医务人员固体颗粒物的接触现状及健康影响调查

摘要

目的 调查医务人员固体颗粒物的接触现况及相关疾病的发生情况,了解其职业暴露的分布特征及影响因素分析.方法 于2016年8月,采用分层整群抽样方法,选取山东省内不同区域、不同行政级别、科室设置齐全的3家三级综合医院,对全院工作人员基本情况、职业性危害因素接触现状及健康影响情况进行面对面问卷调查,采用二分类logistic回归分析对医务人员固体颗粒物接触情况与职业健康效应关系进行分析.结果 医务人员固体颗粒物总体接触率为41.5%(1 843/4 446),其中接触率最高的固体颗粒物为滑石粉尘(28.2%,1 254/4 446).不同职业、现工龄、学历及所在医院类型医务人员固体颗粒物接触率差异有统计学意义(χ2=76.3、41.26、26.16、188.97,P<0.05).不同科室接触固体颗粒物情况及种类差异有统计学意义(χ2=740.23,P<0.05).与对照组比较,接触组医务人员过敏性哮喘、慢性气管支气管炎和皮炎的发生率高(P<0.05).接触氧化锆粉尘、滑石粉尘、棉尘是医务人员发生皮炎的危险因素(OR=2.09、1.45、1.34);接触氧化锆粉尘、棉尘是医务人员发生慢性气管支气管炎的危险因素(OR=2.38、1.66);接触氧化锆粉尘、石膏粉尘是医务人员发生过敏性哮喘的危险因素(OR=3.90、1.52).结论 医务人员固体颗粒物接触率较高,且接触种类多,频繁接触固体颗粒物是相关疾病发生的危险诱因,应进一步对医务人员工作环境进行监测,加强对医务人员固体颗粒物暴露针对性的防护措施和监管制度.%Objective To investigate the current situation of exposure of solid particles in medical staff and the occurrence of related diseases, and to understand the distribution characteristics of occupational exposure and the influencing factors. Methods In August 2016, the stratified cluster sampling method was adopted to select three tertiary general hospitals with different regions, different administrative levels and departments in Shandong Province.A face-to-face questionnaire survey was conducted on the basic situation of the staff of the hospital, the status of exposure to occupational hazards and the health effects.Two-class logistic regression analysis was used to analyze the relationship between medical staffˊs solid particle contact and occupational health effects.In August 2016, the stratified cluster sampling method was adopted to select three tertiary general hospitals with different regions, different administrative levels and departments in Shandong Province, which were in contact with the basic conditions and occupational hazards of the staff of the hospital. Current situation and health impacts were conducted face-to-face questionnaires.Two-class logistic regression analysis was used to analyze the relationship between medical staffˊs solid particle contact and occupational health effects. Results The overall contact rate of solid particles of medical staff was 41.5% (1843／4 446), and the solid particles with the highest contact rate were 28.2% (1254／4 446) of talc dust. There was a statistically significant difference in the contact rate of solid particles between medical staff of different occupations, current working age, education and hospital type (χ2=76.30, 41.26, 26.16, 188.97, P<0.05). There were significant differences in the conditions and types of solid particles in different departments (χ2=740.23, P<0.05).Compared with the control group, the incidence of allergic asthma, chronic tracheobronchitis and dermatitis was higher in the contact group medical staff (P<0.05).Contact with zirconia dust, talc dust, cotton dust is a risk factor for dermatitis in medical staff (OR=2.09, 1.45, 1.34); exposure to zirconia dust and cotton dust is a risk factor for chronic tracheobronchitis in medical staff (OR=2.38,1.66); exposure to zirconia dust, gypsum dust is a risk factor for allergic asthma in medical staff (OR=3.90, 1.52).Conclusion The con-tact rate of solid particles in medical staff is high, and there are many types of contact.Frequent contacted with solid particles is a dangerous cause of related diseases.The working environment of medical staff should be fur-ther monitored and be strengthen the targeted protective measures and regulatory systems for the exposure of medical personnel to solid particles.