职业性铅接触对作业人群的增龄效应

Aging Effect of Lead on Occupational Exposure Workers

[目的]以职业性铅接触人群为研究对象,选用与年龄有关并可反映机体功能状态的生理、心理指标,同时应用工作能力指数(WAI)测定研究对象的工作能力,分析职业性铅接触对作业人群的增龄效应。[方法]以蓄电池制造企业铅接触工人为接触组,以同一企业非铅接触工人为对照组,应用工作能力指数调查表确定研究对象的WAI,使用生理功能测试仪器、CD-1型老化度仪、心理及临床老化征象调查表测试生理和心理功能并确定其生理年龄(PhA)和心理年龄(PsA),以观察职业性铅接触的增龄作用。根据工作能力、生理年龄、心理年龄提出衰老指数模型并结合血铅浓度测定结果进行验证。[结果]随着工人血铅水平的升高,WAI评分减少,接触组中WAI等级为"优"者血铅值相对较低,等级为"差"者血铅值相对较高(P=0.010),表明铅接触在一定程度上影响了工人的工作能力。接触组与对照组比较,握力、动作稳定度、敲击试验、心理老化测试结果差别均有统计学意义;配对t检验表明,>40岁铅接触组作业工人的生理年龄和心理年龄均高于其日历年龄(CA),分别增高0.51岁和3.92岁(P<0.05和P<0.01)。建立衰老指数模型:衰老指数(AEI)=[(49/WAI)X1+(PhA/CA)X2+(PsA/CA)X3]·100,(X1、X2、X3分别是根据体力劳动、脑力劳动及体力与脑力混合比例来确定的权重系数)。>40岁年龄段工人的年龄与衰老指数之间存在正相关关系(r=0.309,F=6.349,P=0.014)。接触组血铅值和衰老指数之间存在正相关关系(r=0.438,F=17.75,P=0.000)。按照衰老指数模型得出铅接触工人的衰老指数平均为1.13±0.074。[结论]长期铅接触作业可降低职业人群的工作能力,降低握力、动作稳定度、神经肌肉协调性,增加心理老化,>40岁铅接触组作业工人的生理年龄和心理年龄分别高于日历年龄。表明铅接触在一定程度上加速机体的衰老过程,存在增龄效应。综合工作能力指数、日历年龄、生理年龄、心理年龄而建立的衰老指数可较好地反映随年龄变化的衰老情况,并与铅接触工人的血铅值呈相关关系。

[ Objective ] To explore the aging effect of lead on occupational exposure workers by work ability index（ WAI ）, physiological and psychological markers. [ Methods ] Lead exposed workers in a battery factory were chosen as subjects and non-exposed workers in the same factory as control group. Physiological age（ PhA ）and psychological age（ PsA ）were obtained by Type CD-1 aging degree analyzer and physiological function instrument. Work ability index table was used to understand the work ability. Aging effect index （ AEI ）model was established based on WAI, physical age and psychological age. [ Results ] WAI was negatively correlated with the lead concentration in blood. In high lead concentration group there were more workers with WAI level ＇poor＇ and less workers with WAI level ＇supper＇ . Lead exposure workers were significantly different with control workers in muscle strength, balance function, neurobehavioral function and psychological markers. Both PhA and PsA were significantly higher than their calendar age（ CA ）in lead exposure workers who were more than 40 years old of age, the differences were 0.51 and 3.92 years respectively. AEI were established as： AEI= [ （ 49/WAI ） X1＋ （ PhA/CA ） X2＋ （ PsA/CA ） X3 ] · 100, （ X1, X2, X3 were defined as the weighted coefficient of physical work and intellectual work ）. AEI was correlated with blood lead concentration （ r = 0.438, F = 17.75, P = 0.000 ） and with age（ r = 0.309, F = 6.349, P = 0.014 ）. [ Conclusion ] Workers long term exposed to lead had decreased WAI and muscle strength, balance function, neurobehavioral function and increased psychological markers. Lead has aging effect on workers exposed to it. AEI could reflect aging effect and correlated with blood lead concentration.