摘要目的:了解黑色金属矽尘接触工人血清表面活性蛋白D（SP-D）和克拉拉细胞蛋白（CCl6）水平，并分析其影响因素。方法:于2021年7-9月，采用横断面调查研究方法，选择5家黑色金属铸造企业37个接触矽尘岗位的174名工人作为研究对象。通过职业卫生现场调查和检测获得矽尘作业工人接触浓度，收集研究对象一般情况并采集外周血；采用双抗原夹心酶联免疫吸附试验（ELISA）检测工人血清中SP-D和CC16浓度；均值的比较用单因素方差分析，工人血清中SP-D和CC16浓度的影响因素用有序多分类logistic回归分析。结果:174名工人接触矽尘（呼吸性粉尘）时间加权平均浓度（C-TWA）浓度范围为0.09 mg/m 3~3.59 mg/m 3，接尘工人C-TWA超标率为32.18%（56/174），不同岗位工人超标率存在差异（χ 2=28.85， P<0.001），以造型岗位矽尘浓度最高，为（0.82±0.11） mg/m 3；以接触矽尘C-TWA<50%职业接触限值（OEL）为参照，≥50% OEL的工人血清SP-D浓度升高（ OR=4.95，95% CI：1.86~13.17， P=0.001）、CC16浓度下降（ OR=0.15，95% CI：0.05~0.40， P<0.001）；接触矽尘C-TWA≥OEL的工人血清CC16浓度下降（ OR=0.46，95% CI：0.28~0.98， P=0.043）。与低职业健康素养者比较，高职业健康素养工人的血清SP-D浓度下降（ OR=0.48，95% CI：0.25~0.92， P=0.027）、CC16浓度升高（ OR=2.09，95% CI：1.10~3.97， P=0.024）。 结论:在工人体检结论未见异常的情况下，血清SP-D和CC16浓度水平发生变化，且该变化和工人接触矽尘的浓度有关。

abstractsObjective:To investigate the levels of serum surface active protein D (SP-D) and clara cell protein (CCl6) in workers exposed to black silica dust, and analyze its influencing factors.Methods:From July to September 2021, 174 workers in 37 positions exposed to silica dust in 5 ferrous metal foundry were investigated by cross-sectional research method. The exposure concentration of silica dust workers was obtained through occupational health field investigation and detection, and the general situation of the study subjects was obtained through questionnaire survey and peripheral blood was collected. Double antigen sandwich enzyme-linked immunosorbent assay (ELISA) was used to detect the concentrations of SP-D and CC16 in serum of workers. The mean values were compared by one-way ANOVA, and the influencing factors of SP-D and CC16 concentrations in serum were analyzed by ordered multiple logistic regression.Results:The time-weighted average concentration (C-TWA) of 174 workers exposed to silica dust (respirable dust) ranged from 0.09 mg/m 3~3.58 mg/m 3, and the C-TWA overstandard rate of dust exposed workers was 32.18% (56/174) , with differences among workers in different positions (χ 2=28.85, P<0.001) . The highest concentration of silica dust was (0.82±0.11) mg/m 3. Using C-TWA<50% OEL occupational exposure limit (OEL) as reference, serum SP-D concentration in workers with ≥50% OEL was increased ( OR=4.95, 95% CI: 1.86~13.17, P=0.001) , while CC16 concentration was decreased ( OR=0.15, 95% CI: 0.05~0.40, P<0.001) ; Serum CC16 concentration decreased in workers exposed to silica dust C-TWA≥OEL ( OR=0.46, 95% CI: 0.28~0.98, P=0.043) . Compared with those with low occupational health literacy, the serum SP-D concentration of workers with high occupational health literacy decreased ( OR=0.48, 95% CI: 0.25~0.92, P=0.027) and CC16 concentration increased ( OR=2.09, 95% CI: 1.10-3.97, P=0.024) . Conclusion:When no abnormality was found in the physical examination of workers, the serum SP-D and CC16 concentration levels changed, and the change was related to the concentration of workers exposed to silica dust.