闫丽丽, 张沁雨, 陈洁玫, 张济明, 周志俊, 张雪涛. 接触肝脏毒物男性作业工人肝功能指标与工龄之间的关系[J]. 职业卫生与应急救援, 2024, 42(3): 336-341. DOI: 10.16369/j.oher.issn.1007-1326.2024.03.010
引用本文: 闫丽丽, 张沁雨, 陈洁玫, 张济明, 周志俊, 张雪涛. 接触肝脏毒物男性作业工人肝功能指标与工龄之间的关系[J]. 职业卫生与应急救援, 2024, 42(3): 336-341. DOI: 10.16369/j.oher.issn.1007-1326.2024.03.010
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YAN Lili, ZHANG Qinyu, CHEN Jiemei, ZHANG Jiming, ZHOU Zhijun, ZHANG Xuetao. Relationship between liver function indicators and exposure time among male workers occupationally exposed to hepatotoxic substances[J]. Occupational Health and Emergency Rescue, 2024, 42(3): 336-341. DOI: 10.16369/j.oher.issn.1007-1326.2024.03.010
Citation: YAN Lili, ZHANG Qinyu, CHEN Jiemei, ZHANG Jiming, ZHOU Zhijun, ZHANG Xuetao. Relationship between liver function indicators and exposure time among male workers occupationally exposed to hepatotoxic substances[J]. Occupational Health and Emergency Rescue, 2024, 42(3): 336-341. DOI: 10.16369/j.oher.issn.1007-1326.2024.03.010
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接触肝脏毒物男性作业工人肝功能指标与工龄之间的关系

Relationship between liver function indicators and exposure time among male workers occupationally exposed to hepatotoxic substances

    摘要
  • 摘要:
    目的  了解接触肝脏毒物男性职业人群的肝功能状况，探究肝功能指标与接触职业病危害因素之间的关系，为制定合理的健康监护方案和采取有效的防护措施提供依据。
    方法  收集2013—2021年在上海市某职业病防治机构进行职业健康检查的从事接触肝脏毒物作业的男性工人的体检资料，对多项肝功能指标和年龄、接害工龄之间的关系进行了分析。
    结果  9年间，共体检接触肝脏毒物作业男性工人92 788例，接害工龄为0.5~45.0年，中位值为5.0年。8项肝功能指标均完成检测的有52 096例。研究对象各肝功能指标异常率分别为：丙氨酸氨基转移酶（ALT）22.7%、天门冬氨酸氨基转移酶（AST）4.4%、血清总蛋白（TP）0.0%、白蛋白（ALB）0.5%、总胆红素（TBIL）44.2%、直接胆红素（DBIL）16.9%、γ-谷氨酰转肽酶（GGT）15.7%和碱性磷酸酶（ALP）4.2%。总体看，研究对象的ALT、AST和GGT有随接害工龄的增加而升高的趋势（r = 0.045~0.155，P＜0.05），其中GGT和工龄的相关性最强。DBIL和ALP有随接害工龄的增加而降低的趋势（r = -0.180、-0.033，P＜0.05）。研究对象接害工龄和TBIL检测值无相关关系（P＞0.05）。在进行年龄分层之后，大部分年龄段研究对象反映肝细胞损伤的指标ALT、AST、GGT和ALP与接害工龄的相关关系依然存在；在低龄组，AST、GGT和ALP与接害工龄的相关关系与总体结果一致；在高龄组，AST、GGT和ALP与接害工龄的相关关系则不再存在（P＞0.05）。反映肝脏合成与代谢的指标DBIL与接害工龄的相关性仅出现在18~29岁年龄段。
    结论  在恰当的防护下，长时间、低水平接触肝脏毒物并不会对人体造成严重的健康损害，但随着接害工龄的增加，肝功能依旧有受损的可能。企业需要规范作业流程，确保接触水平低于接触限值，保障劳动者的健康。

     

    Abstract:
    Objective  To understand the liver function status of male workers occupationally exposed to hepatotoxic substances and to explore the relationship between liver function indicators and exposed hazards, providing a basis for formulating reasonable health monitoring plans and effective protective measures.
    Methods  Health examination data of male workers engaged in work related to hepatotoxic substances from 2013 to 2021 at a certain occupational disease prevention institution in Shanghai was collected. The occurrences of various liver function indicators and their relationship with age or exposure time were studied.
    Results  Over 9 years, 92 788 male workers were examined. The exposure time of these workers occupationally exposed to hepatotoxic substances ranged from 0.5 to 45.0 years, with a median value of 5.0 years. A total of 52 096 workers were tested for all 8 liver function indicators. The abnormality rates of each liver function indicator were as follows: ALT 22.7%, AST 4.4%, TP 0.0%, ALB 0.5%, TBIL 44.2%, DBIL 16.9%, GGT 15.7%, and ALP 4.2%. Overall, the indicators ALT, AST, and GGT showed an increasing trend with years of service (r = 0.045-0.155, P < 0.05), with GGT having the strongest correlation with years of service. DBIL and ALP showed a decreasing trend with years of service (r = -0.180, -0.033, P < 0.05). There was no significant correlation between years of service and TBIL levels (P > 0.05). After age stratification, most age groups still showed a correlation between liver cell damage indicators (ALT, AST, GGT, and ALP) and years of service; in the younger age group, the correlation between AST, GGT, and ALP with years of service was consistent with the overall results; in the older age group, the correlation was no longer significant. The correlation between the liver synthesis and metabolism indicator DBIL and years of service only appeared in the 18-29 age group.
    Conclusions  With proper protection, long-term, low-level exposure to hepatotoxic substances does not cause severe health damage to workers. However, as years of service increase, there is still potential for liver function impairment. Enterprises need to standardize operating procedures, ensure exposure levels are below the national exposure limits, and protect the health of workers.

     

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