摘要
[背景]井下作业人群中,患有骨质疏松和骨量减少的比例远高于井上作业人群。特殊的井下作业环境,以及吸烟、饮酒、高盐饮食等不良习惯容易导致骨代谢的改变,从而增加患上脆性骨折的风险,给个人和社会都带来了沉重的经济负担。[目的]探讨不同作业环境的煤矿从业人员发生脆性骨折的影响因素,为制定针对性措施和预防脆性骨折提供依据和参考。[方法]在2006年6月至2020年12月期间,选取至少参加一次开滦集团健康体检的男性人群为研究对象。包括井上与井下两类作业岗位。采用1∶4病例对照研究方法,其中新发脆性骨折患者为病例组,以参加相同年度健康体检并且年龄(±1岁)的非脆性骨折者为对照组。分别在井上作业人群与井下作业人群中进行两次个体匹配。同时采用条件logistic回归模型分别分析不同作业环境人群中脆性骨折的影响因素。[结果]在113138名开滦集团职业人群中,分别纳入82631名井上作业人员和30507名井下作业人员,其中脆性骨折发生人数为1375,占总人数的1.22%,井下作业人群脆性骨折的患病率高于井上作业人群(1.63%>1.07%,P<0.001)。条件logistic回归模型结果显示,目前吸烟(OR=1.26,95%CI:1.05~1.51)、体力劳动者(OR=1.37,95%CI:1.06~1.78)、糖尿病(OR=1.26,95CI:1.04~1.54)、窦性心动过速(OR=1.81,95%CI:1.23~2.66)、脑卒中病史(OR=1.51,95%CI:1.09~2.09)、大专及以上学历(OR=0.65,95%CI:0.45~0.95)、高收入水平(OR=0.69,95%CI:0.54~0.90)、血红蛋白水平增加(OR=0.91,95%CI:0.85~0.98)以及总胆固醇水平增加(OR=0.90,95%CI:0.82~0.99)均是井上作业人群的脆性骨折影响因素;目前吸烟(OR=1.48,95%CI:1.17~1.87)、目前饮酒(OR=1.26,95%CI:1.01~1.56)、体力劳动者(OR=2.64,95%CI:1.41~4.94)、粉尘接触史(OR=1.28,95%CI:1.03~1.58)以及肥胖(OR=0.72,95%CI:0.52~0.96)均是井下作业人群脆性骨折的影响因素。[结论]在预防脆性骨折方面,应特别关注�
Background The prevalence of osteoporosis and osteopenia is higher among underground coal miners than surface workers.The special underground work environment and unhealthy habits such as smoking,drinking,and a high-salt diet may lead to changes in bone metabolism,increasing the risk of fragility fractures and placing a heavy economic burden on individuals and society.ObjectiveTo identify potential factors influencing fragility fractures among coal miners in different working environments and to provide a basis for targeted preventive measures to reduce the occurrence of fragility fractures.MethodsMale participants who attended at least one of the physical examinations in Kailuan Group between June 2006 and December 2020 were included in the study.The participants were divided into two groups based on their working environment:surface or underground.A case-control study was conducted,where patients with new fragility fractures served as the case group and participants without fragility fractures served as the control group.The two groups were matched with a case:control ratio of 1:4 by age(±1 year)and the same year of physical examination.The matching process was repeated twice,once for the surface working population and once for the underground working population.The analysis of risk factors was conducted using conditional logistic regression models.ResultsAmong a total of 113138 employees in Kailuan Group,82631 surface workers and 30507 underground workers were included,respectively.The number of individuals who suffered fragility fractures was 1375,accounting for 1.22%of the total population.The incidence of fragility fractures in underground workers was significantly higher than that in surface workers(1.63%>1.07%,P<0.001).The results of conditional logistic regression model showed that current smoking(OR=1.26,95%CI:1.05,1.51),manual labor(OR=1.37,95%CI:1.06,1.78),diabetes(OR=1.26,95%CI:1.04,1.54),sinus tachycardia(OR=1.81,95%CI:1.23,2.66),history of stroke(OR=1.51,95%CI:1.09,2.09),education at college and a
作者
于耀惠
张楠
吴寿岭
陈朔华
侯晓丽
郭路
刘翠霞
田发明
YU Yaohui;ZHANG Nan;WU Shouling;CHEN Shuohua;HOU Xiaoli;GUO Lu;LIU Cuixia;TIAN Faming(School of Public Health,North China University of Science and Technology,Tangshan,Hebei 063000,China;Kailuan General Hospital Department of Orthopedic Surgery,Kailuan General Hospital,Tangshan,Hebei 063000,China;Department of Cardiology,Kailuan General Hospital,Tangshan,Hebei 063000,China)
出处
《环境与职业医学》
CAS
CSCD
北大核心
2023年第7期788-795,共8页
Journal of Environmental and Occupational Medicine
基金
中央引导地方发展资金项目(226Z7709G)
河北省青年拔尖人才支持计划项目(JI-2016-10)
河北省高校百名优秀创新人才支持计划(JJK-2019-14)。
关键词
煤矿工
脆性骨折
工作环境
病例对照研究
影响因素
coal miner
fragility fracture
work environment
case-control study
influencing factor
