铅作业工人血铅水平与某些健康指标的关系  

Relationship between blood lead levels and the selected indicators for health in workers occupationally exposed to lead

作　　者：陶刚 徐安冬 赵娜 佟锦 吴宇晓 罗小虎[1] TAO Gang;XU An-dong;ZHAO Na;TONG Jing;WU Yu-xiao;LUO Xiao-hu(Department of Toxicant Occupational Disease Testing Laboratory,Xuzhou Caner Hospital,Jiangsu 221000,China)

机构地区：[1]徐州市肿瘤医院毒检室,江苏221000

出　　处：《工业卫生与职业病》2022年第5期396-400,共5页Industrial Health and Occupational Diseases

摘　　要：目的了解徐州市铅作业相关的工人血铅水平特征及相关健康指标变化,为保护铅作业工人健康提供理论依据。方法选择2019年1月1日-2019年12月31日到徐州市职业健康检查机构参加在岗期间职业健康检查的765名铅作业相关的工人作为研究对象,测定其血铅浓度值并收集其部分职业史及健康检查相关指标,分析血铅对铅作业工人健康的影响。结果本次调查与铅作业相关工人血铅含量超标为41人(血铅含量为400~600μg/L),检出率为5.4%,未见慢性铅中毒者。性别、年龄、工龄、企业规模是血铅高值的影响因素,男性、工龄长和大型企业是血铅高值的危险因素。随着年龄、工龄增长和企业规模的扩大,铅作业相关的工人血铅高值的风险增加,经趋势检验,差异有统计学意义(OR=2.32、6.42、11.31,P<0.05)。中浓度组的铅作业相关的工人收缩压[124(114,134)mmHg)]高于低浓度组[119(111,130)mmHg)],差异有统计学意义(Z0=58.39,P<0.05)。高浓度组的谷丙转氨酶(ALT)[33.32(21.21,39.39)U/L]高于中浓度组[29.90(16.10,35.00)U/L]和低浓度组[15.30(9.50,26.75)U/L)],差异有统计学意义(Z=6.33和22.61,P<0.05)。中浓度组的γ-谷氨酰基转肽酶(GGT)[25.77(18.62,32.60)U/L]高于低浓度组[22.29(13.94,29.73)U/L],差异有统计学意义(Z=13.11,P<0.05)。结论徐州市与铅作业相关的工人的血铅水平高于一般人群。性别、年龄、工龄和企业规模是影响血铅高值的因素。血铅升高可引起ALT及GGT的变化,长期铅接触对工人健康会有一定的危害,应采取有效措施控制铅对工人的危害,保护铅作业工人健康。Objective To investigate the levels of blood lead and the change of health indicators in workers exposed to lead,providing theoretical basis for health improvement.Methods A total of 765 workers participated in occupational health examination in Xuzhou during 2019 were recruited as the research subjects.The levels of lead in blood were measured.The data of exposure history and the results of occupational health examination were collected.The effects of blood lead on the health of occupational workers were studied.Results There were 41 persons whose blood lead was above the standard(400-600μg/L),the detection rate was 5.4%,and no people with chronic lead poisoning was found.Significant difference of blood lead was found in groups by gender,age,length of service,and enterprise scales,and multiple logistic regression analysis revealed that man,age,length of service,and enterprise scale were independent risk factors for the high blood lead.The risk of the people with high blood lead increased with age,length of service,and the size of the enterprise,and trend test indicated that the difference was statistically significant(OR=2.32,6.42 and11.31,P<0.05).The mean value of SBP of workers in medium blood lead group[124(114,134)mmHg)]was higher than that in low blood lead group[119(111,130)mmHg](Z=58.39,P<0.05).The ALT of high blood lead group[33.32(21.21,39.39)U/L]was significantly(P<0.05)higher than that of low blood lead group[29.90(16.10,35.00)U/L]and medium blood lead group[15.30(9.50,26.75)U/L],and the GGT of medium blood lead group[25.77(18.62,32.60)U/L]was significantly(Z=13.11,P<0.05)higher than that of low blood lead group[22.29(13.94,29.73)U/L].Conclusions The levels of blood lead in workers exposed to lead were higher than that in controls.Age,length of service,and enterprise scale were found to be the risk factors for high blood lead.High level of blood lead may lead to abnormal ALT and GGT,and chronic exposure of lead will impact the health of workers.Therefore,it is necessary to take effective measures to

关 键 词：血铅 职业性铅接触 肝功能 职业健康 

分 类 号：R135.1[医药卫生—劳动卫生]