倒班對鋼鐵工人高血壓影響的回顧性隊列研究
發(fā)布時間：2019-06-22 14:56
【摘要】：目的以鋼鐵工人為研究對象,采用回顧性隊列研究分析倒班與高血壓的關系,探討開始倒班年齡、倒班年限與高血壓關聯(lián)程度的劑量-反應關系,從而為鋼鐵企業(yè)工時制度的建立提供科學依據(jù)。方法2014年8月至2015年11月,以某鋼鐵企業(yè)進行職業(yè)健康體檢的工人作為研究對象,采用回顧性隊列研究方法分析倒班與高血壓的關系。觀察時間從第一位工人入廠1971年3月起至2015年11月,根據(jù)入廠時倒班與否分為倒班組和白班組。資料收集包括面對面問卷調查及職業(yè)健康檔案資料的摘錄,內容包括工人的社會人口學特征、生活飲食習慣、高血壓個人病史和家族史、工作情況以及職業(yè)有害因素的暴露情況等,同時測量血壓。采用Epi Data3.1建庫,SPSS19.0、SAS9.1.3進行統(tǒng)計分析。應用χ2檢驗比較年齡、性別、民族等在倒班和白班兩組間的構成;倒班及倒班類型與高血壓關系的單因素分析應用χ2檢驗,倒班與高血壓關系的多因素分析應用傾向性評分分層法和多因素Cox回歸;倒班高溫、倒班噪聲的聯(lián)合作用與高血壓的關系以及退出倒班后對高血壓的影響應用Cox回歸分析;應用基于限制性立方樣條的Cox、Logistic回歸模型分析開始倒班年齡、倒班年限與高血壓關聯(lián)程度的劑量-反應關系。結果1本研究共收集問卷7314份,剔除不合格問卷303份,共7011人進入研究隊列,觀察人年為105269.4人年,平均隨訪15.0年。進入隊列年齡為16歲~42歲,平均(22.1±4.0)歲,工齡為1年~43年,平均(15.0±9.6)年,鋼鐵工人高血壓的發(fā)病密度為16.61‰。倒班與白班兩組間年齡、性別、吸煙、飲酒、父親和母親高血壓史、高溫噪聲暴露的構成比較,差異有統(tǒng)計學意義(P0.05)。兩組間文化程度、民族、婚姻狀況、食鹽情況和體育鍛煉的構成比較,差異無統(tǒng)計學意義(P0.05)。2倒班組發(fā)生高血壓的風險為白班組的1.540倍(95%CI:1.381-1.719),歸因危險度(AR)為5.43‰,歸因危險度百分比(AR%)為35.06%,人群歸因危險度(PAR)為3.57‰,人群歸因危險度百分比(PAR%)為21.49%。3四班三運轉發(fā)生高血壓的風險為白班的1.601倍(95%CI:1.433-1.790)。4與單純白班相比較,單純倒班、倒班高溫聯(lián)合組、倒班噪聲聯(lián)合組發(fā)生高血壓的風險RR(95%CI)分別為1.599(1.309-1.958)、1.922(1.567-2.357)和1.602(1.429-1.831),差異均有統(tǒng)計學意義(P0.05),單純高溫、噪聲組發(fā)生高血壓的風險RR(95%CI)分別為1.087(0.853-1.386)和1.112(0.863-1.432),差異無統(tǒng)計學意義(P0.05)。5開始倒班年齡與高血壓之間的關聯(lián)程度呈非線性劑量反應關系(χ2=12.30,P0.05)。6倒班年限與高血壓之間的關聯(lián)程度呈非線性劑量反應關系(χ2=8.15,P0.05),與倒班1年相比較,于15年時高血壓發(fā)生的風險開始有統(tǒng)計學意義。7倒班年限為1~10年時,隨著離開倒班崗位時間的延長高血壓發(fā)生的風險RR值降低,當?shù)拱嗄晗薮笥诘扔?0年時發(fā)現(xiàn)同樣結果。結論1倒班為高血壓發(fā)生的一個獨立危險因素。2倒班者中發(fā)生的高血壓有35.06%可歸因于倒班;鋼鐵工人中發(fā)生的高血壓有21.49%可歸因于倒班。3將倒班年限控制在15年內可降低高血壓的發(fā)生風險。4隨著退出倒班崗位時間的延長,發(fā)生高血壓的風險下降。
[Abstract]:Objective To study the relationship between shift and hypertension by retrospective cohort study to study the relationship between shift and hypertension, and to provide scientific basis for the establishment of man-time system of iron and steel enterprise. Methods From August 2014 to November 2015, a retrospective cohort study was used to analyze the relationship between the shift and hypertension. The observation time was from March 1971 to November 2015 from the first worker to the factory, and it was divided into the reverse group and the white shift group according to whether the shift was in the factory. The data collection includes a face-to-face questionnaire and an excerpt from the occupational health profile, which includes the social and demographic characteristics of the worker, the life eating habits, the personal history of the hypertension, the family history, the working condition, and the exposure of the occupational harmful factors, while measuring the blood pressure. Statistical analysis was performed using Epi Data3.1 built-in, SPSS19.0, SAS9.1.3. The two groups, such as age, sex, and ethnic group, were used to test the composition of the two groups in the shift and the white shift. The single-factor analysis of the relationship between the shift and the shift and the hypertension was applied to the multi-factor analysis of the relationship between the shift and the hypertension, and the stratified and multi-factor Cox regression was applied to the multi-factor analysis of the relationship between the shift and the hypertension. Cox regression was used to analyze the effect of combined action of high-temperature and reverse-shift noise on hypertension and the effect of withdrawal on hypertension. Cox and Logistic regression model based on restricted cubic spline were used to analyze the start-up age. Dose-response relationship between the degree of shift and the degree of association of hypertension. Results A total of 7314 questionnaires were collected in this study, and 303 of the non-conforming questionnaires were rejected. The total number of 7011 persons was enrolled in the study cohort, with the observation of 105269.4 in human year and the average follow-up of 15.0 years. The age of the access to the cohort was 16 to 42 years. The average age (22.1 to 4.0) was from 1 to 43 years, with an average of 15.0 (9.6) years. The incidence of hypertension among the steel workers was 16.61%. The difference of age, sex, smoking, drinking, father and mother's hypertension and high-temperature noise exposure was statistically significant (P0.05). The risk of hypertension was 1.540 times (95% CI: 1.381-1.719), and the attributable risk (AR) was 5.43%. The percentage of attributable risk (AR%) was 35.06%, the population attributable risk (PAR) was 3.57%, and the percentage of the population attributable risk (PAR%) was 21.49%. The risk of hypertension was 1.601 times (95% CI: 1.433-1.790) in the white class. The RR (95% CI) of hypertension was 1.599 (1.309-1.958), 1.922 (1.567-2.357) and 1.602 (1.429-1.831), respectively. There was no statistical significance (P0.05). The association between the shift age and the hypertension was the non-linear dose-response relationship (Sup2 = 12.30, P0.05). The degree of association between the shift and the hypertension was the non-linear dose-response relationship (Sup2 = 8.15, P0.05). The risk of hypertension at 15 years started to be statistically significant.7-10 years, the risk of increasing the risk of hypertension with the time of leaving the shift post was reduced, and the same result was found when the shift number was greater than or equal to 10 years. Conclusion 1.1-shift is an independent risk factor in the occurrence of hypertension, and 35.06% of the hypertension in the shift group can be attributed to the shift. The high blood pressure in the steel workers is 21.49%, which can be attributed to the shift. The risk of high blood pressure can be reduced within 15 years. The risk of high blood pressure is reduced with the extension of the time of withdrawal.
【學位授予單位】：華北理工大學
【學位級別】：碩士
【學位授予年份】：2016
【分類號】：R544.1
本文編號：2504689
[Abstract]:Objective To study the relationship between shift and hypertension by retrospective cohort study to study the relationship between shift and hypertension, and to provide scientific basis for the establishment of man-time system of iron and steel enterprise. Methods From August 2014 to November 2015, a retrospective cohort study was used to analyze the relationship between the shift and hypertension. The observation time was from March 1971 to November 2015 from the first worker to the factory, and it was divided into the reverse group and the white shift group according to whether the shift was in the factory. The data collection includes a face-to-face questionnaire and an excerpt from the occupational health profile, which includes the social and demographic characteristics of the worker, the life eating habits, the personal history of the hypertension, the family history, the working condition, and the exposure of the occupational harmful factors, while measuring the blood pressure. Statistical analysis was performed using Epi Data3.1 built-in, SPSS19.0, SAS9.1.3. The two groups, such as age, sex, and ethnic group, were used to test the composition of the two groups in the shift and the white shift. The single-factor analysis of the relationship between the shift and the shift and the hypertension was applied to the multi-factor analysis of the relationship between the shift and the hypertension, and the stratified and multi-factor Cox regression was applied to the multi-factor analysis of the relationship between the shift and the hypertension. Cox regression was used to analyze the effect of combined action of high-temperature and reverse-shift noise on hypertension and the effect of withdrawal on hypertension. Cox and Logistic regression model based on restricted cubic spline were used to analyze the start-up age. Dose-response relationship between the degree of shift and the degree of association of hypertension. Results A total of 7314 questionnaires were collected in this study, and 303 of the non-conforming questionnaires were rejected. The total number of 7011 persons was enrolled in the study cohort, with the observation of 105269.4 in human year and the average follow-up of 15.0 years. The age of the access to the cohort was 16 to 42 years. The average age (22.1 to 4.0) was from 1 to 43 years, with an average of 15.0 (9.6) years. The incidence of hypertension among the steel workers was 16.61%. The difference of age, sex, smoking, drinking, father and mother's hypertension and high-temperature noise exposure was statistically significant (P0.05). The risk of hypertension was 1.540 times (95% CI: 1.381-1.719), and the attributable risk (AR) was 5.43%. The percentage of attributable risk (AR%) was 35.06%, the population attributable risk (PAR) was 3.57%, and the percentage of the population attributable risk (PAR%) was 21.49%. The risk of hypertension was 1.601 times (95% CI: 1.433-1.790) in the white class. The RR (95% CI) of hypertension was 1.599 (1.309-1.958), 1.922 (1.567-2.357) and 1.602 (1.429-1.831), respectively. There was no statistical significance (P0.05). The association between the shift age and the hypertension was the non-linear dose-response relationship (Sup2 = 12.30, P0.05). The degree of association between the shift and the hypertension was the non-linear dose-response relationship (Sup2 = 8.15, P0.05). The risk of hypertension at 15 years started to be statistically significant.7-10 years, the risk of increasing the risk of hypertension with the time of leaving the shift post was reduced, and the same result was found when the shift number was greater than or equal to 10 years. Conclusion 1.1-shift is an independent risk factor in the occurrence of hypertension, and 35.06% of the hypertension in the shift group can be attributed to the shift. The high blood pressure in the steel workers is 21.49%, which can be attributed to the shift. The risk of high blood pressure can be reduced within 15 years. The risk of high blood pressure is reduced with the extension of the time of withdrawal.
【學位授予單位】：華北理工大學
【學位級別】：碩士
【學位授予年份】：2016
【分類號】：R544.1
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