电焊烟尘的金属组分对甲状腺功能的影响研究  

Influences of welding fume metal composition on the thyroid function of welders

作　　者：刘霖[1] 罗永斌 戴霞云 LIU Lin;LUO Yong-bin;DAI Xia-yun(Wuhan Childrens Hospital(Wuhan Maternal and Child Health Hospital,Wuhan Women and Childrens Health Care Center)Tongji Medical,Huazhong University of Science&Technology,Wuhan,Hubei 430016,China;不详)

机构地区：[1]华中科技大学同济医学院附属武汉儿童医院(武汉市妇幼保健院)检验科,湖北武汉430016 [2]武汉市职业病防治院

出　　处：《现代预防医学》2023年第18期3299-3304,共6页Modern Preventive Medicine

基　　金：国家自然科学基金(81703203);武汉市卫生健康科研基金资助项目(WG21Q01);武汉科技大学,职业危害识别与控制湖北省重点实验室(OHIC2022Z10)

摘　　要：目的探讨电焊作业产生的金属烟尘与职业人群甲状腺功能的关系,为电焊工人甲状腺疾病的早期防控提供依据.方法采用整群抽样方法,于2022年4月选取某车辆制造企业参加职业健康检查的484名工人(CO_(2)保护焊工人223人,辅助作业工人261人)分析电焊作业相关金属对甲状腺功能的影响.作业场所空气中和作业工人尿液中的金属浓度分别采用电感耦合等离子体发射光谱法和电感耦合等离子体质谱法进行检测.采用全自动化学发光测定仪检测甲状腺功能指标:三碘甲状腺原氨酸(Total triiodothyronine,TT3)、甲状腺素(Total thyroxine,TT4)、游离甲状腺素(Free thyroxine,T4)、游离三碘甲状腺原氨酸(Free triiodothyronine,FT3)和促甲状腺激素(Thyroid stimulating hormone,TSH).金属与甲状腺功能的关联性采用广义线性回归分析,其中自变量尿金属采用肌酐进行校正.结果电焊作业空气中存在的主要金属为铬、铜、铁、锰、镍和碲,其中位浓度分别为10.19μg/m^(3),40.38μg/m^(3),1658.06μg/m^(3),155.37μg/m^(3),7.94μg/m^(3)和6.94μg/m^(3),高于对照区域,差异有统计学意义(P值均<0.05),电焊岗位锰超标率为60%(>0.15 mg/m^(3)).电焊工人尿液中铬、锰、镍和碲的中位浓度分别为0.09、1.08×10^(-2)、0.13和0.72×10^(-2)μg/mmol肌酐,高于辅助工(均有P<0.05).尿液中锰和碲浓度分别与血清FT3[β(95%CI)=0.03(0.01~0.06)]和FT4[β(95%CI)=0.02(0.00~0.04)]呈正相关(均有P<0.05).结论CO_(2)气体保护焊所致电焊烟尘的金属组分主要为铬、锰、铁、镍、铜和碲.锰和碲接触与甲状腺激素水平升高有关.Objective To investigate the associations between welding fume metal composition and thyroid function of occupational workers,and to provide the evidence for early protection of occupational injury among welders.Methods A total of 484 workers(223 CO_(2) gas shielded welders,261 auxiliary workers)in a vehicle manufacturing enterprise who participated in occupational health examination were selected using a cluster sampling method in April 2022.The concentrations of metals in the air of work places and urine of operational workers were detected by inductively coupled plasma emission spectrometry and inductively coupled plasma mass spectrometry,respectively.Triodothyronine(TT3),thyroxine(TT4),free thyroxine(FT4),free triodothyronine(FT3)and thyroid stimulating hormone(TSH)were detected by fully automated chemiluminescence assay.The associations between metals and thyroid function were analyzed by generalized linear regression,where urinary metals were corrected using creatinine.Results The primary metals in welding fumes were chromium(Cr),copper(Cu),iron(Fe),manganese(Mn),nickel(Ni)and tellurium(Te).Their concentrations were 10.19μg/m^(3),40.38μg/m^(3),1658.06μg/m^(3),155.37μg/m^(3),7.94μg/mand 6.94μg/m^(3),respectively,which were significantly higher than those in the control areas.The exceedance rate of Mn in electric welding posts was 60%(>0.15 mg/m).The urinary concentrations of Cr,Mn,Ni and Te in welders were 0.09,1.08×10^(-2),0.13 and 0.72×10^(-2)μg/mmol creatinine,respectively,higher than those of auxiliary workers(all with P<0.05).Urinary Mn and Te concentrations were positively correlated with serum FT3[β(95%CI)=0.03(0.01-0.06)]and FT4[β(95%CI)=0.02(0.00-0.04)],respectively(both P<0.05).Conclusion The main components of the welding fumes produced by CO_(2) gas shielded welding are Cr,Mn,Fe,Ni,Cu and Te.Exposing to Mn and Te is associated with elevated thyroid hormone levels.

关 键 词：电焊作业 金属 甲状腺功能 

分 类 号：R581[医药卫生—内分泌]