选煤厂纯稳态噪声对人体健康危害以及作业人员血脂水平影响的研究
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摘要
目的:研究噪声对作业工人血脂水平的影响,并揭示接触噪声时间、作业工人年龄、不同频谱噪声和血脂浓度水平之间的关系以及接触噪声时间与作业工人主诉不良反应症状、心电图改变的关系。
方法:研究对象选用11个选煤厂矿风机工、空压机工、水泵工等接触噪声作业人员893名。现场噪声测定采用国营红声仪器厂生产的ND2型精密韦级计(使用前经中国计量科学院校正)进行。体检前进行纯噪声作业人员一般情况的调查,同时进行内科各血压的检查。听力测定按GBZ49-2002《职业性听力损伤诊断标准》附录A的要求,在本底噪声＜30dB(A)的隔音室中进行纯音气导听阈的测定,然后按要求进行年龄的修正。取噪声作业人员清晨空腹静脉血,在规定时间内进行血样处理,用酶法测定血清总胆固醇(TC)、血清甘油三脂(TG)、高密度脂蛋白(HDL)、低密度脂蛋白(LDL),计算冠心病危险因子(CHDRI)并进行血常规检查。对893名接触噪声的作业人员进行主诉不良反应症状问卷调查。
结果:TC、TG与HDL的检查结果在各年龄组之间的比较有统计学意义(P＜0.05);而LDL和CHDRI的检查结果在各年龄组之间的比较差异无统计学意义(P＞0.05)。TC、TG、LDL及CHDRI均有随年龄的升高而升高的趋势,而HDL则有随年龄升高而降低的趋势。TG与TC及LDL的检查结果在各接噪时间组之间的比较有统计学意义(P＜0.01);而HDL和CHDRI的检查结果在各接噪时间组之间的比较差异无统计学意义(P＞0.05)。TC、TG、LDL及CHDRI均随累计接触噪声时间的延长而呈现升高的趋势,而HDL则随累计接触噪声时间的延长而降低的趋势。方差分析结果表明:TC、TG、LDL在接触不同频率的噪声作业人员之间的差异都有统计学意义(P＜0.05),HDL在各频率组之间的差异无统计学意义(P＞0.05),TC、TG、LDL均随着噪声频率的升高而升高的趋势,而HDL则随着噪声频率升高而呈现降低的趋势。听力损伤组与听力正常组的TC、LDL和HDL检查结果之间的差异有统计学意义,接触噪声作业人员头痛、头昏、失眠、记忆力减退症状、心电图异常的发生率随着接触噪声时间的延长而呈现升高的趋势。
结论:噪声对健康造成了损害,引起体内血脂浓度的变化;年龄、接触噪声时间、不同频谱噪声、听力损害程度与人体内血脂浓度存在相关性;噪声可引起人体主观不良反应症状并导致心电生理异常改变。
Objective:To evaluate the influence of noise exposure on blood lipid levels and investigate the relationship among the time of noise exposure,age of workers,different frequency spectrum and blood lipid levels.,And to investigate the relationship between the time of noise exposure and principal action symptom and electrocardiogram.
Methods:Eight hundred ninety-three noise exposure workers were examined by pure tone audiometry,and then the levels of total cholesterol(TC),triglyeride(TG),high density lipoprotein cholesterol(HDL-C)and low density lipoprotein cholesterol(LDL-C)were examined.Finally,the Coronary heart disease risk factors were computed and principal action symptom of eight hundred ninety-three noise exposure workers was investigated by questionnaire.
Results:The levels of TC,TG and HDL were significantly different among every age group(P＜0.05);but the levels of LDL and CHDRI were not significantly different among the groups(P＞0.05).The levels of TC,TG,LDL and CHDRI increase accompanied with the increase of ages;but the levels of HDL decrease.The levels of TC,TG and LDL were significantly different among every exposure time group(P＜0.01);but the levels of HDL and CHDRI were not significantly different among the groups(P＞0.05).The levels of TC,TG,LDL and CHDRI increase accompanied with the increase of noise exposure time;but the levels of HDL decrease.The levels of TC,TG and LDL were significantly different among different frequency spectrum groups(P＜0.05);but the level of HDL was not significantly different among the groups (P＞0.05).The levels of TC,TG and LDL increase accompanied with the increase of the frequency;but the levels of HDL and CHDRI decrease.The levels of TC,LDL and HDL were significantly different between the normal group and impaired group.The degree of principal action symptom of Eight hundred ninety-three noise exposure workers increase accompanied with noise exposure time.
Conclusions:Noise do harm to our health.It can affect the levels of blood lipid.This investigation indicate there are some relationship among age of workers,different frequency of the noise,the degree of hearing loss and the levels of blood lipid.
方法:研究对象选用11个选煤厂矿风机工、空压机工、水泵工等接触噪声作业人员893名。现场噪声测定采用国营红声仪器厂生产的ND2型精密韦级计(使用前经中国计量科学院校正)进行。体检前进行纯噪声作业人员一般情况的调查,同时进行内科各血压的检查。听力测定按GBZ49-2002《职业性听力损伤诊断标准》附录A的要求,在本底噪声＜30dB(A)的隔音室中进行纯音气导听阈的测定,然后按要求进行年龄的修正。取噪声作业人员清晨空腹静脉血,在规定时间内进行血样处理,用酶法测定血清总胆固醇(TC)、血清甘油三脂(TG)、高密度脂蛋白(HDL)、低密度脂蛋白(LDL),计算冠心病危险因子(CHDRI)并进行血常规检查。对893名接触噪声的作业人员进行主诉不良反应症状问卷调查。
结果:TC、TG与HDL的检查结果在各年龄组之间的比较有统计学意义(P＜0.05);而LDL和CHDRI的检查结果在各年龄组之间的比较差异无统计学意义(P＞0.05)。TC、TG、LDL及CHDRI均有随年龄的升高而升高的趋势,而HDL则有随年龄升高而降低的趋势。TG与TC及LDL的检查结果在各接噪时间组之间的比较有统计学意义(P＜0.01);而HDL和CHDRI的检查结果在各接噪时间组之间的比较差异无统计学意义(P＞0.05)。TC、TG、LDL及CHDRI均随累计接触噪声时间的延长而呈现升高的趋势,而HDL则随累计接触噪声时间的延长而降低的趋势。方差分析结果表明:TC、TG、LDL在接触不同频率的噪声作业人员之间的差异都有统计学意义(P＜0.05),HDL在各频率组之间的差异无统计学意义(P＞0.05),TC、TG、LDL均随着噪声频率的升高而升高的趋势,而HDL则随着噪声频率升高而呈现降低的趋势。听力损伤组与听力正常组的TC、LDL和HDL检查结果之间的差异有统计学意义,接触噪声作业人员头痛、头昏、失眠、记忆力减退症状、心电图异常的发生率随着接触噪声时间的延长而呈现升高的趋势。
结论:噪声对健康造成了损害,引起体内血脂浓度的变化;年龄、接触噪声时间、不同频谱噪声、听力损害程度与人体内血脂浓度存在相关性;噪声可引起人体主观不良反应症状并导致心电生理异常改变。
Objective:To evaluate the influence of noise exposure on blood lipid levels and investigate the relationship among the time of noise exposure,age of workers,different frequency spectrum and blood lipid levels.,And to investigate the relationship between the time of noise exposure and principal action symptom and electrocardiogram.
Methods:Eight hundred ninety-three noise exposure workers were examined by pure tone audiometry,and then the levels of total cholesterol(TC),triglyeride(TG),high density lipoprotein cholesterol(HDL-C)and low density lipoprotein cholesterol(LDL-C)were examined.Finally,the Coronary heart disease risk factors were computed and principal action symptom of eight hundred ninety-three noise exposure workers was investigated by questionnaire.
Results:The levels of TC,TG and HDL were significantly different among every age group(P＜0.05);but the levels of LDL and CHDRI were not significantly different among the groups(P＞0.05).The levels of TC,TG,LDL and CHDRI increase accompanied with the increase of ages;but the levels of HDL decrease.The levels of TC,TG and LDL were significantly different among every exposure time group(P＜0.01);but the levels of HDL and CHDRI were not significantly different among the groups(P＞0.05).The levels of TC,TG,LDL and CHDRI increase accompanied with the increase of noise exposure time;but the levels of HDL decrease.The levels of TC,TG and LDL were significantly different among different frequency spectrum groups(P＜0.05);but the level of HDL was not significantly different among the groups (P＞0.05).The levels of TC,TG and LDL increase accompanied with the increase of the frequency;but the levels of HDL and CHDRI decrease.The levels of TC,LDL and HDL were significantly different between the normal group and impaired group.The degree of principal action symptom of Eight hundred ninety-three noise exposure workers increase accompanied with noise exposure time.
Conclusions:Noise do harm to our health.It can affect the levels of blood lipid.This investigation indicate there are some relationship among age of workers,different frequency of the noise,the degree of hearing loss and the levels of blood lipid.
引文
[1]赵一鸣.噪声累积暴露研究的进展.中华劳动卫生职业病杂志,1998,4(2):123-124.
[2]丁茂平,赵一鸣,穆玉梅,等.脉冲与稳态噪声引起听力损伤的差异.中华劳动卫生职业病杂志.1995,83:72-73.
[3]Hsuan SL,Kannan MS,Jeyaseelan S,et al.Epidemiology of occupation and coronary heart disease:research agenda.Am J Ind Med,1996.30(4):495-499.
[4]吴金贵,邱杏娣,史玲玲,等.高温噪声暴露对钢铁冶金工人血脂的影响.中国职业医学,2001,28(1):28.
[5]愈忠敏,陆瑞元,余延山.生产性噪声对工人心电图的影响.化工劳动保护(工业卫生与职业病分册),1998,19:255-256.
[6]Forari R,Zoppi A,Vanasia A,et al.Occupational noise expose and blood press.J Hypertens,1994,12(4):475-479.
[7]Sdeeki L.Effect Of impulse vibration and noise on vasomotor function of peripheral blood vessels among pneumatic forge hammer operators.Cam Eur J Public Health.1995,3:S88-S89.
[8]李亚红.噪声对接噪人员血脂影响的观察.职业医学,1995,22(6):49-50.
[9]吴喜江,黄在坤,祁光伟.噪声作业对生产工人血脂成分影响的调查研究.工业卫生与职业病,1999,25(1):40-43.
[10]姬红蓉,贺建刚,史春波,等.工业噪声对接噪人员血脂影响的调查分析[J].中国公共卫生,1997,13(7):423.
[11]曹多志,吴金贵,邱杏娣,等.钢铁企业噪声暴露与男工高血脂症的剂量.反应关系研究.工业卫生与职业病.2000,6(6):338-340.
[12]刘素香.中低频噪声对电力生产工人健康影响的调查研究.职业与健康,2003,19(12):3-5.
[13]赵建华,王洪伟,常宏,等.浅谈选煤厂的环境污染与环境保护.煤质技术,2004,2-3:8-10.
[14]胡琳.血脂综合指数与冠心病的关系.青海:青海医药杂志,2004年第34卷第九期:16-17.
[15]赵一鸣.听力对噪声的易感性在噪声所致高血压中的作用.中华劳动卫生职业病杂志,2002,22(2):128-130.
[16]ENZI P,FRENZILLI G,GESI M,et al.DNA damage associated with ultrastmetural alterations in rat myecardium after loud noise exposure.Environ Health Perpect,2003,111(4):167-471.
[17]陈卓.噪声对作业工人血脂影响的方差分析.实用预防医学,2002,9(5):540-541.
[18]DAVIS R R,NEWI NDER J K,LING x,et al.Genetic basis for susceptibility to noise —induced heating loss in mice.Hear Res,2001,155(1-2):82-90.
[19]RALPH H.Progressive hearing loss and increased susceptibility tonoise-induced heating loss in mice carrin8 a Cdh23 but not a Myo 7 amutation[J].Jaro,2004,5(1):66-79.
[20]杨杪.职业性噪声暴露工人噪声性听力损失的遗传易感性研究.第八次全国劳动卫生与职业病学术会议论文汇编.中华预防医学会,2004:101-107.
[21]KOZEL P J,DAVIS R R,KRIEG E F,et al.Deficiency in plasma membrahe calcium ATPase isoform 2 increases susceptibilily to noise—induced hearing loss in mice[J].Hear Res,2002,164(1-2):231-239.
[22]刘书乾,关建国.噪声对大鼠血脂、脂蛋白胆固醇的影响.中国公共卫生学报,1999,18(2):94.
[23]OHLEMILI R K,MCFADDEN S L,DING D I,et al.Targeteddeletion of the eytosolie eu /Zn-superoxide dismutase gene(Sedl)in Cl～ase8 susceptibility to noise-induced heating loss.AudiolNeurootol,1999,4(5):237-246.
[24]RABINOWITZ P M,PIERCE WISE J Sr,HUR MOBO B,et al.Antioxidantstatus and hearing function in noise—exposed workem[J].HearRas,2002,173(1-2):164-171.
[1]HYDE G E,RUBEL E W.Mitechondrial role in hair cell survival after injury[J].Otdaryhyd Head Neck Surg。1995,113(5):530-540.
[2]LENZIP,FRENZILLI G,GESI M。et al.DNA damage associated with ultrastmetural alterations in rat myecardium after loud noise expo-sure[J].Environ Health Pe～pect,2003,111(4):,167-471.
[3]赵一鸣.听力对噪声的易感性在噪声所致高血压中的作用[J].中华劳动卫生职业病杂志,2002,22(2):128-130.
[4]陈卓.噪声对作业工人血脂影响的方差分析[J].实用预防医学,2002,9(5):540-541.
[5]DAVIS R R,NEWI NDER J K,LING x,et al.Genetic basis for susceptibility to noise -induced heating loss in mice[J].Hear Res,2001,155(1-2):82-90.
[6]RALPH H.Progressive hearing loss and increased susceptibility to noise-induced heating loss in mice carrin8 a Cdh23 but not a Myo 7 a mutation[J].Jaro,2004,5(1):66-79.
[7]杨杪.职业性噪声暴露工人噪声性听力损失的遗传易感性研究[A].第八次全国劳动卫生与职业病学术会议论文汇编[c].宁波:中华预防医学会,2004:101-107.
[8]KOZEL P J,DAVIS R R,KRIEG E F,et al.Deficiency in plasma mem brahe calcium ATPase isoform 2 increases susceptibilily to noise-inducedhearing loss in mice[J].Hear Res,2002,164(1-2):231-239.
[9]KOZEL P J.FRIEDMAN R A,ERWAY L C,et al.Balance and hearing deficits in mice with a null mutation in the gene encoding plas ma membrane Ca2 ATPa8e isoform 2[J].J Biol Chem,1998,273(30):18693-18696.
[10]OHLEMILI R K K,MCFADDEN S L,DING D I.et al.Targeted deletion of the eytosolie Cu/Zn-superoxide dismutase gene(Sedl)in Cl～ase8 susceptibility to noiseinduced heating loss[J].Audiol Neurootol,1999,4(5):237-246.
[11]RABINOWITZ P M,PICRCE WISE J Sr,HUR MOBO B,et al.Antioxidant status and hearing function in noise-exposed workem[J].HearRas,2002,173(1-2):164-171.
[12]赵一鸣.听力对噪声的易感性与线粒体DNA7.4kb缺失的初步观察[J].中华劳动卫生职业病杂志。1999。17(5):283-285.
[13]姬红蓉,贺建刚,史春波,等.工业噪声对接噪人员血脂影响的调查分析[J].中国公共卫生,1997,13(7):423.
[14]吴金贵,邱可娣,史玲玲,等.高温噪声暴露对钢铁冶金工人血脂的影响[J].中国职业医学,2001,28(1):28.
[15]李亚红.噪声对接噪人员血脂影响的观察.职业医学,1994,22(6):49.
[16]Hsuan SL,Kannan MS,Jeyaseelan S,et al.Epidemiology of occupation Andnaryheartdisease:researchagenda[J].AmJIndMed,1996,30(4):495-499.
[17]Yomei F,Papaleo B,Baccolo TP,Chronic exposure and hecardiovascular system in aircraft pilotes[j].Med Lav,1996,87(5):394-410.
[2]丁茂平,赵一鸣,穆玉梅,等.脉冲与稳态噪声引起听力损伤的差异.中华劳动卫生职业病杂志.1995,83:72-73.
[3]Hsuan SL,Kannan MS,Jeyaseelan S,et al.Epidemiology of occupation and coronary heart disease:research agenda.Am J Ind Med,1996.30(4):495-499.
[4]吴金贵,邱杏娣,史玲玲,等.高温噪声暴露对钢铁冶金工人血脂的影响.中国职业医学,2001,28(1):28.
[5]愈忠敏,陆瑞元,余延山.生产性噪声对工人心电图的影响.化工劳动保护(工业卫生与职业病分册),1998,19:255-256.
[6]Forari R,Zoppi A,Vanasia A,et al.Occupational noise expose and blood press.J Hypertens,1994,12(4):475-479.
[7]Sdeeki L.Effect Of impulse vibration and noise on vasomotor function of peripheral blood vessels among pneumatic forge hammer operators.Cam Eur J Public Health.1995,3:S88-S89.
[8]李亚红.噪声对接噪人员血脂影响的观察.职业医学,1995,22(6):49-50.
[9]吴喜江,黄在坤,祁光伟.噪声作业对生产工人血脂成分影响的调查研究.工业卫生与职业病,1999,25(1):40-43.
[10]姬红蓉,贺建刚,史春波,等.工业噪声对接噪人员血脂影响的调查分析[J].中国公共卫生,1997,13(7):423.
[11]曹多志,吴金贵,邱杏娣,等.钢铁企业噪声暴露与男工高血脂症的剂量.反应关系研究.工业卫生与职业病.2000,6(6):338-340.
[12]刘素香.中低频噪声对电力生产工人健康影响的调查研究.职业与健康,2003,19(12):3-5.
[13]赵建华,王洪伟,常宏,等.浅谈选煤厂的环境污染与环境保护.煤质技术,2004,2-3:8-10.
[14]胡琳.血脂综合指数与冠心病的关系.青海:青海医药杂志,2004年第34卷第九期:16-17.
[15]赵一鸣.听力对噪声的易感性在噪声所致高血压中的作用.中华劳动卫生职业病杂志,2002,22(2):128-130.
[16]ENZI P,FRENZILLI G,GESI M,et al.DNA damage associated with ultrastmetural alterations in rat myecardium after loud noise exposure.Environ Health Perpect,2003,111(4):167-471.
[17]陈卓.噪声对作业工人血脂影响的方差分析.实用预防医学,2002,9(5):540-541.
[18]DAVIS R R,NEWI NDER J K,LING x,et al.Genetic basis for susceptibility to noise —induced heating loss in mice.Hear Res,2001,155(1-2):82-90.
[19]RALPH H.Progressive hearing loss and increased susceptibility tonoise-induced heating loss in mice carrin8 a Cdh23 but not a Myo 7 amutation[J].Jaro,2004,5(1):66-79.
[20]杨杪.职业性噪声暴露工人噪声性听力损失的遗传易感性研究.第八次全国劳动卫生与职业病学术会议论文汇编.中华预防医学会,2004:101-107.
[21]KOZEL P J,DAVIS R R,KRIEG E F,et al.Deficiency in plasma membrahe calcium ATPase isoform 2 increases susceptibilily to noise—induced hearing loss in mice[J].Hear Res,2002,164(1-2):231-239.
[22]刘书乾,关建国.噪声对大鼠血脂、脂蛋白胆固醇的影响.中国公共卫生学报,1999,18(2):94.
[23]OHLEMILI R K,MCFADDEN S L,DING D I,et al.Targeteddeletion of the eytosolie eu /Zn-superoxide dismutase gene(Sedl)in Cl～ase8 susceptibility to noise-induced heating loss.AudiolNeurootol,1999,4(5):237-246.
[24]RABINOWITZ P M,PIERCE WISE J Sr,HUR MOBO B,et al.Antioxidantstatus and hearing function in noise—exposed workem[J].HearRas,2002,173(1-2):164-171.
[1]HYDE G E,RUBEL E W.Mitechondrial role in hair cell survival after injury[J].Otdaryhyd Head Neck Surg。1995,113(5):530-540.
[2]LENZIP,FRENZILLI G,GESI M。et al.DNA damage associated with ultrastmetural alterations in rat myecardium after loud noise expo-sure[J].Environ Health Pe～pect,2003,111(4):,167-471.
[3]赵一鸣.听力对噪声的易感性在噪声所致高血压中的作用[J].中华劳动卫生职业病杂志,2002,22(2):128-130.
[4]陈卓.噪声对作业工人血脂影响的方差分析[J].实用预防医学,2002,9(5):540-541.
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