铬酸盐职业接触人群全血中铬、铅、镉、锰水平与红细胞相关指标的关联  

Association between whole blood levels of chromium,lead,cadmium,manganese and erythrocyte-related indicators in people occupationally exposed to chromates

作　　者：龙昌茂 胡贵平 闫赖赖[2] 余善法 王天成[5] 贾光[2] LONG Chang-mao;HU Gui-ping;YAN Lai-lai;YU Shan-fa;WANG Tian-cheng;JIA Guang(School of Public Health,Nanchang University/Jiangxi Provincial Key Laboratory of Preventive Medicine,Nanchang 330006,China;School of Public Health,Peking University;School of Engineering Medicine,Beihang University/Key Laboratory of Big Data-Based Precision Medicine(Beihang University),Ministry of Industry and Information Technology of the People’s Republic of China;Henan Institute for Occupational Medicine;Department of Clinical Laboratory,Peking University Third Hospital)

机构地区：[1]南昌大学公共卫生学院江西省预防医学重点实验室,南昌330006 [2]北京大学公共卫生学院 [3]北京航空航天大学医学科学与工程学院大数据精准医疗工信部重点实验室 [4]河南省职业病防治研究院 [5]北京大学第三医院临床检验科

出　　处：《环境卫生学杂志》2023年第6期405-415,共11页JOURNAL OF ENVIRONMENTAL HYGIENE

基　　金：国家自然科学基金项目(82003427;U2004202)。

摘　　要：目的探讨铬酸盐职业接触人群全血中铬、铅、镉、锰水平与红细胞相关指标的关联。方法根据纳入排除标准,选择铬酸盐接触人群170人和非接触人群123人,收集研究对象的全血和基本信息,采用电感耦合等离子体质谱检测研究对象全血铬、铅、镉和锰的浓度,使用血细胞自动分析仪测定全血中红细胞相关指标。运用加权分位数和回归(weighted quantile sum,WQS)、分位数g计算和贝叶斯核机器回归(Bayesian kernel machine regression,BKMR)分析全血血铬、铅、镉和锰水平与红细胞相关指标的关联。结果铬酸盐接触组人群的全血铬中位数[2.34(1.38,4.59)μg/L]和全血锰中位数[14.08(11.37,17.35)μg/L]显著高于对照组[1.01(0.71,1.94)μg/L]和[11.95(10.07,14.80)μg/L],两组人群全血铅和血镉无显著统计学差异。在控制年龄、性别、文化程度、BMI、吸烟及饮酒等混杂因素后,与对照组相比,接触组人群中红细胞计数(red blood cell count,RBC)、红细胞压积(hematocrit,HCT)以及红细胞体积分布宽度变异系数(coefficient variation of red blood cell volume distribution width,RDW-CV)升高(P<0.001),而平均血红蛋白量(mean corpuscular hemoglobin,MCH)、平均血红蛋白浓度(mean corpuscular hemoglobin concentration,MCHC)及红细胞分布宽度标准差(standard deviation in red cell distribution width,RDW-SD)显著降低(P<0.001)。WQS分析显示重金属总体水平与RBC、血红蛋白(hemoglobin,HGB)、HCT、红细胞平均体积(mean corpuscular volume,MCV)和RDW-CV呈整体正相关,其中锰的权重系数最大;分位数g计算和BKMR分析显示RBC和RDW-CV与重金属混合物总体水平呈正相关,而MCH和RDW-SD与重金属混合物总体水平呈负相关。分位数g计算分析显示重金属混合物中引起铬酸盐劳动者RBC增加的主要金属为铬;BKMR分析显示重金属混合物水平从第25个百分数上升到第75个百分数时,RBC增加了42.3%。结论铬酸盐职业接触可能引�Objective To investigate the association between the whole blood levels of chromium,lead,cadmium,manganese and erythrocyte-related indicators in people with occupational exposure to chromates.Methods A total of 170 people exposed to chromates and 123 non-exposed people were selected according to the inclusion and exclusion criteria,and their whole blood samples and basic information were collected.The mass concentrations of chromium,lead,cadmium,and manganese in whole blood were measured by inductively coupled plasma mass spectrometry.The indices of red blood cells(RBC)were analyzed by using an automatic blood cell analyzer.The relationship between blood levels of chromium,lead,cadmium,manganese and erythrocyte related indexes was analyzed using weighted quartile sum(WQS)regression,quartile g-computation,and Bayesian kernel machine regression(BKMR).Results The chromate exposure group showed significantly higher median blood levels of chromium(2.34[1.38,4.59]μg/L vs 1.01[0.71,1.94]μg/L)and manganese(14.08[11.37,17.35]μg/L vs 11.95[10.07,14.80]μg/L)than the control group.There were no significant differences in blood levels of lead and cadmium between the two groups.After controlling for confounding factors such as age,sex,education level,body mass index,smoking,and alcohol drinking,the exposure group showed significantly higher red blood cell count(RBC)count,hematocrit(HCT),and coefficient variation of red blood cell volume distribution width(RDW-CV)and significantly lower mean corpuscular hemoglobin(MCH),mean corpuscular hemoglobin concentration(MCHC),and standard deviation in red cell distribution width(RDW-SD)(all P<0.001)compared with the control group.The WQS analysis showed that the overall level of heavy metals was positively correlated with RBC count,hemoglobin,hematocrit,mean corpuscular volume,and RDW-CV,with the largest weight coefficient of manganese.Quartile g-computation and BKMR showed that the overall level of the heavy metal mixture was positively correlated with RBC count and RDW-CV,and negat

关 键 词：重金属 红细胞 加权分位数和回归 分位数g计算 贝叶斯核机器回归 

分 类 号：R12[医药卫生—环境卫生学]