Objective: To evaluate the effects of occupational aluminum exposure on workers' overall cognitive function and cognitive fields. Methods: From July to August 2019, using the method of cluster sampling, 101 and 117 workers were selected from the electrolytic aluminum workshop of an aluminum plant in a region and the maintenance workshop of a plant in the same region. The venous blood of the subjects was collected, the plasma was extracted, and the blood aluminum concentration was measured by ICP-MS. According to the blood aluminum concentration and type of work, 93 workers who were lower than the median blood aluminum concentration and in the maintenance workshop of a factory were divided into low aluminum exposure group, and 85 workers who were higher than the median blood aluminum concentration and in the electrolytic aluminum workshop of an aluminum factory were divided into high aluminum exposure group. The basic information of the respondents, was collected through the employee physical examination form. The overall cognitive function of workers was evaluated by Beijing Montreal Cognitive Assessment Scale (MoCA) . Multiple linear regression analysis and logistic regression analysis were used for multiple statistical analysis. Results: Compared with the low aluminum exposure group (25.42±1.808) , the total score of MoCA in the high aluminum exposure group (23.84±2.919) was significantly lower, and the scores of visual space, executive function, abstract and delayed recall were significantly lower (P<0.05) . Linear regression analysis showed that the total score of MoCA, visual space and executive function, naming and delayed recall were negatively correlated with blood aluminum concentration (β=-0.018、-0.008、-0.003、-0.008, P<0.05) .MOCA total score, visual space and executive function, attention, language, abstraction, orientation were positively correlated with educational level (β=0.853、0.310、0.216、0.171、0.412、0.122, P<0.05) . Logistic regression analysis showed that adjusting for age, smoking, drinking and education, blood aluminum was a risk factor for mild cognitive impairment (OR=1.017, P<0.05) ; Education level was the protective factor of mild cognitive impairment (OR=0.419, P<0.05) . Conclusion: Occupational aluminum exposure can affect the overall cognitive function of workers, and occupational aluminum exposure increases the risk of MCI.
目的： 评估职业铝接触对工人总体认知功能及各认知领域的影响。 方法： 于2019年7~8月，采用整群抽样方法，选择某地区某铝厂电解铝车间及同地区某厂维修车间的作业工人，分别101、117人为研究对象，采集研究对象静脉血，提取血浆，利用电感耦合等离子体质谱法（ICP-MS）测定血铝浓度。根据工人血铝浓度和工种进行分组，将血铝浓度低于中位数且为维修车间的工人作为低铝接触组，共93例；血铝浓度高于中位数且为铝厂电解铝车间的工人作为高铝接触组，共85例。通过职工健康体检表收集调查对象的基本情况，采用北京版蒙特利尔认知评估量表（MoCA）评估工人总体认知功能。采用多重线性回归分析和logistic回归分析进行多元统计学分析。 结果： 与低铝接触组（25.42±1.81）比较，高铝接触组MoCA总分（23.84±2.92）明显较低，视空间与执行功能、抽象和延迟回忆领域得分明显较低，差异均有统计学意义（P<0.05）。多重线性回归分析结果显示，MoCA总分、视空间与执行功能、命名和延迟回忆均和血铝浓度呈负相关（β=-0.018、-0.008、-0.003、β=-0.008，P<0.05）；MoCA总分、视空间与执行功能、注意、语言、抽象、定向均和文化程度呈正相关（β=0.853、0.310、0.216、0.171、0.412、0.122，P<0.05）。logistic回归分析显示：血铝是轻度认知功能障碍（MCI）的危险因素（OR=1.017，P<0.05）；文化程度是MCI的保护因素（OR=0.419，P<0.05）。 结论： 职业铝接触可以影响工人的总体认知功能，职业铝接触增加工人患MCI的风险。.
Keywords: Aluminium; Cognition function; Cognitive impariment; Montreal cognitive assessment scale; Occupational exposure.