噪声和苯联合暴露对接害工人外周血细胞计数的影响  

Effects of noise and benzene combined exposure on peripheral blood cell counts of workers exposed to hazard

作　　者：张琼云 周珊宇[2] 陈嘉斌 ZHANG Qiong-yun;ZHOU Shan-yu;CHEN Jia-bin(School of Public Health,Guangzhou Medical University,Guangzhou,Guangdong 511436,China;不详)

机构地区：[1]广州医科大学公共卫生学院,广东广州511436 [2]广东省职业病防治院,广东广州510300

出　　处：《现代预防医学》2023年第5期820-825,907,共7页Modern Preventive Medicine

基　　金：广东省职业病防治重点实验室(2017B030314152)。

摘　　要：目的 探讨噪声和苯联合暴露对职业工人外周血细胞计数的影响。方法 广东省2018年进行在岗期间职业健康检查并收录在广东省重点职业病职业健康检查个案数据库中的企业,采用整群抽样的方法共选取接触苯和(或)噪声的15 865名工人作为研究对象,职业接触苯的9 421名工人为苯接触组,职业接触噪声的4 086名工人为噪声接触组,同时接触苯和噪声的2 358名工人为联合暴露组。分析其外周血细胞计数异常情况以及年龄、性别、工龄、所在企业规模及经济类型对工人外周血细胞计数异常率的影响。结果 噪声接触组的红细胞计数(RBC)和血红蛋白含量(Hb)异常率大于苯接触组和联合暴露组(χ^(2)_(RBC)=40.29,χ^(2)_(HB)=44.66,P<0.05)。相较于苯和噪声联合暴露,噪声暴露工人Hb出现异常的OR值(95%CI)为1.352(1.120~1.633)。三组暴露组中女性的Hb和PLT异常率均高于男性,差异具有统计学意义(苯暴露组:χ^(2)_(HB)=334.835,χ^(2)_(PLT)=123.600,P<0.05;噪声接触组:χ^(2)_(HB)=120.954,χ^(2)_(PLT)=8.986,P<0.05;联合暴露组:χ^(2)_(HB)=51.605,χ^(2)_(PLT)=15.450,P<0.05)。相对男性,女性RBC和Hb异常的风险增加,OR值(95%CI)分别为1.343(1.214~1.485)和3.269(2.936~3.639)。工龄、企业规模和经济类型是Hb异常的影响因素,企业规模是RBC异常的影响因素(P<0.05)。结论 噪声对工人的血液健康同样存在威胁,工作场所中同时存在苯和噪声污染的多重危害有待深入研究。建议将外周血细胞计数检测广泛纳入的噪声接触工人的职业健康体检项目中,在关注听力损伤的同时也不能忽视其血象异常问题。女性在苯和噪声接触中可能存在更高的风险;应加强大型企业、微型企业、集体经济企业、私有经济企业和外商经济企业的卫生监管。Objective To investigate the effects of noise and co-exposure of benzene on peripheral blood counts in occupational workers.Methods In 2018,occupational health examination data of workers in Guangdong Province were included in the case database of occupational health examination of key occupational diseases in Guangdong Province,and a total of 15865 workers exposed to benzene and/or noise were selected by cluster sampling.In total 9421 workers exposed to benzene were in the benzene exposure group,4086 workers exposed to occupational noise were in the noise exposure group,and 2358 workers exposed to both benzene and noise were in the combined exposure group.he abnormal peripheral blood cell count and the effects of age,sex,length of service,enterprise scale,and economic type on the abnormal peripheral blood cell count rate of workers were analyzed.Results The abnormal rates of red blood cell count(RBC)and hemoglobin(Hb)in the noise exposure group were significantly higher than the benzene group and the combined exposure group(χ^(2) _(RBC)=40.29,χ^(2) _(Hb)=44.66,P<0.05).Compared with the combined exposure of benzene and noise,the OR value(95%CI)of abnormal Hb among noise exposed workers was 1.352(1.120-1.633).The abnormal rates of Hb and PLT among female workers in three groups were higher than those in males,and the difference was statistically significant(benzene exposure group:χ^(2) _(Hb)=334.835,χ^(2) _(PLT)=123.600,P<0.05;noise exposure group:χ^(2) Hb=120.954,χ^(2) PLT=8.986,P<0.05;combined exposure group:χ^(2) _(Hb)=51.605,χ^(2) _(PLT)=15.450,P<0.05).Compared with male workers,the risks of abnormal RBC and Hb in female workers increased,and the OR values(95%CI)were 1.343(1.214-1.485)and 3.269(2.936-3.639).Length of service,enterprise scale,and economic type were the influencing factors of Hb abnormality,and enterprise scale was the influencing factor of RBC abnormality(P<0.05).Conclusion Noise also poses a threat to the blood health of workers,and the multiple hazards of benzene and noise pollution i

关 键 词：噪声 苯 联合暴露 外周血细胞计数 

分 类 号：R135[医药卫生—劳动卫生]