铅作业人员尿铅、血锌卟啉和血红蛋白相关性分析  

Study on association between urinary lead,blood zinc protoporphyrin and hemoglobin levels in the workers exposed to lead

作　　者：张胜 涂晓志 徐新云[2] 陈金茹 宾海华 何必隆 赵转地 

机构地区：[1]深圳市宝安区松岗预防保健所,广东深圳518105 [2]深圳市疾病预防控制中心,518055

出　　处：《中国职业医学》2014年第4期428-431,共4页China Occupational Medicine

基　　金：深圳市科技计划项目(201203304)

摘　　要：目的探讨铅作业工人尿铅、血锌原卟啉(ZPP)和血红蛋白(Hb)的相关性。方法以深圳市宝安区2家铅酸蓄电池生产企业92名铅作业工人为接触组,以90名不接触铅的管理人员为对照组,检测接触组工作场所空气中铅烟(尘)的时间加权平均浓度(CTWA),检测2组人员尿铅、ZPP和Hb水平,分析三者的相关性。结果接触组工作场所空气中铅烟(尘)CTWA超标率为66.7%。接触组头晕、头痛、记忆力减退和失眠的检出率均高于对照组(33.7%vs 17.8%,31.5%vs 16.7%,40.2%vs 20.0%,38.0%vs 21.1%,P<0.05),尿铅升高、ZPP升高和Hb下降检出率均高于对照组(6.5%vs 0.0%,5.4%vs 0.0%,13.0%vs 2.2%,P<0.01),观察对象和职业性慢性轻度铅中毒检出率为6.5%。接触组人员尿铅升高分别和ZPP升高、Hb下降呈高度和中度正相关,Spearman秩相关系数(rS)分别为0.908、0.682(P<0.01);ZPP升高和Hb下降呈中度正相关,rS为0.619(P<0.01)。结论尿铅、ZPP和Hb之间存在正相关。建议将ZPP作为铅作业人群职业健康监护的必检项目。Objective To investigate the relationship between urinary lead concentration, blood zinc protoporphyrin （ZPP） levels and hemoglobin （Hb） in the workers exposed to lead. Methods Totally 92 lead workers in two lead-acid battery manufactures in Baoan district of Shenzhen were selected as lead exposure group, 90 management staff without lead exposure were taken as the control group. Urinary lead, Hb and ZPP levels were detected, the time weighted average concentrations （CTWA ） of lead smoke （dust） in workplace air in the lead exposure group were monitored, then the correlation analysis among the three factors were conducted. Results The exceeding standard rate of lead smoke （ dust ） CTWA in workplace air in lead exposure group was 66. 7%. The rates of dizziness, headache, memory,loss and insomnia in lead exposure group were higher than those in control group （33.7% vs 17. 8% , 31.5＂% vs 16. 7% , 40. 2% vs 20. 0% , 38. 0% vs 21.1%, P 〈0. 05）. The rates of elevated urinary lead, ZPP levels and Hb decrease were higher than those of the control group （6. 5% vs 0. 0%, 5.4% vs 0.0%, 13.0% vs 2. 2%, P 〈0. 01）. The rate of observation objects and occupational chronic mild lead poisoning was 6. 5%. Additionally, in lead exposure group, urinary lead increase had high and moderate positive correlation with ZPP increase and Hb decrease, Spearman rank correlation coefficients （ rs ） were 0. 908 and 0. 682 respectively （P 〈 0. 01 ）. ZPP increase and Hb decrease showed moderate positive correlation, rs = 0. 619 （P 〈 0. 01 ）. Conclusion Moderate positive correlation existed among urinary lead, ZPP and Hb. It is suggested that ZPP should be consi-dered as a required test item for the occupational health check of lead exposed workers.

关 键 词：铅 中毒 尿铅 血锌原卟啉 血红蛋白 相关性分析 

分 类 号：R135.11[医药卫生—劳动卫生]