[A case-control study on effect of occupational factor exposures on carotid atherosclerosis in steel workers]

Objective: To investigate the effect of occupational factor exposures on carotid atherosclerosis (CAS) in steel workers. Methods: A frequency matched case-control study was conducted by age and factory proportion. A total of 1 033 workers with carotid atherosclerosis diagnosed by ultrasonography examination from February to June 2017 were selected as case group, and 1 033 workers without carotid atherosclerosis indicated by physical examination at the same time were selected as control group. The basic information of the workers, such as diet pattern, lifestyle, serum biochemical index and occupation history, were collected. The effects of occupational hazards on carotid atherosclerosis were analyzed by univariate and multivariate logistic regression analyses. The combined effects of various occupational hazards on carotid atherosclerosis were evaluated by environmental risk score (ERS). Results: High temperature, noise, occupational stress and night shift days increased the risk of CAS. With the increase of cumulative high temperature and noise exposure, occupational stress and night shift days, the risk of CAS increased (trend text: χ(2)=37.53, P<0.01; χ(2)=16.98, P<0.01; χ(2)=13.93, P<0.01; χ(2)=5.59, P<0.05). After adjustment of covariates, compared with P(20) group, the risk of carotid artery in P(40), P(60), P(80) and P(100) groups were as follows: high temperature 1.61 (1.19-2.18), 1.69 (1.25-2.30), 1.84 (1.36-2.49), 2.43 (1.77-3.34); noise 1.70 (1.15-2.52), 1.68 (1.20-2.35), 1.80 (1.34-2.42), 2.23 (1.53-3.26); occupational stress 1.39 (1.04- 1.86), 1.41 (1.06-1.89), 1.45(1.09-1.95), 1.48 (1.10-1.98); night shift days 1.58 (1.08-2.33), 1.66 (1.12-2.47), 1.55 (1.04-2.31), 1.76 (1.17-2.64). The results of the environmental risk score showed that the risk of carotid atherosclerosis increased with the increase of ERS (ERS trend text χ(2)=51.61, P<0.01); RCS results showed that there was a linear relationship between ERS and CAS in steel workers(P<0.01). Linear dose-response relationship existed between ERS and CAS (nonlinear test P>0.05). Conclusions: High temperature, noise, occupational stress and night shift days were related to carotid atherosclerosis. Linear dose-response relationship existed between ERS and CAS in steel workers.