| Objective To investigate and analyze the incidence and risk factors of chromium rhinopathy among workers exposed to chromium plating in Huishan District of Wuxi City from 2015 to 2017,so as to provide basic data for effective control of occupational chromium rhinopathy.Methods 22 chromium plating enterprises in Huishan District of Wuxi City were selected as exposure group and 11 zinc plating enterprises as control group,with 808 people in each group.The morbidity and related influencing factors of chromium rhinopathy were studied by general physical examination,chromium rhinopathy examination,chromium compounds,acid nebulic anhydride and noise measurement in the workplace.The diagnostic standard of chromium rhinopathy refers to GB 7806-87"Diagnostic standard and treatment principle of occupational chromium rhinopathy".Dibenzoyl dihydrazine spectrophotometry is used to monitoring the chromium compounds in chromium-exposed workplaces.The detection frequency is three consecutive days,twice a day,in the morning and once in the afternoon.In order to facilitate the passage of labor and health protection effect.For hygienic evaluation,samples should be sampled at different times in the same place every day.The number of samples should be at least five,and the chromium compounds should be averaged.Univariate and multivariate Logistic analysis was used to analyze the risk factors for the prevalence of chromium rhinopathy.Results1.monitoring of harmful substances in workplacesThere are 10 chromium plating enterprises detected the presence of chromium compounds,the concentration range is(0.00～0.02)mg/m3,the average value is(0.0161006)mg/m3,according to the state regulations of chromium trioxide(CrO3)maximum allowable concentration of 0.05 mg/m3 to calculate,the chromium compounds concentration of production workshop did not exceed the standard.Acid nebulic anhydride was detected in 14 chromium plating enterprises and 8 zinc plating enterprises.The concentration ranged from(0.00～0.85)mg/m3 with an average value of(0.37±0.18)mg/m3.Nickel and its compounds,tin dioxide,cyanide and zinc oxide were detected in 5 other enterprises.2.detection of nasopharyngeal symptoms in two groupsThe most common symptoms in the exposed group were nasal obstruction(47.6%),dry nose(45.1%)and runny nose(31.8%).The more common symptoms in the control group were nasal obstruction(20.7%)and dry pharynx itching(14.4%).The incidence of nasal obstruction,dry nose,runny nose,burning sensation in the nose and dry pharynx itching in the exposed group was significantly higher than that in the control group(P<0.05).3.Detection of chromium rhinopathy and other nasal diseases in two groups of peopleAmong 22 chromium plating enterprises,6,12 and 16 cases of chromium rhinopathy were detected from 2015 to 2017,respectively.There were 34 cases of chromium rhinopathy,the incidence was 4.21%.From 2015 to 2017,1,2 and 2 cases of the same symptoms as chromium rhinopathy were detected in 11 zinc plating enterprises.There were 5 cases of the same symptoms as chromium rhinopathy,the incidence was 0.62%.The incidence of chromium rhinopathy in exposed group was significantly higher than that in control group(P<0.05).There were 124 cases(15.3%)of other nasal diseases in the exposed group,including 54 cases(6.7%)of chronic rhinitis,28 cases(3.5%)of sinusitis and 32 cases(3.9%)of deviation of nasal septum,which were also significantly higher than 49 cases(6.1%)in the control group(P<0.05).4.Investigation of chromium rhinopathy in exposure groupAmong 34 patients with chromium rhinopathy,29(85.3%)had nasal lesions mainly at the septum angle and center of the nose,including 2 cases of congestion(5.9%),9 cases of erosion(26.5%),1 case of ulcer(2.9%)and 17 cases of perforation(50.0%),followed by 4 cases(8.8%)of anterior turbinate and 1 case(2.9%)of nasal vestibule.The main type of lesion was nasal perforation in 18 cases(52.9%).The perforation was mainly located in the septum angle and the central part of the nose.In addition,9 cases of erosion(26.5%),5 cases of hyperemia(14.7%)and 2 cases of ulcer(5.9%)were observed.5.Analysis of the related factors of chromium rhinopathyAccording to the working environment status of 22 chromium plating enterprises and relevant literature,the indexes of sex,age,length of service,liver and kidney function,chromium compounds,acid fog anhydride,noise and personal protection were investigated.The univariate analysis showed that there were significant differences in working age,chromium compound concentration,acid nebulic anhydride and personal protection between the two groups(P<0.05).Logistic analysis showed that chromium compounds,acid nebulic anhydride and length of service were the risk factors of chromium rhinosis(OR=4.352,2.451,2.159),and personal protection was the protective factor of chromium rhinosis(OR=0.586).The regression equation of risk prediction was P=l/[l+e(4’563-0.856XI-0.736X2-0.773X3+0.787X4)].The accuracy,sensitivity and specificity were 88.43%,72.7%and 89.2%,respectively.Conclusion The incidence of chromium rhinopathy in workers of chromium plating enterprises in Huishan District of Wuxi City is high.The lesions mainly focus on the nasal septum and the central part,especially perforation.The occurrence of chromium rhinopathy in chromium plating enterprises is affected by many factors.Chromium compounds,acid nebulic anhydride and length of service are the risk factors of chromium rhinopathy,and personal protection is the protective factor. |
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