依据2005 - 2014年全国饮水型砷中毒病区尿砷数据分析人群尿砷安全指导值  

Analysis of safety guidance value of urinary arsenic in population by using the data of urinary arsenic in the drinking water arsenic poisoning area from 2005 to 2014

作　　者：包莹 李俊骏 李悦 李冰洋 霍思梦 范玉梅 严画竹 杨艳梅 高彦辉 佟建冬[2] 张海涛[2] 侯晓东[3] Bao Ying, Li Janjun, Li Yne, Li Bingyang, Huo Simeng, Fan Yumei, Yan Huazhu, Yang Yanmei, Gao Yanhui, Tong Jiandong, Zhang Haitao, Hou Xiaodong(1 Institute of Endemic Fluorasis, Center for Endemic Disease Control, Chinese Center for Disease Control and Prevention, Harbin Medical University, Harbin 150081, China ; 2Jilin Province Institute of Endemic Disease Prevention and Control, Baicheng 137000, China; 3Tongyu County Center for Disease Control of Baicheng City Jilin Province, Tongyu 137200, China)

机构地区：[1]哈尔滨医科大学中国疾病预防控制中心地方病控制中心地氟病防治研究所,哈尔滨150081 [2]吉林省地方病第一防治研究所,白城137000 [3]通榆县疾病预防控制中心,通榆县137200

出　　处：《中华地方病学杂志》2018年第5期370-374,共5页Chinese Journal of Endemiology

基　　金：国家卫生计生委标准制修订项目(20160401)

摘　　要：目的 研究人群尿砷安全指导值，用以评价人群的砷暴露水平，为地方性砷中毒病区防治措施落实效果评价提供依据。方法 利用2005 - 2014年全国饮水型砷中毒病区高砷水源筛查以及改水工程质量监督检测数据资料、全国地方性砷中毒病区砷中毒普查数据资料、地方性砷中毒监测数据资料，筛选出个人信息资料详实、水砷暴露资料完整、尿砷检测资料准确的人群作为研究对象，共10 722人。其中，利用2013、2014年4 501人的调查数据进行尿砷与水砷相关关系分析，并以水砷暴露剂量在（0.050 ± 0.005）mg／L范围内的人群为研究对象，确定该人群的尿砷几何均数，将该几何均数作为安全指导值。利用2005 - 2012年6 221人的资料进行安全指导值验证，每次抽取2 000人作为验证样本，使用受试者工作特征曲线（ROC）下面积（AUC）判定该指标对于区分水砷暴露是否超标的灵敏度和特异度，共计进行10次抽样验证。结果 水砷≤0.01 mg／L时，水砷与尿砷的相关系数（r）为0.097（P 〈 0.01）；水砷 〉 0.01 - 0.05 mg／L时，尿砷与水砷的r值为0.456（P 〈 0.01）；水砷 〉 0.05 mg／L时，水砷与尿砷的r值为0.630（P 〈 0.01）。随着水砷的含量升高尿砷显著增加，且差异有统计学意义（χ2 = 2 337.956，P 〈 0.01）。水砷在（0.050 ± 0.005）mg／L范围内，人群尿砷几何均数为0.032 mg／L。以人群尿砷几何均数为0.032 mg／L为安全指导值，10次抽样验证的AUC值均 〉 0.94，能准确判定该人群的水砷暴露水平是否超过0.05 mg／L且灵敏度和特异度达到0.898、0.844。结论 人群尿砷几何均数为0.032 mg／L可以作为人群尿砷安全指导值。当人群尿砷几何均数超过该指标时，可提示该人群有较高的砷暴露风险。Objective To study the urinary arsenic safety guideline value of a population for evaluating the arsenic exposure level in a certain population and providing evidence for the implementation of prevention and control measures in endemic arsenicosis area. Methods According to the data from the national high-arsenic drinking water sources screening in endemic arsenicosis area of drinking water type and quality supervision and inspection for water-improving project to decrease arsenic from 2005 to 2014, census data on arsenic poisoning in endemic arsenicosis area, data on surveillance of endemic arsenicosis, 10 722 people with detailed personal information, complete water arsenic exposure data and accurate urinary arsenic detection data were selected to be the research objects. The relationship between urinary arsenic and water arsenic was analyzed based on the surveillance data of 4 501 people from 2013 to 2014. The safety guidance value of urinary arsenic was determined based on the geometric mean value of urinary arsenic in people exposed to water arsenic in the range of （0.050 ± 0.005） mg/L, and verified using the data of 6 221 people from 2005 to 2012. Every time, a random sample of 2 000 people was taken as the verification sample, the sensitivity and specificity of the index for determining whether water arsenic exposure exceeded the standard were determined by area under the ROC curve （AUC）, and a total of 10 sample tests was performed. Results When the water arsenic concentration was less than 0.01 mg/L, the correlation coefficient of water arsenic concentration with urinary arsenic concentration was 0.097 （P 〈 0.01）; when the water arsenic concentration was more than 0.01 mg/L and less than 0.05 mg/L, the correlation coefficient of arsenic concentration with water arsenic concentration was 0.456 （P 〈 0.01）; when the water arsenic concentration was more than 0.05 mg/L, the correlation coefficient of water arsenic concentration with urinary arsenic concentration was 0.630 （P 〈 0.01）

关 键 词：砷中毒 尿 水 

分 类 号：R599.1[医药卫生—内科学]