不同轮班工作制铁路职业人群生活方式与血脂异常的关联  

Association between lifestyle factors and dyslipidemia among railway workers under different shift work schedules

作　　者：肖赢成 陈浩 蒋林 贾英男[1] XIAO Yingcheng;CHEN Hao;JIANG Lin;JIA Yingnan(School of Public Health,Fudan University,Shanghai 200032,China;Shanghai Railway Disease Prevention and Control Institute,China Railway Shanghai Group Co.,Ltd.,Shanghai 200071,China)

机构地区：[1]复旦大学公共卫生学院,上海200032 [2]中国铁路上海局集团有限公司上海铁路疾病预防控制所,上海200071

出　　处：《环境与职业医学》2024年第6期661-667,共7页Journal of Environmental and Occupational Medicine

基　　金：国家自然科学基金项目(72004027);中国铁路上海局集团有限公司科研计划课题项目(2022193)。

摘　　要：[背景]不良生活方式可能是导致血脂异常风险增加的重要危险因素,鲜有研究关注从事轮班工作较多的铁路职业人群中上述二者间的相关性。[目的]掌握铁路职业人群血脂异常与生活方式现状,并探究不同轮班工制职工生活方式与血脂异常间的关联,为制定有针对性的铁路职业人群血脂异常预防措施提供参考依据。[方法]研究对象选取自2021年某铁路单位在职职工,采取配额抽样的方法,每个部门至少抽取50%以上的职工参与调查。研究通过自填式问卷收集2021年在职职工人口学特征与生活方式信息,并通过对员工进行健康体检收集生理生化指标。采用χ^(2)检验分析不同特征的铁路职工血脂异常的分布差异,采用二元logistic回归分析各研究变量与血脂异常间的统计关联,采用相加交互模型分析生活方式健康状况与不同轮班工作制间的交互作用。[结果]研究共计纳入17392名研究对象,血脂异常率31.3%,从事夜班轮班以及常夜班的职工血脂异常率相比从事常白班职工更高,分别为33.5%与34.3%。铁路职业人群的主要不良生活方式为身体活动不活跃(59.6%)、饮酒(40.0%)与吸烟(35.7%),拥有健康生活方式者占13.6%,此外,不同生活方式的在职职工的血脂异常率差异均具有统计学意义(P<0.01)。经调整混杂因素后发现,吸烟是血脂异常的危险因素(OR=1.61,95%CI:1.48~1.75),身体活动高度活跃是血脂异常的保护因素(OR=0.79,95%CI:0.71~0.88)。总体而言,健康的生活方式可以降低血脂异常风险(OR=0.86,95%CI:0.77~0.95)。进一步按不同轮班工作制进行分层分析后发现,在不同轮班工作人群中吸烟与血脂异常间的关联均具有统计学意义(P<0.001),具体分别为:常白班,OR=1.62,95%CI:1.42~1.84;夜班轮班,OR=1.54,95%CI:1.35~1.76;常夜班,OR=1.75,95%CI:1.40~2.18。在常白班群体中,身体活动高度活跃者血脂异常风险降低(OR=0.81,95%CI:0.69~0.95);在�[Background]Unhealthy lifestyles may constitute significant risk factors for dyslipidemia.However,limited studies focus on the association mentioned above among railway workers undertaking frequent shift work.[Objective]To understand the status of dyslipidemia and lifestyles among railway workers,and to investigate the association between the lifestyles of workers involved in different shift work schedules and dyslipidemia,aiming to provide a reference for the development of targeted intervention strategies against dyslipidemia in this occupational group.[Methods]The participants were selected from the in-service staff of a railway unit in 2021.A quota sampling approach was used to ensure the participation of at least 50%of employees from each department.Demographic and lifestyle information of the railway workers in 2021 was collected through self-administered questionnaires,while physiological and biochemical indicators were obtained through health examinations.Chi-square tests were employed to analyze the distribution of dyslipidemia among railway workers with different characteristics.Binary logistic regression was utilized to examine the associations between selected variables and dyslipidemia,and additive model was used to investigate the interaction between lifestyle and different shift work schedules on dyslipidemia.[Results]A total of 17392 railway workers were included in the study,and the total prevalence of dyslipidemia was 31.3%,with a higher prevalence reported among workers undertaking rotating night shifts(33.5%)and permanent night shifts(34.3%)than those with regular day work.The main adverse lifestyles among the railway workers were physical inactivity(59.6%),alcohol consumption(40.0%),and smoking(35.7%),and only 13.6%reported a healthy lifestyle.Furthermore,significant statistical differences in the prevalence of dyslipidemia were reported among workers with different lifestyles(P<0.01).After adjusting for confounding factors,smoking was a risk factor for dyslipidemia(OR=1.61,95%CI:1.48,1.75),w

关 键 词：铁路职工 轮班工作 生活方式 血脂异常 交互作用 

分 类 号：R13[医药卫生—劳动卫生]