铅接触工人血铅水平对职业健康检查指标影响  

Effects of blood lead level on the occupational health examination index in workers with lead exposure

作　　者：苏冬梅 赵凤玲 鲁效峰 

机构地区：[1]河南省职业病防治研究院,河南郑州450052

出　　处：《中国职业医学》2017年第1期60-64,共5页China Occupational Medicine

基　　金：国家科技支撑计划项目(2014BAI12B01);国家重点临床专科建设项目(2011-17)

摘　　要：目的分析蓄电池企业铅接触工人血铅水平对职业健康检查有关指标的影响。方法采用判断抽样法,以412名蓄电池企业铅接触工人为研究对象,根据血铅水平分为<100.0、100.0~、200.0~、300.0~和400.0~μg/L组,分析血铅水平对工人的临床症状、心电图、尿常规、血压、肝功能和血常规等指标的影响。结果 412名工人血铅水平中位数和第25、75百分位数[M(P25,P75)]为169.0(76.6~320.4)μg/L,血铅超标(血铅水平≥400.0μg/L)率为12.6%,男性工人血铅水平高于女性工人[225.8(91.3,351.2)vs 131.0(64.6,248.9)μg/L,P<0.01]。女性工人中,血铅水平<100.0μg/L组的心电图异常率低于400.0~μg/L组(6.7%vs 41.2%,P<0.005),血铅水平<100.0μg/L组的舒张压水平低于300.0~μg/L组[(78.4±11.7)vs(72.6±5.6)mm Hg,P<0.01]。Spearman相关分析结果显示,尿β2-微球蛋白水平与血铅水平无相关关系[秩相关系数(rS)=-0.044,P=0.82],诊断性驱铅试验24 h尿铅水平与血铅水平呈正相关关系(rS=0.657,P<0.01)。结论血铅对女性心血管的影响较男性明显,常规的肝功能指标和尿常规(尿蛋白)指标不能早期反映铅的肝、肾毒性。Objective To investigate the effects of blood lead level on the occupational health examination index in workers with lead exposure. Methods Using judgment sampling method,412 workers exposed to lead from a lead acid battery factory were selected. According to the blood lead levels,the participants were divided into 5 groups（ 〈100. 0,100. 0-,200. 0-,300. 0- and 400. 0- μg / L）. The effects of blood lead level on the health status of the workers such as clinical symptoms,electrocardiogram（ ECG）,routine urine and blood pressure,liver function and blood routine were analyzed.Results The median（ the 25 th and 75 th percentiles） of the blood lead level was 169. 0（ 76. 6,320. 4） μg / L in the 412 workers,and over standard rate was 12. 6%. Male workers ＇blood lead level was higher than that of female workers[225. 8（ 91. 3,351. 2） vs 131. 0（ 64. 6,248. 9） μg/L,P〈0. 01]. In the female workers,the abnormal rate of ECG in the 100. 0 μg / L group was lower than those of the 400- μg / L group（ 6. 7% vs 41. 2%,P〈 0. 005）; the level of diastolic pressure in the 〈100. 0 μg / L group was lower than that of the 300. 0- μg / L group [（ 78. 4 ± 11. 7） vs（ 72. 6 ±5. 6） mm Hg,P〈0. 01]. It was no correlation between blood lead level and urine β2-microglobulin（ rS=- 0. 044,P =0. 82）,while it was positive correlation between blood lead level and 24 hours urine lead content（ rS= 0. 657,P〈0. 01）.Conclusion Lead exposed could cause the increase of cardiovascular abnormalities in female workers than that of male workers. Routine blood index,liver function index and routine urine index（ urine protein） could not early reflect the blood,liver and kidney toxicity of lead.

关 键 词：血铅 血压 心电图 尿Β2-微球蛋白 职业健康检查 

分 类 号：R135.11[医药卫生—劳动卫生]