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低浓度混苯暴露对石油炼化企业工人血压的影响OA北大核心CSTPCD

Effect of low-concentration benzene,toluene,and xylene exposure on blood pressure of workers in a petroleum refining enterprise

中文摘要英文摘要

[背景]我国从事接苯或含苯溶剂作业工人多呈低浓度暴露水平,长期低浓度混苯暴露可对血压造成影响. [目的]研究低浓度混苯暴露对职业工人血压的影响,为企业对工人健康管理策略提供依据,以减少低浓度混苯暴露工人高血压的发生率. [方法]采用横断面调查方法,以 2022年参加职业健康检查的海南某石油炼化企业 884名工人为研究对象,依据是否接触混苯将工人分为暴露组 649人和对照组 235人.收集研究对象的职业接触混苯浓度和健康检查资料,并进行问卷调查.此外,使用高效液相色谱-三重四极杆质谱联用仪测定工人尿中苯巯基尿酸(S-PMA)、马尿酸(HA)、甲基马尿酸(MHA,包括2-MHA、3-MHA和4-MHA 3种同分异构体),评估体内混苯负荷水平,分析低浓度混苯暴露对工人血压的影响. [结果]2022年该企业混苯作业车间各检测点苯、甲苯、二甲苯时间加权平均容许浓度(TWA)与短时间接触容许浓度(STEL)均未超过国家职业接触限值,为低浓度混苯暴露.混苯内负荷结果:暴露组工人尿中苯代谢产物S-PMA、甲苯代谢产物HA、二甲苯代谢产物 3-MHA和4-MHA浓度,均分别高于对照组(均P<0.05).相关性分析显示,工人尿中S-PMA浓度与舒张压呈正相关(r=0.265,P<0.05).不同性别、年龄、工龄、文化程度、月收入、体质量指数(BMI)、饮酒、食油、家庭住址类型工人的收缩压、舒张压分布差异均有统计学意义(均P<0.05);不同吸烟、劳动强度工人收缩压分布差异均有统计学意义(均P<0.05);与对照组比较,暴露组工人舒张压明显升高(P<0.05).多元线性回归分析结果显示,年龄、性别及BMI对收缩压影响均具有统计学意义(均P<0.05),年龄、工龄及BMI对舒张压影响均具有统计学意义(均P<0.05);年龄>35岁、男性、超重及肥胖工人收缩压高于年龄≤35岁、女性及消瘦工人,年龄>35岁、工龄>5年及肥胖工人舒张压高于年龄≤35岁、工龄≤5年及消瘦工人.低浓度混苯暴露是舒张压的主要影响因素之一,与对照组相比,暴露组工人舒张压上升1.337 mmHg(P<0.05). [结论]低浓度混苯暴露、工龄>5年、肥胖可能导致石油炼化工人血压升高,应对该职业人群定期检测血压,加强对工人的健康干预.

[Background]Workers engaged in benzene-exposed or benzene-containing solvent-exposed op-erations in China are predominantly subjected to a low concentration of benzene series com-pounds,and prolonged exposure to low concentrations of benzene,toluene,and xylene(BTX)may have implications for blood pressure. [Objective]To investigate the influence of low-concentration BTX exposure on the blood pressure of workers,aiming to provide a basis for enterprises to devise associated health management strategies to mitigate the occurrence of hypertension among workers exposed to low concentrations of BTX. [Methods]Using a cross-sectional design,884 workers from a petroleum refining enterprise in Hainan who participated in an occupational health examination in 2022 were selected as the study population,and were divided into an exposure group of 649 workers and a control group of 235 workers based on their reporting of BTX exposure or not.Data on workplace BTX concentrations and health examinations of the study subjects were collected and questionnaires were administered.In addition,S-phenylmercapturic acid(S-PMA),hippuric acid(HA),and methyl hippuric acid(MHA,including the three isomers 2-MHA,3-MHA,and 4-MHA)were measured in the urine of the workers using high-performance liquid chromatography-tandem triple quadrupole mass spectrometry to assess internal BTX burden.The effects of low-concentration BTX exposure on blood pressure were analyzed. [Results]In 2022,the concentrations of benzene,toluene,and xylene of all monitoring points did not exceeded the national limits by either time-weighted average(TWA)or short-term exposure limit(STEL),indicating low-concentration BTX exposure.Regarding the internal burden of BTX,the concentrations of benzene metabolite S-PMA,toluene metabolite HA,and xylene metabolites 3-MHA and 4-MHA in the urine samples in the exposure group were higher than those in the control group(P<0.05).The correlation analysis showed a positive correlation between urinary S-PMA concentration and diastolic blood pressure in the workers(r=0.265,P<0.05).Differences in systolic and diastolic blood pressure distributions were statistically significant among workers grouped by sex,age,work years,educational levels,monthly income,body mass index(BMI),alcohol use,dietary oil,and types of residential address(P<0.05).Significant differences in systolic blood pressure distribution were observed among workers by smoking status and levels of labor intensity(P<0.05).Compared with the control group,the workers in the exposure group exhibited a significant increase in diastolic blood pressure(P<0.05).The results of multiple linear regression showed that age,sex,and BMI had statistically significant effects on systolic blood pressure(P<0.05),while age,work years,and BMI had statistically significant effects on diastolic blood pressure(P<0.05).The systolic blood pressure of age>35 years,male,overweight and obese workers was significantly higher than that of age≤35 years,female,and underweight workers,and the diastolic blood pressure of age>35 years,work years>5 years,and obese workers was higher than age≤35 years,≤5 years of service,and un-derweight workers.Low-concentration BTX exposure was one of the main influencing factors for elevated diastolic blood pressure,and the exposed workers showed a 1.337 mmHg increase in diastolic blood pressure compared to the control group(P<0.05). [Conclusion]Low-concentration BTX exposure,work years>5 years,and obesity may elevate blood pressure among petroleum refininig workers.Regular blood pressure monitoring and enhanced health interventions for this occupational group are warranted.

周炳贤;张静;吴祺晟;范世恒;苏朱娜;彭建业;卢春芸;张能德;金蕾;于德娥

海南医科大学公共卫生学院,Heinz Mehlhorn 院士工作站/热带转化医学教育部重点实验室,海南 海口 571199海南省疾病预防控制中心职业卫生室,海南海口 570203

预防医学

职业暴露甲苯二甲苯血压

occupational exposurebenzenetoluenexyleneblood pressure

《环境与职业医学》 2024 (009)

1012-1019 / 8

2021年海南医学院研究生创新科研课题项目(HYYS2021A23) This study was funded.

10.11836/JEOM24024

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