

摘　　要：目的调查某汽车制造企业接触金属加工液工人的呼吸系统症状,测定工人班前班后肺功能变化,以探讨金属加工液暴露对接触者呼吸系统的影响。方法对观察组158名接触金属加工液的工人和对照组116名装配作业工人,进行职业健康检查和跨班肺功能测定并进行比较。结果观察组作业场所检出低浓度的二乙胺、三乙醇胺。咳嗽、胸闷、气喘是金属加工液(MWF)接触工人常见的呼吸系统症状,观察组中有70例(占44.30%)工人至少出现1种呼吸系统症状,高于对照组(27例,占23.28%)(P<0.01)。观察组班后呼气峰流速(PEF)异常率较班前升高,差异有统计学意义(P<0.05)。与班前比较,观察组工人班后肺功能指标FEV_(1)、FEV_(1)/FVC、PEF均降低(P<0.05),其中FEV_(1)、FEV_(1)/FVC、PEF分别下降7.72%、4.43%、6.75%。观察组班后FEV_(1)/FVC、PEF低于对照组(P<0.05)。观察组班后肺功能损伤发生率高于班前(P<0.05),且班后异常率高于对照组(P<0.05),主要表现为以FEV_(1)降低、伴FEV_(1)/FVC降低为特征的阻塞性通气功能障碍。高工龄观察组班后FEV_(1)、FEV_(1)/FVC、PEF均低于低工龄组(P<0.05)。观察组工人班后FEV_(1)、FEV_(1)/FVC、PEF下降大于15%的工人分别占3.16%、1.90%、6.33%,有3.16%达到诊断哮喘的水平。结论金属加工液接触可致呼吸系统健康危害,表现为呼吸系统症状发生率增高和肺功能下降,应加强金属加工液接触者的呼吸防护。Objective The pulmonary function changing of workers to metalworking fluids pre-and post-shift and their respiratory symptoms in an automobile manufacturing company were investigated to explore the effects of metalworking fluids exposure on the respiratory system.Methods Totally 158 workers exposed to metalworking fluids(MWF)and 116assembly workers(as control group)were examined for occupational health and their pulmonary function were measured pre-and post-shift.Results Low concentrations of diethylamine and triethanolamine were detected in the MWF exposed workers’workplaces.Cough,chest tightness and asthma were common respiratory symptoms in MWF exposed workers.Totally 70 MWF exposed workers(44.30%)had one respiratory symptom at least,which was higher than that in the control group(27 cases,23.28%)(P<0.01).The abnormality of PEF of MWF exposed workers post-shift was higher than pre-shift,and the difference was statistically significant(P<0.05).Compared with the pre-shift,FEV_(1),FEV_(1)/FVC and PEF of the MWF exposed workers decreased post-shift(P<0.05),in which FEV_(1),FEV_(1)/FVC and PEF decreased by 7.72%,4.43%and 6.75%,respectively.FEV_(1)/FVC and PEF of exposed workers were lower than those of workers in the control group(P<0.05).The incidence of lung function injury of exposed workers after shift was higher than before shift(P<0.05),and the abnormal rate after shift was higher than that of control workers(P<0.05).The main manifestation was obstructive ventilation dysfunction characterized by decreased FEV_(1)and FEV_(1)/FVC.FEV_(1),FEV_(1)/FVC and PEF of exposed workers with longer working time were lower than those of workers with shorter working time(P<0.05).3.16%,1.90%and 6.33%of exposed workers’FEV_(1),FEV_(1)/FVC and PEF decreased by more than 15%after shift,respectively,and 3.16%could be diagnosed as asthma.Conclusions Exposure to metalworking fluids can cause respiratory health hazards,including increased prevalence of respiratory system and decreased pulmonary function.Therefore,respiratory pr

关 键 词：金属加工液 肺功能 跨班 机械加工 

分 类 号：R135.1[医药卫生—劳动卫生]