铅作业工人早期铅损害监测指标研究  

Research on early lead damage monitoring index among lead-exposed workers

作　　者：郭恩谊 李金凤[2] 付志斌[2] 赵春香[2] 陈福尊[2] 常凤启[2] 王晓波[1] 袁聚祥 

机构地区：[1]广东药科大学公共卫生学院,广东广州510310 [2]河北省疾病预防控制中心,河北石家庄050019 [3]华北理工大学公共卫生学院,河北唐山063009

出　　处：《职业与健康》2017年第4期448-451,共4页Occupation and Health

基　　金：河北省科技支撑计划重点项目(13277709D)

摘　　要：目的分析铅作业工人接触生物标志物及生化指标,筛选铅损害的早期监测指标。方法采用职业流行病学调查方法,选取2013—2014年间河北省保定市徐水县的460例蓄电池制造行业接触铅工人作为接铅组,100例非接触铅工人为对照组,对两组人员进行职业健康检查。分析两组人群血铅、尿铅、唾液铅与血液生化指标水平。结果接铅组血铅、尿铅平均水平较对照组高(Z=-7.269,Z=-4.176,P<0.05)。血铅与血尿酸呈正相关[Pearson相关系数(r)=0.257,P<0.05]。控制年龄因素后,血铅与收缩压呈正相关(相关系数为0.216,P<0.01)。血尿酸与丙氨酸转氨酶(ALT)呈正相关(r=0.504,P<0.05),与收缩压呈正相关(r=0.399,P<0.05)。随着年龄增加,血铅与血尿酸、收缩压的相关系数逐渐增大。在低浓度血铅(0.97~1.90μmol/L,未达到观察对象时),接铅组血尿酸水平与对照组差异有统计学意义(t=4.454,P<0.05)。结论职业性铅接触可引起工人血铅、收缩压、血尿酸升高。血尿酸联合ALT、收缩压升高有可能成为铅损害的早期监测指标,随年龄增高铅损害的敏感性增加。[Objective] To analyze the lead-exposure biomarkers and biochemical indexes of lead-exposed workers,screen the early monitoring indexes of lead damage.[Methods]In Xushui county of Baoding of Hebei Province,460 lead-exposure workers of battery manufacturing industry as the exposure group and 100 workers without lead exposure as the control group were selected by occupational epidemiological investigation from 2013-2014. The occupational health examination was performed in two groups to analyze the levels of blood lead,urine lead,saliva lead,and blood biochemical indexes.[Results]The levels of blood lead of urine lead in the exposed group were higher than those in the control group（Z=-7.269,Z=-4.176,P〈0.05）. The blood lead level was positively correlated with serum uric acid level[Pearson correlation coefficient（r）was 0.257,P〈0.05]. After controlling for age,the blood lead level was positively correlated with systolic blood pressure（partial correlation coefficient was 0.216,P〈0.001）. Serum uric acid level was positively correlated with alanine aminotransferase（ALT）activity（r=0.504,P〈0.05）and systolic blood pressure（r=0.399,P〈0.05）. With the increase of age,the correlation coefficient between blood lead and serum uric acid,systolic blood pressure increased gradually. In the low blood lead level group（0.97-1.90 μmol/L,which did not reach the standard of the observation objects）,there was statistically significant difference in serum uric acid level between the exposure group and the control group（t=4.454,P〈0.05）.[Conclusion]Occupational lead exposure may induce elevated increase blood lead,systolic blood pressure and blood uric acid in workers. The blood uric acid level combined with increased ALT and systolic blood pressure can be used as the early monitoring indexes of lead damage,and the sensitivity to lead damage increase with increasing age.

关 键 词：铅暴露 血铅 血压 血尿酸 

分 类 号：R135.11[医药卫生—劳动卫生]