工人脱离职业性噪声接触后的心电图分析

目的探讨工人脱离职业性噪声接触后的心电图变化。方法在进行《广州生物库队列研究》时，第一阶段收集10413名年龄在≥50岁居民的一般资料、体格检查和实验室检查结果。受检者70％为女性，50％以上年龄在60～69岁；受检者中有2120名（21．0％）曾经接触职业性噪声，但均已脱离接触且为退休或离岗者；用上海惠普有限公司制造的MAC-CS多导联心电图机进行12导联的心电图检查；噪声职业接触史通过问卷采集，心电图由2名中级以上具有诊断资格的医师进行独立诊断。结果（1）心电图异常检出率女性为82．4％，明显高于男性的79．1％；不论男性或女性，心电图异常检出率随年龄增加而上升（P=0．000），女性随文化程度增高而明显下降（P=0．000），但无论男女，脱离职业性噪声接触后，其心电图异常检出率与从未职业性噪声接触者比较，差异无统计学意义（P〉0．05）；（2）比较曾经有职业性噪声接触与非接触者心电图异常的分类，在校正年龄因素和文化程度后，心律失常、心电轴偏移、房或室肥厚、ST-T改变、心肌劳损、冠状动脉综合征等比较，差异无统计学意义（P〉0．05）。结论脱离职业性噪声接触后的工人心电图异常检出率未见明显高于非职业性噪音接触者。

Electrocardiogram change of workers after disengaging occupational noise exposure

OBJECTIVE: To examine electrocardiogram (ECG) change of workers after leaving occupational noise exposure. METHODS: In the first phase of the Guangzhou Biobank Cohort Study, 10413 Guangzhou residents aged 50 years or more received a face-to face interview including noise exposure history, a full medical check-up and laboratory tests in 2003 - 4. ECG examination was carried out using 12-lead MAC-CS ECG machine made in HP Ltd, Shanghai, China. ECG of every subject was independently diagnosed by two doctors who had obtained ECG diagnosis qualification. RESULTS: (1) Among 10413 subjects, 70% were female, and more than half were aged 60-69 years. The mean age and education level in males were higher than those in females. (2) 2119 subjects (21.0%) were previously exposed to noise and were retired now. (3) The prevalence of ECG abnormality was respectively 82.4% and 79.1% in females and males. Rate of ECG abnormality increased with age in both females and males (P = 0.000), and was lower in females with higher education level (P = 0.000). There was not significant difference in ECG abnormality between workers previously exposed or unexposed to noise in both females and males (P > 0.05). 4 Comparing workers previously exposed to those unexposed to noise in both females and males, after adjusting for age, educational level and smoking status, the rates of arrhythmia, axes deviation, atria and ventricle hypertrophy, ST-T change and coronary artery syndrome were not significantly different (P > 0.05). CONCLUSION: Our study showed that the prevalence of ECG abnormality was not significantly increased in workers previously exposed to noise and had left exposure now compared to those never exposed to noise. Because our study was cross section and occupational history was obtained from a questionnaire but was not confirmed by the companies, further study is needed.