倒班对钢铁工人高血压影响的回顾性队列研究
发布时间：2019-06-22 14:56
【摘要】：目的以钢铁工人为研究对象,采用回顾性队列研究分析倒班与高血压的关系,探讨开始倒班年龄、倒班年限与高血压关联程度的剂量-反应关系,从而为钢铁企业工时制度的建立提供科学依据。方法2014年8月至2015年11月,以某钢铁企业进行职业健康体检的工人作为研究对象,采用回顾性队列研究方法分析倒班与高血压的关系。观察时间从第一位工人入厂1971年3月起至2015年11月,根据入厂时倒班与否分为倒班组和白班组。资料收集包括面对面问卷调查及职业健康档案资料的摘录,内容包括工人的社会人口学特征、生活饮食习惯、高血压个人病史和家族史、工作情况以及职业有害因素的暴露情况等,同时测量血压。采用Epi Data3.1建库,SPSS19.0、SAS9.1.3进行统计分析。应用χ2检验比较年龄、性别、民族等在倒班和白班两组间的构成;倒班及倒班类型与高血压关系的单因素分析应用χ2检验,倒班与高血压关系的多因素分析应用倾向性评分分层法和多因素Cox回归;倒班高温、倒班噪声的联合作用与高血压的关系以及退出倒班后对高血压的影响应用Cox回归分析;应用基于限制性立方样条的Cox、Logistic回归模型分析开始倒班年龄、倒班年限与高血压关联程度的剂量-反应关系。结果1本研究共收集问卷7314份,剔除不合格问卷303份,共7011人进入研究队列,观察人年为105269.4人年,平均随访15.0年。进入队列年龄为16岁~42岁,平均(22.1±4.0)岁,工龄为1年~43年,平均(15.0±9.6)年,钢铁工人高血压的发病密度为16.61‰。倒班与白班两组间年龄、性别、吸烟、饮酒、父亲和母亲高血压史、高温噪声暴露的构成比较,差异有统计学意义(P0.05)。两组间文化程度、民族、婚姻状况、食盐情况和体育锻炼的构成比较,差异无统计学意义(P0.05)。2倒班组发生高血压的风险为白班组的1.540倍(95%CI:1.381-1.719),归因危险度(AR)为5.43‰,归因危险度百分比(AR%)为35.06%,人群归因危险度(PAR)为3.57‰,人群归因危险度百分比(PAR%)为21.49%。3四班三运转发生高血压的风险为白班的1.601倍(95%CI:1.433-1.790)。4与单纯白班相比较,单纯倒班、倒班高温联合组、倒班噪声联合组发生高血压的风险RR(95%CI)分别为1.599(1.309-1.958)、1.922(1.567-2.357)和1.602(1.429-1.831),差异均有统计学意义(P0.05),单纯高温、噪声组发生高血压的风险RR(95%CI)分别为1.087(0.853-1.386)和1.112(0.863-1.432),差异无统计学意义(P0.05)。5开始倒班年龄与高血压之间的关联程度呈非线性剂量反应关系(χ2=12.30,P0.05)。6倒班年限与高血压之间的关联程度呈非线性剂量反应关系(χ2=8.15,P0.05),与倒班1年相比较,于15年时高血压发生的风险开始有统计学意义。7倒班年限为1~10年时,随着离开倒班岗位时间的延长高血压发生的风险RR值降低,当倒班年限大于等于10年时发现同样结果。结论1倒班为高血压发生的一个独立危险因素。2倒班者中发生的高血压有35.06%可归因于倒班;钢铁工人中发生的高血压有21.49%可归因于倒班。3将倒班年限控制在15年内可降低高血压的发生风险。4随着退出倒班岗位时间的延长,发生高血压的风险下降。
[Abstract]:Objective To study the relationship between shift and hypertension by retrospective cohort study to study the relationship between shift and hypertension, and to provide scientific basis for the establishment of man-time system of iron and steel enterprise. Methods From August 2014 to November 2015, a retrospective cohort study was used to analyze the relationship between the shift and hypertension. The observation time was from March 1971 to November 2015 from the first worker to the factory, and it was divided into the reverse group and the white shift group according to whether the shift was in the factory. The data collection includes a face-to-face questionnaire and an excerpt from the occupational health profile, which includes the social and demographic characteristics of the worker, the life eating habits, the personal history of the hypertension, the family history, the working condition, and the exposure of the occupational harmful factors, while measuring the blood pressure. Statistical analysis was performed using Epi Data3.1 built-in, SPSS19.0, SAS9.1.3. The two groups, such as age, sex, and ethnic group, were used to test the composition of the two groups in the shift and the white shift. The single-factor analysis of the relationship between the shift and the shift and the hypertension was applied to the multi-factor analysis of the relationship between the shift and the hypertension, and the stratified and multi-factor Cox regression was applied to the multi-factor analysis of the relationship between the shift and the hypertension. Cox regression was used to analyze the effect of combined action of high-temperature and reverse-shift noise on hypertension and the effect of withdrawal on hypertension. Cox and Logistic regression model based on restricted cubic spline were used to analyze the start-up age. Dose-response relationship between the degree of shift and the degree of association of hypertension. Results A total of 7314 questionnaires were collected in this study, and 303 of the non-conforming questionnaires were rejected. The total number of 7011 persons was enrolled in the study cohort, with the observation of 105269.4 in human year and the average follow-up of 15.0 years. The age of the access to the cohort was 16 to 42 years. The average age (22.1 to 4.0) was from 1 to 43 years, with an average of 15.0 (9.6) years. The incidence of hypertension among the steel workers was 16.61%. The difference of age, sex, smoking, drinking, father and mother's hypertension and high-temperature noise exposure was statistically significant (P0.05). The risk of hypertension was 1.540 times (95% CI: 1.381-1.719), and the attributable risk (AR) was 5.43%. The percentage of attributable risk (AR%) was 35.06%, the population attributable risk (PAR) was 3.57%, and the percentage of the population attributable risk (PAR%) was 21.49%. The risk of hypertension was 1.601 times (95% CI: 1.433-1.790) in the white class. The RR (95% CI) of hypertension was 1.599 (1.309-1.958), 1.922 (1.567-2.357) and 1.602 (1.429-1.831), respectively. There was no statistical significance (P0.05). The association between the shift age and the hypertension was the non-linear dose-response relationship (Sup2 = 12.30, P0.05). The degree of association between the shift and the hypertension was the non-linear dose-response relationship (Sup2 = 8.15, P0.05). The risk of hypertension at 15 years started to be statistically significant.7-10 years, the risk of increasing the risk of hypertension with the time of leaving the shift post was reduced, and the same result was found when the shift number was greater than or equal to 10 years. Conclusion 1.1-shift is an independent risk factor in the occurrence of hypertension, and 35.06% of the hypertension in the shift group can be attributed to the shift. The high blood pressure in the steel workers is 21.49%, which can be attributed to the shift. The risk of high blood pressure can be reduced within 15 years. The risk of high blood pressure is reduced with the extension of the time of withdrawal.
【学位授予单位】：华北理工大学
【学位级别】：硕士
【学位授予年份】：2016
【分类号】：R544.1
本文编号：2504689
[Abstract]:Objective To study the relationship between shift and hypertension by retrospective cohort study to study the relationship between shift and hypertension, and to provide scientific basis for the establishment of man-time system of iron and steel enterprise. Methods From August 2014 to November 2015, a retrospective cohort study was used to analyze the relationship between the shift and hypertension. The observation time was from March 1971 to November 2015 from the first worker to the factory, and it was divided into the reverse group and the white shift group according to whether the shift was in the factory. The data collection includes a face-to-face questionnaire and an excerpt from the occupational health profile, which includes the social and demographic characteristics of the worker, the life eating habits, the personal history of the hypertension, the family history, the working condition, and the exposure of the occupational harmful factors, while measuring the blood pressure. Statistical analysis was performed using Epi Data3.1 built-in, SPSS19.0, SAS9.1.3. The two groups, such as age, sex, and ethnic group, were used to test the composition of the two groups in the shift and the white shift. The single-factor analysis of the relationship between the shift and the shift and the hypertension was applied to the multi-factor analysis of the relationship between the shift and the hypertension, and the stratified and multi-factor Cox regression was applied to the multi-factor analysis of the relationship between the shift and the hypertension. Cox regression was used to analyze the effect of combined action of high-temperature and reverse-shift noise on hypertension and the effect of withdrawal on hypertension. Cox and Logistic regression model based on restricted cubic spline were used to analyze the start-up age. Dose-response relationship between the degree of shift and the degree of association of hypertension. Results A total of 7314 questionnaires were collected in this study, and 303 of the non-conforming questionnaires were rejected. The total number of 7011 persons was enrolled in the study cohort, with the observation of 105269.4 in human year and the average follow-up of 15.0 years. The age of the access to the cohort was 16 to 42 years. The average age (22.1 to 4.0) was from 1 to 43 years, with an average of 15.0 (9.6) years. The incidence of hypertension among the steel workers was 16.61%. The difference of age, sex, smoking, drinking, father and mother's hypertension and high-temperature noise exposure was statistically significant (P0.05). The risk of hypertension was 1.540 times (95% CI: 1.381-1.719), and the attributable risk (AR) was 5.43%. The percentage of attributable risk (AR%) was 35.06%, the population attributable risk (PAR) was 3.57%, and the percentage of the population attributable risk (PAR%) was 21.49%. The risk of hypertension was 1.601 times (95% CI: 1.433-1.790) in the white class. The RR (95% CI) of hypertension was 1.599 (1.309-1.958), 1.922 (1.567-2.357) and 1.602 (1.429-1.831), respectively. There was no statistical significance (P0.05). The association between the shift age and the hypertension was the non-linear dose-response relationship (Sup2 = 12.30, P0.05). The degree of association between the shift and the hypertension was the non-linear dose-response relationship (Sup2 = 8.15, P0.05). The risk of hypertension at 15 years started to be statistically significant.7-10 years, the risk of increasing the risk of hypertension with the time of leaving the shift post was reduced, and the same result was found when the shift number was greater than or equal to 10 years. Conclusion 1.1-shift is an independent risk factor in the occurrence of hypertension, and 35.06% of the hypertension in the shift group can be attributed to the shift. The high blood pressure in the steel workers is 21.49%, which can be attributed to the shift. The risk of high blood pressure can be reduced within 15 years. The risk of high blood pressure is reduced with the extension of the time of withdrawal.
【学位授予单位】：华北理工大学
【学位级别】：硕士
【学位授予年份】：2016
【分类号】：R544.1
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