铅对工人肝功能和血液及神经系统影响的现场调查  

Effects of lead on liver function,blood and nervous system of workers

作　　者：张小娟 王连兰 辛晓恩 ZHANG Xiao-juan;WANG Lian-lan;XIN Xiao-en(The Fourth People’s Hospital of Qinghai Province,Xining 810000,China;不详)

机构地区：[1]青海省第四人民医院,青海西宁810000 [2]青海省慈铭体检中心,青海西宁810000

出　　处：《工业卫生与职业病》2020年第6期470-473,共4页Industrial Health and Occupational Diseases

摘　　要：目的调查分析铅(Pb)接触对工人的肝功能、血液及神经系统的影响,为该群体职业防护提供参考。方法抽取某工厂265名Pb作业工人为接触组,根据血Pb水平分为高血Pb组(血Pb≥400μg/L)和低血Pb组(血Pb<400μg/L);另选同工厂非铅接触工人或行政人员134名为对照组。检测并比较两组的肝功能指标[天门冬氨酸氨基转移酶(AST)、丙氨酸氨基转移酶(ALT)、谷氨酰肽转移酶(GGT)]、血液指标[血红蛋白(Hb)、红细胞(RBC)计数、白细胞(WBC)计数]、血Pb水平及神经行为评分[包括简易智力状态量表(MMSE)评分和情感状态问卷(POMS)评分]。结果接触组的血Pb、AST、ALT、GGT水平明显高于对照组,Hb、RBC、WBC水平明显低于对照组(P<0.05),血Pb水平超标率、肝功能异常率及血液指标异常率均高于对照组(P<0.05);接触组的MMSE评分明显低于对照组,POMS中除有力-好动外各维度评分均高于对照组(P<0.05)。高血Pb组的肝功能异常率及血液指标异常率均明显高于低血Pb组(P<0.05),MMSE评分明显低于低血Pb组(P<0.05),POMS各维度评分均高于低血Pb组(P<0.05)。结论长期Pb接触可引起工人肝功能损害、血液指标异常及神经系统损害,且随着血Pb浓度的升高损害有加重趋势。企业需强化职业性Pb接触防护措施。Objective To investigate and analyze the effects of lead(Pb)exposure on the liver function,blood and nervous system of workers,so as to provide reference for occupational protection of this group.Methods Two hundred and sixty-five Pb exposed workers in a certain factory were selected as the exposure group.According to their blood Pb levels,they were divided into the high-blood Pb group(blood Pb≥400μg/L)and the low-blood Pb group(blood Pb<400μg/L).The control group was selected as 134 non-lead exposed workers or administrators.Liver function index[aspartic acid transaminase(AST),alanine aminotransferase(ALT),glutamine peptide transferase(GGT)],blood index[hemoglobin(Hb),red blood cell count(RBC),white blood cell count(WBC)],blood Pb level and neurological function score[including simple intelligence scale(MMSE)score and emotional state(POMS)questionnaire score]were tested and the results were compared between these two groups.Results The levels of Pb,AST,ALT and GGT in the exposure group were significantly higher than those in the control group,while the levels of Hb,RBC and WBC in the exposure group were significantly lower than those in the control group(P<0.05).The MMSE scores of the exposure group were significantly lower than those of the control group,and the scores of all dimensions in POMS were higher than those of the control group except for power-to-hyperactivity(P<0.05).The abnormal rate of liver function and blood index in the high blood Pb group was significantly higher than that in the low blood Pb group(P<0.05),the MMSE score was significantly lower than that in the low blood Pb group(P<0.05),and the POMS score in all dimensions was higher than that in the low blood Pb group(P<0.05).Conclusions Long-term lead exposure can lead to liver function damage,abnormal blood index and nervous system damage in workers,which will be aggravated with the increase of blood Pb concentration.Enterprises need to strengthen occupational exposure to lead protection measures.

关 键 词：铅接触 肝功能 血液系统 神经系统 

分 类 号：R135.1[医药卫生—劳动卫生]