某铜冶炼厂448名铅作业人员职业健康检查结果  

Occupational health examination results of 448 lead-exposed workers in a copper smelter

作　　者：刘颖 李文鹏 胡定海 

机构地区：[1]昆明市东川区疾病预防控制中心公共卫生科,云南昆明654100

出　　处：《职业与健康》2017年第6期737-739,743,共4页Occupation and Health

摘　　要：目的了解铜冶炼企业铅作业工人铅接触情况并探索铅职业接触人群健康损伤效应的敏感生物指标,为采取有效的保护措施提供依据。方法以昆明市东川区某中型铜冶炼生产企业448名铅作业工人为铅接触组,以200名不接触铅的管理、行政、营销、后勤等非接铅作业者列为对照组。检测工作场所空气中铅烟(尘)的时间加权平均浓度(C_(TWA)),检测2组人员尿铅、红白细胞锌原卟啉和血红蛋白水平分析相关性。结果尿铅检测648人,超标7人,浓度范围为1.0~220μg/L,工人工龄均值7.2 a,年龄均值40.2岁,平均尿铅浓度为(22.3±19.66)μg/L。接铅组工作场所空气中定点铅烟(尘)的时间加权平均浓度(C_(TWA))超标率为16.7%,个体接触铅烟(尘)C_(TWA)超标率为15.2%。尿铅升高、ZPP升高和Hb下降检出率与对照组检出率差异无统计学意义;铅中毒观察对象和疑似职业性慢性轻度铅中毒检出率为0.5%和0.6%;心电图的异常检出率最高(19.60%);尿铅、Hb与ZPP间不存在显著的线性相关。结论该厂应加强作业场所的监测评价和职业健康监护工作,对于铅超标岗位采取积极有效的防护措施,在职业健康体检建议选择合适的铅检测指标,结合红细胞锌原卟啉检测,能更好地反映铅对人体的生物学意义。[Objective] To understand the lead exposure situation among workers in a copper smelter,to explore the sensitive biomarker of health damage effect,and provide evidence for taking effective protection measures.[Methods]A total of 448 leadexposed workers from a medium-sized copper smelting production enterprise in Dongchuan District of Kunming City were recruited as lead-exposed group,another 200 worker without lead exposure in divisions of management,administration,marketing and logistics were selected as control group. The time weighted average concentration（CTWA）of lead smoke（dust）in workplace air was detected,and the correlation between urine lead,zinc protoporphyrin of leukocyte and erythrocyte and Hemoglobin level was analyzed.[Results]A total of 648 workers received urine lead detection, 7 over standard, the concentration ranged from 1.0-220 μg/L,the mean length of service was 7.2 years,the mean age was 40.2 years,and mean urine lead concentration was22.3±19.66 μg/L. The over-standard rate of CTWAof lead smoke（dust）in workplace air was 16.7% among lead-exposed group,that of individual lead exposure was 15.2%. Between lead-exposed group and control group,the differences of the urine lead increasing,ZPP increasing and Hb decreasing were not significant. The detection rates of lead poisoning observation object and suspected slightly chronic lead poisoning were 0.5% and 0.6%. The ECG abnormal rate was highest（19.60%）. There was no significant linear correlation between urine lead, Hb and ZPP.[Conclusion]It is necessary to enhance monitoring and occupational health surveillance,and to take effectively protection measures in this factory. The appropriate lead detection index in occupational health examination combined with erythrocyte zinc protoporphyrin detection can better reflect the biological significance of lead to human body.

关 键 词：铅作业 职业健康检查 尿铅 

分 类 号：R135.11[医药卫生—劳动卫生]