[Effect of occupational factors on pre-diabetes mellitus among iron and steel workers].

Objective: To investigate the prevalence of pre-diabetes mellitus (PDM) and the impact of occupation-related factors on PDM, among workers from a steel company in Tangshan city, Hebei province. Methods: Clustering sampling method was used to select a steel company and to carry out occupational health-related physical checkup programs for eligible workers who had working in this company for longer than one year. The study began in February and ended up in June, 2017. Workers who were with FPG level as ≤6.9 mmol/L, and free from diabetes, were selected as the subjects for this study. Questionnaires were used and physical examinations and FPG testing conducted. Results: The total number of subjects in this study was 4 173, of which 2 648 appeared as pre-diabetic, with the prevalence rate as 63.4%. Increase of the PDM prevalence was in parallel with the length of service, among the workers. The risk for the pre-diabetes in those who worked more than 8 hours per day was 1.696 times higher than those who worked less than or equal to 8 h/d (95%CI:1.517-1.937). Compared with those workers without exposures to heat, noise or carbon monoxides, the proportion of pre-diabetes appeared higher in workers exposed to heat, noise or CO with OR=1.782 (95%CI: 1.205-2.636), 1.815 (95%CI: 1.209-2.794) and 1.653 (95%CI: 1.158-2.361), respectively. Risks for those who were exposed to heat or noise were higher than those who were free from exposure to any occupational hazards (OR=2.098, 95%CI: 1.296-3.397). Prevalence rates of pre-diabetes in those who were exposed to heat, noise or CO, were higher than that those who were not. Conclusion: Working hours and exposures to heat, noise or CO appeared as influential factors on PDM.目的： 调查唐山市某钢铁集团工人糖尿病前期（pre-diabetes mellitus，PDM）的患病情况，并分析职业因素对该人群PDM的影响。 方法： 2017年2－6月，采用整群抽样的方法选择某钢铁集团工龄≥1年、FPG≤6.9 mmol/L，且调查时未患有糖尿病的参加职业健康体检的在职职工作为研究对象，并对他们进行问卷调查、体格检查和FPG检测。 结果： 本次研究共调查4 173名工人，糖尿病前期患病率为63.4%。随着工龄的延长PDM患病风险在增加；工作时间>8 h/d的工人PDM的患病风险是工作时间≤8 h/d的工人的1.696倍（95%CI：1.517～1.937）；仅接触高温、噪声、CO的工人PDM患病风险是高温、噪声、CO均不接触工人的1.782倍（95%CI：1.205～2.636）、1.815倍（95%CI：1.209～2.794）和1.653倍（95%CI：1.158～2.361）；高温、噪声联合暴露的工人PDM患病风险是均不接触的2.098倍（95%CI：1.296～3.397）；3种职业有害因素均接触的工人PDM患病风险为均不接触者的4.414倍（95%CI：3.051～6.386）。 结论： 工作时间、高温暴露、噪声暴露和CO暴露是影响糖尿病前期的职业因素。.