上海市2012—2017年非传统严重铅污染行业作业人员血铅水平及影响因素  

Blood lead levels and related risk factors among workers in non-traditional industries with heavy lead pollution in Shanghai in 2012-2017

作　　者：顾明华[1] 吕玲 章敏华[1] 包黎明 方亚敏[1] GU Ming-hua;LU Ling;ZHANG Min-hua;BAG Li-ming;FANG Ya-min(Department of Occupational Health Surveillance,Shanghai Municipal Center for Disease Control and Prevention,Shanghai 200336,China;Department of Occupational Diseases,Huashan Hospital Affiliated to Fudan University,Shanghai 200040,China;Geisel School of Medicine at Dartmouth College,New Hampshire NH03755,USA）.)

机构地区：[1]上海市疾病预防控制中心职业健康监护科,上海200336 [2]复旦大学附属华山医院职业病科,上海200040 [3]达特茂斯学院盖泽尔医学院,美国新罕布什尔州nh03755

出　　处：《环境与职业医学》2018年第9期816-820,共5页Journal of Environmental and Occupational Medicine

摘　　要：[目的]分析上海市非传统严重铅污染行业作业人员的血铅水平,发现该人群血铅水平的流行特征。[方法]选择2012—2017年上海市疾病预防控制中心职业健康监护信息系统中非传统严重铅污染行业(机械制造、电子加工、新能源、五金电器、汽车及配件制造等行业)作业人员7 382人作为暴露组,另外选择铅作业岗前人员875人作为未暴露组;采集研究对象空腹血样,使用石墨炉原子吸收光谱法测定血铅水平。计算并比较不同分组间血铅限下高值(100~399.9μg/L)发生率。采用多元logistic回归分析方法建立方程,探讨铅作业暴露、性别、年龄、吸烟、饮酒和铅接触工龄对血铅水平的影响。[结果] 2012—2017年上海市非传统严重铅污染行业作业人员血铅值≥400μg/L的发生数为0;血铅限下高值的发生率为3.10%(229/7 382),血铅≥50μg/L的发生率为12.07%(891/7 382)。多元logistic回归分析结果显示:铅暴露、吸烟和男性是发生血铅限下高值的独立危险因素,其OR(95%CI)分别为1.67(1.03~2.69)、1.58(1.13~2.22)和1.52(1.11~2.10);40岁以上人群的血铅限下高值发生率明显高于30岁以下人群(P <0.001)。[结论]上海市非传统严重铅污染行业作业人员的血铅处于较低水平。男性、吸烟、较大年龄的铅作业人员应成为职业健康监护的重点。[ Objective ] To analyze the blood lead levels of workers in non-traditional industries with heavy lead pollution in Shanghai, and describe the epidemiological pattern of blood lead levels in this population. [ Methods ] We selected 7 382 lead workers engaged in non-traditional heavy lead pollution industries including machinery manufacturing, electronic processing, new energy, electric hardware, and automobile and accessories manufacturing as exposure group and another 875 pre-service workers as non-exposure group from the occupational Health Surveillance Information System of Shanghai Municipal Center for Disease Control and Prevention in 2012-2017. Fasting blood samples were collected from all subjects. Graphite furnace atomic absorption spectrometric method was applied to measure the blood lead levels. We compared the incidence of high blood lead （100-399.9 μg/L） among different groups. Multiple logisticregression analysis was used to explore the effects of lead exposure, gender, age, smoking, drinking, and length of service on blood lead levels. [ Results ] In this study, none of the workers＇ blood lead levels exceeded 400 μg/L. The incidence of high blood lead （100-399.9 μg/L） was 3.10% （229/7 382） and the incidence of blood lead ≥ 50 μg/L was 12.07% （891/7 382）. Multiple logistic regression analyses revealed that lead exposure, smoking, and men were the independent risk factors for high blood lead, and the ORs （95%CI） were 1.67 （1.03-2.69）, 1.58 （1.13-2.22）, 1.52（1.11-2.10）, respectively. The incidence rate of high blood lead was significantly higher in those aged over 40 years than in those under 30 （P 〈 0.001）. [ Conclusion ] The blood lead levels of workers in non-traditional industries with heavy lead pollution are at a low level in Shanghai. Men, smoking, and older lead workers should be the key populations of occupational health surveillance.

关 键 词：铅 血铅 职业暴露 流行病学 

分 类 号：R135.11[医药卫生—劳动卫生]