镉致人体健康损害的环境流行病学研究  

Environmental Epidemiology:Human Health Impacts Caused by Cadmium

作　　者：金泰廙[1] 孔庆瑚 叶葶葶[3] 王洪复[4] 蒋学之[1] 汪再娟 朱国英[4] 吴训伟[1] 曾祥斌[1] 薄梅花[3] 

机构地区：[1]复旦大学公共卫生学院劳动卫生教研室,上海200032 [2]浙江医学科学院环境卫生研究室,杭州310013 [3]复旦大学公共卫生学院预防医学教研室,上海200032 [4]复旦大学医学院放射医学研究所,上海200032

出　　处：《环境与职业医学》2002年第1期10-16,共7页Journal of Environmental and Occupational Medicine

基　　金：欧共体INCO DC项目 (No .ERB351 4PL971 4 30 );瑞典发展中国家科研合作基金 (SWE 94 1 4 7;SWE 96 1 73和SAREC 1 997 0 4 85)

摘　　要：[目的 ]通过对环境镉接触人群的流行病学调查 ,探讨和评价环境镉接触和所致人体健康不良效应间的剂量 效应关系。 [方法 ]选择居住在污染区 3 5年以上并以当地自产米为主食的居民为调查对象 ,通过问卷和体检收集其既往接触史及健康状况 ,同时采集血、尿等样本 ,以尿镉、血镉和估计镉摄入量作为镉接触生物标志物 ;以尿 β2 微球蛋白、视黄醇结合蛋白、NAG酶和白蛋白 (肾损害 )、骨密度 (骨损害 )和性激素及前列腺特异抗原 (男性生殖系统损害 )为损害效应生物标志物。 [结果 ]不同污染地区调查对象的体内镉负荷与环境镉污染程度呈正相关 ,且各地区间调查对象尿镉水平差异具有显著性 (P <0 0 1)。值得注意的是 ,不同性别之间的尿镉水平存在明显的差别 ,女性高于男性。对照组尿镉均低于 5 μg/L ,低接触组大多小于 5 μg/L ,但高接触组大多大于 5 μg/L ,而且大多数尿镉异常增高者也在该组中。高污染区居民尿中 β2 微球蛋白、视黄醇结合蛋白、NAG酶和白蛋白水平均显著高于对照区 ,且与镉接触 (尿镉 )有着明显的剂量 效应关系。研究同时提示镉引起肾脏损害的广泛程度与镉接触的水平有关 :低剂量时仅累及 1～ 2个肾小管效应生物标志物变化 ,而高剂量时则引起 2个以上肾小管效应生物标志物的变化。An assessment of the dose response relationships between cadmium exposure and its adverse effects on kidney,bone and male reproduction,would be performed in a polluted area near a smelting factory. Population groups with different levels of cadmium exposure via rice were compared with controls concerning:measured cadmium concentration in urine (UCd) and blood,estimated cadmium uptake,(exposure biomarkers) and renal effect biomarkers (urinary beta 2 microglobulin,NAG,retinol binding protein,and albumin). Bone density was measured in the same population groups by external measurements. Male persons were invited to join a sex hormones test. Specific prostate antigen (SPA),an index used for the diagnosis of prostate cancer,was measured in the male participants. There were significant differences in urinary cadmium concentration of residents in the different areas and these differences were related to the extent of exposure to cadmium. It was also obvious that urinary cadmium concentration in females were higher than those in males,even in each subgroup. It was shown that all the UCd values were less than 5 μg/L in the control area. In the medium exposure area,most of the UCd values also were lower than 5 μg/L. On the contrary,in the high exposure area most of the UCd values were more than 5 μg/L and higher UCd values were almost exclusively found in this area. The studies generated new and important knowledge about the dose response relationships for kidney dysfunction using biomarkers. In other words,the prevalence of renal dysfunction was increased following the increase in dose of cadmium exposure. The occurrence of kidney dysfunction caused by cadmium exposure is related to the extent of cadmium exposure. The hierarchical classification of glomerular and tubular damage was applied to analysis the relationship with cadmium exposure(cadmium in urine and blood and cadmium uptake). There were significant differences between total,glomerular and tubular damages and cadmium exposure. Cadmium is one of the

关 键 词：镉 环境接触 肾功能损害 骨质疏松 男性生殖系统损害 剂量-效应关系 

分 类 号：R181.34[医药卫生—流行病学]