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目的探讨镉接触对作业工人鼻腔的损害。方法以整群抽样的方法选择某2家蓄电池企业共1 367名作业工人为调查对象,分别以工作场所空气中镉及其化合物水平超标5倍及以上、小于5倍和不超标的457、581和329名作业工人作为高接触组、低接触组和接触对照组;另以不接触镉及其他可能引起鼻腔损害的化学物的309名作业工人为正常对照组。检测该2家蓄电池企业工作场所空气中镉及其化合物水平,同时对上述4组作业工人进行尿镉水平检测,并进行鼻腔检查和嗅觉检查。结果 2家蓄电池企业工作场所空气中镉及其化合物超标率为75.68%(28/37)。1 367名蓄电池企业作业工人尿镉水平超标者455例(超标率为33.28%),其中高接触组超标率为71.99%,低接触组超标率为21.69%。接触组作业工人鼻腔自觉症状以嗅觉减退为主,其次为鼻干燥、灼痛和鼻衄;鼻腔体征以充血为主,其次为糜烂、肿胀和溃疡;检出嗅觉减退者399例(检出率为29.19%),嗅觉丧失者19例(检出率为1.39%);且随着接触镉及其化合物水平的增加,作业工人鼻腔自觉症状、体征、嗅觉减退和嗅觉丧失检出率均随之增加(P<0.05)。鼻腔糜烂部位以鼻中隔中部为主,左右鼻腔发生部位基本一致。尿镉超标作业工人嗅觉减退、鼻干燥、灼痛和鼻衄症状检出率为97.58%、8.57%、6.59%和1.10%,充血、糜烂、肿胀和溃疡的鼻腔体征检出率分别为99.78%、81.10%、73.85%和38.68%。结论蓄电池企业工作场所空气中镉及其化合物污染严重,应重视镉对鼻腔损害的防治工作。
Objective To investigate the damage to the nasal cavity of workers exposed to cadmium. Methods A total of 1,367 workers from a battery company in a cluster were sampled by cluster sampling method. The levels of cadmium and its compounds in the air of the workplace exceeded 5 times and above, less than 5 times and 457,581 And 329 workers were used as high-exposure group, low-exposure group and exposure control group. Another 309 workers who did not contact with cadmium and other chemicals that could cause nasal damage were selected as normal control group. The levels of cadmium and its compounds in the air of the two storage battery enterprises were detected. Urinary cadmium levels were detected in the four groups of workers and nasal and olfactory tests were performed. Results The over-standard rate of cadmium and its compounds in the air of two storage battery enterprises was 75.68% (28/37). There were 455 cases of urine cadmium level in 1 367 battery workers (exceeding the standard rate of 33.28%), in which the over-standard rate was 71.99% in high-exposure group and 21.69% in low-exposure group. In the contact group, the nasal symptoms of the workers mainly decreased with the loss of smell, followed by dry nose, burning pain and epistaxis. The nasal signs were mainly congestive, followed by erosions, swelling and ulcers; 399 cases were detected with the sense of smell loss 29.19%), and 19 cases of loss of sense of smell (detection rate was 1.39%). With the increase of exposure to cadmium and its compounds, the detection rate of nasal symptoms, signs, hyposmia and olfactory loss Increase (P <0.05). Nasal erosion of the nasal septum mainly in the central part of the nasal cavity about the same place. The detection rate of nasal symptoms of 97.58%, 8.57%, 6.59% and 1.10% in nasal cavity with dry urine, cadmium, cadmium, and cadmium in workers with excessive urinary cadmium were 99.78% , 81.10%, 73.85% and 38.68% respectively. Conclusion Cadmium and its compounds in the air of battery enterprises are seriously polluted. Cadmium should be taken into account for the prevention and treatment of nasal damage.