摘要
目的通过对山东省某硬金属生产企业进行现场调查及接触工人职业健康检查,了解硬金属粉尘暴露对作业工人健康的影响。方法选取2019年某硬金属生产企业的筛料工、混料工、修形打磨工共89名为暴露组,89名无粉尘暴露人员为对照组,进行问卷调查、职业健康筛检,以及作业场所现场调查,空气钴暴露水平测定。结果筛料工序接触的钴浓度范围为0.01~0.02 mg/m^3;混料工序接触的钴浓度范围为0.09~1.04 mg/m^3;修形研磨工序接触的钴浓度范围为0.02~0.18 mg/m^3。筛料工序与混料工序、研磨工序钴暴露浓度比较均有差异(P<0.05),混料和研磨工序暴露浓度差异无统计学意义(P>0.05)。硬金属粉尘暴露组作业人员气短、胸闷、咳嗽、咳痰等呼吸道症状的发生率高于对照组(P<0.01),呼吸困难、胸部紧束感、胸疼等呼吸道症状的出现率无统计学意义(P>0.05),皮疹/皮肤瘙痒的体征两组比较差异无统计学意义(P>0.05),暴露组影像学异常检出率为64.04%,对照组异常检出率为4.49%。暴露组工人胸片出现纹理增多、点状线状影、网状影的比例较对照组高(P<0.01)。暴露组肺功能损伤检出率为FVC%28.09%、FEV1%24.72%、FEV1/FVC%2.25%;对照组损伤检出率为FVC%4.49%、FEV1%3.37%、FEV1/FVC%0.00%。暴露组FVC%、FEV1%异常检出率均高于对照组(P<0.01),2组FEV1/FVC%异常检出率差异无统计学意义(P>0.05)。结论硬金属作业工人粉尘暴露水平最高的工序为混料工。硬金属粉尘暴露对作业工人有一定的呼吸系统损害,出现呼吸系统症状,肺纹理粗乱增多,点线状影、网状影,肺功能检查呈限制性通气功能障碍。
Objective To understand the effect of hard metal dust exposure on the workers’health by an on-site survey and occupational health examination of workers in a hard metal production enterprise in Shandong province.Methods In 2019,a total of 89 workers who were exposed to dust in a hard metal production company,including screening,mixing,and grinding workers,were selected as the exposed group,and another 89 workers who were not exposed to dust were selected as the control group,and all of them were followed up by questionnaire and carried out occupational health examination.In addition,field surveys were conducted and the cobalt exposure levels in the workplace were also detected.Results The concentrations of cobalt in the screening,mixing and grinding process were 0.01-0.02 mg/m^3,0.09-1.04 mg/m^3,0.02-0.18 mg/m^3 respectively.There were statistically significant differences in the concentrations of the cobalt exposure between the screening process and the mixing process,and that of the screening process and the grinding process(P<0.05).There was no significant difference between the mixing process and the grinding process(P>0.05).The incidence of respiratory symptoms such as shortness of breath,chest distress,cough,and sputum were higher in the workers exposed to the hard metal dust(P<0.01).There was no significant difference in the incidence of dyspnea,tightness in the chest,chest pain(P>0.05).The signs of skin pruritus were not significantly different between the 2 groups(P>0.05).The rate of abnormal imaging results in exposure group was 64.04%,and that of control group was 4.49%.The X-ray indicated that increased lung texture,dot and line shadows,and net shadows were higher in the exposed group(P<0.01).The detection rate of lung function damage in the exposed group,the FVC%was 28.09%,FEV1%was 24.72%,FEV1/FVC%was 2.25%.The FVC%was 4.49%,FEV1%was 3.37%,FEV1/FVC%was 0.00%in the control group respectively.The abnormal detection rate of FVC%and FEV1%in the exposed group was higher than that in the control group(P<0.01),but there were no difference in the rate of FEV1/FVC%(P>0.05).Conclusion The mixing process owns the highest dust exposure level for the workers.Hard metal dust exposure has certain respiratory damage.The workers may develop respiratory symptoms,including increased lung texture,dot-line and net shadows,and the restrictive ventilation dysfunction.Hard metal production enterprises should improve their understanding of hard metal lung disease and carry out the regular occupational health examination to prevent the occurrence of hard metal lung disease.
作者
李西西
罗英男
张静
张娟
范晓丽
闫永建
LI Xi-xi;LUO Ying-nan;ZHANG Jing;ZHANG Juan;FAN Xiao-li;YAN Yong-jian(Shandong Academy of Occupational Health and Occupational Medicine,Jinan,Shandong,250002,China)
出处
《预防医学论坛》
2020年第11期813-816,823,共5页
Preventive Medicine Tribune
基金
山东省医药卫生科技发展计划(2017WS608)。
关键词
硬金属
硬金属肺病
职业暴露
钴
Hard metal
Hard metal lung disease
Occupational exposure
Cobalt
作者简介
李西西(1989-),女,硕士,助理研究员,研究方向:职业卫生与职业病;通讯作者:闫永建,研究员,E-mail:yyj1212015@163.com。
