某蓄电池厂工人血铅水平及其与血锌原卟啉的相关性  

Blood lead levels and the association with zinc protoporphyrin in battery factory workers

作　　者：赵秋妮 张恒东[2] 陈林[1,2] 朱宝立[1,2] 

机构地区：[1]东南大学公共卫生学院,江苏南京210009 [2]江苏省疾病预防控制中心职业病防治所,江苏南京210028

出　　处：《环境与职业医学》2017年第4期311-315,共5页Journal of Environmental and Occupational Medicine

基　　金：江苏省临床医学科技专项(编号:BL2014082)

摘　　要：[目的]探讨影响职业性铅作业工人血铅水平的因素,并分析其与血锌原卟啉(ZPP)的相关性。[方法]以江苏省某蓄电池厂所有454名员工(男性300名,女性154名)作为研究对象,对其工作岗位空气中铅浓度进行现场检测。采用问卷调查的形式记录工人吸烟、饮酒等行为习惯,测定其血铅及ZPP,将血铅质量浓度大于400μg/L作为高血铅组,<100μg/L作为低血铅组,100~400μg/L之间的人群作为中血铅组,进行统计分析。以血铅作为接触标志,ZPP作为效应标志,采用基准剂量计算软件(BMDS 2.6.1)计算血铅基准剂量和基准剂量的95%可信区间下限(BMDL)。[结果]三组研究对象的单因素分析中,血铅值、年龄、受教育程度、工种、工龄、接铅工龄、吸烟和饮酒分布差异有统计学意义;logistic回归分析发现受教育程度低、工种为操作工、饮酒、接铅工龄短是血铅水平增高的危险因素;线性相关分析显示血铅在100~400μg/L范围内和ZPP具有正相关性(P<0.001)。以血铅作为接触标志,ZPP作为效应标志,血铅基准剂量和BMDL分别为562.23μg/L和441.13μg/L(P=0.78)。[结论]在血铅水平较高时,血铅与ZPP具有较好的正相关性,ZPP是铅接触的敏感效应生物标志。在实际工作中应用ZPP作为低血铅水平(<100μg/L)的筛查指标时,应注意和其他指标联合应用。[ Objective ] To assess the factors influencing blood lead levels of workers occupationally exposed to lead, and the association between zinc protoporphyrin （ZPP） and blood lead. [ Methods ] A total of 454 workers （300 males and 154 females） in a lead battery factory located in Jiangsu Province were recruited in the study. Lead concentrations in workplace air were measured. All the subjects underwent structured questionnaire survey on lifestyle and measurement of blood lead and ZPP. Workers with blood lead 〉400 μg/L, 100-400 μg/L, and 〈100 μg/L were stratified into high, medium, and low blood lead groups for statistical analysis respectively. Benchmark dose calculation software （BMDS 2.6.1） was used to calculate blood lead benchmark dose and the 95% lower confidence limit of benchmark dose （BMDL） by applying blood lead as the exposure marker and ZPP as the effect marker. [ Results ] Statistical differences among the three groups were observed in blood lead, age, educational level, type of work, job seniority, lead-exposed seniority, smoking, and drinking in univariate analysis. Low educational level, operation worker, drinking, and short lead-exposed seniority were the risk factors of high blood lead in logistic regression analysis. There was a positive linear correlation between ZPP and blood lead （100-400 μg/L） （P 〈 0.001）. The blood lead benchmark dose and the related BMDL were 562.23 μg/L and 441.13 μg/L, respectively （P=0.78）.[ Conclusion ] High-level btood lead and ZPP are positively correlated, and ZPP is a sensitive indicator of lead exposure. In practical work, other indicators should be combined with ZPP when screening workers with low blood lead level （〈100 μg/L）.

关 键 词：血铅值 锌原卟啉 铅中毒 职业卫生 筛查 

分 类 号：R135.11[医药卫生—劳动卫生]