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目的了解太仓市二甲基甲酰胺(DMF)职业危害因素分布情况及其对接触人群健康状况的影响。方法选择2家皮革制造企业及1家皮革浆料生产企业接触DMF的员工865名作为接触组,以该3家企业不接触DMF的员工386名作为对照组。测定作业场所空气DMF浓度;调查劳动者基本情况、职业史、既往史、工伤职业病发生情况、主诉症状;进行血清生化指标、尿液、血细胞分析,以及心电图、肝脾B超检查。结果两组研究对象在年龄、性别、工龄、吸烟、饮酒等方面的分布差异无统计学意义。皮革制造行业较浆料生产行业空气中DMF浓度高,其中配料、涂台岗位浓度最高。接触组临床表现以消化系统症状为主,发生率较高的分别是食欲减退(25.5%)、恶心(23.6%)、腹胀(22.2%)、肝区痛(17.3%)。接触组血清ALT、AST、尿胆红素异常率(分别为18.5%、11.4%、10.2%),明显高于对照组。血清GGT、尿酮体、尿蛋白、尿白细胞、尿隐血、血白细胞、血红蛋白、血小板等指标异常率在两组人群中差异无统计学意义。结论太仓市DMF职业危害在皮革制造企业较为突出,尤其是配料和涂台两个工种。DMF主要影响接触人群的肝功能。
Objective To understand the distribution of occupational hazards in dimethylformamide (DMF) in Taicang City and its impact on the health status of the exposed population. METHODS: Totally 865 workers in two leather manufacturing enterprises and one leather pulp production enterprise contacted with DMF were selected as the contact group, and 386 employees who did not contact DMF in the three enterprises were selected as the control group. Determination of workplace air DMF concentration; investigation of workers basic situation, occupation history, past history, occupational injury occupational disease, the main complaint symptoms; serum biochemical indicators, urine, hematology, and electrocardiogram, liver and spleen B ultrasound examination. Results There was no significant difference in the distribution of age, sex, length of service, smoking, alcohol consumption between the two groups. In the leather manufacturing industry, the concentration of DMF in the air is higher than that in the slurry production industry, and the highest concentration is in ingredients and coating stations. The clinical manifestations of the contact group were digestive system symptoms. The high incidence rates were anorexia (25.5%), nausea (23.6%), abdominal distension (22.2%) and liver area pain (17.3%). The serum ALT, AST, urinary bilirubin abnormalities (18.5%, 11.4%, 10.2%, respectively) in the exposure group were significantly higher than those in the control group. Serum GGT, urine ketone body, urine protein, urinary leucocytes, urine occult blood, white blood cells, hemoglobin, platelet and other indicators of abnormal rates in the two groups of people no significant difference. Conclusion The occupational hazards of DMF in Taicang City are more prominent in the leather manufacturing enterprises, especially the two kinds of work materials, coating and coating. DMF mainly affects the liver function of the exposed population.