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目的探讨粉尘对接尘工人健康损害的危险因素及预防对策。方法以成都市某单位2014年的467名粉尘作业人员(接尘组)与280名非粉尘作业人员(对照组)为研究对象,对比两组人员的高仟伏胸片检查结果,采用多因素logistic回归分析粉尘作业人员健康损害的危险因素,并制定针对性预防对策,于2015年实施。比较该单位2014与2015年接尘工人高仟伏胸片结果异常率。结果 2014年接尘组高仟伏胸片结果异常率为16.06%(75/467),显著高于对照组6.43%(P<0.05)。高仟伏胸片结果异常主要表现为肺纹理增多、肺阴影、疑似肺结核与尘肺。接尘组用力肺活量(FVC)、第1秒末用力呼气量(FEV_(1.0))、第1秒肺活量占用力肺活量的比例(FEV_(1.0)/FVC)分别为(3 678.56±118.94)ml、(2 869.55±102.47)ml、(78.01±9.11)%,均低于对照组(P<0.01)。接尘组年龄≥35岁、工龄≥5 a、每天吸烟≥15支者所占比例分别为61.03%、74.95%、55.25%,均高于对照组(P<0.05)。2015年该单位接尘工人的高仟伏胸片异常率为5.71%,低于2014年的16.06%(P<0.05)。实施预防对策后2015年接尘作业人员的FVC、FEV_(1.0)、(FEV_(1.0)/FVC)%分别为(3 867.57±104.66)ml、(3 159.80±105.87)ml、(81.70±8.53)%,均高于实施前(P<0.01)。结论粉尘对接尘工人的健康损害检出率较高,对年龄稍大(≥35岁)、长工龄(≥5 a)接尘作业工人进行个人监护措施并及时更换岗位、积极倡导戒烟,有助于改善该部分人群的肺功能,降低身体损害风险。
Objective To explore the risk factors of health damage caused by dust to workers exposed to dust and the preventive measures. Methods A total of 467 dust workers (dust-pick group) and 280 non-dust workers (control group) from a unit in Chengdu were enrolled in this study. The results of high-kV chest radiography were compared between the two groups. Multivariate Logistic regression analysis of risk factors for health hazards of dust workers, and to develop targeted preventive measures, implemented in 2015. Compare the unit rate of abnormal chest X-ray results of dust collectors in 2014 and 2015. Results In 2014, the abnormal rate of high kV chest radiographs was 16.06% (75/467), significantly higher than that of the control group (6.43%, P <0.05). High Qianxu chest radiograph abnormalities mainly for increased lung markings, lung shadow, suspected pulmonary tuberculosis and pneumoconiosis. FVC, FEV_ (1.0) at 1 second and FEV_ (1.0) / FVC at 1 second were (3 678.56 ± 118.94) ml , (2 869.55 ± 102.47) ml and (78.01 ± 9.11)% respectively, all lower than those in the control group (P <0.01). The proportion of patients who were ≥35 years old, ≥5 years of work, and ≥15 cigarettes per day were respectively 61.03%, 74.95% and 55.25%, which were higher than those of the control group (P <0.05). In 2015, the abnormality rate of high-kV chest radiographs for dust-exposed workers in this unit was 5.71%, down from 16.06% in 2014 (P <0.05). The FVC, FEV_ (1.0) and (FEV_ (1.0) / FVC)% of dust-pick workers in 2015 after implementing preventive measures were (3 867.57 ± 104.66) ml, (3 159.80 ± 105.87) ml and (81.70 ± 8.53) %, Both higher than before (P <0.01). Conclusions Dust has a higher detection rate of health damage to workers exposed to dust. It provides personal guardianship to workers who are slightly older (≥35 years old) and workers with long working life (≥5 years) and promptly change their jobs, and actively encourages smoking cessation To improve the lung function of this part of the population, reduce the risk of physical damage.