某铅蓄电池厂工人健康状况及其影响因素分析
Health status of lead exposed workers in a battery factory and its influence factors
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摘要:目的 了解某铅蓄电池厂铅作业工人健康状况及其影响因素, 为企业健康监护提供基础资料。方法 以该铅蓄电池厂1 179名铅作业工人作为研究对象, 进行问卷调查和健康体检。结果 1 179名研究对象血铅值中位数和第25、75百分位数M (P25, P75)为152.2(65.4, 356.7)μg/L, 血铅超标(血铅值≥ 400 μg/L)120人, 超标率为10.2%。男性心电图异常率为14.3%, 高于女性的2.2%, 血常规异常率为7.1%, 低于女性的18.1%, 差异均有统计学意义(P < 0.01)。多因素logistic回归分析结果显示:铅接触组发生血铅异常的危险性是不接触组的7.469倍(95% CI:2.817~19.804);男性发生心电图异常的危险性是女性的7.974倍(95% CI:4.099~15.511), 血铅水平在300~μg/L组发生心电图异常的危险性是对照组(血铅水平 < 100 μg/L)的3.450倍(95% CI:1.724~15.690);男性发生贫血的危险性是女性的34.2%(95% CI:0.235~0.499), 血铅200~μg/L组、300~μg/L组发生贫血的危险性分别是对照组(< 100 μg/L)的3.020倍(95% CI:1.234~8.562)、3.870倍(95% CI:1.985~16.398)。结论 心电图异常率男性高于女性, 贫血发生率则是女性高于男性; 血铅是铅作业工人健康状况的独立危险因素, 应进一步加强监测, 组织工人定期体检, 保护工人健康。Abstract:Objective In order to learn the health status of lead exposed workers and its influence factors, and to provide base data for the promotion of workers' health.Methods Totally 1 179 lead exposed workers in a lead acid battery factory were surveyed with both occupational questionnaire and health examination.Results Of 1 179 workers, the median (the 25th and 75th percentiles) of blood lead level was 152.2(65.4, 356.7) μg/L and 10.2% workers had blood lead level no less than 400 μg/L. The electrocardiogram (ECG)examination showed male workers had higher abnormality (14.3%) than female workers(2.2%)(P < 0.01), however, they had lower abnormal rate of blood routine examination (7.1% vs. 18.1%)(P < 0.01). Multivariate logistic regression analysis showed that the risk of blood lead abnormality among lead-exposed workers was 7.469 times higher than that in non-exposed group (95%CI:2.817-19.804), and the risk of ECG abnormality in male workers was 7.974 times higher than that in the female workers (95%CI:4.099-15.511). It also showed the risk of ECG abnormality among workers with blood lead level no less than 300 g/L was 3.450 times higher than that in the control group (blood lead level < 100 g/L)(95%CI:1.724-15.690); the risk of anemia in male workers was 0.342 of that in female workers(95%CI:0.235-0.499). The risk of anemia among workers with blood lead level no less than 200 g/L or 300 g/L was 3.020 times (95%CI:1.234-8.562) and 3.870 times (95%CI:1.985-16.398) higher than those in the control group, respectively.Conclusion The ECG abnormality of male lead-exposed workers was higher than that of female workers, while the incidence of anemia showed inverse condition. Blood lead level is the independent risk factor for workers' health. The health surveillance and periodic physical examination should be taken to safeguard workers' health in the future.