职业锰接触工人血细胞锰与血红蛋白的关联性研究  

Correlation study of blood cell manganese and hemoglobin levels among workers occupationally exposed to manganese

作　　者：周英花 葛小婷 游源源 何俊秀 林森才 胡思瀚 杨晓波[2] ZHOU Yinghua;GE Xiaoting;YOU Yuanyuan;HE Junxiu;LIN Sencai;HU Sihan;YANG Xiaobo(School of medicine,Guangxi University of Science and Technology,Liuzhou,Guangxi 545006,China;School of public health,Guangxi Medical University,Nanning,Guangxi 530021,China)

机构地区：[1]广西科技大学医学部,广西柳州545006 [2]广西医科大学公共卫生学院,广西南宁530021

出　　处：《职业卫生与应急救援》2024年第6期734-739,共6页Occupational Health and Emergency Rescue

基　　金：国家自然科学基金(82304105);国家级大学生创新创业训练计划资助项目(202310594033)。

摘　　要：目的探讨职业锰接触工人血细胞锰与血红蛋白的关联及剂量-效应关系,为预防职业锰接触导致的健康损害提供科学依据。方法选取广西某锰铁合金冶炼厂的826名锰接触工人作为研究对象,收集他们在2017年随访期间完成的流行病学问卷调查和现场职业卫生学调查数据。通过电感耦合等离子体质谱仪测量血细胞中锰的质量浓度,并利用全自动血细胞分析仪检测血红蛋白含量。运用广义线性模型和限制性立方样条分析方法,探讨血细胞中锰含量与血红蛋白水平之间的关联及其剂量-效应关系。结果因数据缺失,最终纳入的823名研究对象中,对照组(n=141)空气中锰质量浓度范围为0.004~0.061 mg/m^(3),低接触组(n=287)空气中锰质量浓度范围为0.004~1.557 mg/m^(3),高接触组(n=395)空气中锰质量浓度范围为0.060~2.461 mg/m^(3)。3组研究对象血细胞锰质量浓度的中位数分别为25.68μg/L、30.87μg/L、32.11μg/L,差异有统计学意义(Р<0.001);3组研究对象血红蛋白平均质量浓度分别为(150.1±17.4)μg/L、(143.9±17.5)μg/L、(149.2±15.8)μg/L,差异亦有统计学意义(Р<0.001)。女性、从不吸烟、从不饮酒、BMI值≥28.0 kg/m^(2)的研究对象血细胞锰质量浓度较高(P<0.05)。广义线性模型分析结果显示:以Q1组(血细胞锰质量浓度<24.17μg/L)研究对象为对照,Q2组(24.17~30.62μg/L)、Q3组(>30.62~39.11μg/L)、Q4组(>39.11μg/L)血红蛋白分别升高4.771μg/L、7.747μg/L和2.995μg/L(均P<0.05)。相对于男性,女性的血红蛋白减少20.824μg/L(P<0.05)。限制性立方样条分析结果显示,血细胞锰质量浓度与血红蛋白水平呈倒“U”型的剂量-效应关系(F=53.9,P<0.05)。结论锰接触工人血细胞锰水平高于一般人群。血细胞中锰在较低水平下,可能促进血红蛋白合成;但在较高浓度下,会抑制血红蛋白的合成。Objective To explore the correlation and dose-response relationship between blood cell manganese(Mn)and hemoglobin(Hb)levels among workers occupationally exposed to manganese,providing the scientific basis for preventing health damage caused by occupational manganese exposure.Methods A total of 826 manganese-exposed workers from a ferromanganese alloy smelting plant in Guangxi were studied.Data from the epidemiologic questionnaires survey and on-site occupational health investigation were conducted during follow-up in 2017.The mass concentration of manganese in blood cells was measured using inductively coupled plasma mass spectrometry(ICP-MS),and hemoglobin levels were measured using an automatic blood cell analyzer.Generalized linear models(GLMs)and restricted cubic spline analyses were used to investigate the correlation and dose-response relationship between blood cell manganese and hemoglobin levels.Results Finally,this study included 823 study subjects due to data missed.The manganese concentration in the air ranged from 0.004 to 0.061 mg/m^(3) for the workers in the control group(n=141),while 0.004 to 1.557 mg/m^(3) for the workers in the low-exposure group(n=141),and 0.060 to 2.461 mg/m^(3) for workers in the high-exposure group(n=141).The median manganese mass concentrations in blood cells of the three study groups were 25.68μg/L,30.87μg/L,and 32.11μg/L,respectively,with significant differences(P<0.001);the mean hemoglobin levels were(150.1±17.4)μg/L,(143.9±17.5)μg/L,and(149.2±15.8)μg/L,respectively,also showing significant differences(P<0.001).Higher blood cell manganese concentrations were observed in the females,non-smokers,non-drinkers,and individuals with a BMI≥28.0 kg/m~2(all P<0.05).GLM analysis showed that compared to the Q1 group(blood cell manganese mass concentration<24.17μg/L),hemoglobin levels increased by 4.771μg/L,7.747μg/L,and 2.995μg/L in the Q2(24.17-30.62μg/L),Q3(>30.62-39.11μg/L),and Q4(>39.11μg/L)groups,respectively(all P<0.05).Compared to the males,the females had

关 键 词：金属接触 锰 血红蛋白 限制性立方样条分析 剂量-效应关系 

分 类 号：R135[医药卫生—劳动卫生]