职业性砷暴露工人尿砷水平及影响因素的研究

发布时间：2018-03-15 08:10

  本文选题：尿砷　切入点：职业砷暴露　出处：《昆明医科大学》2016年硕士论文　论文类型：学位论文

【摘要】：[目的]通过对个旧某锡冶炼厂在职砷作业人群尿砷含量的检测,了解职业性砷暴露工人尿砷水平。同时通过对现场劳动卫生学和职业人群的调查,结合尿砷检测结果,分析尿砷的影响因素,为探讨职业性砷暴露人群的保护措施提供线索。[方法]选择个旧某锡冶炼厂砷暴露工人作为研究对象,采集一次班后尿,采用湿法消化-氢化物发生-原子荧光光度法进行尿砷水平的检测；同时在现场采用面对面问卷调查的方式收集调查对象的一般人口学特征、生活习惯、最近三天膳食营养素摄入情况等资料。采用Epidata3.1软件,将调查结果由专人双录入,建立的数据库经一致性检验后,将数据导入SPSS20.0软件进行数据分析,经过多因素Logistic回归分析,探讨尿砷的影响因素。[结果](1)本次调查发现119例该锡冶炼厂工人尿砷含量中位数为268.34μg/L,男女尿砷含量中位数分别为274.97μ g/L、250. 01μ g/L,男女尿砷水平差异没有统计学意义(P0.05)。(2)单因素分析发现,尿砷水平与年龄、工龄不相关(P0.05),尿砷在不同年龄、工龄之间差异无统计学意义(P0.05)；各车间工人尿砷差异无统计学意义(P0.05)；但尿砷在不同民族之间差异具有统计学意义(P0.05),进一步两两比较分析知,哈尼族尿砷含量高于汉族及其他少数民族,并且差异具有统计学意义(P0.05)；其他民族之间尿砷含量差异无统计学意义(P0.05)；不同文化程度之间尿砷水平差异无统计学意义(P0.05)。(3)尿砷含量与工人BMI之间呈负相关(rs=-0.734,P0.001),即尿砷随着BMI值的升高而降低。尿砷在不同BMI分组之间差异具有统计学意义(χ2=108.973,P=0.000)；经两两比较知,BMI正常的工人尿砷高于BMI超重工人尿砷,且尿砷水平差异有统计学意义(P=0.006)；其他组工人尿砷差异没有统计学意义(P0.05)。(4)工人的吸烟量、饮酒量与其尿砷水平不相关。吸烟组与不吸烟组尿砷水平差异无统计学差异(P0.05)；饮酒组与不饮酒组尿砷水平差异没有统计学意义(P0.05)；不同饮茶频率、饮茶种类工人尿砷水平差异无统计学意义(P0.05)。(5)经进一步Logistic回归分析知,影响尿砷水平的因素有年龄、饮用绿茶、每日食肉量、近三天蛋白质总摄入量、近三天膳食纤维总摄入量、近三天维生素C总摄入量、近三天烟酸总摄入量；饮用绿茶、近三天膳食纤维总摄入量、近三天烟酸总摄入量促进尿砷排泄；年龄、每日食肉量、近三天蛋白总摄入量、近三天维生素C总摄入量不促进尿砷排泄。(6)调查对象文化程度普遍偏低,砷毒性认识严重匮乏,并且砷毒性相关知识获取渠道窄,形式单一。(7)临床表现以类神经症和皮肤损害为主,并与尿砷超标有关系。[结论](1)尿砷水平与年龄、工龄、吸烟量、饮酒量等无关,尿砷在不同性别、年龄、工龄、文化程度之间差异无统计学意义；(2)不同民族之间尿砷水平不同,哈尼族尿砷高于汉族,并且差异有统计学意义；BMI与尿砷水平呈负相关,不同BMI分组尿砷水平不同,BMI正常者尿砷高于BMI异常者；(3)膳食营养素的摄入如每天蛋白质、膳食纤维素、烟酸的摄入量增加将可促进尿砷的排泄,改善接砷作业者的营养状况可以在一定程度上减少砷对机体的危害；(4)慢性职业砷暴露会引起机体的健康损害,尤其是皮肤损害具有特异性,并且尿砷含量越高,皮损表现越明显；(5)无论作业环境砷浓度是否超过国家标准,均应加强接砷人群尿砷监测,发现高危人群,及时调离接砷岗位；定期进行作业场所环境监测并组织接砷工人进行职业健康体检,及早发现职业性健康损害的存在,及早脱离作业岗位、及早治疗；改善作业人群营养状况如增加蛋白质、膳食纤维素、烟酸等的摄入,可以促进体内砷的排泄,同时加强锻炼,提高体质；应积极开展健康促进措施,提高企业主管对砷毒性的防护的认识,做好现场通风、排毒,履行用人单位的职责,加强砷相关的职业病预防知识的宣传,拓宽作业人员对砷毒性知识的获取渠道,提高作业人员对砷毒性的认识,加强自我防护。
[Abstract]:[Objective] through the detection of Gejiu Tin Smelter in workers exposed to arsenic arsenic in urine, urine arsenic exposure levels of workers to understand the occupation of arsenic. At the same time through the survey in the labor hygiene and occupation groups, combined with urinary arsenic detection results, analysis of influencing factors of urinary arsenic, protective measures to investigate the occupation of arsenic exposure people to provide clues. Methods] Gejiu Tin smelter workers exposed to arsenic as the research object, collecting a class of urine, by wet digestion hydride generation detection of urine arsenic level atomic fluorescence spectrophotometry; at the same time, general demographic characteristics, face-to-face questionnaire survey used at the site living habits, the last three days of dietary intake data. Using Epidata3.1 software, the result of investigation by hand for double entry and establishment of the database through the consistency test, the data into SPSS2 0 software was used for data analysis by multivariate Logistic regression analysis, to explore the influencing factors of urine arsenic results.] (1) the survey found that 119 cases of the tin smelter workers median urinary arsenic content was 268.34 g/L, urine arsenic content medians were 274.97 g/L, 250.01 g/ L, gender differences in urine arsenic levels were not statistically significant (P0.05). (2) single factor analysis showed that urinary arsenic levels and age, not related to age (P0.05), urinary arsenic in different age, there was no significant difference between the length of service (P0.05); the workshop workers urinary arsenic had no significant difference (P0.05); but in the urine arsenic the differences between different ethnic groups has statistical significance (P0.05, 22) further comparative analysis, the arsenic content in urine was higher than that of the Hani nationality Han nationality and other ethnic minorities, and the difference was statistically significant (P0.05); there was no significant difference between the content of arsenic in urine of other nationalities (P0.05) ; there was no significant difference of urine arsenic level between different cultural level (P0.05). (3) there was a negative correlation between urinary arsenic content and workers BMI (rs=-0.734, P0.001), the urine arsenic with the increase of BMI value of urine arsenic decreased. The difference was statistically significant between BMI group (2= 108.973, P=0.000) by comparison; 22, BMI normal urine arsenic BMI is higher than that of overweight workers workers urinary arsenic, and there were statistically significant differences in the level of urinary arsenic (P=0.006); the other group of workers of arsenic in urine was not statistically significant difference (P0.05). (4) the amount of smoking workers, not related to alcohol intake and the urinary arsenic levels was not statistically. The difference between the smoking group and non-smoking group urine arsenic level (P0.05); drinking group and alcohol group differences in urinary arsenic levels was not statistically significant (P0.05); different tea frequency, the type of tea workers urinary arsenic levels showed no significant difference (P0.05). (5) after further Logistic regression Analysis of knowledge, influence factors of urinary arsenic levels were age, drinking Green Tea, daily meat intake, nearly three days of total protein intake, nearly three days of total dietary fiber intake, vitamin C intake for nearly three days, nearly three days of total niacin intake; drinking Green Tea, nearly three days of total dietary fiber intake, nearly three days of nicotinic acid total intake promotes urinary arsenic excretion; age, daily meat intake, nearly three days of total protein intake, nearly three days of total intake of vitamin C does not promote urinary excretion of arsenic. (6) respondents generally lower educational level, lack of understanding of arsenic toxicity, and toxicity of arsenic related knowledge acquisition channel is narrow, single form (7). The clinical manifestations of neural disease and skin damage, and urinary arsenic exceed the standard relationship. Conclusion: (1) urinary arsenic levels and age, age, smoking, alcohol consumption and irrelevant, urinary arsenic in different gender, age, age, culture degree difference between no statistical significance Yi; (2) the levels of urinary arsenic among different ethnic groups, Hani urinary arsenic is higher than the Han nationality, and the difference was statistically significant; BMI was negatively correlated with urinary arsenic levels and urinary arsenic levels in different BMI group, normal BMI abnormal urinary arsenic is higher than that of BMI; (3) the dietary intake of nutrients such as protein every day, dietary fiber, niacin intake increases will promote urinary arsenic excretion, improve the nutritional status of arsenic operators can reduce arsenic harm to the body to a certain extent; (4) health damage will induce chronic occupation of arsenic exposure, especially with specific skin damage, and the higher the urine arsenic content. The lesions showed more obvious; (5) whether arsenic concentration exceeded the national standard working environment should be strengthened, arsenic urinary arsenic monitoring, found that the high risk population, promptly removed arsenic jobs; regular workplace environmental monitoring and industrial organization of arsenic 浜鸿繘琛岃亴涓氬仴搴蜂綋妫，

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