焦化作业工人代谢综合征与脂肪肝流行病学研究

目的 通过焦化作业工人代谢综合征、脂肪肝流行病学研究，为探讨代谢综合征、脂肪肝防治对策提供科学依据。方法选择某冶金焦化厂焦炉和化产作业工龄10年以上的男性工人535人为暴露组：选择不接触或较少接触焦炉逸散物的该厂工龄1年以上的男性工人174人为对照组。调查内容包括现场劳动卫生学调查、一般情况、职业史、个人史、血常规内科检查、血常规、血生化、乙肝五项、B超等。结果焦化生产场所不同程度存在焦炉逸散物（COE）危害，其中炉顶作业区苯并（a）芘（BaP）、苯溶物（BSM）危害比炉侧作业区和化产作业区严重，炉侧作业区BaP、BSM浓度比化产作业区略高。炉顶作业组高血压、代谢综合征、脂肪肝检出率分别为28．2％、10．4％、19．3％，炉侧作业组脂肪肝检出率为20．3％．均高于对照组（P〈0．05）；化产作业组高血压检出率为31．7％，与对照组（17．2％）相比，两者有极显著性差异（P〈0．01）。结论焦化作业工人中焦炉作业工人代谢综合征、脂肪肝高发可能与其职业暴露有关，COE有可能导致机体胰岛素抵抗（1R）而使代谢综合征和脂肪肝发生，应引起高度重视。

An epidemiological study of metabolic syndrome and Fatty Liver Disease among coke oven workers

Objective To study the metabolic syndrome(MS) and fatty liver disease(FLD) among coke oven workers so as to provide evidence for preventing MS and FLD.(Methods)Exposed group: 535 male coke-oven workers and by-product workers in a metallurgic facory who have been working for more than ten years;and control group:174 male coke-oven factory workers who were not or less exposed to coke oven emission(COE) and have been working for more than one year in this factory.(Results) Different coke oven working spots might cause different degree of harm by COE.Mean concentration of BaP and BSM on coke-oven top was higher than that beside the coke oven and by-product spots.Mean concentration of BaP and BSM beside the coke oven was a little higher than on the by-product spot.The prevalence rate of hypertension,MS and FLD on coke-oven top was 28.2%,10.4%,19.3% respectively,and were significantly higher than the control goup(P<0.05).The prevalence rate of FLD beside coke oven was 20.3%,and was significantly higher than the control goup(P<0.05).The prevalence rate of hypertension on the by-product spot was 31.7%,and was significantly higher than the control group(17.2%)(P<0.01).Conclusion The higher prevalence rate of MS and FLD among coke oven workers was possibly associated with occupational exposure,and COE might lead to insulin resistance and cause MS and FLD.Therfore special attention should be paid to prevention.