摘要目的:探讨机械制造业噪声和粉尘暴露对作业人员高血压患病和心电图异常风险的影响及二者联合作用，为劳动者的职业相关性疾病防治提供支持。方法:于2024年1月，采用方便抽样方法，以内蒙古包头市某机械制造企业2023年1至12月进行职业健康体检的2 802例在岗作业工人为研究对象。按暴露因素分为噪声组、粉尘组、粉尘噪声组、对照组，对其血压和心电图结果进行分析，对计数资料用 χ2检验分析各组间差异性，使用二元logistic回归模型分析粉尘、噪声对高血压及心电图异常的影响。 结果:分层分析结果显示，在男性、年龄>30~40岁、>40~50岁、>50岁及不同接害工龄、不同企业规模中，四组间高血压患病率比较，差异有统计学意义（ P<0.001）。在男性、年龄>30~40岁、不同企业规模和接害工龄≤15年中，四组间心电图异常率比较，差异有统计学意义（ P<0.001）。不同年龄四组间高血压患病率趋势性检验结果显示，随着年龄的增加噪声组、粉尘组和粉尘噪声组高血压患病率呈上升趋势（ χ2趋势=10.76、4.25、6.60， P<0.001、0.039、0.010）。二元logistic回归分析显示，噪声组、粉尘组和粉尘噪声组高血压患病风险分别是对照组的2.63倍（ OR=2.63，95% CI：1.89~3.67， P<0.001）、2.36倍（ OR=2.36，95% CI：1.76~3.16， P<0.001）、2.69倍（ OR=2.69，95% CI：2.14~3.38， P<0.001）。与对照组比较，粉尘、噪声、粉尘噪声组心电图异常风险差异无统计学意义（ P>0.05）。 结论:粉尘和噪声联合暴露增加了机械制造企业作业工人高血压患病的风险并呈联合作用。

abstractsObjective:To explore the impact of noise and dust exposure in the mechanical manufacturing industry on the risk of hypertension and abnormal electrocardiogram in workers, and their combined effects, in order to provide support for the prevention and treatment of occupational related diseases among workers.Methods:In January 2024, A convenience sampling method was used to study 2802 on-the-job workers who underwent occupational health check-ups from January 2023 to December 2023 at a machinery manufacturing enterprise in Baotou, Inner Mongolia. Blood pressure and electrocardiogram results were analyzed in the noise group, dust group, dust noise group and control group according to the exposure factors. For count data, the chi-square test was employed to analyze differences among groups. Additionally, a binary logistic regression model was utilized to assess the impact of dust and noise exposure on the prevalence of hypertension and electrocardiogram abnormalities.Results:The stratified analysis results showed that the differences in hypertension prevalence among the four groups were statistically significant ( P<0.001) in males, age groups >30-40 years, >40-50 years, >50 years, different exposure durations, and different enterprise sizes. For ECG abnormalities, significant differences were observed among the four groups ( P<0.001) in males, the age group >30-40 years, different enterprise sizes, and those with exposure durations ≤15 years. The trend test for hypertension prevalence across different age groups revealed that as age increased, the prevalence of hypertension showed an upward trend in the noise-exposed group, dust-exposed group, and combined dust-noise-exposed group ( χ2=10.76, 4.25, 6.60, P<0.001, 0.039, 0.010) . Binary regression model analyses revealed that the the risk of hypertension in the noise group, dust group and dust noise group was 2.63 times ( OR=2.63, 95% CI: 1.89~3.67, P<0.001) , 2.36 times ( OR=2.36, 95% CI: 1.76~3.16, P<0.001) and 2.69 times ( OR=2.69, 95% CI: 2.14~3.38, P<0.001) . Using ECG abnormalities as the dependent variable and incorporating the statistically significant variables from Table 1 as independent variables into the binary logistic regression model, the results showed no statistically significant differences in the risk of ECG abnormalities in the dust-exposed, noise-exposed, and combined dust-noise-exposed groups compared to the control group ( P> 0.05) . Conclusion:Combined exposure to dust and noise increases the risk of hypertension in workers and has a combined effect.