摘要
目的评估海南省2022—2024年中小企业苯暴露工人的健康状况及致癌风险,为预防和控制海南省中小企业苯的职业病危害提供科学依据。方法收集海南省2022—2024年中小企业苯暴露工人的职业健康检查资料,随机抽取715名苯暴露工人进行生物监测指标反,反式粘糠酸(trans,trans-muconic acid,tt-MA)浓度的检测,分析tt-MA与血常规关键指标的相关关系,并采用基于苯的内暴露浓度的线性多阶致癌模型评估苯暴露对工人的致癌风险,数据的统计分析采用SPSS 26.0软件和R4.2.0语言。结果海南省2022—2024年共有662家中小企业的11662名苯暴露工人参加了在岗期间职业健康检查,以男性为主(9772人,占83.79%),年龄的M(P_(25),P_(75))为33.0(27.0,41.0)岁;常规体检指标异常检出率以血常规最高(24.02%),其次为肝功能(14.81%);血常规专项检查异常检出率为19.53%,地区以海口市最高(21.76%),行业以制造业最高(23.83%),企业规模以小型企业最高(20.47%),女性异常率(29.74%)高于男性(17.56%)(χ^(2)=149.355,P<0.05),年龄以≥55岁组最高(22.25%);3项血常规关键指标白细胞、中性粒细胞、血小板计数偏低检出率分别为2.12%、0.69%、0.27%;715名生物监测对象的tt-MA浓度超标率合计为4.34%,tt-MA浓度与中性粒细胞计数呈非线性剂量-反应关系(P_(整体)<0.001,P_(非线性)<0.001);715名工人的苯暴露致癌风险均超过职业人群致癌风险可接受水平(10^(-4)),其中居于前3位的岗位分别为纸制品制造业的包装岗位、汽车零部件及配件制造业的涂装岗位、专业技术服务业的检验岗位,致癌风险分别为564.207(164.021~964.394)×10^(-4)、309.869(2.652~3288.607)×10^(-4)、208.668(2.656~3868.348)×10^(-4)。结论海南省中小企业苯暴露工人的职业健康风险不容忽视,应加强重点行业和高风险岗位的苯暴露防护,尽可能降低苯暴露对工人的致癌风险。
Objective To evaluate health status and carcinogenic risks of workers exposed to benzene in small and medium-sized enterprises in Hainan Province from 2022 to 2024,and to provide a scientific basis for control and prevention of occupational disease hazards of benzene in small and medium-sized enterprises in Hainan Province.Methods Occupational health examination data of workers exposed to benzene in small and medium-sized enterprises were collected in Hainan Province from 2022 to 2024.A total of 715 workers exposed to benzene were randomly selected for detection of concentration of trans,trans-muconic acid(tt-MA)as a biological monitoring indicator.The correlation between tt-MA and key indicators of blood routine examination was analyzed.The linear multi-stage carcinogenic model based on internal exposure concentration of benzene was used to evaluate carcinogenic risk of benzene exposure to workers.SPSS 26.0 software and R 4.2.0 language were used for statistical analysis of the data.Results From 2022 to 2024,a total of 11662 workers exposed to benzene from 662 small and medium-sized enterprises in Hainan Province participated in the occupational health examination during their employment.The majority were male(9772 people,accounting for 83.79%),and M(P_(25),P_(75))of age was 33.0(27.0,41.0)years old.Among the abnormal detection rates of routine examination indicators,blood routine examination had the highest rate(24.02%),followed by liver function(14.81%).The abnormal detection rate of blood routine special examination was 19.53%,the highest rate was in Haikou City(21.76%),in manufacturing industry(23.83%),in small-sized enterprises(20.47%),and the abnormal rate for females(29.74%)was higher than that for males(17.56%)(χ^(2)=149.355,P<0.05),and the age group of≥55 years old had the highest abnormal rate(22.25%).The detection rates of low counts of three key blood routine indicators including white blood cells,neutrophils and platelets were 2.12%,0.69%and 0.27%,respectively.The over-limit rate of tt-MA concentration among 715 biological monitoring subjects was 4.34%.The tt-MA concentration had a non-linear dose-response relationship with the neutrophil count(P_(overall)<0.001,P_(non-linear)<0.001).The carcinogenic risks of benzene exposure for all 715 workers exceeded the acceptable level of carcinogenic risk for occupational population(10^(-4)).Among them,the top three positions were packaging position in the paper products manufacturing industry,painting position in the automotive parts and accessories manufacturing industry,and inspection position in the professional and technical service industry,with carcinogenic risks of 564.207(164.021-964.394)×10^(-4),309.869(2.652-3288.607)×10^(-4) and 208.668(2.656-3868.348)×10^(-4),respectively.Conclusion The occupational health risks of workers exposed to benzene in small and medium-sized enterprises in Hainan Province should not be underestimated.It is necessary to strengthen protection against benzene exposure in key industries and high-risk positions,and reduce the carcinogenic risks of benzene exposure to workers as much as possible.
作者
金蕾
王川健
陈玉珅
黎承
蔡月
陈文龙
冯福
周凌
JIN Lei;WANG Chuanjian;CHEN Yushen;LI Cheng;CAI Yue;CHEN Wenlong;FENG Fu;ZHOU Ling(Hainan Provincial Center for Disease Control and Prevention(Hainan Academy of Preventive Medicine),Haikou,Hainan 571129,China;Hainan Medical University,Haikou,Hainan 570100,China;Haikou Center for Disease Control and Prevention,Haikou,Hainan 570203,China)
出处
《中国热带医学》
北大核心
2025年第8期1061-1068,共8页
China Tropical Medicine
基金
海南省卫生健康科技创新联合项目(No.WSJK2024MS183)。
关键词
苯暴露
职业健康检查
中小企业
生物监测
反
反式粘糠酸
致癌风险
Benzene exposure
occupational health examination
small and medium-sized enterprises
biological monitoring
trans,trans-muconic acid
carcinogenic risk
作者简介
金蕾(1981-),女,硕士,副主任医师,研究方向:职业病防治;通信作者:金蕾,E-mail:jinleihn@163.com。
