天津市某鞋厂苯作业工人血细胞异常的影响因素分析

摘要/Abstract

摘要： 目的探讨天津市苯作业工人血细胞异常的影响因素。方法 2021年收集天津市某鞋厂苯作业工人2020年职业健康检查资料,并通过自行设计问卷进行流行病学调查。用logistic回归分析苯作业工人个人一般情况、职业史、既往及家族疾病史、个人行为习惯、女性生理和生育情况对苯作业工人血细胞异常的影响。结果收集95例苯作业工人职业健康检查资料,并配合完成流行病学调查问卷,正常组苯作业工人66例,血细胞异常组苯作业工人29例。女性苯作业工人血细胞异常率高于男性（χ²=5.033,P<0.05）,未绝经的女性苯作业工人血细胞异常率高于绝经的女性工人（χ²=7.469,P<0.01）,年龄在18~<50岁的苯作业工人血细胞异常率高于年龄≥50岁的工人（χ²=5.265,P<0.05）。Logistic回归分析发现,低文化程度的苯作业工人血细胞异常风险高于中高文化程度工人（OR=4.951,95%CI：1.078~22.748）,未绝经的女性苯作业工人血细胞异常风险高于绝经的女性工人（OR=0.127,95%CI：0.033~0.487）。结论在职业健康管理中,除加强职业健康监护,还应重点关注文化程度、女性生理等高风险因素,加强高危人群应管理,预防职业病的发生。

关键词: 苯, 血细胞异常, 影响因素, 职业暴露

Abstract: Objective To investigate the influencing factors of blood cell abnormalities in benzene-exposed workers in Tianjin. Methods In 2021,the occupational health inspection data of benzene-exposed workers in a shoe factory in Tianjin were collected,and the epidemiological investigation was conducted through self-designed questionnaires. The logistic regression was used to assess the impact on blood cell abnormalities in benzene-exposed workers from personal general condition,occupational history,past and family medical history,personal behavior,female physiological and reproductive status. Results The occupational health examination data of 95 benzene-exposed workers were collected,and they cooperated with completing the epidemiological questionnaire. There were 66 benzene-exposed workers in the normal group and 29 benzene-exposed workers in the abnormal blood cells group. The rate of abnormal blood cells in females was higher than that in males（χ²=5.033,P<0.05）. The rate of abnormal blood cells in premenopausal female workers was higher than that in postmenopausal female workers（χ²=7.469,P<0.01）. The rate of abnormal blood cells in benzene-exposed workers aged 18-<50 years old was higher than that in those aged ≥50 years old（χ²=5.265,P<0.05）. The logistic regression analysis found that benzene workers with low education had higher risk of blood cell abnormalities than workers with medium and high education（OR=4.951,95%CI：1.078-22.748）,and premenopausal female benzene workers have higher risk of blood cell abnormalities than menopausal female workers（OR=0.127,95%CI：0.033-0.487）. Conclusion In occupational health management,in addition to strengthening occupational health monitoring,it is necessary to focus on high-risk factors such as educational level and female physiology,strengthen the management of high-risk groups,and prevent the occurrence of occupational diseases.

Key words: Benzene, Blood cell abnormalities, Influencing factors, Occupational exposure

中图分类号:

R135.1⁺3

李培, 王欣, 高雅, 刘静, 曾强, 张金月. 天津市某鞋厂苯作业工人血细胞异常的影响因素分析. [J]职业与健康, 2023, 39(5): 597-601.

LI Pei, WANG Xin, GAO Ya, LIIU Jing, ZENG Qiang, ZHANG Jin-yue. Analysis on influencing factors of abnormal blood cells in benzene-exposed workers in a shoe factory in Tianjin. [J]OCCUPATION AND HEALTH, 2023, 39(5): 597-601.

参考文献

[1] YIN S N,LI G L,TAIN F D,et al.Leukaemia in benzene workers:A retrospective cohort study[J].Br J Ind Med,1987,44(2):124-128.
[2] 叶云杰.代谢酶基因多态与苯致有害作用易感性的研究[D].上海:复旦大学,2012.
[3] 职业病分类和目录(国卫疾控发〔2013〕48号)[R/OL].(2013-12-23)[2022-04-12].http://www.nhfpc.gov.cn.
[4] LAN Q,ZHANG L,LI G,et al.Hematotoxicity in workers exposed to low levels of benzene[J].Science,2004,306(5702):1774-1776.
[5] KOH D H,JEON H K,LEE S G,et al.The relationship between low-level benzene exposure and blood cell counts in Korean workers[J].Occup Environ Med,2015,72(6):421-427.
[6] 刘月红,潘宝忠,相葵,等.低浓度混苯对作业工人血常规的影响[J].海峡预防医学杂志,2010,16(4):49-50.
[7] BOOGAARD P J,VAN SITTERT N J.Suitability of S-phenyl mercapturic acid and trans-trans-muconic acid as biomarkers for exposure to low concentrations of benzene[J].Environ Health Perspect,1996,104(Suppl 6):1151-1157.
[8] PANEV T,POPOV T,GEORGIEVA T,et al.Assessment of the correlation between exposure to benzene and urinary excretion of t,t-muconic acid in workers from a petrochemical plant[J].Int Arch Occup Environ Health,2002,75(Suppl):S97-S100.
[9] 孙懿.临床血常规检测中误差产生的原因及影响因素探讨[J].中国医药指南,2019,17(29):105-106.
[10] 陈仁强.某石化企业接苯工人健康状况及影响因素[D].济南:山东大学,2015.
[11] 中华人民共和国国家卫生和计划生育委员会.职业健康监护技术规范:GBZ188—2014[S].北京:中国标准出版社,2014:27-28.
[12] 中华人民共和国卫生部疾病控制司.中国成人超重和肥胖症预防控制指南[M].北京:人民卫生出版社,2006:1-4.
[13] 赵向伟,李志恒.接触苯及苯系化合物作业人员血常规检查结果分析[J].中国现代药物应用,2015,9(17):43-44.
[14] 王娟,姜光瑶.某厂苯作业工人职业健康检查结果分析[J].职业卫生与病伤,2016,31(1):5-7.
[15] 中华人民共和国国家卫生健康委员会.职业性苯中毒诊断标准:GBZ 68—2022[S].北京:中国标准出版社,2022:1-2.
[16] 朱福康.低浓度苯暴露的职业健康风险评估[D].北京:中国疾病预防控制中心,2021.
[17] 王欣,李梅莉,李培,等.天津市职业健康检查中发现疑似职业病情况分析[J].公共卫生与预防医学,2019,30(1):32-36.
[18] SCHNATTER A R,GLASS D C,TANG G,et al.Myelodysplastic syndrome and benzene exposure among petroleum workers:An international pooled analysis[J].J Natl Cancer Inst,2012,104(22):1724-1737.
[19] COPLEY G B,SCHNATTER A R,ARMSTRONG T W,et al.Hospital-based case-control study of mds subtypes and benzene exposure in Shanghai[J].J Occup Environ Med,2017,59(4):349-355.
[20] STENEHJEM J S,KJÆRHEIM K,BRÅTVEIT M,et al.Benzene exposure and risk of lymphohaematopoietic cancers in 25 000 offshore oil industry workers[J].Br J Cancer,2015,112(9):1603-1612.
[21] 国家市场监管总局,国家标准化管理委员会.个体防护装备配备规范第1部分:总则:GB 39800.1—2020[S].北京:中国标准出版社,2020:3-12.
[22] 中华人民共和国卫生部.呼吸防护用品的选择、使用与维护:GB/T 18664—2002[S].北京:中国标准出版社,2002:4-11.
[23] 中华人民共和国国家卫生健康委员.工作场所职业卫生管理规定[EB/OL].(2020-12-31)[2022-04-12].http://www.gov.cn/gongbao/content/2021/content_5595923.htm.
[24] 中华人民共和国卫生部.工作场所职业病危害警示标识:GBZ 158—2003[S].北京:中国标准出版社,2003:1-8.
[25] SATO A,NAKAJIMA T,FUJIWARA Y,et al.Kinetic studies on sex difference in susceptibility to chronic benzene intoxication--with special reference to body fat content[J].Br J Ind Med,1975,32(4):321-328.