摘要
[背景]有研究发现重金属暴露显著增加非酒精性脂肪肝(NAFLD)的患病风险,而汽车制造企业焊装作业人员工作环境中接触重金属。[目的]研究广州地区某汽车企业工人NAFLD的患病情况及相关因素。[方法]选取2023年1月1日—2023年12月31日在广州市职业病防治院职业健康监护中心参与体检的5463名广州某汽车企业工人作为研究对象,通过体检系统获取体检者的一般资料、实验室检查、B超检查等资料。根据该汽车企业提供的工作场所危害因素检测报告确定研究对象接触的职业病危害因素,采用logistic回归模型分析NAFLD患病情况的影响因素,并采用分层分析根据模型逐步调整混杂因素来评估锰及其无机化合物暴露与NAFLD患病之间的关系。[结果]作业人群检出NAFLD 2129例,占38.97%。多因素logistic回归分析发现:女性NAFLD患病风险低(OR=0.40,95%CI:0.25~0.64),年龄>25岁(OR=1.49,95%CI:1.39~1.60)、体重指数(BMI)≥24 kg·m^(−2)(OR=7.54,95%CI:6.46~8.79)、丙氨酸氨基转移酶(ALT)(OR=4.87,95%CI:3.73~6.36)、γ-谷氨酰转肽酶(γ-GGT)(OR=1.54,95%CI:1.17~2.02)、甘油三酯(TG)(OR=3.47,95%CI:2.92~4.14)、空腹血糖(OR=1.70,95%CI:1.32~2.20)升高者NAFLD患病风险高。39.40%重金属暴露工人(701/1779)检出NAFLD。45.19%的锰及其无机化合物暴露工人中检出NAFLD(169/374),其中年龄在34岁以上的工人中,锰及其无机化合物暴露(OR=1.79,95%CI:1.07~2.97)显著增加其NAFLD患病率。[结论]广州地区某汽车企业工人重金属暴露对NAFLD的患病影响尚不显著,但年龄、性别与NAFLD患病率有关,BMI、ALT、γ-GGT、TG、空腹血糖与NAFLD患病率呈正相关。其中,存在锰及其无机化合物暴露的汽车企业焊装工人具有一定的患病风险,在34岁以上工人中NAFLD患病率明显增加。
[Background]Some studies have found that exposure to heavy metals significantly increases the risk of nonalcoholic fatty liver disease(NAFLD),and welding operators in automobile manufacturing enterprises are exposed to heavy metals in the working environment.[Objective]To analyze the prevalence and related factors of NAFLD in workers of an automobile company in Guangzhou.[Methods]From January 1 of 2023 to December 31 of 2023,5463 workers of an automobile company in Guangzhou who participated in the physical examination in the Occupational Health Surveillance Centre of Guangzhou Occupational Disease Prevention and Treatment Hospital were selected as research subjects.The general data,laboratory examinations,B-ultrasound examinations,and other data of the subjects were obtained through the physical examination system.The exposed occupational hazards were identified based on the workplace hazard surveillance report provided by the automotive company.Logistic regression was used to analyze potential influencing factors of NAFLD,and stratified analysis was used to adjust confounding factors according to the stepwise model to evaluate the relationship between exposure to manganese and its inorganic compounds and NAFLD.[Results]A total of 2129 cases(38.97%)were reported positive NAFLD.The results of logistic regression analysis showed that women had a lower risk of NAFLD(OR=0.40,95%CI:0.25,0.64),while age>25 years old(OR=1.49,95%CI:1.39,1.60),body mass index(BMI)≥24 kg·m^(−2)(OR=7.54,95%CI:6.46,8.79),and elevated alanine aminotransferase(ALT)(OR=4.87,95%CI:3.73,6.36),γ-glutamyl transpeptidase(γ-GGT)(OR=1.54,95%CI:1.17,2.02),triglyceride(TG)(OR=3.47,95%CI:2.92,4.14),and fasting blood glucose(OR=1.70,95%CI:1.32,2.20)associated with a higher risk of NAFLD.NAFLD was positive in 39.40%of heavy metal exposed workers(701/1779).NAFLD was positive in 45.19%of workers exposed to manganese and its inorganic compounds(169/374),and among workers over 34 years old,exposure to manganese and its inorganic compounds(OR=1.79,95%CI
作者
唐婷
朱常青
丘丛玺
李燕茹
白树真
陈汉清
宋慧东
TANG Ting;ZHU Changqing;QIU Congxi;LI Yanru;BAI Shuzhen;CHEN Hanqing;SONG Huidong(Occupational Health Surveillance Centre,Guangzhou Twelfth People'sHospital/Guangzhou Occupational Disease Prevention and Treatment Hospital,Guangzhou,Guangdong 510620,China;Department of Endocrinology,Guangzhou Twelfth People's Hospital,Guangzhou Medical University,Guangzhou,Guangdong 510620,China;Department of Nutrition&Food Hygiene,School of Public Health,Capital Medical University,Beijing 100069,China)
出处
《环境与职业医学》
CAS
CSCD
北大核心
2024年第10期1124-1129,共6页
Journal of Environmental and Occupational Medicine
基金
广州市科技计划项目2023年度市校(院)企联合资助专题项目(2023A03J0493)。
关键词
非酒精性脂肪肝
重金属
锰及其无机化合物
汽车企业
接害工龄
nonalcoholic fatty liver disease
heavy metal
manganese and its inorganic compounds
automotive enterprise
service length with exposure
