某化工厂过氯酸铵粉尘作业工人健康状况调查

摘要

目的 了解过氯酸铵(AP)粉尘对作业工人健康的影响,为其预防措施提供依据.方法 选择该厂接触AP粉尘的36名作业工人为接触组,不接触AP粉尘的48名该厂工人为对照组.调查工厂的一般情况,监测作业场所的AP粉尘浓度,对两组人群进行职业健康体检,检测血常规、肝肾功能、甲状腺激素指标,进行肺通气功能和X线胸片检查.结果 AP总粉尘浓度以组批车间最高,为(51.63±43.27) mg/m3.接触组收缩压[(146.14±21.03)mmHg]明显高于对照组[(134.67±18.58)mmHg],差异有统计学意义(P＜0.05).接触组全身各系统症状(皮粗、皮痒、气短、咳嗽、咳痰、咽干、疲乏无力等)累计检出率、气短及皮痒的检出率分别为86.11％、30.56％、36.11％,均明显高于对照组(66.67％、12.50％、10.42％),差异均有统计学意义(P＜0.05).接触组的游离三碘甲状腺原氨酸(FT3)水平[(1.29±0.20) ng/ml]明显低于对照组[(1.41±0.23) ng/ml],差异有统计学意义(P＜0.01).接触组工人的1秒用力肺活量与用力肺活量百分比值(FEV1.0/FVC)低于对照组,但差异无统计学意义(P＞0.05).接触组检出1例肺部X线影像异常者,并诊断为尘肺,对照组检出1例左肺门区有1约1.0x1.0小结节影.结论 接触组工人的收缩压明显高于对照组,不排除与接触AP粉尘有关；接触组工人的FT3低于对照组,提示长期接触AP粉尘可能会对作业工人甲状腺功能造成影响.%Objective To understand the occupational hazards of ammonium perchlorate dust on operating workers and to provide the basis preventive measures for protecting the workers' health.Methods 36 workers exposed to ammonium perchlorate dust and 48 unexposed workers from one factory were selected as the exposure and control groups.Investigations on the general condition,sampling of dust in the workplaces and a special medical examination were conducted for two groups,including occupational history,clinical manifestations,blood routine test,hepatic and renal functions,indexes of thyroid hormone,spirometric test and chest X-ray.Results The total dust concentration of AP in the batch plant reached to 51.63±43.27 mg/m3,exceeding the U.S.Occupational Safety and Health Administration (OSHA) permission exposure limits.The systolic blood pressure in the exposure group was higher than that of the control group (146.14±21.03 VS 134.67±18.58),and the difference was statistically significant (P＜0.05).The detection rates of the cumulative total symptoms,short of breath and skin itch symptoms in the exposure group were significantly higher than those in the control group (86.11％ VS 66.67％; 30.56％ VS 12.50％) (P＜0.05),respectively.FT3 level in the exposure group significantly lowered than the control group,and the difference was statistically significant (P＜0.01); The pulmonary function result showed that FEV1/FVC％ in the exposure group was lower than that in the control group (106.50±28.99 VS 111.70±19.72),but the difference was not significant.X-ray examination revealed one case of pulmonary X-ray abnormalities in the exposure group,diagnosis of pneumoconiosis,and one case with about 1.0 x 1.0 small nodules detected on the left of lung door area in the control group.Conclusions The systolic blood pressure of workers in the exposure group was significantly higher,which could not exclude related to the exposure to AP dust; The T3 levels in the exposure workers were lower than those in the control group,which may due to AP exposure,suggesting that long-term chronic exposure to AP dust may affect thyroid function.