首页|不同氯乙烯生产工艺下职业人群的肝脏损伤状况

不同氯乙烯生产工艺下职业人群的肝脏损伤状况

扫码查看
目的 比较电石法与乙烯法2种不同工艺下氯乙烯职业接触人群的肝脏损伤状况差异并分析原因。方法 2022年6-9月对天津市滨海新区某聚氯乙烯企业中电石法(78人)与乙烯法(69人)装置区的职业人群开展横断面调查。通过问卷调查收集人口学信息、职业史、防护设施等资料,体检时采集静脉血(4 mL/人)及尿液(10~50 mL/人),并收集受试对象的肝功能指标及肝脏B超结果。经ELISA法测定血清中8羟基脱氧鸟苷(8-hydroxy-2 deoxyguanosine,8-OHdG),经固相萃取-离子色谱法测定尿中的亚硫基二乙酸(thiodiglycolic acid,TDGA)浓度。结果 2组人群在年龄和性别比上具有较好的匹配性,接害工龄、饮酒及每日睡眠时长的人数构成比差异有统计学意义(P<0。01或P<0。05)。按岗位分类后,电石组6种岗位(F=6。94)及乙烯组5种岗位(F=6。74)的TDGA含量差异有统计学意义(P<0。01)。8-OHdG平均浓度与TDGA平均含量在电石组的聚合清理工(r=0。53)、聚合外操工(r=0。47)、维修保全工(r=0。45)及现场采样工(r=0。41)等岗位上呈现中等强度正相关(P<0。05);在乙烯组的裂解反应工(r=0。64)、DCS操控工(r=0。51)、氧氯化工(r=0。50)及化学备料工(r=0。44)等岗位上同样呈中等强度正相关(P<0。05)。2组人群的 ALT(x2=15。41)、AST(x2=9。95)及 ALP(x2=3。79)差异有统计学意义(P<0。01)。电石组丙氨酸氨基转移酶、天门冬氨酸氨基转移酶、天门冬氨酸氨基转移酶/丙氨酸氨基转移酶、碱性磷酸酶及白蛋白/球蛋白异常人数显著高于乙烯组(P<0。05),肝脏B超异常人数差异有统计学意义(x2=17。33,P<0。01)。二分类Logistic回归分析显示,血中8-OHdG平均浓度超过90 µg/m3、尿中TDGA平均含量高于0。60 mg/L、男性、接害工龄>10年、习惯饮酒及每日睡眠时长<6h等因素均为导致2组劳动者出现肝脏损伤状况的风险因素(P<0。05)。结论 该PVC企业中电石组人群发生的肝脏损伤程度显著高于乙烯组,与工作场所中电石组岗位接触氯乙烯浓度较高、累积接害时间长及接害工龄长、习惯饮酒、轮班工作制导致的睡眠时间不足等因素共同作用诱发的氧化应激损伤有关。
Liver impairment status toward workers exposed to vinyl chloride under different techniques
OBJECTIVE To analyse potential differences towards liver impairment status on vinyl chloride monomer(VCM)exposed population from technique under acetylene hydrochlorination to the one of ethylene oxychlorination respectively and to explore the possible reasons,which will pave the way for occupational health promotion in terms of hazard reduction.METHODS a cross-sectional study was initiated between June and September in 2022 towards 2 groups of VCM exposed population from the facility of acetylene hydrochlorination(n=78)and the one of ethylene oxychlorination(n=69)in a PVC petrochemical complex enterprise(abbreviation of H)in Tianjin City.The demographic information concerning age,gender,messages on occupational history,field investigation were inquired through questionnaire interview.Then,venous blood(4 mL/person)and urine(10-50 mL/person)were collected during the physical exam phase and indices of 8-hydroxy-2 deoxyguanosine(8-OHdG)in blood and thiodiglycolic acid(TDGA)in urine were detected through ELISA and solid phase extraction-ion chromatography respectively.RESULTS The 2 groups of population were matched well in terms of average age distribution and gender composition ratio,with significant differences on population composition ratio were found on variables of working years,alcohol consumption and daily sleeping duration(P<0.01 or P<0.05).It was found that the average content of TDGA in acetylene hydrochlorination group was(0.81±0.05)mg/L while the content in ethylene oxychlorination group reached to(0.83±0.06)mg/L,noteworthy differences were only found among 6 posts in the acetylene hydrochlorination group and 5 others in the ethylene oxychlorination group after classification for specific posts,however,the average concentration of 8-OHdG in acetylene hydrochlorination group(122(78.3,168.8)μg/m3)was different from the one in ethylene oxychlorination group(101.7(79.6,149.7)μg/m3)(Z=6.82,P<0.05).Moreover,a series of positive correlations in moderate intensity between 8-OHdG concentration and TDGA content were observed among posts of polymerization cleaners(r=0.53),aggregation operators(r=0.47),maintenance repairers(r=0.45),sampling operators(r=0.41)in acetylene hydrochlorination group(P<0.05)and posts of cracking reactants(r=0.64),DCS operators(r=0.51),oxychlorination operators(r=0.50)and chemical loaders(r=0.44)in ethylene oxychlorination group(P<0.05).Liver function indices such as content on ALT(x2=15.41,P<0.01),AST(x2=9.95,P<0.01)and ALP(x2=3.79,P<0.01)were different in the 2 groups population with statistical significance,then proportions on population composition ratio that exceeded normal ranges of indices on ALT,AST,AST/ALT ratio,ALP and Alb/Glb ratio were higher in acetylene hydrochlorination group than ones in ethylene oxychlorination group with great significance(P<0.05),so as to the abnormalities in liver B altrosonography test between groups(x2=17.33,P<0.01).Binary logistic regression model indicated that 8-OHdG concentration in blood that exceed 90 μg/m3,TDGA content in urine that exceed 0.60 mg/L,working years that were over 10a,alcohol consumption,sleeping duration less than 6 h per day and male workers were potential risky factors for liver impairment(P<0.05).CONCLUSION The degree on liver impairment status was higher in acetylene hydrochlorination group than ones in in ethylene oxychlorination group under the same PVC factory,which might be associated with the oxidative stress injury induced from the combination of higher VCM concentration at workplaces,longer cumulative exposure time,longer working years,alcohol consumption habits and sleep shortage caused by shift work patterns.

acetylene hydrochlorinationethylene oxychlorinationvinyl chloride monomerthiodiglycolic acid8-hydroxy-2 deoxyguanosineliver injury status

董一文、张文翠、王新刚、胡伟江、王鑫、边洪英、康宁、张璘、叶萌

展开 >

中国疾病预防控制中心职业卫生与中毒控制所,北京 100050

天津市滨海新区疾病预防控制中心,天津 300480

电石法 乙烯法 氯乙烯 亚硫基二乙酸 8-羟基脱氧鸟苷 肝脏损伤

职业健康风险评估与国家职业卫生标准制定项目

131031109000150003

2024

卫生研究
中国疾病预防控制中心

卫生研究

CSTPCD北大核心
影响因子:0.761
ISSN:1000-8020
年,卷(期):2024.53(2)
  • 19