Cohort Study On The Relationship Between Occupational Hazaids And Type 2 Diabetes In Workers Of Iron And Steel Group

Objective : To explore the relationship between high temperature,noise,dust,Co,illumination and the risk of type-2 diabetes in steel-workers?Methods:Using the method of historical cohort study,Baotou Steel's employees exposed to occupational harmful factors who had physical examination in the physical examination center of the Third Affiliated Hospital of Inner Mongolia Medical University from 2014 to2019 were selected as the exposure group.At the same time,healthy workers of the same department who were not exposed to harmful factors in different workshops were selected as the control group.The total sample is 7887 workers?With the physical examination data in2014 as the baseline data,the general situation,family history,physical examination report,occupational environment monitoring data and other data were collected.The workers who had diabetics were excluded from the study group.According to the exposure level of the study group,2014-2019 medical examination data and occupational environment monitoring data were collected,from which newly diagnosed patients were found.The incidence density of diabetes mellitus in occupational exposure group and non exposure group was calculated,and the significant test of the difference in incidence rate was carried out.The relationship between exposure to occupational harmful factors and the incidence risk of T2 DM was analyzed by using incidence density and Cox proportional risk regression model.The generalized multifactor dimensionality reduction method(GMRD)was usedto incorporate occupational hazards and environmental factors into the model to analyze the interaction between occupational hazards and the environment.Result:1.A total of 7887 subjects were collected.Of them,468 diabetic patients were excluded from the baseline,113 died of normal natural death or other diseases,and 161 cases of variable loss were unable to determine the outcome of diabetes.Finally,7125 subjects were included in the study,including 6341 males and 784 females.The average follow-up time was5.01 years,a total of 35553.25 years.During the follow-up period,361 cases(307 males and54 females)of new T2 DM developed,with a density of 10.15/1000 person years(10.21/1000 males and 10.09/1000 females).Comparison of baseline gender,age,alcohol consumption,smoking,hypertension,hyperlipidemia and family history of steel workers in the exposed group and the non-exposed group showed statistically significant differences(P < 0.05),while comparison of education level,BMI,family income,nationality,marital status and physical exercise composition between the exposed group and the non-exposed group showed no statistically significant differences(P > 0.05).2.Steel workers' exposure to occupational harmful factors incidence density from high to low in turn for high temperature 13.05/1000 years,intensity of illumination group 12.36/1000 people,noise of 12.30/1000 years,dust 11.91/1000 years,CO group 10.42/1000 years.In the unadjusted model,exposure to occupational harmful factors significantly increased the risk of developing diabetes(Trend test P<0.01).Workers exposed to illumination,dust,CO,noise and high temperature had 1.04 times the risk of developing diabetes [HR1.04,95% CI(1.01,2.02)],1.19 times [HR1.19,95% CI(1.10-1.73)],1.57 times [HR1.057,95% CI(1.03,1.78)] and1.73 times [HR1.73,95% CI(1.43,2.49)],1.88 times [HR1.08,95% CI(1.08,2.6)].After adjusting for gender,age,alcohol consumption,smoking,hypertension,hyperlipidemia and family history,Cox proportional hazard regression results showed that: The risk of T2 DM among steelworkers exposed to illumination,dust,CO,noise and high temperature was higher than that of non-exposed steelworkers,with HR(95%CI)of 1.12(1.07-2.11),1.22(1.13-1.79),1.26(1.11-1.91),1.56(1.33-2.71)and 1.99(1.15-2.24),respectively,and the highest risk of T2 DM among steel workers exposed to high temperature.3.After adjusting the baseline gender,age,smoking,drinking,hypertension,hyperlipidemia,and family history of diabetes,taking the steel workers in the same workshop who are not exposed to noise,high temperature,dust,CO or illuminance as control group,the multivariate-adjusted HR(95% CI)in persons who suffered 1,2,3,4or5 the components were1.99(1.15-2.24)? 2.21(1.33-2.67)? 3.96(3.21-4.80)?3.71(3.25-4.89)?4.43(3.44-5.28)?4.The generalized multifactor dimensionality reduction method(GMDR)is adopted,for the fourth part of the study further analysis shows that: Based on the Cox regression of principal component analysis,12 principal components will be extracted to build the model,The results showed that there was interaction between dust and CO in Model 2,the crossconsistency was 100%,P<0.001,and the accuracy of test set was 0.6261.The cross consistency of model 9 was 100%,the accuracy of test set was 0.7706,and P<0.001.There were interactions between occupational harmful factors such as noise,high temperature,dust,illuminance and CO,and gender,age,drinking,hyperlipidemia,hypertension and family history.The cross-consistency of model 10 was 100%,the accuracy of test set was 0.7809,and P<0.001.There were interactions between occupational harmful factors noise,high temperature,dust,illumination,CO,and gender,age,drinking,smoking,hyperlipidemia,hypertension,and family history,all of which were the optimal models.Conclusion:1.The risk of T2 DM was increased in iron and steel workers exposed to dust,Co,high temperature,noise and illumination.2.The risk of T2 DM increased with the increase of the number of occupational risk factors.3.Based on the Cox regression model,the risk factors will be 12 points for GMDR building model,display,high temperature,dust,noise intensity of illumination,CO and gender,age,family history,smoking,drinking,hyperlipidemia and hypertension,the model for the optimal interaction model.