职业性噪声接触对劳动者血液检查结果的影响

摘要/Abstract

摘要： 目的探讨职业性噪声接触对劳动者血液检查结果的影响,为保障职业性噪声作业人员职业健康提供依据。方法选择2021年南京市某厂547名职业性噪声接触者为研究对象（噪声组）,同期245名非噪声接触的工作人员为对照组,分析、比较两组间血常规、肝肾功能、血糖、血脂、消化道肿瘤标志物及胃蛋白酶原Ⅰ和Ⅱ等血液指标的整体水平及异常情况,噪声组按工龄分组（1~<11、11~<21、≥21年）,比较、分析不同工龄组间血液检查结果的差异及异常情况。结果噪声组白细胞（white blood cell,WBC）[（7.06±1.82）×10⁹/L]、丙氨酸转氨酶（alanine transaminase,ALT）[（37.32±28.50）U/L]、总胆红素（total bilirubin,TBIL）[（12.65±5.14）μmol/L]、尿素（urea,BUN）[（5.01±1.11）mmol/L]、尿酸（uric acid,UA）[（376.88±92.74）μmol/L]、葡萄糖（glucose,GLU）[（5.66±1.55）mmol/L]、三酰甘油（triglyceride,TG）[（1.96±2.14）mmol/L]、总胆固醇（total cholesterol,TC）[（4.76±0.96）mmol/L]、糖类抗原72-4（carbohydrate antigen,CA72-4）[（4.69±13.19）U/mL]及胃蛋白酶原Ⅰ（pepsinogen Ⅰ,PGⅠ）[（128.03±22.39）ng/mL]和胃蛋白酶原Ⅱ（pepsinogen Ⅱ,PGⅡ）[（17.41±9.55）ng/mL]的水平均高于对照组,红细胞（red blood corpuscle,RBC）[（5.14±0.46）×10⁹/L]、血小板（platelets,PLT）[（203.42±50.67）×10⁹/L]、总蛋白（total protein,TP）[（72.40±5.51）g/L]水平均低于对照组,差异均有统计学意义（均P<0.05）。噪声组RBC、PLT、ALT、BUN、UA、GLU、TG、TC、CA72-4及 PGⅠ、PGⅡ的异常率均高于对照组,差异均有统计学意义（均P<0.05）。随着工龄的增加,噪声组ALT、UA、GLU、TC及PGⅠ、PGⅡ的水平升高,RBC、PLT及TP水平降低,BUN及TG水平在工龄11~<21年组最高。BUN、GLU、TC及PGⅡ的异常率随着工龄的增加而升高（均P<0.05）,RBC、PLT、ALT、UA及TG异常率在工龄11~<21年组最高。结论长期职业性噪声接触对血液检查结果有影响,RBC、PLT、ALT、BUN、UA、GLU、TG、TC及PGⅡ水平可成为评价噪声接触的非特异性血液指标。

关键词: 职业性噪声接触, 血液检查, 血液指标, 职业健康

Abstract: Objective To explore the influence of occupational noise exposure on blood test results of workers,so as to provide a basis for protecting occupational health of workers exposed to occupational noise. Methods A total of 547 workers exposed to occupational noise in a factory in Nanjing in 2021 were selected as the study objects（noise group）,and 245 workers without noise exposure during the same period were selected as the control group,and the overall levels and abnormalities of blood routine,liver and kidney function,blood glucose,blood lipid,gastrointestinal tumor markers,pepsinogen Ⅰ and Ⅱ were analyzed and compared between the two groups. The noise group was divided by working age（1-<11,11-<21,≥21 a）,and the difference and abnormal condition of blood test results among different working-age groups were compared and analyzed. Results The levels of white blood cell（WBC）[（7.06±1.82）×10⁹/L],alanine aminotransferase（ALT）[（37.32±28.50）U/L],total bilirubin（TBIL）[（12.65±5.14）μmol/L],urea[（5.01±1.11）mmol/L],uric acid（UA）[（376.88±92.74）μmol/L],glucose（GLU）[（5.66±1.55）mmol/L],triglycerid（TG）[（1.96±2.14）mmol/L],total cholesterol（TC）[（4.76±0.96）mmol/L],carbohydrate antigen 72-4（CA72-4）[（4.69±13.19）U/mL] and pepsinogen Ⅰ（PGⅠ）[（128.03±22.39）ng/mL] and Ⅱ[（17.41±9.55）ng/mL] in noise group were higher than those in control group,while the levels of red blood corpuscle（RBC）[（5.14±0.46）×10⁹/L],platelets（PLT）[（203.42±50.67）×10⁹/L] and total protein（TP）[（72.40±5.51）g/L] in noise group were lower than those in control group,with statistical significance（all P<0.05）. The abnormal rates of RBC,PLT,ALT,BUN,UA,GLU,TG,TC,CA72-4 and PG Ⅰ and Ⅱ in noise group were higher than those in control group,with statistical significance（all P<0.05）. With the increase of working age,the levels of ALT,UA,GLU,TC,PG Ⅰ and Ⅱ in noise group were increased,while the levels of RBC,PLT and TP were decreased,the levels of BUN and TG were the highest in the group of 11-<21 a. The abnormal rates of BUN,GLU,TC and PG Ⅱ had an increasing trend with the increase of working age（all P<0.05）. The abnormal rates of RBC,PLT,ALT,UA,TG were the highest in the group of 11-<21 a. Conclusion Long-term occupational noise exposure has an effect on blood test results. The levels of RBC,PLT,ALT,BUN,UA,GLU,TG,TC and PGⅡ can be used as non-specific blood indexes to evaluate noise exposure.

Key words: Occupational noise exposure, Blood tests, Blood index, Occupational health

中图分类号:

R135

徐光, 朱宝立. 职业性噪声接触对劳动者血液检查结果的影响. [J]职业与健康, 2023, 39(23): 3184-3189.

XU Guang, ZHU Baoli. Effects of occupational noise exposure on blood test results of workers. [J]OCCUPATION AND HEALTH, 2023, 39(23): 3184-3189.

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