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目的观察高原环境对青藏铁路参建者健康的影响,为高原地区卫生保障工作提供科学依据。方法应用现况调查和前瞻性调查方法,对109429名建设人员职业危害情况和采取的预防措施进行分析。结果2001-2004年青藏铁路建设人员109429人中,共发生559例肺水肿;294例脑水肿。2002年参建人员工后血常规改变、心电图改变、血压改变、尿常规改变和肝功改变检出率均高于工中,差异有统计学意义(P<0.01);2003年参建人员工后检查指标除尿常规未见显著性变化外,血常规、心电图、血压、和肝功能改变检出率均高于工中,差异有统计学意义(P<0.01)。按月份的发病情况进行统计结果显示肺水肿和脑水肿的发病率均以4月份发病率最高,9月份末最低,4月份的发病率明显高于其他月份,差异有统计学意义(P<0.01)。结论青藏高原环境恶劣,存在多种职业有害因素,对建设人员的危害严重。研究制定切实可行的防治措施可以明显减轻职业危害,保障建设者的安全健康。
Objective To observe the impact of plateau environment on the health of participants in the Qinghai-Tibet Railway and provide a scientific basis for health insurance in plateau areas. Methods The status quo and prospective investigation methods were used to analyze the occupational hazards of 109429 construction workers and preventive measures taken. Results A total of 105929 pulmonary edema and 294 cerebral edema occurred among the 109,429 Qinghai-Tibet Railway construction workers during 2001-2004. In 2002, the post-construction workers’ blood routine changes, electrocardiogram changes, blood pressure changes, urine routine changes and liver function changes were higher than those in the workers, with significant difference (P <0.01). In 2003, There was no significant difference in post-test except urinary routine test. The detection rate of blood routine, electrocardiogram, blood pressure and liver function were all higher than those in the work, the difference was statistically significant (P <0.01). According to the monthly incidence, the incidence of pulmonary edema and cerebral edema were the highest in April and the lowest in September, the incidence in April was significantly higher than the other months (P <0.01) ). Conclusion The environment in the Qinghai-Tibet Plateau is bad and there are many occupational hazards, which seriously jeopardize the construction workers. To study and formulate practical prevention and control measures can obviously reduce occupational hazards and ensure the safety and health of builders.