鋼鐵鑄造業勞工健檢資料分析、代謝症候群研究及職業危險因子暴露分析

The epidemiologic study of metabolic Syndrome and occupational exposure survey in smelting workers

葉柏材(Po-Tsai Yeh) ； 賴錦皇(Ching-Huang Lai) ； 陳勃仲(Po-Chung Chen) ； 張哲輔(Che-Fu Chang)

《中華職業醫學雜誌》 24卷4期 (2017/10) Pp. 297-310

摘要

目的：代謝症候群又稱為胰島素抗阻症候群(insulin resistance syndrome)或X症候群，近年受到醫學界格外重視，因為患此症候群之人數頗眾，而且相關之疾病如不加以防治，其後果可能頗嚴重，此研究藉由資料分析了解鋼鐵鑄造業勞工個人以及不同部門的健康差異，用以日後對勞工健康促進的依據。方法：研究設計採橫斷式研究法，以2013年於本院接受年度勞工健康檢查之鋼鐵鑄造工廠勞工體檢資料。研究對象為台灣北部一鋼鐵鑄造工廠勞工，其中包含行政管理部門，製造部門及外包廠商等共328位勞工。行政管理部門部分包含行政、總務、品管、會計、業務部門；製造部門包含鋼構、軋延、焊接等第一線製造工人。結果：製造部門的勞工在嚼食檳榔等生活不良習慣比率和行政部門勞工相比有顯著差異，另外身高部分，製造部門勞工和行政部門勞工也有顯著差異，性別和部門分類分析可以發現在性別部分，除了總膽固醇、飯前血糖以及eGFR沒有差異外，其餘指標皆有顯著差異；而在不同部門分類比較方面，除了總膽固醇、飯前血糖、肝腎功能、血紅素以及血小板、尿液檢查無顯著差異外，其餘血液生化檢查在製造部門以及行政部門都有顯著差異。迴歸分析方面結果。在校正年齡、性別、生活習慣、工作部門後，可以發現BMI異常的勞工比BMI正常的勞工得到代謝症候群的風險為1.7倍(p value ＜0.001)，而其餘項目皆未達顯著差異。結論：針對鋼鐵鑄造業勞工而言，男性勞工的代謝症候群盛行率比女性高，此外，不健康的生活習慣(抽菸、嚼檳榔)在此類勞工而言，導致代謝症候群的風險較高。所以，在未來針對此類勞工的健康促進計畫，也必須將這些風險納入計畫範圍。

關鍵字

健康檢查 ； 鋼鐵鑄造業 ； 代謝症候群

並列摘要

Background: The main purpose of this study is to look at the prevalence of metabolic syndrome among steel foundry workers, assess their exposure to occupational risk factors and analyze their physical health status. Method: The study is undertaken as a cross-sectional study. Drawing from the annual physical examinations on employees of the iron and steel casting industry in 2013. 328 workers from the administrative management and manufacturing departments and outside suppliers. Administrative management refers to administration, general affairs, quality control, accounting, and sales, while manufacturing covers such front-line duties as steel framing, rolling, and welding. Result: Upon analyzing the anomaly rate of key indicators such as BMI, hypertension, hyper-lipidemia, hyperglycemia, liver function and high uric acid among workers of different ages, sex and units at a single factory, the results were found to be similar to the previous comparison in that significant differences existed for the sex groups. Significant difference (p value ＜0.05) asserted itself across the board in the gender-based analysis except in total cholesterol, glucose AC, and eGFR levels. After adjusting for age, sex, lifestyle habit and unit, it can be seen that the risk of metabolic syndrome was 1.7 times higher for workers with abnormal BMI than workers with normal BMI (p value ＜0.001). Conclusion: As far as iron and steel casting workers are concerned, men tend to be more likely to suffer from metabolic syndrome than women. Moreover, these workers are at a greater risk of developing metabolic syndrome than other societal groups due to their unhealthy lifestyles (smoking, betel-quid chewing, etc.). Therefore, any future health promotion plan designed specifically for the aforementioned workers needs to take into account the risks cited above.

並列關鍵字

Health exams ； smelting foundry ； Metabolic syndrome