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[目的]探讨职业性高温暴露对男性钢铁工人肾功能异常的影响,为男性钢铁工人肾功能异常的防治提供理论依据。[方法]以某钢铁集团2015年10月—2016年5月进行职业健康检查的4 992名男性钢铁工人作为研究对象,采用面对面调查方式收集工人的社会人口学特征、生活方式、职业性高温接触史等,并采集血样检测血肌酐,根据血肌酐估算肾小球滤过率,判断肾功能是否异常。采用χ2检验、多因素非条件logistic回归和限制性立方样条模型,分析职业性高温暴露及暴露年限对男性钢铁工人肾功能异常的影响。[结果]共4 400人纳入分析。在控制了年龄、文化程度、人均月收入、食盐摄入、吸烟、饮酒、体育锻炼各因素后,<50岁的男性钢铁工人职业性高温暴露对肾功能异常有影响(P<0.05),OR(95%CI)为1.85(1.16~2.95)。限制性立方样条分析结果显示:高温暴露年限与肾功能异常有关(χ2=8.45,P<0.05),且呈非线性关系(χ2=5.44,P<0.05);高温暴露年限低于20.5年时,肾功能异常风险呈逐渐增加的趋势,到20.5年以后呈下降趋势。[结论]<50岁的男性钢铁工人职业性高温暴露对肾功能异常有影响,且高温暴露年限与肾功能异常呈先增加后减少的非线性关系。
[Objective] To investigate the effect of occupational high temperature exposure on renal dysfunction in male steel workers and provide theoretical basis for the prevention and treatment of renal dysfunction in male steel workers. [Methods] A total of 4 992 steel workers who carried out occupational health examination from October 2015 to May 2016 in a certain iron and steel group were selected as research objects. The face-to-face survey was used to collect the demographic characteristics, lifestyle, occupational high temperature exposure History, etc., and blood samples were collected for serum creatinine, glomerular filtration rate estimated according to serum creatinine to determine whether abnormal renal function. The χ2 test, multivariate non-conditional logistic regression and restrictive cubic spline models were used to analyze the effects of occupational hyperthermia exposure and exposure duration on renal dysfunction in male steel workers. [Results] A total of 4 400 people were included in the analysis. Occupational hyperthermia exposure of male steel workers <50 years had an effect on abnormal renal function (P <0.05) after controlling for various factors such as age, education level, per capita monthly income, salt intake, smoking, drinking and physical exercise. (95% CI) was 1.85 (1.16-2.95). The results of restrictive cubic spline analysis showed that the exposure duration at high temperature was related to the abnormal renal function (χ2 = 8.45, P <0.05), and there was a nonlinear relationship (χ2 = 5.44, P <0.05) , Renal dysfunction risk showed a gradual increase trend to 20.5 years later showed a downward trend. [Conclusion] The occupational hyperthermia exposure of male steel workers in 50 years old had an effect on abnormal renal function, and the non-linear relationship between the exposure time at high temperature and the renal dysfunction increased first and then decreased.