低浓度铅接触对工人血常规早期影响的研究

Study on the early effect of low concentration lead exposure on routineblood indexes of workers

目的探讨低浓度铅接触对工人血常规早期影响的敏感指标。方法以2017-2018年在杭州市职业病防治院进行职业健康检查的血铅值低于400 g/L的1157名铅作业工人作为接触组,将同期同企业的行政、后勤、研发人员等421名非铅接触人员作为对照组,分析低浓度铅接触与血常规各项指标的关系。结果低浓度铅接触导致血常规WBC、红细胞分布宽度变异系数(RDW-CV)、红细胞压积(HCT)升高,平均血红蛋白含量(MCH)、平均血红蛋白浓度(MCHC)、血小板计数(PLT)下降;其中男职工RDW-CV升高,MCH、MCHC、血红蛋白(Hb)、PLT下降;而女职工HCT升高;非条件logistic回归结果显示,WBC异常OR=1.839、HCT异常OR=1.348。结论低浓度铅接触影响血常规多项指标,是WBC、HCT异常的危险因素,WBC、RDW-CV、HCT、MCH、MCHC、PLT可作为低浓度铅接触对铅作业工人血常规早期影响的敏感指标。

Objective To investigate the sensitive index of early effect of low concentration lead exposure on blood routine of workers.Methods There were1157 workers with blood lead value lower than 400μg/L who underwent occupational health examination in Hangzhou Hospital for the Prevention and Treatment Occupational Diseases from 2017 to 2018 were selected as the exposure group,and 421 non-lead exposed workers from the same enterprises in the same period were selected as the control group.The relationship between low concentration lead exposure and blood routine indicators was analyzed.Results Low concentration lead exposure led to the increase of WBC,RDW-CV and HCT,and the decrease of MCH,MCHC and PLT.There werethe increase of RDW-CV,and the decrease of MCH,MCHC,Hb and PLTin male workers,and the increase of HCT in female workers.Unconditional logistic regression results showed that abnormal WBC(OR=1.839)and abnormal HCT(OR=1.348)were statistically correlated.Conclusions Low-concentration lead exposure can cause significant changes in many blood routine indicators that are not conducive to health.It is a risk factor for abnormal WBC and HCT.WBC,RDW-CV,HCT,MCH,MCHC,PLT can be used as sensitive indicators of early effect of low concentration lead exposure on blood routine.