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缺血性心脏病与职业暴露:新西兰普通人群和毛利人群的纵向关联研究。

Ischaemic Heart Disease and Occupational Exposures: A Longitudinal Linkage Study in the General and Māori Populations of New Zealand.

机构信息

Centre for Public Health Research, Massey University, Wellington, New Zealand.

School of Fundamental Sciences - Statistics, College of Sciences, Massey University, Palmerston North, New Zealand.

出版信息

Ann Work Expo Health. 2022 Apr 22;66(4):433-446. doi: 10.1093/annweh/wxab087.

Abstract

OBJECTIVES

This study assessed associations between occupational exposures and ischaemic heart disease (IHD) for males and females in the general and Māori populations (indigenous people of New Zealand).

METHODS

Two surveys of the general adult [New Zealand Workforce Survey (NZWS); 2004-2006; n = 3003] and Māori population (Māori NZWS; 2009-2010; n = 2107), with information on occupational exposures, were linked with administrative health data and followed-up until December 2018. Cox proportional hazards regression (adjusted for age, deprivation, and smoking) was used to assess associations between organizational factors, stress, and dust, chemical and physical exposures, and IHD.

RESULTS

Dust [hazard ratio (HR) 1.6, 95%CI 1.1-2.4], smoke or fumes (HR 1.5, 1.0-2.3), and oils and solvents (HR 1.5, 1.0-2.3) were associated with IHD in NZWS males. A high frequency of awkward or tiring hand positions was associated with IHD in both males and females of the NZWS (HRs 1.8, 1.1-2.8 and 2.4, 1.1-5.0, respectively). Repetitive tasks and working at very high speed were associated with IHD among NZWS females (HRs 3.4, 1.1-10.4 and 2.6, 1.2-5.5, respectively). Māori NZWS females working with vibrating tools and those exposed to a high frequency of loud noise were more likely to experience IHD (HRs 2.3, 1.1-4.8 and 2.1, 1.0-4.4, respectively). Exposure to multiple dust and chemical factors was associated with IHD in the NZWS males, as was exposure to multiple physical factors in males and females of the NZWS.

CONCLUSIONS

Exposures associated with an elevated IHD risk included dust, smoke or fumes, oils and solvents, awkward grip or hand movements, carrying out repetitive tasks, working at very high speed, loud noise, and working with tools that vibrate. Results were not consistently observed for males and females and between the general and Māori populations.

摘要

目的

本研究评估了职业暴露与普通人群(新西兰原住民毛利人)和男性及女性缺血性心脏病(IHD)之间的关系。

方法

对普通成年人群(新西兰劳动力调查(NZWS);2004-2006 年;n=3003)和毛利人群(毛利 NZWS;2009-2010 年;n=2107)进行了两次调查,调查中包含职业暴露信息,并与行政健康数据进行了关联,随访至 2018 年 12 月。采用 Cox 比例风险回归(调整年龄、贫困和吸烟因素)评估组织因素、压力和粉尘、化学和物理暴露与 IHD 之间的关系。

结果

粉尘(危险比[HR] 1.6,95%CI 1.1-2.4)、烟雾或烟尘(HR 1.5,1.0-2.3)和油和溶剂(HR 1.5,1.0-2.3)与 NZWS 男性的 IHD 相关。在 NZWS 男性和女性中,频繁出现不舒适或疲劳的手位与 IHD 相关(HR 分别为 1.8、1.1-2.8 和 2.4、1.1-5.0)。重复任务和高速工作与 NZWS 女性的 IHD 相关(HR 分别为 3.4、1.1-10.4 和 2.6、1.2-5.5)。使用振动工具的毛利 NZWS 女性和暴露于高频强噪声的女性更易发生 IHD(HR 分别为 2.3、1.1-4.8 和 2.1、1.0-4.4)。在 NZWS 男性中,多种粉尘和化学因素的暴露与 IHD 相关,而在 NZWS 男性和女性中,多种物理因素的暴露也与 IHD 相关。

结论

与 IHD 风险升高相关的暴露因素包括粉尘、烟雾或烟尘、油和溶剂、不舒适的握持或手部动作、重复任务、高速工作、强噪声和使用振动工具。这些结果并非在男性和女性以及普通人群和毛利人群中都一致观察到。

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