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Article(id=1321169602839695614, tenantId=1146029695717560320, journalId=1319373219989389464, issueId=1321169578152014376, articleNumber=null, orderNo=null, doi=10.11847/zgggws1146511, pmid=null, cstr=null, oa=null, hot=null, price=null, onlineType=0, articleFormat=0, articleType=null, articleTypeStr=null, receivedDate=1732464000000, receivedDateStr=2024-11-25, revisedDate=1753372800000, revisedDateStr=2025-07-25, acceptedDate=1755014400000, acceptedDateStr=2025-08-13, onlineDate=1792920979460, onlineDateStr=2026-10-25, pubDate=1760025600000, pubDateStr=2025-10-10, doiRegisterDate=null, doiRegisterDateStr=null, onlineIssueDate=1792920979460, onlineIssueDateStr=2026-10-25, onlineJustAcceptDate=null, onlineJustAcceptDateStr=null, onlineFirstDate=null, onlineFirstDateStr=null, sourceXml=null, magXml=null, createTime=1792920979460, creator=13701087609, updateTime=1792920979460, updator=13701087609, issue=Issue{id=1321169578152014376, tenantId=1146029695717560320, journalId=1319373219989389464, year='2025', volume='41', issue='10', pageStart='1153', pageEnd='1280', issueExtLink='null', onlineDate='null', pubDate='1760025600000', pubDateStr='2025-10-10', beforeIssueId=null, nextIssueId=null, price=null, status=1, issueComplete=1, articleOrder=1, issueType=-1, specialIssue=null, createTime=1792920973575, creator='13701087609', updateTime=1792920973575, updator='13701087609', preIssue=null, nextIssue=null, articleTotal=null, ext=null, issueFiles=null, downloadFileDto=null}, startPage=1161, endPage=1167, ext={EN=ArticleExt(id=1321169604530000127, articleId=1321169602839695614, tenantId=1146029695717560320, journalId=1319373219989389464, language=EN, title=The relationship between metabolites of polycyclic aromatic hydrocarbons in urine and changes in cognitive function of steel mill workers：a longitudinal study, columnId=1320427696342020970, journalTitle=Chinese Journal of Public Health, columnName=Epidemiological Research, runingTitle=null, highlight=null, articleAbstract=
Objective

To investigate the relationship between the metabolites of polycyclic aromatic hydrocarbons (PAHs) in urine and the changes in cognitive function of steel mill workers.

Methods

In 2019, 960 workers from a coking plant in Shanxi province were selected to undergo basic information investigations, cognitive function tests, and detection for hydroxylated metabolites of polycyclic aromatic hydrocarbons (OH-PAHs) in urine. During the follow-up in 2023, a total of 567 workers completed the cognitive function tests. The Beijing version of the Montreal Cognitive Assessment (MoCA) was employed to test the cognitive function of the workers. High performance liquid chromatography with tandem mass spectrometry (HPLC-MS/MS) was utilized to detect OH-PAHs in urine. The generalized linear model and the generalized estimation equation were adopted to analyze the relationship between urinary OH-PAHs and the cognitive function of the workers.

Results

Subjects were 49 (46, 53) years old at baseline, with 91.7% being the male. In the longitudinal study, the high exposure groups of 2-hydroxynaphthalene (2-OHNAP) and 1-hydroxypyrene (1-OHPYR) showed decreases in attention (β = –0.338, 95%CI: –0.454 to –0.222, P < 0.001; β = –0.450, 95%CI: –0.557 to –0.343, P < 0.001), abstract thinking (β = –0.463, 95%CI: –0.549 to –0.377, P < 0.001; β = –0.360, 95%CI: –0.450 to –0.269, P < 0.001) and the total score (β = –0.863, 95%CI: –1.284 to –0.443, P < 0.001; β = –0.548, 95%CI: –0.987 to –0.108, P = 0.015).

Conclusions

Long-term exposure to high concentrations of PAHs can lead to reduced cognitive function in steel mill workers.

, authors=Siyu WANG, Xutao GAO, Jingya SHI, Jisheng NIE, authorsList=Siyu WANG, Xutao GAO, Jingya SHI, Jisheng NIE, authorCompany=null, correspAuthors=Jisheng NIE, authorNote=null, correspAuthorsNote=
NIE Jisheng, E-mail:
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目的

探讨某钢铁厂工人尿中多环芳烃（PAHs）代谢物与认知功能之间的关系。

方法

2019年，抽取山西省某焦化厂的960名工人进行基本情况调查、认知功能测试和尿中多环芳烃羟基代谢物（OH-PAHs）检测。于2023年随访，共567名工人完成认知功能测试。采用北京版蒙特利尔认知评估量表MoCA）测试工人认知功能；使用高效液相色谱–串联质谱联用（HPLC-MS/MS）检测尿中OH-PAHs。使用广义线性模型和广义估计方程分析工人尿中OH-PAHs与认知功能的关系。

结果

调查对象基线年龄49（46，53）岁，其中，男性占91.7%。纵向研究中，2–羟基萘（2-OHNAP）和1-OHPYR高暴露组的注意力（β= –0.338，95%CI= –0.454～–0.222，P<0.001；β= –0.450，95%CI= –0.557～–0.343，P<0.001）、抽象思维（β= –0.463，95%CI= –0.549～–0.377，P<0.001；β= –0.360，95%CI= –0.450～–0.269，P<0.001）及总得分（β= –0.863，95%CI= –1.284～–0.443，P<0.001；β= –0.548，95%CI= –0.987～–0.108，P=0.015）降低。

结论

长期暴露于高浓度多环芳烃环境中可能会导致钢铁厂工人认知功能降低。

, authors=王思宇, 高旭涛, 时婧雅, 聂继盛*, *, authorsList=王思宇, 高旭涛, 时婧雅, 聂继盛, authorCompany=null, correspAuthors=聂继盛, authorNote=

王思宇（1999—），硕士，研究方向：职业病学

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聂继盛，E-mail：
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A comparison of the mini-mental state examination (MMSE) with the montreal cognitive assessment (MoCA) for mild cognitive impairment screening in Chinese middle-aged and older population: a cross-sectional study[J]. 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Journal of Analytical Toxicology, 2012, 36(5): 334-339., articleTitle=null, refAbstract=null)], funds=null, companyList=[AuthorCompany(id=1321169605763125509, tenantId=1146029695717560320, journalId=1319373219989389464, articleId=1321169602839695614, xref=null, ext=[AuthorCompanyExt(id=1321169605775708422, tenantId=1146029695717560320, journalId=1319373219989389464, articleId=1321169602839695614, companyId=1321169605763125509, language=EN, country=null, province=null, city=null, postcode=null, companyName=null, departmentName=null, remark=Department of Occupational Health, School of Public Health, Shanxi Medical University, Taiyuan 030000, China), AuthorCompanyExt(id=1321169605784097031, tenantId=1146029695717560320, journalId=1319373219989389464, articleId=1321169602839695614, companyId=1321169605763125509, language=CN, country=null, province=null, city=null, postcode=null, companyName=null, departmentName=null, remark=山西医科大学公共卫生学院劳动卫生学教研室，太原 030000)])], figs=[ArticleFig(id=1321169609827406118, tenantId=1146029695717560320, journalId=1319373219989389464, articleId=1321169602839695614, language=EN, label=Tab.1, caption=

Basic information of follow-up population and lost population (n=952)

, figureFileSmall=null, figureFileBig=null, tableContent=
变量随访人群（n=567）失访人群（n=385）χ2值P值
人数构成比/%人数构成比/%
性别0.1120.906
　男52091.735291.4
　女478.3338.6
BMI/（kg/m2）5.2040.062
　<18.571.261.6
　18.5～<2418733.019149.6
　≥2437365.818848.8
饮酒情况2.4270.302
　从不饮酒31154.921856.6
　现在饮酒22339.314838.4
　曾经饮酒335.8194.9
吸烟情况4.5010.141
　从不吸烟21037.012933.5
　现在吸烟29952.721455.6
　曾经吸烟5810.34210.9
体育锻炼6.2480.031
　否15727.712131.4
　偶尔20536.312031.2
　经常20436.014437.4
), ArticleFig(id=1321169609928069415, tenantId=1146029695717560320, journalId=1319373219989389464, articleId=1321169602839695614, language=CN, label=表1, caption=

随访人群与失访人群基本信息比较（n=952）

, figureFileSmall=null, figureFileBig=null, tableContent=
变量随访人群（n=567）失访人群（n=385）χ2值P值
人数构成比/%人数构成比/%
性别0.1120.906
　男52091.735291.4
　女478.3338.6
BMI/（kg/m2）5.2040.062
　<18.571.261.6
　18.5～<2418733.019149.6
　≥2437365.818848.8
饮酒情况2.4270.302
　从不饮酒31154.921856.6
　现在饮酒22339.314838.4
　曾经饮酒335.8194.9
吸烟情况4.5010.141
　从不吸烟21037.012933.5
　现在吸烟29952.721455.6
　曾经吸烟5810.34210.9
体育锻炼6.2480.031
　否15727.712131.4
　偶尔20536.312031.2
　经常20436.014437.4
), ArticleFig(id=1321169610024538408, tenantId=1146029695717560320, journalId=1319373219989389464, articleId=1321169602839695614, language=EN, label=Tab.2, caption=

Basic information of participants (n=567)

, figureFileSmall=null, figureFileBig=null, tableContent=
变量总人数（n=567）构成比/%低暴露组（n=283）高暴露组（n=284）χ2值P值
人数构成比/%人数构成比/%
性别2.0720.151
　男52091.725991.526191.9
　女478.3248.5238.9
BMI/（kg/m2）2.7150.336
　<18.571.220.751.8
　18.5～<2418733.09332.99433.1
　≥2437365.818866.418565.1
饮酒状况2.5360.370
　从不饮酒31154.915354.115855.6
　现在饮酒22339.311339.911038.8
　曾经饮酒335.8176.0165.6
吸烟情况0.8310.810
　从不吸烟21037.111239.69834.5
　现在吸烟29952.713246.616758.8
　曾经吸烟5810.23913.8196.7
体育锻炼15.023<0.001
　从不15727.75519.49734.2
　偶尔20536.210838.39734.2
　经常20436.111442.39031.6
值夜班38691.026493.312262.93.6370.049
基线MCI检出情况2.3040.117
　MCI阳性23842.09834.614049.3
　MCI阴性32958.018565.414450.7
随访MCI检出情况0.7240.476
　MCI阳性31956.314250.217762.3
　MCI阴性24843.714149.810737.7
), ArticleFig(id=1321169610108424489, tenantId=1146029695717560320, journalId=1319373219989389464, articleId=1321169602839695614, language=CN, label=表2, caption=

研究对象基本信息（n=567）

, figureFileSmall=null, figureFileBig=null, tableContent=
变量总人数（n=567）构成比/%低暴露组（n=283）高暴露组（n=284）χ2值P值
人数构成比/%人数构成比/%
性别2.0720.151
　男52091.725991.526191.9
　女478.3248.5238.9
BMI/（kg/m2）2.7150.336
　<18.571.220.751.8
　18.5～<2418733.09332.99433.1
　≥2437365.818866.418565.1
饮酒状况2.5360.370
　从不饮酒31154.915354.115855.6
　现在饮酒22339.311339.911038.8
　曾经饮酒335.8176.0165.6
吸烟情况0.8310.810
　从不吸烟21037.111239.69834.5
　现在吸烟29952.713246.616758.8
　曾经吸烟5810.23913.8196.7
体育锻炼15.023<0.001
　从不15727.75519.49734.2
　偶尔20536.210838.39734.2
　经常20436.111442.39031.6
值夜班38691.026493.312262.93.6370.049
基线MCI检出情况2.3040.117
　MCI阳性23842.09834.614049.3
　MCI阴性32958.018565.414450.7
随访MCI检出情况0.7240.476
　MCI阳性31956.314250.217762.3
　MCI阴性24843.714149.810737.7
), ArticleFig(id=1321169610204893482, tenantId=1146029695717560320, journalId=1319373219989389464, articleId=1321169602839695614, language=EN, label=Tab.3, caption=

MoCA scale scores of participants

, figureFileSmall=null, figureFileBig=null, tableContent=
变量总人数（n=567）低暴露组（n=283）高暴露组（n=284）t值P值
基线MoCA量表得分
　视空间与执行能力3.87±1.083.95±1.053.78±1.111.8820.002
　命名2.94±0.272.95±0.222.93±0.310.8850.046
　注意力5.60±0.725.63±0.685.58±0.760.8180.422
　语言2.29±0.682.34±0.662.24±0.691.7650.316
　抽象1.50±0.681.58±0.621.42±0.722.8380.021
　延时回忆3.37±1.363.47±1.363.27±1.361.7510.136
　定向5.97±0.175.99±0.125.96±0.212.1030.015
　MoCA总分25.54±2.7725.91±2.6425.17±2.863.2020.109
随访MoCA量表得分
　视空间与执行能力3.6±1.343.48±1.383.84±1.23−3.2770.002
　命名2.87±0.432.84±0.472.92±0.34−2.3180.046
　注意力5.47±0.975.47±1.045.40±1.010.8090.422
　语言2.01±0.851.98±0.882.06±9.80−0.1410.316
　抽象1.15±0.801.09±0.811.26±0.78−2.5520.021
　延时回忆2.99±1.593.06±1.562.85±1.681.5440.136
　定向5.86±0.545.82±0.635.94±0.26−3.0120.015
　MoCA总分23.96±4.1123.76±4.3224.34±3.68−1.7160.109
), ArticleFig(id=1321169610305556779, tenantId=1146029695717560320, journalId=1319373219989389464, articleId=1321169602839695614, language=CN, label=表3, caption=

研究对象MoCA量表得分情况（$ \overline{x}\pm s $/分）

, figureFileSmall=null, figureFileBig=null, tableContent=
变量总人数（n=567）低暴露组（n=283）高暴露组（n=284）t值P值
基线MoCA量表得分
　视空间与执行能力3.87±1.083.95±1.053.78±1.111.8820.002
　命名2.94±0.272.95±0.222.93±0.310.8850.046
　注意力5.60±0.725.63±0.685.58±0.760.8180.422
　语言2.29±0.682.34±0.662.24±0.691.7650.316
　抽象1.50±0.681.58±0.621.42±0.722.8380.021
　延时回忆3.37±1.363.47±1.363.27±1.361.7510.136
　定向5.97±0.175.99±0.125.96±0.212.1030.015
　MoCA总分25.54±2.7725.91±2.6425.17±2.863.2020.109
随访MoCA量表得分
　视空间与执行能力3.6±1.343.48±1.383.84±1.23−3.2770.002
　命名2.87±0.432.84±0.472.92±0.34−2.3180.046
　注意力5.47±0.975.47±1.045.40±1.010.8090.422
　语言2.01±0.851.98±0.882.06±9.80−0.1410.316
　抽象1.15±0.801.09±0.811.26±0.78−2.5520.021
　延时回忆2.99±1.593.06±1.562.85±1.681.5440.136
　定向5.86±0.545.82±0.635.94±0.26−3.0120.015
　MoCA总分23.96±4.1123.76±4.3224.34±3.68−1.7160.109
), ArticleFig(id=1321169610410414380, tenantId=1146029695717560320, journalId=1319373219989389464, articleId=1321169602839695614, language=EN, label=Tab.4, caption=

Detection of OH-PAHs in urine of participants (n=567)

, figureFileSmall=null, figureFileBig=null, tableContent=
代谢产物检出限/（ng/mL）检出率/%P25/（ng/mL）P50/（ng/mL）P75/（ng/mL）
2-OHNAP0.005 396.80.126 00.314 00.752 0
1-OHNAP0.024 093.90.051 00.083 00.150 0
3-OHFLU0.004 193.90.023 00.051 00.119 0
2-OHFLU0.001 797.90.071 00.107 00.163 0
2-OHPHE0.001 498.30.072 00.143 00.315 0
9-OHPHE0.044 198.70.180 00.263 00.422 0
1-OHPHE0.014 278.90.024 00.064 00.116 0
1-OHPYR0.009 897.60.083 00.131 00.233 0
), ArticleFig(id=1321169610494300461, tenantId=1146029695717560320, journalId=1319373219989389464, articleId=1321169602839695614, language=CN, label=表4, caption=

研究对象尿中OH-PAHs检测情况（n=567）

, figureFileSmall=null, figureFileBig=null, tableContent=
代谢产物检出限/（ng/mL）检出率/%P25/（ng/mL）P50/（ng/mL）P75/（ng/mL）
2-OHNAP0.005 396.80.126 00.314 00.752 0
1-OHNAP0.024 093.90.051 00.083 00.150 0
3-OHFLU0.004 193.90.023 00.051 00.119 0
2-OHFLU0.001 797.90.071 00.107 00.163 0
2-OHPHE0.001 498.30.072 00.143 00.315 0
9-OHPHE0.044 198.70.180 00.263 00.422 0
1-OHPHE0.014 278.90.024 00.064 00.116 0
1-OHPYR0.009 897.60.083 00.131 00.233 0
), ArticleFig(id=1321169610578186542, tenantId=1146029695717560320, journalId=1319373219989389464, articleId=1321169602839695614, language=EN, label=Tab.5, caption=

Association of urinary OH-PAHs with cognitive function at baseline (n=567)

, figureFileSmall=null, figureFileBig=null, tableContent=
变量视空间与执行能力命名注意力语言
β值95%CIP值β值95%CIP值β值95%CIP值β值95%CIP值
∑OH-PAHs0.055−0.200～0.3100.6720.003−0.060～0.0660.9250.013−0.153～0.0230.8790.024−0.136～0.1830.772
2-OHNAP−0.230−0.455～–0.0050.045−0.014−0.070～0.0420.6180.083−0.063～0.2300.263−0.044−0.185～0.0970.541
1-OHNAP0.120−0.106～0.3460.2990.016−0.040～0.0720.5850.064−0.083～0.2110.393−0.019−0.160～0.1230.796
3-OHFLU0.025−0.177～0.2280.807−0.028−0.078～–0.0230.2810.016−0.116～0.1480.8110.019−0.108～0.1460.768
2-OHFLU−0.055−0.286～0.1750.638−0.012−0.069～0.0450.689−0.056−0.206～0.0940.465−0.100−0.044～0.2440.174
2-OHPHE−0.095−0.325～0.1340.4150.014−0.043～0.0710.629−0.080−0.229～0.0690.293−0.093−0.236～0.0510.206
9-OHPHE0.173−0.035～0.3810.1020.047−0.004～0.0990.0720.022−0.113～0.1570.7530.016−0.114～0.1460.811
1-OHPHE−0.020−0.262～0.2210.868−0.009−0.069～0.0500.7620.030−0.127～0.1870.707−0.070−0.221～0.0810.363
1-OHPYR−0.009−0.227～0.2080.9340.004−0.049～0.0580.8730.032−0.110～0.1730.6610.039−0.097～0.1750.572
∑OH-PAHs−0.026−0.182～0.1040.747−0.274−0.593～0.0450.093−0.007−0.046～0.0320.732−0.217−0.875～0.4410.519
2-OHNAP−0.274−0.412～0.135<0.001−0.092−0.374～0.1900.522−0.023−0.057～0.0120.193−0.059−1.176～–0.1300.045
1-OHNAP0.058−0.082～0.1970.4170.148−0.135～0.4320.3050.024−0.110～0.0580.1750.352−0.233～0.9370.238
3-OHFLU0.047−0.077～0.1720.4550.024−0.230～0.2780.8530.011−0.020～0.0420.4990.109−0.414～0.6320.683
2-OHFLU0.051−0.91～0.1920.4840.050−0.239～0.3380.7360.016−0.051～–0.010.3850.079−0.517～0.670.795
2-OHPHE−0.038−0.179～0.1030.601−0.118−0.405～0.1700.4220.012−0.023～0.0470.492−0.385−0.978～0.2080.203
9-OHPHE−0.066−0.194～0.0610.309−0.011−0.271～0.2490.933−0.003−0.035～0.0290.8430.138−0.399～0.6750.615
1-OHPHE0.084−0.064～0.2320.2670.212−0.090～0.5140.1680.010−0.027～0.0460.6110.358−0.266～0.9810.261
1-OHPYR−0.012−0.146～0.1210.8580.212−0.06～0.4840.127−0.009−0.042～0.0240.5880.251−0.310～0.8130.380
), ArticleFig(id=1321169610708209967, tenantId=1146029695717560320, journalId=1319373219989389464, articleId=1321169602839695614, language=CN, label=表5, caption=

基线研究中尿中OH-PAHs与认知功能之间的关系（n =567）

, figureFileSmall=null, figureFileBig=null, tableContent=
变量视空间与执行能力命名注意力语言
β值95%CIP值β值95%CIP值β值95%CIP值β值95%CIP值
∑OH-PAHs0.055−0.200～0.3100.6720.003−0.060～0.0660.9250.013−0.153～0.0230.8790.024−0.136～0.1830.772
2-OHNAP−0.230−0.455～–0.0050.045−0.014−0.070～0.0420.6180.083−0.063～0.2300.263−0.044−0.185～0.0970.541
1-OHNAP0.120−0.106～0.3460.2990.016−0.040～0.0720.5850.064−0.083～0.2110.393−0.019−0.160～0.1230.796
3-OHFLU0.025−0.177～0.2280.807−0.028−0.078～–0.0230.2810.016−0.116～0.1480.8110.019−0.108～0.1460.768
2-OHFLU−0.055−0.286～0.1750.638−0.012−0.069～0.0450.689−0.056−0.206～0.0940.465−0.100−0.044～0.2440.174
2-OHPHE−0.095−0.325～0.1340.4150.014−0.043～0.0710.629−0.080−0.229～0.0690.293−0.093−0.236～0.0510.206
9-OHPHE0.173−0.035～0.3810.1020.047−0.004～0.0990.0720.022−0.113～0.1570.7530.016−0.114～0.1460.811
1-OHPHE−0.020−0.262～0.2210.868−0.009−0.069～0.0500.7620.030−0.127～0.1870.707−0.070−0.221～0.0810.363
1-OHPYR−0.009−0.227～0.2080.9340.004−0.049～0.0580.8730.032−0.110～0.1730.6610.039−0.097～0.1750.572
∑OH-PAHs−0.026−0.182～0.1040.747−0.274−0.593～0.0450.093−0.007−0.046～0.0320.732−0.217−0.875～0.4410.519
2-OHNAP−0.274−0.412～0.135<0.001−0.092−0.374～0.1900.522−0.023−0.057～0.0120.193−0.059−1.176～–0.1300.045
1-OHNAP0.058−0.082～0.1970.4170.148−0.135～0.4320.3050.024−0.110～0.0580.1750.352−0.233～0.9370.238
3-OHFLU0.047−0.077～0.1720.4550.024−0.230～0.2780.8530.011−0.020～0.0420.4990.109−0.414～0.6320.683
2-OHFLU0.051−0.91～0.1920.4840.050−0.239～0.3380.7360.016−0.051～–0.010.3850.079−0.517～0.670.795
2-OHPHE−0.038−0.179～0.1030.601−0.118−0.405～0.1700.4220.012−0.023～0.0470.492−0.385−0.978～0.2080.203
9-OHPHE−0.066−0.194～0.0610.309−0.011−0.271～0.2490.933−0.003−0.035～0.0290.8430.138−0.399～0.6750.615
1-OHPHE0.084−0.064～0.2320.2670.212−0.090～0.5140.1680.010−0.027～0.0460.6110.358−0.266～0.9810.261
1-OHPYR−0.012−0.146～0.1210.8580.212−0.06～0.4840.127−0.009−0.042～0.0240.5880.251−0.310～0.8130.380
), ArticleFig(id=1321169610808873264, tenantId=1146029695717560320, journalId=1319373219989389464, articleId=1321169602839695614, language=EN, label=Tab.6, caption=

Association of urinary OH-PAHs with cognitive function in a longitudinal study (n=567)

, figureFileSmall=null, figureFileBig=null, tableContent=
变量视空间与执行能力命名注意力语言
β值95%CIP值β值95%CIP值β值95%CIP值β值95%CIP值
∑OH-PAHs0.081−0.143～0.1780.8310.0530.007～0.0990.025−0.417−0.526～–0.307<0.001−0.024−0.124～0.0750.634
2-OHNAP−0.072−0.229～0.0850.3680.028−0.018～0.0740.226−0.338−0.454～–0.222<0.001−0.055−0.152～0.0410.259
1-OHNAP0.022−0.141～0.1840.07−0.004−0.049～0.0410.8480.2000.0140～0.3850.035−0.042−0.141～0.0570.41
3-OHFLU0.032−0.127～0.1910.694−0.001−0.045～0.0420.9560.044−0.082～0.1710.4930.037−0.064～0.1380.471
2-OHFLU0.028−0.132～0.1890.7310.021−0.022～0.0640.338−0.021−0.146～0.1030.735−0.010−0.109～0.0890.846
2-OHPHE0.025−0.123～0.1730.740−0.003−0.048～0.0420.891−0.017−0.134～0.1000.779−0.024−0.123～0.0750.636
9-OHPHE0.2520.097～0.4070.0010.029−0.015～0.0730.1990.028−0.087～0.2260.6340.038−0.061～0.1360.452
1-OHPHE0.080−0.088～0.2480.352−0.036−0.081～0.0090.117−0.071−0.189～0.0460.2320.026−0.069～0.1210.595
1-OHPYR0.029−0.135～0.1940.7260.039−0.007～0.0840.098−0.450−0.557～–0.343<0.001−0.009−0.109～0.0350.852
续表 6
Table 6 Continued
变量抽象延迟回忆定向总分
β值95%CIP值β值95%CIP值β值95%CIP值β值95%CIP值
∑OH-PAHs−0.026−0.182～0.1040.747−0.274−0.593～0.0450.093−0.007−0.046～0.0320.732−0.217−0.875～0.4410.519
2-OHNAP−0.274−0.412～0.135<0.001−0.092−0.374～0.1900.522−0.023−0.057～0.0120.193−0.059−1.176～–0.1300.045
1-OHNAP0.058−0.082～0.1970.4170.148−0.135～0.4320.3050.024−0.110～0.0580.1750.352−0.233～0.9370.238
3-OHFLU0.047−0.077～0.1720.4550.024−0.230～0.2780.8530.011−0.020～0.0420.4990.109−0.414～0.6320.683
2-OHFLU0.051−0.91～0.1920.4840.050−0.239～0.3380.7360.016−0.051～–0.010.3850.079−0.517～0.670.795
2-OHPHE−0.038−0.179～0.1030.601−0.118−0.405～0.1700.4220.012−0.023～0.0470.492−0.385−0.978～0.2080.203
9-OHPHE−0.066−0.194～0.0610.309−0.011−0.271～0.2490.933−0.003−0.035～0.0290.8430.138−0.399～0.6750.615
1-OHPHE0.084−0.064～0.2320.2670.212−0.090～0.5140.1680.010−0.027～0.0460.6110.358−0.266～0.9810.261
1-OHPYR−0.012−0.146～0.1210.8580.212−0.06～0.4840.127−0.009−0.042～0.0240.5880.251−0.310～0.8130.380
), ArticleFig(id=1321169610892759345, tenantId=1146029695717560320, journalId=1319373219989389464, articleId=1321169602839695614, language=CN, label=表6, caption=

纵向研究中尿中OH-PAHs与认知功能之间的关系（n=567）

, figureFileSmall=null, figureFileBig=null, tableContent=
变量视空间与执行能力命名注意力语言
β值95%CIP值β值95%CIP值β值95%CIP值β值95%CIP值
∑OH-PAHs0.081−0.143～0.1780.8310.0530.007～0.0990.025−0.417−0.526～–0.307<0.001−0.024−0.124～0.0750.634
2-OHNAP−0.072−0.229～0.0850.3680.028−0.018～0.0740.226−0.338−0.454～–0.222<0.001−0.055−0.152～0.0410.259
1-OHNAP0.022−0.141～0.1840.07−0.004−0.049～0.0410.8480.2000.0140～0.3850.035−0.042−0.141～0.0570.41
3-OHFLU0.032−0.127～0.1910.694−0.001−0.045～0.0420.9560.044−0.082～0.1710.4930.037−0.064～0.1380.471
2-OHFLU0.028−0.132～0.1890.7310.021−0.022～0.0640.338−0.021−0.146～0.1030.735−0.010−0.109～0.0890.846
2-OHPHE0.025−0.123～0.1730.740−0.003−0.048～0.0420.891−0.017−0.134～0.1000.779−0.024−0.123～0.0750.636
9-OHPHE0.2520.097～0.4070.0010.029−0.015～0.0730.1990.028−0.087～0.2260.6340.038−0.061～0.1360.452
1-OHPHE0.080−0.088～0.2480.352−0.036−0.081～0.0090.117−0.071−0.189～0.0460.2320.026−0.069～0.1210.595
1-OHPYR0.029−0.135～0.1940.7260.039−0.007～0.0840.098−0.450−0.557～–0.343<0.001−0.009−0.109～0.0350.852
续表 6
Table 6 Continued
变量抽象延迟回忆定向总分
β值95%CIP值β值95%CIP值β值95%CIP值β值95%CIP值
∑OH-PAHs−0.026−0.182～0.1040.747−0.274−0.593～0.0450.093−0.007−0.046～0.0320.732−0.217−0.875～0.4410.519
2-OHNAP−0.274−0.412～0.135<0.001−0.092−0.374～0.1900.522−0.023−0.057～0.0120.193−0.059−1.176～–0.1300.045
1-OHNAP0.058−0.082～0.1970.4170.148−0.135～0.4320.3050.024−0.110～0.0580.1750.352−0.233～0.9370.238
3-OHFLU0.047−0.077～0.1720.4550.024−0.230～0.2780.8530.011−0.020～0.0420.4990.109−0.414～0.6320.683
2-OHFLU0.051−0.91～0.1920.4840.050−0.239～0.3380.7360.016−0.051～–0.010.3850.079−0.517～0.670.795
2-OHPHE−0.038−0.179～0.1030.601−0.118−0.405～0.1700.4220.012−0.023～0.0470.492−0.385−0.978～0.2080.203
9-OHPHE−0.066−0.194～0.0610.309−0.011−0.271～0.2490.933−0.003−0.035～0.0290.8430.138−0.399～0.6750.615
1-OHPHE0.084−0.064～0.2320.2670.212−0.090～0.5140.1680.010−0.027～0.0460.6110.358−0.266～0.9810.261
1-OHPYR−0.012−0.146～0.1210.8580.212−0.06～0.4840.127−0.009−0.042～0.0240.5880.251−0.310～0.8130.380
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钢铁厂工人尿中多环芳烃代谢物与认知功能变化关系的纵向研究
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王思宇 , 高旭涛 , 时婧雅 , 聂继盛 *, *
中国公共卫生 | 流行病学研究 2025,41(10): 1161-1167
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中国公共卫生 |流行病学研究 2025 , 41 (10) : 1161 -1167
钢铁厂工人尿中多环芳烃代谢物与认知功能变化关系的纵向研究
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王思宇, 高旭涛, 时婧雅, 聂继盛*, *
作者信息
  • 山西医科大学公共卫生学院劳动卫生学教研室，太原 030000
通讯作者:
聂继盛，E-mail：
作者简介:

王思宇（1999—），硕士，研究方向：职业病学

The relationship between metabolites of polycyclic aromatic hydrocarbons in urine and changes in cognitive function of steel mill workers：a longitudinal study
Siyu WANG, Xutao GAO, Jingya SHI, Jisheng NIE
Affiliations
  • Department of Occupational Health, School of Public Health, Shanxi Medical University, Taiyuan 030000, China
    • Corresponding Author:
    NIE Jisheng, E-mail:
出版时间: 2025-10-10 doi: 10.11847/zgggws1146511
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摘要
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目的

探讨某钢铁厂工人尿中多环芳烃（PAHs）代谢物与认知功能之间的关系。

方法

2019年，抽取山西省某焦化厂的960名工人进行基本情况调查、认知功能测试和尿中多环芳烃羟基代谢物（OH-PAHs）检测。于2023年随访，共567名工人完成认知功能测试。采用北京版蒙特利尔认知评估量表MoCA）测试工人认知功能；使用高效液相色谱–串联质谱联用（HPLC-MS/MS）检测尿中OH-PAHs。使用广义线性模型和广义估计方程分析工人尿中OH-PAHs与认知功能的关系。

结果

调查对象基线年龄49（46，53）岁，其中，男性占91.7%。纵向研究中，2–羟基萘（2-OHNAP）和1-OHPYR高暴露组的注意力（β= –0.338，95%CI= –0.454～–0.222，P<0.001；β= –0.450，95%CI= –0.557～–0.343，P<0.001）、抽象思维（β= –0.463，95%CI= –0.549～–0.377，P<0.001；β= –0.360，95%CI= –0.450～–0.269，P<0.001）及总得分（β= –0.863，95%CI= –1.284～–0.443，P<0.001；β= –0.548，95%CI= –0.987～–0.108，P=0.015）降低。

结论

长期暴露于高浓度多环芳烃环境中可能会导致钢铁厂工人认知功能降低。

多环芳烃  /  认知功能  /  蒙特利尔认知评估量表  /  广义估计方程  /  钢铁厂工人
Objective

To investigate the relationship between the metabolites of polycyclic aromatic hydrocarbons (PAHs) in urine and the changes in cognitive function of steel mill workers.

Methods

In 2019, 960 workers from a coking plant in Shanxi province were selected to undergo basic information investigations, cognitive function tests, and detection for hydroxylated metabolites of polycyclic aromatic hydrocarbons (OH-PAHs) in urine. During the follow-up in 2023, a total of 567 workers completed the cognitive function tests. The Beijing version of the Montreal Cognitive Assessment (MoCA) was employed to test the cognitive function of the workers. High performance liquid chromatography with tandem mass spectrometry (HPLC-MS/MS) was utilized to detect OH-PAHs in urine. The generalized linear model and the generalized estimation equation were adopted to analyze the relationship between urinary OH-PAHs and the cognitive function of the workers.

Results

Subjects were 49 (46, 53) years old at baseline, with 91.7% being the male. In the longitudinal study, the high exposure groups of 2-hydroxynaphthalene (2-OHNAP) and 1-hydroxypyrene (1-OHPYR) showed decreases in attention (β = –0.338, 95%CI: –0.454 to –0.222, P < 0.001; β = –0.450, 95%CI: –0.557 to –0.343, P < 0.001), abstract thinking (β = –0.463, 95%CI: –0.549 to –0.377, P < 0.001; β = –0.360, 95%CI: –0.450 to –0.269, P < 0.001) and the total score (β = –0.863, 95%CI: –1.284 to –0.443, P < 0.001; β = –0.548, 95%CI: –0.987 to –0.108, P = 0.015).

Conclusions

Long-term exposure to high concentrations of PAHs can lead to reduced cognitive function in steel mill workers.

polycyclic aromatic hydrocarbons  /  cognitive function  /  Montreal Cognitive Assessment  /  generalized estimation equation  /  steal mill worker
王思宇, 高旭涛, 时婧雅, 聂继盛. 钢铁厂工人尿中多环芳烃代谢物与认知功能变化关系的纵向研究. 中国公共卫生, 2025 , 41 (10) : 1161 -1167 . DOI: 10.11847/zgggws1146511
Siyu WANG, Xutao GAO, Jingya SHI, Jisheng NIE. The relationship between metabolites of polycyclic aromatic hydrocarbons in urine and changes in cognitive function of steel mill workers：a longitudinal study[J]. Chinese Journal of Public Health, 2025 , 41 (10) : 1161 -1167 . DOI: 10.11847/zgggws1146511
正文
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在钢铁行业中炼焦是一个必不可少的关键环节，这个过程伴随大量焦炉逸散物的产生，包括颗粒物（PM10、PM2.5）及可挥发性有机物（CO、SO2、苯系物、苯溶物及多环芳烃等）[1]。多环芳烃（polycyclic aromatic hydrocarbons，PAHs）不仅被视为导致焦化行业工人罹患肺癌的首要诱因[2–3]，还有研究表明，其可能会对中枢神经系统产生不良影响，诱发大脑结构异常，如尾状核体积减小以及额叶、颞叶和顶叶区域在放射影像中显示白质区域减少[4–5]，进而增加认知功能障碍及其他相关疾病的风险[6]。相较于普通人群，钢铁厂工人面临着更高浓度且更复杂的PAHs暴露风险。当前的研究大多是通过横断面研究探讨不同浓度PAHs暴露与认知功能之间的关系，而对于长期暴露于高浓度PAHs的职业人群，其认知功能随时间推移而变化的纵向研究仍显不足。为此，本研究分别于2019年和2023年调查山西省某钢铁厂部分工人，通过纵向研究，运用广义估计方程（generalized estimating equation, GEE）分析钢铁厂工人长期接触PAHs对其认知功能的潜在影响，以期为该职业暴露人群构建科学合理的防护体系提供流行病学依据。
1　对象与方法
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1.1　调查对象
采用整群抽样的方法，于2019年1月选取山西省某钢铁厂于太钢总医院定点参加职工体检的952名工人，收集其基本情况、认知测试以及尿样，用以检测尿中PAHs代谢物（polycyclic aromatic hydrocarbons hydroxyl metabolites, OH-PAHs）含量并评估认知功能。2023年4月进行第2次认知功能测试，因岗位调动、离职、退休、未完成测试等原因，有385人失访，最终纳入567名符合条件的工人。纳入标准：在该单位工作时间至少一年，且在最近2个月内未服用过可能影响神经系统的药物。排除标准：具有精神或神经疾病家族史者；近6个月内存在对酒精或药物控制能力极差的成瘾者；过去48 h内参与过高强度体力活动者；以及患有肝脏疾病、肾功能障碍、心血管疾病、自身免疫性疾病、高血压或脑部疾病者。本研究已获山西医科大学伦理委员会批准（2020GLL037），所有参与者均已签署知情同意书。
1.2　研究方法
1.2.1　问卷调查
采用本课题组自编的“基本信息调查问卷”，由受过专业培训的调查员对被调查者进行一对一面谈收集信息。问卷内容包括基本情况、居住状况、日常行为与生活习惯、职业相关情况、既往病史及睡眠状况等。本研究将每天至少吸烟1支且持续时长达到或超过6个月定义为吸烟；将平均每周至少饮酒1次、至多4次且持续时长达到或超过6个月定义为饮酒；将平均每周3次体育活动以上且每次时长超过30分钟定义为经常锻炼。
1.2.2　认知功能测试
作为一种高效且可靠的筛查工具，蒙特利尔认知评估量表（Montreal Cognitive Assessment, MoCA）已被证明在轻度认知功能障碍和阿尔茨海默病早期阶段的检测具有准确性[7–8]，显著优点在于对多个认知领域进行全面评估[9]。本次研究采用北京版MoCA量表，该量表包括8个认知领域[10–11]：视空间和执行能力、命名、记忆、注意力、语言、抽象思维、延迟回忆和定向，总分30分。总分≥26视为认知功能正常，将总分<26分定义为轻度认知障碍（mild cognitive impairment, MCI）阳性。
1.2.3　尿样收集与检测
调查期间，收集工人晨尿中段尿，并将其保存于−80 ℃待后续检测。在检测前将样品取出解冻后实施水解、萃取等一系列预处理，采用高效液相色谱–串联质谱联用仪8050（high performance liquid chromatography with tandem mass spectrometry 8050，HPLC-MS/MS 8050，日本岛津公司）定量检测尿中的11种OH-PAHs[12]。本研究将检出率>50%的8种OH-PAHs代入研究，分别为1–羟基萘（1-OHNAP）、2–羟基萘（2-OHNAP）、2–羟基芴（2-OHFLU）、3–羟基芴（3-OHFLU）、1–羟基菲（1-OHPHE）、2–羟基菲（2-OHPHE）、9–羟基菲（9-OHPHE）和1–羟基芘（1-OHPYR）。
1.3　统计分析
使用Epi data 3.0软件建立数据库，运用SPSS 2.0版和R 4.2.1版统计分析数据。采用频数（百分比）描述计量数据，使用（$ \bar{x} $±s）描述近似或完全服从正态分布的计量资料，以中位数（median, M）和四分位数间距（interquartile range, IQR）描述非正态分布计量资料。采用秩和检验比较两组间非正态计量数据的差异，使用独立样本t检验比较两组间正态分布的计量数据的差异，运用χ2检验分析两组间分类计量数据的差异。依据工人尿液中各OH-PAHs中位数浓度将工人分为低暴露组和高暴露组，参考以往的研究与本次研究中工人的实际情况，调整年龄、性别、BMI、吸烟和饮酒等可能的混杂因素。为探究基线中研究对象PAHs暴露与认知功能之间的联系广义线性回归模型，在纵向研究中采用广义估计方程分析PAHs暴露与认知功能之间的关系。所有分析均采用双侧检验，以P<0.05为差异有统计学意义。
2　结　果
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2.1　基本情况（表1、2）
最终随访567名工人，随访人群年龄与工龄分别为49（46，53）岁和30（27，36）年，失访人群年龄与工龄分别为49（44，53）岁和30（25，34）年。随访人群与失访人群在年龄（t=6.200）、工龄（t=5.601）和体育锻炼（χ2=6.248）方面差异有统计学意义（P<0.05），在性别（χ2=0.112）、BMI（χ2=5.204）、饮酒（χ2=2.427）、吸烟（χ2=4.501）方面差异均无统计学意义（P>0.05）。低暴露组和高暴露组工人在年龄（t=1.518）、体育锻炼（χ2=15.023）、夜班频率（χ2=3.637）方面差异有统计学意义（P<0.05），且低暴露组工人锻炼以及夜班频率明显高于高暴露组工人；在性别（χ2=2.072）、BMI（χ2=2.715）、饮酒情况（χ2=2.536）、吸烟情况（χ2=0.831）方面两组间差异均无统计学意义（P>0.05）。
2.2　MoCA量表得分情况（表3）
进一步分析MoCA量表中的各项得分后发现，视空间与执行能力（t=1.882，t= –3.277）、命名（t=0.885，t= –2.318）、抽象（t=2.838，t= –2.552）和定向（t=2.103，t= –3.012）的得分差异均有统计学意义（P<0.05），且低暴露组得分均高于高暴露组。
2.3　尿中OH-PAHs检出情况（表4）
在尿液OH-PAHs中，2-OHNAP与9-OHPHE浓度相对较高，中位浓度分别为0.314和0.263 ng/mL，检出率为96.8%和98.7%。
2.4　尿中OH-PAHs与工人认知功能的关系（表5、6）
根据各OH-PAHs浓度的中位数分组，调整混杂因素后，基线研究中，2-OHNAP高暴露组的工人视空间和执行能力、抽象、总分得分更低。纵向研究中，总OH-PAHs高暴露组的注意力、抽象得分降低；2-OHNAP高暴露组的注意力、抽象、总分得分降低；1-OHPYR高暴露组的注意力、抽象、总得分均降低，但延迟回忆得分升高；1-OHNAP高暴露组的注意力和延迟回忆得分升高；1-OHNAP高暴露组的注意力得分和9-OHPHE高暴露组的视空间与执行能力得分均升高。
3　讨　论
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本研究从流行病学角度，选取职业人群为研究对象，通过纵向研究探讨职业性PAHs暴露工人尿液中多种OH-PAHs与认知功能之间的联系。失访人群与随访人群的大部分基本信息均无明显差异，表明研究样本在这些基本特征上具有较好的一致性，表明失访现象对研究结果的影响较小。在运用广义估计方程调整所有协变量后发现，长期暴露于高浓度2-OHNAP和1-OHPYR会导致工人认知功能出现减退现象，同时，总OH-PAHs水平与注意力和抽象思维能力也呈负相关关系。本研究属于队列研究，可提示PAHs职业暴露与MCI阳性发生率之间可能存在因果关系。因此，减少职业环境中PAHs浓度可减轻工人的健康损害，对认知功能具有保护作用。本研究为预防多环芳烃诱导的神经毒性提供重要的理论依据，从而有助于减少神经系统相关疾病的发生，保证职业人群的健康。
基线研究中发现，高2-OHNAP暴露的工人视空间和执行能力、抽象思维和总分得分更低；在纵向研究中也发现，低暴露组的工人相比高暴露组工人的2-OHNAP和1-OHPYR注意力、抽象思维及总得分下降幅度更多。总OH-PAHs较多的工人注意力、抽象思维得分更大程度下降；且高暴露组工人MCI检出率高于低暴露组工人。结果提示，2-OHNAP和1-OHPYR对高暴露组工人的注意与集中和抽象思维以及认知能力有更明显的影响，与Lu X等人[13]的研究结论一致。一项针对美国老年人的研究显示，2-OHNAP和尿OH-PAHs混合物与持续注意力、工作记忆和信息处理速度呈负相关。此外，Shahsavani S和Jang H等人[14–15]的研究也发现，尿中OH-PAHs，特别是1-OHPYR和2-OHNAP水平升高与MCI和阿尔茨海默病风险增加显著相关。上述研究提示，PAHs可能对注意力、视空间与执行能力等认知相关功能产生不良影响并且可能进一步加剧神经退行性变的风险。本研究中仅发现高浓度的2-OHNAP与1-OHPYR导致工人的认知功能降低，很可能是由于这两种代谢物在体内的高浓度累积。据报道，接触萘是职业PAHs暴露的一个重要途径，在焦炉作业环境中，萘的含量远超芴和菲，达到3～5倍之多[16]。通过分析尿液样品，OH-NAP已被确认为含量最高的代谢物之一[17–18]，与本研究结果相吻合。此外，Morgan M K等人[19]将1-OHPYR视为PAHs暴露的生物标志物，原因在于芘是PAHs混合物的主要成分。所以，以往的研究多选用1-OHPYR作为PAHs暴露的生物标志物[20]，而本次研究检测11种OH-PAHs，能够更全面且准确地反映PAHs的暴露情况。
本研究也存在一定的局限性。首先，本研究仅为2次调查的样本且人数较少，未来研究需要扩大至多年度的大样本以进行验证。其次，本研究仅检测研究对象的基线尿液代谢物，而后续研究将增加尿液羟基代谢物的检测次数，以更全面反映多环芳烃的暴露情况。最后，本研究尚未评估工人接触其他重金属及颗粒物等因素对认知功能的综合影响。因此，未来的调查与研究需要进一步优化。

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doi: 10.11847/zgggws1146511
  • 接收时间：2024-11-25
  • 首发时间：2026-10-25
  • 出版时间：2025-10-10
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  • 收稿日期：2024-11-25
  • 修回日期：2025-07-25
  • 录用日期：2025-08-13
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    山西医科大学公共卫生学院劳动卫生学教研室，太原 030000

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