Prediction Of Atherosclerosis Based On Occupational Hazards And Serum Markers In Iron And Steel Workers

Objectives By analyzing the influence of occupational hazards and serum markers on carotid atherosclerosis(CAS)in iron and steel workers,a prediction model of CAS was established so as to provide scientific basis for early detection of CAS of high-risk population among iron and steel workers and for making targeted preventive measures.Methods From February 2017 to may 2017,selecting steel workers who have worked for more than one year as source population for the establishment of CAS prediction model.Baseline data were collected including demographics,behavioral life style,occupational exposure history,CAS ultrasound and the laboratory test data.Validation data was also collected by the same way from March to June 2019.Epidata3.1 was used to build the database,SPSS 23.0 and SAS 9.4 were used for statistical analysis.Chi-square test and multivariate nonconditional Logistic regression analysis were used to analyze the effects of occupation hazards and serum markers on CAS.According to the results of multifactor analysis,the CAS prediction model was established and the effect of the model was verified by source population data and prediction population data.The dose-response relationship between occupational hazards and CAS was analyzed by Restricted cubic spline model with Logistic regression analysis.Results 1 The prevalence of CAS in 5161 steel workers was 26.7%(1377 / 5161).79.7%,60.6%,64.0%,50.7% and 39.7% of the workers were exposed to shift,high temperature,noise,dust and CO,respectively.2 The single factor results showed that shift work and high temperature,noise,dust and CO exposure increased the prevalence of CAS(P<0.001).Abnormal concentrations of MCH,TC,LDL-C,Hcy,Apo A,apo B and hs-CRP increased the prevalence of CAS(P< 0.01).With the increasement of cumulative high temperature,noise,dust,CO exposure and night shift days,the risk of CAS increased(P<0.001).3 The results of single occupational harmful factors showed that the risk of CAS in the exposed group was higher than that of the non exposed to high temperature,noise,dust,CO and occupational stress group,OR(95% CI)values was 1.90(1.64-2.20),1.98(1.70-2.30),1.64(1.43-1.89),1.87(1.62-2.14)and 1.26(1.10-1.45)respectively.The risk of CAS in the past shiftr or present shift workers was higher than that in the never shift workers,OR(95% CI)was 2.48(1.97-3.14)and 1.87(1.52-2.30),respectively.The results of multiple occupational harmful factors showed that the risk of CAS in the combination of occupational hazards groups was higher than that in the non-exposure to high temperature,noise,dust,CO and occupational stress,OR(95% CI)were 1.45(1.24-1.70),1.58(1.35-1.85),1.45(1.25-1.68),1.58(1.36-1.82)and 1.28(1.11-1.48),respectively.The risk of CAS in past and present worker was as 2.12(1.67-2.70)and1.68(1.36-2.07)times asthosewho never worked.4 The results of multivariate unconditional logistic regression analysis of serum markers showed that the risk of CAS in patients with abnormal WBC and MCH was as 1.48(1.05-2.08)and 1.35(1.16-1.56)times as that in normal people.With the increasement of CRP and apo B,the prevalence of CAS was increaseing.5 Based on the results of multivariate and non-conditional logistic regression of environmental risk factors score(ERS),a single occupational hazard model and a variety of occupational hazard models were constructed.The scores of ERS1 and ERS2 in CAS patients were higher than those in non CAS patients(P<0.001),and the incidence of CAS increased with ERS.6 The area under ROC curve(AUC(95% CI))was 0.747(0.732,0.762),0.757(0.742,0.772),0.770(0.756,0.784),0.769(0.755,0.783),respectively.According to the data validationresults of 2019 validation population,22.4% and 21.5% of the prediction models(ERS1 / ERS2)were positive,93.0% and 94.4% of the prediction models(ERS1 / ERS2)were true positive,and 76.2% and 74.6% of the prediction models(ERS1 / ERS2)were positive and negative.Conclusions 1 Occupational hazardous factors including high temperature,noise,dust,CO and shift work are all related to CAS.Serum markers including WBC,MCH,hs-CRP and apo B are also related to CAS.2 The combined effect of the occupational hazard group(ERS)was greater than that of the single factor.3 The risk of CAS rose with the increase of occupational hazard combined cumulative exposure(ERS).4 Compared with the independent prediction of occupational hazards,ERS combined with serum markers had better prediction effect.5According to the baseline data,the prediction model is better for non-CAS population and is worse for CAS population.Figure3;Table19;Reference 168...