某金属冶炼厂周边女性镉暴露水平及其对生殖健康的影响

Investigation of cadmium exposure and its reproductive health effect on female residents living around a metal smelting plant

目的了解某金属冶炼厂周边女性镉暴露情况,分析镉污染对女性生殖健康的影响。方法于2016年8—10月,选取冶炼厂周边3 km以内常住10年以上,年龄35~55岁间女性162人为污染组,冶炼厂上风向10 km处经济水平和生活习惯相似地区同等条件的女性167人为对照组,检测两调查区灌溉水、土壤和食物中镉含量以及两组研究对象尿镉、尿β2-M、尿NAG酶水平,调查两组研究对象的月经及生育状况。结果污染区土壤和食物中镉含量高于对照区,差异有统计学意义(P<0.05)。与对照组相比,污染组妇女尿镉水平及超标率、尿NAG酶活力、联合反应率均较高,差异有统计学意义(P<0.05);而尿β2-M的含量及超标率均无明显改变。与对照组比较,污染组妇女的绝经率、不良妊娠发生率和不孕症发生率均较高,差异有统计学意义(P<0.05);而月经周期异常率、痛经发生率均无明显改变。根据尿镉水平四分位间距将研究对象进行分层(P25为2.38μg/g cr、P50为4.59μg/g cr、P75为8.83μg/g cr),尿镉>8.83μg/g cr组妇女不良妊娠发生率、不孕症发生率、绝经率均最高,差异有统计学意义(P<0.05)。<45岁和≥45岁的妇女,均以尿镉>8.83μg/g cr组绝经率最高,差异有统计学意义(P<0.05)。结论该冶炼厂周边地区镉污染较严重,周边地区女性体内镉负荷增加,生殖健康已受到一定程度影响。

Objective To evaluate the cadmium exposure of female residents living around a metal smelting plant,and to analyze the adverse effects on female reproductive health.Methods From August to October in 2016,a total of 162 women living around a metal smelting plant within 3 km for more than 10 years,aged 35-55,were chosen as the exposure group,167 women with similar economic level and living habit,living upwind side of the metal smelting plant were chosen as the control group.Urine cadmium,urineβ2-M,NAG enzyme in urine and cadmium concentration in the irrigation water,soil and food were determined,menstruation and reproductive status were investigated.Results The cadmium contents in soil and food in pollution area were significantly higher than that in the control area(P<0.05).Compared with the control group,the content and abnormity rate of urine cadmium,urine NAG enzyme and the joint response rate in the exposure group were significantly higher(P<0.05);And there was no significant difference in the concentration and abnormity rate ofβ2-M(P>0.05).Compared with the control group,the incidence rate of menopause,adverse pregnancy and infertility in the exposure group were significantly higher(P<0.05);And there were no significant differences in the incidence rate of abnormal menstrual cycle and dysmenorrheal(P>0.05).All the participants were stratified according to the interquartile range of urinary cadmium(P25:2.38μg/g cr;P50:4.59μg/g cr;P75:8.83μg/g cr),the incidence rate of adverse pregnancy,infertility and menopause in the women with urinary cadmium>8.83μg/g cr were the highest,the differences were statistically significant(P<0.05).Women both in the group of<45 years old and≥45 years old,the incidence rate of menopause were the highest in the women with urinary cadmium>8.83μg/g cr,and the differences were statistically significant(P<0.05).Conclusion The cadmium pollution in the surrounding of the investigated metal smelting plant is serious,and the cadmium body burden of female residents living around the factory is increased with an adverse reproductive health effect.