累积粉尘接触量对职业人群血脂水平的影响-现代医学

累积粉尘接触量对职业人群血脂水平的影响

单位：1. 南京医科大学公共卫生学院, 江苏南京 211166;
2. 东南大学公共卫生学院, 江苏南京 210009;
3. 南京南钢医院, 江苏南京 210044;
4. 江苏省疾病预防控制中心, 江苏南京 210009

分类号：R135.2

出版年·卷·期（页码）：2022·50·第十期（1232-1238）

摘要：

目的：探讨累积粉尘接触对职业人群血脂各项指标的影响，为职业人群血脂异常的防治提供参考依据。方法：2020年6月至12月选取南京江北新区某大型化工企业的职业人群为调查对象，采用自行设计的调查问卷，对目标人群进行问卷调查、体格检查以及相关生化指标检测。根据是否接触粉尘分为暴露组和非暴露组，用Logistic回归分析两组人群的血脂异常特征。将累积粉尘接触量（CDE）4分组后采用多因素Logistic回归计算粉尘累积接触量与血脂异常的OR值。结果：接触粉尘职业人群血脂异常率为45.2%，高于非暴露组血脂异常率38.4%，且总胆固醇（TC）、甘油三酯（TG）以及低密度脂蛋白胆固醇（LDL-C）组间差异均有统计学意义（P<0.05）；Logistic回归结果显示，调整相关变量后接触粉尘职业人群患血脂异常的OR值为1.30（95%CI 1.070~1.583）。随着粉尘累积接触量的增加，职业人群患血脂异常的风险逐渐增加，累积粉尘接触量最高组（99.48±8.67） g的职业人群血脂异常率是非接触组的1.91倍。结论：粉尘浓度达标的情况下，粉尘对职业人群血脂水平仍有明显影响，对接触粉尘职业人群应采取更为严格的防护措施，以降低职业人群的血脂异常率。

Objective: To explore the influence of occupational dust exposure on various blood lipid indexes, and to provide evidence for the prevention and treatment of dyslipidemia in the occupational population. Methods: The occupational population in a large chemical enterprise in Jiangbei New Area of Nanjing was surveyed from June to December 2020. A self-designed questionnaire was conducted to collect the data of basic information, physical examination and the related biochemical indicators. According to the dust exposure, the occupational population was classified into exposed and non-exposed groups. The dyslipidemia characteristics of both populations were analyzed by Logistic regression. After grouping the cumulative dust exposure (CDE) into four groups, the odds ratio (OR) of the cumulative dust exposure and dyslipidemia was calculated by multifactor Logistic regression. Results: The dyslipidemia rate of the exposed group was 45.2%, higher than 38.4% in the non-exposed group, and the differences in total TC, TG and LDL-C between the two groups were statistically significant. Results of the Logistic regression showed that the occupational dust exposure was a risk factor for dyslipidemia and the OR of dyslipidemia was 1.30 (95%CI 1.070-1.583) after adjusting related variables. With the increase of CDE, the risk of dyslipidemia in the occupational population gradually increased. The dyslipidemia rate of the occupational population in the highest CDE exposed group (99.48±8.67)g was 1.91 times than that of the non-exposed group. Conclusion: The occupational dust has a significant effect on the level of blood lipid in the occupational population, although the dust concentration was lower than the national standard. Thus, stricter protection measures should be taken for those occupational populations exposed to dust, and to reduce the rate of dyslipidemia in the occupational population.

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