钢铁工人职业紧张与颈动脉粥样硬化关系的 现况研究

背景　钢铁工人作业环境单一，常处于高温、噪声的环境中，易形成职业紧张（OS）。OS不仅影响工人的生产效率，而且对若干生化指标（如总胆固醇、三酰甘油等）产生不利影响，造成血脂异常，引发颈动脉粥样硬化（CAS）。钢铁工人OS与CAS之间关系的研究目前依然缺乏。目的　探讨钢铁工人CAS的危险因素及其与OS的关系。方法　采用整群分层抽样方法，选择2017年3—6月在唐山泓慈医院体检中心参加职业健康检查者（在岗，从事钢铁作业1年及以上）为研究对象。采用多普勒超声诊断仪进行CAS的诊断。采用中文版《工作内容问卷》进行OS的测评。CAS影响因素分析采用单因素和多因素Logistic回归分析。结果　共调查4 525名钢铁工人，1 151名诊断为CAS，检出率为25.44%；OS 317名，占7.01%。单因素Logistic回归分析结果显示，性别、年龄、体质指数（BMI）、学历、婚姻状况、倒班情况、吸烟、饮酒及高血压、高脂血症检出率为钢铁工人罹患CAS的影响因素（P0.05）。CAS组与非CAS组钢铁工人工作要求、工作自主度、社会支持维度得分及工作要求/工作自主度比值比较，差异均无统计学意义（P>0.05）。多因素Logistic回归分析结果显示，性别、年龄、学历、倒班情况、吸烟、饮酒、高血压是钢铁工人发生CAS的独立影响因素（P<0.05）。结论　钢铁工人罹患CAS受多种因素的影响，尚未发现OS与CAS存在关联。

Occupational Stress and Carotid Atherosclerosis among Steel Workers:a Cross-sectional Study

Background Steel workers are at particularly high risk of occupational stress due to engaging in repetitive tasks and often working in hot and noisy environment.Occupational stress may reduce the work efficiency.Moreover,it may adversely affect some biochemical markers,such as total cholesterol and triglyceride,and so on,causing dyslipidemia and even carotid atherosclerosis(CAS).However,research on the relationship between occupational stress and CAS among steel workers is still lacking.Objective To explore CAS-related risk factors and the relationship between CAS and occupational stress among steel workers.Methods Stratified cluster sampling was used to select employed steel workers with at least one year of work experience who underwent occupational health examination in Physical Examination Center,Tangshan Hongci Hospital during from March to June 2017.CAS was diagnosed by carotid ultrasound.Occupational stress was assessed by the Chinese version of the Job Content Questionnaire.Both univariate and multivariate Logistic regression analyses were used to determine the influencing factors of CAS.Results A total of 4525 workers were recruited.Overall,the prevalence of CAS and occupational stress was 25.44%(n=1151),and 7.01%(n=317),respectively.In the univariate analysis,sex ratio,distributions of age,BMI,education level,marital status,and shift work status,as well as prevalence of smoking,drinking,hypertension and hyperlipidemia were independently associated with CAS(P<0.05).However,two groups showed no obvious differences in the prevalence of occupational stress(P>0.05).Two groups also had no obvious differences in mean scores of job requirements,job autonomy,and social support as well as the ratio of job requirements mean score to job autonomy mean score(P>0.05).In multivariate Logistic regression analysis showed that male,older age,lower education level,engaging in shift work,smoking,drinking,and hypertension were independently associated with CAS(P<0.05).Conclusion CAS is affected by several factors.Our analysis suggests that the available data does not support the relationship between occupational stress and CAS.