目的调查硬质合金粉尘对作业工人健康的影响,为人体钨钴的生物接触限值、硬金属肺病诊断标准的制定及早期防治提供依据。方法选取江苏省某硬金属加工厂165名硬质合金粉尘作业工人作为调查组,132名无硬质合金粉尘接触的作业工人作为对照组。收集问卷调查、职业健康检查、工人班后尿钴含量以及现场作业环境检测等相关资料。结果该厂硬质合金生产环境中的粉尘浓度,其几何均值均未超过国家标准。作业环境中空降尘游离二氧化硅含量均小于1.0%。调查组呼吸系统异常及黏膜刺激症状检出率高于对照组,差异有统计学意义(P<0.05)。与对照组比较,调查组胸片X线结果阳性检出率明显增高。在调查组中肺功能指标用力肺活量(FVC)、尿钴检测值超标率均高于对照组,差异有统计学意义(P<0.05)。结论硬质合金粉尘中含有一定量的钴;工人接触硬质合金粉尘早期可导致呼吸系统异常及黏膜刺激症状、胸部肺纹理增加;可致肺功能轻度限制性通气功能障碍改变,肺部损伤部位主要在小气道。因此,应加强对硬质合金粉尘接尘工人的劳动防护,做好防尘工作,定期做职业健康检查,及时采取有效防治措施,确保接尘工人的身体健康。 Objective To investigate the impact of cemented carbide dust on workers’ health, provide the basis for bio-contact limits of human tungsten and cobalt, and to formulate the diagnostic criteria of hard metal lung disease and prevent it early. Methods A total of 165 cemented carbide dust workers in a hard metal processing factory in Jiangsu Province were selected as survey group and 132 non-cemented carbide dust exposure workers as control group. Collect questionnaires, occupational health checks, urinary cobalt content of workers after class and field operations environment testing and other related information. Results The factory dust concentration in carbide production environment, the geometric mean value did not exceed the national standard. The working environment of the airborne dust free silica content of less than 1.0%. The detection rate of respiratory system abnormalities and mucosal irritation in the investigation group was higher than that in the control group, with significant difference (P <0.05). Compared with the control group, the positive rate of X-ray findings in the survey group was significantly higher. FVC and urinary cobalt in the survey group were higher than the control group, the difference was statistically significant (P <0.05). Conclusion Carbide dust contains a certain amount of cobalt; workers exposed to cemented carbide dust early may lead to respiratory disorders and mucosal irritation, chest lungs increased texture; can cause mild pulmonary function limitations of ventilatory dysfunction changes, lung injury The main part of the small airway. Therefore, we should strengthen the labor protection of workers engaged in cemented carbide dust dusting, carry out dust prevention work, do regular occupational health checks, and take effective prevention and control measures in a timely manner to ensure the health of dust-pick workers.