| Objectives Through the establishment of occupational harmful factors exposome of steel workers and the analysis of the relationship between the exposome and prevalence of hypertension,we will seek and discover new ideas for studying the relationship between occupational exposure and hypertension,and provide more intervention clues for the prevention and treatment of hypertension.Methods The study was based on the worker cohort established by the Beijing-TianjinHebei occupational health effect cohort project.The 7660 workers(7023 males and 637 females)of an iron and steel mill who underwent occupational health examinations from March 2017 to May 2017 and March 2018 to July 2018 were used as research objects.In this study,the available data,such as participants' organic factors,behavioral lifestyle factors,socioeconomic and working conditions were collected through face-to-face questionnaire interviews;the exposure measurements to occupational hazard factors were collected through on-site hygienic investigation;the biochemical indicators(such as blood pressure,blood sugar,blood lipids and high-density lipoprotein cholesterol,etc.)were tested through laboratory examination;the anthropometric indicators(such as waist circumference,abdominal circumference,neck circumference,etc.)were obtained through physical examination.During the process of statistics,the harmful factors exposome was treated as the main explanatory variables.The general condition of workers and the prevalence of hypertension and so on were described by means of mean and standard deviation or median and quartile.Subsequently,the restricted cubic spline and multivariate unconditional logistic regression were used to explore the dose-response relationship and associations between the harmful factors exposome and hypertension,respectively.Ultimately,the health risk factor score(HRFS)model was used to explore the effects of the combined exposure to occupational risk factors on hypertension.Results 1 The results of the study showed that the prevalence of hypertension in the surveyed population was 25.56%.The average systolic blood pressure was(128.95±12.03)mm Hg,and the diastolic blood pressure was(82.54±10.37)mm Hg.Among the surveyed workers,52.04%(3987/7660)of the total population have an intermediate degree,92.73%(6513/7023)of men and 93.23%(594/637)of women are married,and the proportion of women who never smoke and who never drink alcohol is reaching 92.45%(589/637)and 94.80%(604/637),respectively.The number of people who can see the objects brightly when go to bed at night is 14.77%(1131/7660).And there are 29.30%(2244/7660)people have a family history of chronic diseases.2 Dose-response relationship shows that the weighted shift work index,cumulative high temperature exposure,cumulative CO exposure and cumulative dust exposure are non-linear dose-response relationships with steel workers' hypertension.Taking the weighted shift work index <867.22(days)as a reference,when the weighted shift work index(days)is at 867.22~ and ?2090.38,the risk of hypertension in steel workers is 0.72(95%CI=0.59~0.88)times and 1.21(95%CI=1.01,1.46)times that of the reference group.Taking the cumulative exposure of high temperature <292.61(?·year)as a reference,when the cumulative exposure of high temperature(?·year)is 292.61~ and ?720.13,the risk of hypertension of steel workers is 1.44(95%CI= 1.04~1.99)times and 1.86(95%CI=1.33~2.60)times.Taking CO cumulative exposure<30.84(mg/m~3·year)as the reference,when the CO cumulative exposure(mg/m~3·year)is 30.84~,the risk of disease is 1.33(95%CI=1.04~1.93)times that of the reference group.When it is?112.74,compared with the reference group,there is no statistically significant impact on the risk of disease(P>0.05).Taking the cumulative dust exposure <18.78(mg/m~3·year)as a reference,when it is ?58.74,the risk of disease is 1.63(95%CI=1.20~2.22)times of the reference group.3 Based on the multi-factor analysis results of the first two parts,the occupational harmful factor exposure group was established with the main influencing factors of workers' hypertension,including gender,age,education level,alcohol consumption,BMI,family history of hypertension,cumulative high temperature exposure,and cumulative dust exposure,cumulative CO exposure and weighted shift work index as components.There is a linear dose-response relationship between the risk score of the exposure group and the worker's hypertension.The single exposure model takes a score of 0~,that is,the first 25% of the model as the reference group.When the score is 36.8~,the risk of hypertension in steel workers is 2.12(95%CI=1.01~4.48)times that of the reference group.When the score is 45.7~,the risk of disease is 3.48(95%CI=1.74~6.98)times that of the reference group.When the score is 54.4~,the risk of disease is 8.34(95%CI=4.19~16.61)times that of the reference group.The combined exposure model also takes a score of 0~,that is,the first 25% of the model as the reference group.When the model score was 33.4~,the risk of hypertension in steel workers was 2.44(95%CI=1.15~5.16)times that of the reference group.When the score was 41.0~,the risk of disease was 3.29(95%CI=1.64~6.59)times that of the reference group.When the score was 49.2~,the risk of disease was 8.90(95%CI=4.482~17.68)times that of the reference group.Conclusions 1 Gender,age,education level,drinking,BMI,family history of hypertension are all related to hypertension of steel workers 2 Cumulative high temperature exposure,cumulative CO exposure,cumulative dust exposure,weighted index of shift work all have a non-linear dose-response relationship with the risk of workers' hypertension.Different exposure levels increase the risk of disease differently;3 The occupational hazard exposome can more comprehensively reflect the impact of exposure on the risk of hypertension in steel workers than the single exposure factor.In the future prevention and control of workers with high blood pressure,we should pay attention to the multi-pronged approach,with more workers rotate positions,to avoid excessive exposure to a variety of occupational harmful factors to increase the risk of illness.Figure11;Table22;Reference 134... |
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