文章摘要
顾明华,苏瑾,刘长河,朱银泉,沈昊,黄月华,钟岚,章敏华,李延红.上海市2012-2015年无机氟作业人群尿氟异常率流行特征研究[J].中华流行病学杂志,2017,38(1):77-80
上海市2012-2015年无机氟作业人群尿氟异常率流行特征研究
Epidemiological pattern of abnormal urinary fluoride rates in population with occupational fluoride exposure in Shanghai
收稿日期:2016-08-23  出版日期:2017-01-12
DOI:10.3760/cma.j.issn.0254-6450.2017.01.015
中文关键词: 尿氟;异常率;职业暴露;蓄积水平
英文关键词: Urinary fluoride;Abnormal rate;Occupational exposure;Accumulative level
基金项目:
作者单位E-mail
顾明华 200070 上海市预防医学研究院门诊部  
苏瑾 200336 上海市疾病预防控制中心健康安全评价所  
刘长河 200070 上海市预防医学研究院门诊部  
朱银泉 200070 上海市预防医学研究院门诊部  
沈昊 200070 上海市预防医学研究院门诊部  
黄月华 200070 上海市预防医学研究院门诊部  
钟岚 200070 上海市预防医学研究院门诊部  
章敏华 200070 上海市预防医学研究院门诊部  
李延红 200336 上海市疾病预防控制中心健康安全评价所 liyanhong@scdc.sh.cn 
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中文摘要:
      目的 分析上海市无机氟作业人群尿氟蓄积水平,探讨不同性别、年龄及职业接触水平对尿氟异常率的影响。方法 采集2012-2015年上海市职业健康监护临床检验系统中相关职业暴露人群4 999例及非暴露人群283例的班前清晨尿样;用氟离子选择电极测定方法进行分析;采用logistic回归进行多因素分析,控制年龄、性别、工龄及其他变量间的混杂效应。结果 2012-2015年上海市作业人群职业暴露组的尿氟≥1.6 mg/L者的异常率为14.38%,明显高于非暴露组(1.43%),两者的尿氟蓄积水平的几何均数分别为0.95 mg/L和0.46 mg/L。暴露组中,34~39岁的青年组与>50岁的中年组异常率最高,分别为19.15%和22.39%;男性尿氟异常率(16.87%)高于女性(6.85%),其中尿氟≥1.6 mg/L的异常人群中男性比例为87.36%;人群尿氟蓄积水平随着职业暴露时间的增加而逐渐缓慢提升,在尿氟≥1.6 mg/L人群中,职业暴露>20年者的异常率为23.28%,而<4年者的异常率为13.29%,高出75.17%。男性、年龄越大及工龄越长,发生尿氟异常值的风险越大;其相对危险性OR值依次分别为2.28、1.10和1.13。结论 职业健康监护面临着巨大的挑战,应尽快更新出台相关的国家标准,干预重点目标人群应为工龄长、>50岁、男性人群;同时应加强健康体检大数据的创新应用,完善评估健康需求机制,在新医改中有针对性地推出针对农民工的精准职业健康监护服务包。
英文摘要:
      Objective To investigate the epidemiological features of abnormal urinary fluoride rates in population with occupational exposure, and its relationships with age, work years and gender in Shanghai. Methods A questionnaire survey was conducted respectively in 4 999 exposed workers and 283 non-exposed people during 2012-2015. Their urine samples were collected in plastic bottles and the fluoride ion selective electrode method was used for urinary fluoride level analysis. Logistic regression model was used to estimate associations between the abnormal rates and demographic/socioeconomic status of the study subjects. Results In the past 4 years, the abnormal urinary fluoride rates (≥1.6 mg/L) in the population with occupational exposure was about 14.38%, it was about 1.43% in the control groups without occupational exposure. Their geometric mean of urinary fluoride content was 0.95 mg/L and 0.46 mg/L, respectively. The incidences of the abnormal rates in those aged ≥50 years and 34-39 years were 19.15% and 22.39%, respectively. The abnormal rate in males was 16.87%, much higher than that in females (6.85%). The abnormal rate had an upward trend along with the increased work years, especially in those with work years of ≥20 years. The abnormal rate was 23.28% in those with work years of ≥20 years and 13.29% in those with work years of <4 years. The relative risk for abnormal urinary fluoride rates was higher in male group, older age group and longer work year group, the odds ratio was 2.28, 1.10 and 1.13, respectively. Conclusions Serious challenges exist in occupational health supervision. The relevant national standards should be updated as soon as possible. Males, those aged >50 years, and those with longer work years are the risk groups for intervention measures. More efforts are needed, such as strengthening the innovative application of health examination data and the equalization of basic public health service with comprehensive occupational health supervision programs among off-farm workers in the new medical reform.
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