背景:世卫组织/国际劳工组织新一轮与工作有关的疾病负担评估联合评估需要进一步研究以提供更多证据,特别是工作场所周围的环境空气污染对健康的影响。然而,工人体内阻塞性通气功能障碍(OVD)与细颗粒物(PM2.5)及其化学成分有关的证据非常有限。关于职业因素与颗粒暴露之间的相互作用影响的证据更加匮乏。我们旨在根据对中国南方工人的大型通气功能检查来填补这些空白。
方法:我们在2020年对中国南方的363,788名工人进行了横断面研究。通过经过验证的时空模型评估了工作场所周围PM2.5及其成分的年平均浓度。我们使用混合效应模型来评估与PM2.5及其成分相关的OVD风险。结果根据基本特征和职业因素进一步分层。
结果:在305,022名工人中,用OVD观察到119,936。我们发现PM2.5浓度每增加一次四分位数范围(IQR),OVD的风险增加了27.8(95%置信区间(CI):26.5-29.2%)。估计值为10.9%(95CI:9.7-12.1%),15.8%(95CI:14.5-17.2%),2.6%(95CI:1.4-3.8%),17.1%(95CI:15.9-18.4%),和11%(95CI:9.9-12.2%),分别,对于硫酸盐的每个IQR增量,硝酸盐,铵盐,有机物和黑碳。我们观察到女性的效果估计更大,年轻工人,工龄为24-45个月的工人,和专业技能工人。此外,特别值得注意的是,接触噪音的工人,高温工人,接触粉尘较少的工人的风险比其他人高5.7-68.2%。
结论:PM2.5及其成分与OVD风险增加显著相关,某些弱势群体之间有更强的联系。
BACKGROUND: The new round of WHO/ILO Joint Estimates of the Work-related Burden of Disease assessment requires futher research to provide more evidence, especially on the health impact of ambient air pollution around the workplace. However, the evidence linking obstructive ventilatory dysfunction (OVD) to fine particulate matter (PM2.5) and its chemical components in workers is very limited. Evidence is even more scarce on the interactive effects between occupational factors and particle exposures. We aimed to fill these gaps based on a large ventilatory function examination of workers in southern
China.
METHODS: We conducted a cross-sectional study among 363,788
workers in southern
China in 2020. The annual average concentration of PM2.5 and its components were evaluated around the workplace through validated spatiotemporal models. We used mixed-effect models to evaluate the risk of OVD related to PM2.5 and its components. Results were further stratified by basic characteristics and occupational factors.
RESULTS: Among the 305,022 workers, 119,936 were observed with OVD. We found for each interquartile range (IQR) increase in PM2.5 concentration, the risk of OVD increased by 27.8 (95 % confidence interval (CI): 26.5-29.2 %). The estimates were 10.9 % (95 %CI: 9.7-12.1 %), 15.8 % (95 %CI: 14.5-17.2 %), 2.6 % (95 %CI: 1.4-3.8 %), 17.1 % (95 %CI: 15.9-18.4 %), and 11 % (95 %CI: 9.9-12.2 %), respectively, for each IQR increment in sulfate, nitrate, ammonium salt, organic matter and black carbon. We observed greater effect estimates among females, younger
workers,
workers with a length of service of 24-45 months, and professional skill
workers. Furthermore, it is particularly noteworthy that the noise-exposed
workers, high-temperature-exposed
workers, and less-dust-exposed workers were at a 5.7-68.2 % greater risk than others.
CONCLUSIONS: PM2.5 and its components were significantly associated with an increased risk of OVD, with stronger links among certain vulnerable subgroups.