2014年上海市矽尘接尘工人呼吸系统健康监测

刘美霞; 丁文彬; 杨凤; 郭薇薇; 瞿菁; 尹艳; 贾晓东

doi:10.16369/j.oher.issn.1007-1326.2015.03.004

2014年上海市矽尘接尘工人呼吸系统健康监测

上海市疾病预防控制中心, 上海 200336

基金项目:

上海市第三轮"公共卫生三年行动计划"学科人才建设项目劳动卫生与毒理学(编号:12GWZX0502)。

详细信息

作者简介:
刘美霞(1976-),女,硕士,主管医师,研究方向:职业流行病学;职业暴露评估。

中图分类号: R135.2
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- 文章访问数: 219
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- PDF下载量: 30
出版历程
- 收稿日期: 2015-04-10
- 修回日期: 2015-05-19

Health surveillance of respiratory disorders among silica-exposed workers in Shanghai in 2014

Shanghai Municipal Center for Disease Control & Prevention, Shanghai 200336, China

摘要

摘要: 目的评估2014年上海市矽尘接尘工人的呼吸系统健康状况。方法选择2014年上海市所有涉及矽尘作业的181家企业中从事矽尘作业1年以上的2 196名劳动者为研究对象,进行肺功能、X线胸片等医学检查。运用问卷调查获得研究对象的人口学特征、吸烟状态、职业史等信息。采用分层随机抽样,对其中169家企业的619名矽尘接尘工人进行矽尘总尘个体采样,计算矽尘总尘的8 h时间加权平均浓度并进行评价。结果矽尘总尘的几何均数和几何标准差分别为1.4 mg/m³和3.3 mg/m³。矽尘总尘的总体超标率为66.4%。矽尘接尘工人X线胸片中可疑尘肺病或观察对象检出率为0.4%;FVC、FEV₁和FEV₁/FVC的异常检出率分别为21.3%、13.4%和0.1%。限制性通气功能障碍总体检出率为19.6%,随接触矽尘接尘工龄的增加而增加(趋势χ²=9.2143,P<0.05)。不同行业、不同工种间限制性通气功能障碍、X线胸片异常检出率差异均有统计学意义(P均<0.01),其中通用设备制造业、黑色金属冶炼和压延加工业等行业以及造型、型砂、清理、熔化、铸造、抛(磨)光等工种的异常检出率较高。结论上海市目前作业场所矽尘危害基本保持在历史的低水平,但整体普遍超标,矽尘接尘工人肺功能损伤明显,尤其表现为限制性通气功能障碍,建议加强对高危行业和工种的监管。
- 矽尘 /
- 肺通气功能 /
- X线胸片 /
- 职业健康监测 /
- 限制性通气功能障碍
+ English
Abstract: Objective To assess the prevalence and pattern of respiratory disorders among the silica-exposed workers in Shanghai in 2014. Methods A total of 2 196 workers exposed to silica dust for at least 1 year from 181 factories were studied. The subjects were examined, according to technical specifications for occupational health surveillance in China. The lung function test and chest X-ray were performed. Questionnaires were done to collect the information about demographic characteristic, health behavior,and employment history. Personal sampling was carried out among 619 workers who were sampled by stratified random sampling from 169 factories in the exposure group. Gravimetrical measurement was applied for 8h-TWA concentration of total dust. The contents of free SiO2 in the dust were determined by X-ray diffraction or judged according to the previous reports. Results The geometric mean and gemetric standard error for 8 h-TWA of silica total dust were 1.4 mg/m³ and 3.3 mg/m³, respectively. We found 66.4 percent of the samples were not compliant with national Occupational Exposure Limits(OELs) of silica total dust. The chest X-ray results showed the prevalence of suspected pneumoconiosis or observed subjects was 0.4% among workers exposed to silica dust. The prevalence of FVC loss, FEV₁ loss and FEV₁/FVC loss, and restrictive pulmonary dysfunction were 21.3%, 13.4%, 0.1%, and 19.6%,respectively. The detectable rates of restrictive pulmonary function increased with the duration of silica exposure (χ²trend= 9.214 3,P<0.05). The higher prevalence of restrictive pulmonary dysfunction or chest X-ray was noted in some industries such as general equipment manufacturing, black metal smelting and rolling processing industry, and some processes such as moulding, casting sand, fettler, smelting, foundry, and polishing. Conclusion The concentrations of silica dust in the workplaces were still high. The loss of functional respiratory capacity among these silica-exposed workers need to be concerned, mainly about restrictive pulmonary dysfunction. High-risk industries and processes should be under intensive inspection.
- silica dust /
- pulmonary ventilation function /
- chest X-ray /
- occupational health surveillance /
- restrictive pulmonary dysfunction

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参考文献(13)

[1]	Steenland K,Ward E. Silica:a lung carcinogen[J]. CA Cancer J Clin,2014,64(1):63-69.
[2]	Leung C,Yu I,Chen W. Silicosis. Lancet,2012,379(9830):2008-2018.
[3]	International Agency for Research on Cancer. IARC Monogr Eval Carcinog Risks Hum:arsenic,metals,fibres,and dusts 100(Pt C)[M].Lyon:IARC-Press,2012.
[4]	Wang X R,David C. Christiani[J]. Int J Occup Environ Health,2003,9(4):320-325.
[5]	李宝平,周云芝,杨德昌,等. 尘肺的流行病学[J]. 职业卫生与应急救援,2005,23(2):110-113.
[6]	朱素蓉,Coble J,贾晓东,等. 上海市1953年至2000年矽尘工种接触矩阵分析[J]. 环境与职业医学,2010,27(6):323-327.
[7]	Steenland,K. One agent,many diseases:exposure-response data and comparative risks of different outcomes following silica exposure[J]. Am J Ind Med,2005,48(1):16-23.
[8]	Gao P,Chen B T,Hearl F J,et al. Estimating factors to convert Chinese ‘total dust’ measurements to ACGIH respirable concentrations in metal mines and pottery industries[J]. Ann Occup Hyg, 2000,44(4):251-257.
[9]	Beeckman,L A,Wang M L,Petsonk E L,et al. Rapid declines in FEV₁ and subsequent respiratory symptoms, illnesses,and mortality in coal miners in the United States[J]. Am J Respir Crit Care Med,2001,163(3 Pt 1):633-639.
[10]	Bruske I,Thiering E,Heinrich J,et al. Respirable quartz dust exposure and airway obstruction:a systematic review and meta-analysis[J]. Occup Environ Med,2014,71(8):583-589.
[11]	刘拓. 铸造作业工人健康损害的现况研究[D]. 北京:中国疾病预防控制中心,2013.
[12]	Malmberg P,Hedenstrom H,Sundblad B M. Changes in lung function of granite crushers exposed to moderately high silica concentrations:a 12 year follow up[J]. Br J Ind Med,1993,50(8):726-731.
[13]	Bang K M,Mazurek J M,Wood J M,et al. Silicosis mortality trends and new exposures to respirable crystalline silica-United States,2001-2010[J]. MMWR Morb Mortal Wkly Rep,2015,64(5):117-120.

施引文献(8)

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2.	邓红平，姚建华，刘强，马春良. 苏州市124家重点行业工业企业矽尘危害状况调查. 职业与健康. 2021(13): 1831-1833 . 百度学术
3.	苏艺伟，陈琳，唐侍豪，林毓嫱，张晋蔚，刘移民. 矽尘作业工人呼吸系统异常和听力损失情况调查. 职业与健康. 2021(18): 2449-2452+2457 . 百度学术
4.	马石头，王永斌，张生奎，丛龙学，陆瑶，高学娟，马崇琪，廖雅静，范红敏，王朝阳，袁聚祥. 累积接尘量与吸烟指数对钢铁工人肺损伤的影响. 中国工业医学杂志. 2019(01): 44-47 . 百度学术
5.	张晓雪，王路遥，李宁，宋瑞瑞，沈福海，蒋守芳，佟俊旺，金玉兰. 纳米二氧化硅对职业接触人群健康影响. 中国职业医学. 2018(04): 530-533 . 百度学术
6.	王欣. 粉尘作业人员肺功能结果分析. 中国继续医学教育. 2017(36): 14-16 . 百度学术
7.	安惠萍. 职业性接触二氧化钛粉尘对呼吸系统和血压的影响. 职业卫生与应急救援. 2017(01): 16-18 . 本站查看
8.	宋远超，陈葆春，胡琼，查晚生. 安徽省12339例煤矿接尘工人肺功能损伤情况分析. 安徽预防医学杂志. 2016(06): 435-437 . 百度学术

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文章访问数: 219
HTML全文浏览量: 25
PDF下载量: 30
被引次数: 8

2014年上海市矽尘接尘工人呼吸系统健康监测

作者简介: 刘美霞(1976-),女,硕士,主管医师,研究方向:职业流行病学;职业暴露评估。

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出版历程

Health surveillance of respiratory disorders among silica-exposed workers in Shanghai in 2014

期刊类型引用(8)

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作者简介:
刘美霞(1976-),女,硕士,主管医师,研究方向:职业流行病学;职业暴露评估。