【摘要】 目的调查硬质合金粉尘对作业工人健康的影响,为人体钨钴的生物接触限值、硬金属肺病诊断标准的制定及早期防治提供依据。方法选取江苏省某硬金属加工厂165名硬质合金粉尘作业工人作为调查组,132名无硬质合金粉尘接触的作业工人作为对照组。收集问卷调查、职业健康检查、工人班后尿钴含量以及现场作业环境检测等相关资料。结果该厂硬质合金生产环境中的粉尘浓度,其几何均值均未超过国家标准。作业环境中空降尘游离二氧化硅含量均小于1.0%。调查组呼吸系统异常及黏膜刺激症状检出率高于对照组,差异有统计学意义(P<0.05)。与对照组比较,调查组胸片X线结果阳性检出率明显增高。在调查组中肺功能指标用力肺活量(FVC)、尿钴检测值超标率均高于对照组,差异有统计学意义(P<0.05)。结论硬质合金粉尘中含有一定量的钴;工人接触硬质合金粉尘早期可导致呼吸系统异常及黏膜刺激症状、胸部肺纹理增加;可致肺功能轻度限制性通气功能障碍改变,肺部损伤部位主要在小气道。因此,应加强对硬质合金粉尘接尘工人的劳动防护,做好防尘工作,定期做职业健康检查,及时采取有效防治措施,确保接尘工人的身体健康。更多还原

【Abstract】 [Objective] To investigate the effect of hard alloy dust on health of exposed workers,provide evidence for the development of the biological contact limit of tungsten and cobalt in the human body and the diagnosis standard of hard metal lung disease.[Methods]165 workers exposed to hard alloy dust in a hard metal processing plant of Jiangsu Province were enrolled in the exposure group,and 132 workers without hard alloy dust exposure were recruited in the control group. The data from questionnaire survey,occupational health examination,urine cobalt content of workers after work,and the field work environment detection were collected and analyzed. [Results]The geometric mean values of d ust concentration in the workplace environment of cemented carbide production met the national standard. The free silicon dioxide contents of airborne dust in the working environment were lower than 1%. The detection rates of abnormal respiratory system and mucosal irritation symptoms in the exposure groups were higher than those in the control group,and the difference was statistically significant(P<0.05). The abnormal rate of chest X-ray in the exposure group was higher than that in the control group. The abnormal rate of forced vital capacity(FVC)and urine cobalt test value in the exposure groups were higher than those in the control group,and the difference was statistically significant(P<0.05).[Conclusion]Hard alloy dust contains a certain amount of cobalt,the exposure to hard alloy dust can lead to abnormal respiratory system and mucous membrane irritation symptoms,and increased lung markings in the early stage,and cause the mild restrictive ventilation dysfunction,while the lung damage mainly occurs in the small airways. Therefore,it is necessary to strengthen the occupational protection among workers exposed to hard alloy dust,improve the dustproof measures,carry out the regular occupational health examination,and take the effective prevention and control measures,to ensure the health of exposed workers.更多还原