摘要
目的了解职业暴露人群血浆23种金属/类金属水平与心律失常发病的关系。方法于2017年从湖南某有色金属企业招募到的765名18岁及以上工人为研究对象。通过问卷调查和体格检查分别获得研究人群的基本信息和体检结果。收集血样,使用电感耦合等离子体质谱法检测血浆金属/类金属水平。分别于2018、2019和2020年进行随访体检。采用套索回归筛选出可能影响心律失常发病的元素后,采用Cox比例风险模型分析选定元素水平与心律失常发病之间的关联,并使用Quantile g-computation模型分析元素混合暴露对心律失常的影响,使用限制性立方样条函数绘制剂量-反应关系曲线。结果研究对象中年龄≤45岁者386人(50.5%),工龄>20年者401人(52.4%),男性712人(93.1%),心律失常发病135人(17.6%)。调整年龄、工龄、性别、体质指数、婚姻状况、文化程度、吸烟、饮酒、饮茶、定期锻炼、慢性病(高血压、高脂血症)、睡眠质量和心理压力后,铬、钼和锑增加心律失常发病风险的HR(95%CI)值分别为1.22(1.11~1.34)、1.51(1.20~1.90)和2.38(1.03~5.49),钡降低心律失常发病风险的HR(95%CI)值为0.98(0.95~1.00)。结论血浆铬、钼和锑是职业暴露人群心律失常发生的危险因素,钡是心律失常的保护因素。
OBJECTIVE To investigate the association between levels of twenty-three plasma metals/metalloids and the risk of arrhythmia among occupational population.METHODS In 2017,a total of 765 workers aged 18 and above were recruited from a non-ferrous metal factory.The general demographic characteristics were obtained by using questionnaire.Plasma metal/metalloid levels were determined by inductively coupled plasma mass spectrometry(ICP-MS).Participants were followed up in 2018,2019 and 2020 respectively.After the elements that may affect the incidence of arrhythmia were screened out by least absolute shrinkage and selection operator(LASSO)regression,Cox regression model was used to analyze the relationship between levels of selected elements and risk of arrhythmia occurrence,Quantile g-computation model was used to analyze the effect of element mixture exposure on arrhythmia,and the doseresponse curve was estimated by using restricted cubic spline(RCS)function.RESULTS Of all the research subjects,386(50.5%)were≤45 years old;401(52.4%)had 20 years or more of work experience;712(93.1%)subjects were male workers.The incidence of arrhythmia was 17.6%.After adjusting for age,seniority,gender,body mass index(BMI),marital status,education level,smoking,drinking,drinking tea,regular exercise,chronic diseases(hypertension,hyperlipidemia),sleep quality and psychological stress,chromium,molybdenum and antimony increased the risk of arrhythmia with HR(95%CI)values of 1.22(1.11-1.34),1.51(1.20-1.90)and 2.38(1.03-5.49),respectively,while barium reduced the risk of arrhythmia with HR(95%CI)value of 0.98(0.95-1.00).CONCLUSION Chromium,molybdenum and antimony are the risk factors while barium is the protective factor for arrhythmia.
作者
曹玉函
段丽丹
陈少仪
张慕阳
陈美玲
杜雨薇
段燕英
Cao Yuhan;Duan Lidan;Chen Shaoyi;Zhang Muyang;Chen Meiling;Du Yuwei;Duan Yanying(Department of Occupational and Environmental Health,Xiangya School of Public Health,Central South University,Changsha 410078,China)
出处
《卫生研究》
CAS
CSCD
北大核心
2023年第6期863-870,共8页
Journal of Hygiene Research
基金
国家重点研发计划项目子课题(No.2016YFC0900802)。
关键词
血浆
金属
类金属
心律失常
职业暴露
队列研究
混合暴露
plasma
metal
metalloid
arrhythmia
occupational exposure
cohort study
mixed exposure
