煤矿工人血液流变学变化临床分析

目的了解煤矿工人血液流变学变化情况，探讨引起血液流变学增高的原因及查找对策。方法将1623例门诊检查血液流变学的体检者，分成实验组（煤矿工人组）和对照组（非煤矿工人组），分析两组各年龄段血液流变学变化情况，比较两组血液流变学总体增高情况；实验组血液流变学变化与煤矿工人井下作业工作年限、接触煤粉尘量、合并肺部疾病关系，统计学分析采用X2检验。结果煤矿工人组血液流变学总体增高率为53．33％，明显高于非煤矿工人组的27．91％（P〈0．01）；血液流变学增高随煤矿工人井下工作年限、接触煤粉尘量的增加而呈上升趋势；血液流变学与伴有肺部疾病密切相关（P〈0．05）。结论煤矿工人血液流变学总体水平偏高，血液粘度相应增高，易合并心脑血管疾病，严重影响煤矿工人生活质量，及时改善生产环境、加强个人防护、加强宣传至关重要。     

煤矿工人红细胞免疫粘附功能变化的探讨

目的:探讨煤矿工人红细胞免疫粘附功能的变化。方法:采用补体致敏酵母菌凝聚花环法测定了某煤矿井下采煤工人和煤工尘肺病人血液红细胞免疫粘附功能。结果:接煤尘组和煤工尘肺RBC.C_3b.RT显著低于对照组(P<0.01)。接煤尘组和煤工尘肺组RBC.IC.RT显著高于对照组(P<0.01)。结论:煤尘导致煤工尘肺的发展过程中,红细胞免疫系统及其功能可能发生改变,表现为继发性红细胞免疫功能低下。     

Lead Exposure and Oxidative Stress in Coal Miners

We aimed to investigate the short-term correlation between blood lead levels and oxidative stress generation in coal miners. The study involved 94 male coal miners from the Velenje Coal mine, arranged into four groups: three groups according to the number of consecutive working days, and a fourth control group. Miners who worked for three consecutive days had higher blood levels of lead and 8-isoprostane than the control group (P<0.001). Correlation between lead and 8-isoprostane was of medium strength (r=0.512,P<0.001). Short-term lead environmental exposure can potentially harmful and should be considered when formulating improvements in working processes.     

Quantitative Risk Assessment for Lung Cancer from Exposure to Metal Ore Dust

To quantitatively assess risk for lung cancer of metal miners,a historical cohort study was conducted.The cohort consisted of 1113 miners who were employed to underground work for at least 12 months between January 1,1960and December,12,1974,According to the records or dust concentration,a cumulative dust dose of each miner in the cohort was estimated.There wer 162 deaths in total and 45 deaths from lung cancer with a SMR of 2184,The SMR for lung cancer increased from 1019 for those with cumulative dust of less than 500mg-year to 2469 for those with the dose of greater than 4500mg-year.Furthermore,the risk in the highest category of combined cumulative dust dose and cigarette smoking was 46-fold greater than the lowest category of dust dose and smoking.This study showed that there was an exposure-response relationship between metal ore dust and lung cancer,and an interaction of lung cancer between smoking and metal ore dust exposure.     

煤矿井下作业对工人心血管系统的影响

目的：探讨煤矿井下作业对工人心血管系统健康的影响。方法：以2013年6月至2014年8月在湖南省职业 病防治院进行职业健康检查且资料完整的男性煤矿工人3 134例为研究对象。选择井下作业工龄2年及以上的工人为 暴露组(n=2 370),无井下作业史的地面作业工人为对照组(n=764),比较两组心血管系统的异常率及其影响因素。 结果：暴露组与对照组心电图异常检出率分别为37.6%和25.4%;高血压检出率分别为20.5%和13.4%;心率异常检出率 分别为5.7%和6.0%;暴露组与对照组总的心血管系统异常率分别为49.8%和35.2%,差异均有统计学意义(均P<0.05)。 心血管系统异常的发生与调查对象的井下作业(OR=3.128,95%CI：1.969~4.970)、井下作业工龄(OR=1.205,95%CI： 1.070~1.358)及工种(采掘工OR=1.820,95%CI：1.527~2.169;井辅工OR=1.937,95%CI：1.511~2.482;其他OR=3.291, 95%CI：2.120~5.109)有关。结论：井下作业可增加煤矿工人心血管系统异常的风险,井下作业工龄越长,风险 越高。     

煤矿工人死亡率研究中的健康工人效应控制方法初探

为探讨煤矿工人死亡率研究中如何减少健康工人效应（Ｈｅａｌｔｈｗｏｒｋｅｒｅｆｆｅｃｔ，简称ＨＷＥ）问题，作者用年龄别校正系数、比例死亡比（ＰＭＲ）、校正标化死亡比（ＣＳＭＲ）和工厂对照组等４种方法对减少ＨｗＥ影响作了初步探讨。结果表明：上述４种方法均可达到减少ＨＷＥ的目的。控制ＨＷＥ后，煤矿工人死亡率显著高于一般人群（Ｐ＜０．０５）；关于减少ＨＷＥ的最优方法需深入研究。     

煤矿工人上消化道疾病的现况研究

目的：探讨煤矿工人上消化道疾病的患病现况,方法：按照整群随机抽样的方法在山东兖州,河北开滦,辽宁铁法选取３０６人,以胃镜进行普查。结果：矿区工人总的上消化道疾病患病率为７７．８％,以红斑性胃炎为主,占各种上消化道疾病的４１．５％井下采煤和掘进作业工人的患病率高于井下其他作业工人,后者的患病率与井上工人的患病率一致,各矿区之间,以山东兖州的工人患病率最高,湖北开滦最低。结论 煤矿工人上消化道疾病患病     

噪声性耳聋早期警戒指标的探讨

通过对某纺织厂进行劳动卫生学调查， 对该厂１８８ 名噪声作业工人和与其年龄性别构成相近的某百货公司４２ 名售货员进行健康受损检查． 结果发现， 耳鸣、头痛、头晕、乏力、记忆力减退、心悸、肢麻等自觉症状出现率噪声组明显高于对照组， 有显著性差异； 高频听损率、语频听损率都是噪声组高于对照组（ Ｐ＜００１） ； 噪声组噪声暴露工龄与听损率呈正相关（ｒｓ ＝ ０９００ ， Ｐ＝ ００５） ； 同时听力曲线提示噪声组高频听损主要呈Ｖ型或Ｕ型下降， 凹陷主要集中在４ ～６ ＫＨｚ． 语频听阈均值和高频听阈均值的相关回归分析结果呈正相关（ｒ＝ ０４４３ ５， Ｐ＜０００１） ， 由两者的回归方程得出， 当高频听损均值达３５ ｄＢ及以上者可作为噪声性耳聋的早期警戒指标．     

Analysis of mortality in chrysotile asbestos miners in China

In order to investigate the mortality of a cohort of chrysotile asbestos miners in China and evaluate its association with exposure to chrysotile,a fixed cohort of 1932 workers in chrysotile asbes-tos mine was established in 1981 and followed till June 1,2010.Information on vital status,cause of death and smoking habits was collected.The workers were divided into two groups according to their exposure status.The exposed group was composed of frontline workers who worked directly on mining or processing asbestos products.The control group consisted of those who were not directly exposed to asbestos in their work.Standardized mortality ratio (SMR) was calculated according to Chinese national death rates.Cox proportional hazards model was applied to estimate the adjusted relative risks of deaths from major causes in exposed and control groups.The results of this study showed that main causes of mortality were malignant neoplasm,cardiovascular disease,cerebrovascular disease and respiratory disease for chrysotile miners.The mortality rate was 939.20 per 100 000 person-years for workers.The SMR for all causes of death was 1.46 in the cohort.Statistically significant mortality excesses were found for lung cancer (SMR=1.51),pulmonary heart disease (SMR=2.70),respiratory disease (SMR=1.93),asbestosis (SMR=9.62),and accident (SMR=1.59).The mortalities from malignant neo-plasm,lung cancer,cerebrovascular disease and digestive disease in the exposed group were signifi-cantly higher than those in the control group.The findings indicate that chrysotile exposure is a risk factor for lung cancer,respiratory disease,cerebrovascular disease and digestive disease.     

变应性鼻炎的流行病学调查

目的了解针织厂一线车间工人变应性鼻炎的流行病学特点。方法抽样选取51家针织厂1 280名一线工人作为观察组,同时选取可比性较好的首次进入城市打工的农村务工人员1280名作为对照组,进行问卷调查、体检及实验室检查。结果观察组1 280名一线工人中,检出患有变应性鼻炎者90例,发病率为7.03%;对照组1 280名首次进入城市的农村务工人员中,检出患有变应性鼻炎者15例,发病率为1.17%。观察组发病率明显高于对照组,其发病症状、体征评分亦高于对照组,差异均有统计学意义(P0.01)。两组人员日工作时间及工作环境比较显示,观察组日工作8h以上人员多于对照组,且工作环境差于对照组,两组比较,差异均有统计学意义(P0.01)。观察组发病率和从业时间关系显示,从业2年、6年、10年发病率出现显著增加。结论农村务工人员进入针织厂一线车间工作1年后变应性鼻炎发病率增加,且症状、体征较为严重。从业时间越长发病率越高,分别于工作2年、6年及10年后发病率出现高峰。这一现象的发生可能与务工者进入工厂后脱离原有的生活环境,在较为封闭、潮湿且人员密集的环境中较长时间接触纺织纤尘,且发病后未及时脱离工作环境有关。