CAJ | 학술논문

目的查明混配农药中毒的发病水平和农药中毒的危险因素。方法采用整群抽样方法，在江苏省和山东省的3个乡随机抽取25个行政村，按大约1∶1的人数比例分为研究组（12个行政村）与对照组（13个行政村）。研究组施药员使用有机磷与菊酯类的混配农药，对照组施药员使用单一有机磷农药。在观察期内喷洒过农药的施药员均为调查对象。中毒病例经高年资职业病医师讨论核实后加以确认。结果研究组2 179名施药员，中毒率为10.10‰；对照组2 615名施药员，中毒率为2.29‰，研究组中毒率高于对照组，其差异有非常显著性。调整其他中毒危险因素后，使用混配农药的中毒危险是使用单一农药的3.45倍。农药中毒的其他危险因素还有：工间吸烟或进食、喷雾器发生故障或滴漏、施药后不能尽快清洗全身、个人防护不严密、长时间施药、女性施药和喷洒棉花。结论如果单剂农药混配后毒性表现为协同或相加作用，则混配用药发生农药中毒的危险增大。应加强对施药员的健康教育和用药技术培训。
목적사명혼배농약중독적발병수평화농약중독적위험인소。방법채용정군추양방법，재강소성화산동성적3개향수궤추취25개행정촌，안대약1∶1적인수비례분위연구조（12개행정촌）여대조조（13개행정촌）。연구조시약원사용유궤린여국지류적혼배농약，대조조시약원사용단일유궤린농약。재관찰기내분쇄과농약적시약원균위조사대상。중독병례경고년자직업병의사토론핵실후가이학인。결과연구조2 179명시약원，중독솔위10.10‰；대조조2 615명시약원，중독솔위2.29‰，연구조중독솔고우대조조，기차이유비상현저성。조정기타중독위험인소후，사용혼배농약적중독위험시사용단일농약적3.45배。농약중독적기타위험인소환유：공간흡연혹진식、분무기발생고장혹적루、시약후불능진쾌청세전신、개인방호불엄밀、장시간시약、녀성시약화분쇄면화。결론여과단제농약혼배후독성표현위협동혹상가작용，칙혼배용약발생농약중독적위험증대。응가강대시약원적건강교육화용약기술배훈。
Objective　To investigate the incidence of pesticide poisoning with mixed preparation and risk factors contributing to it.Methods　Twenty-five administrative villages were studied in three townships of Jiangsu and Shandong Provinces with cluster sampling.The sampled villages were divided into study group (12 villages) and control group (13 villages) with approximately equal number of people each.Pesticide sprayers in the study group applied mixed preparation containing organophosphorous and dimethrin and those in the control group applied single organophosphorous preparation.All the sprayers in sampled villages were interviewed with a same questionnaire about their situation of pesticide spraying during the observation period.Cases of pesticide poisoning were ascertained by seniors physicians in occupational diseases after group discussion.Results　Incidence of pesticide poisoning was higher in 2 179 sprayers of the study group (10.10‰) than that in 2 615 of the control group (2.29‰), with a highly statistically difference (χ2=12.46，P<0.01) and an risk ratio (RR) of 4.45 (95％ CI＝1.94～10.05) adjusted for other risk factors by logistic regression.Other risk factors for pesticide poisoning with mixed preparation were smoking or taking food during spraying, leaking or breakdown of sprayers, without washing their whole body as soon as possible after spraying, poor personal protection, spraying for a long time, spraying by women and spraying pesticide on cotton.Conclusions　If toxicity of mixed preparation of single pesticide showed a synergistic or additional effect, risk of poisoning by spraying mixed preparation increased.Health education and technical training should be strengthened for pesticide sprayers.