铅暴露水平与主要生物监测指标的剂量-反应关系

Dose-reponse relationship between the level of lead exposure and main biological monitoring indicators

目的分析2012年度无锡市14家铅蓄电池生产企业1 134名铅作业人员的职业健康检查结果,了解铅暴露水平与主要生物监测指标的剂量-反应关系。方法健康监护结果按照血铅浓度不同分组,采用SPSS 15.0统计软件分析不同浓度下血、尿常规主要生物指标与铅水平的剂量-反应关系。结果调查铅作业工人1 134人,其中男性573人,女性561人;年龄19～66(38.2±8.87)岁,工龄1个月～35 a。血铅浓度范围0.01～7.60μmol/L,以血铅浓度作为内暴露剂量分析不同暴露水平对主要生物监测指标的影响,结果显示,不同暴露水平组间血红蛋白减少异常率、红细胞减少异常率、血小板减少异常率、尿胆红素阳性率差异有统计学意义(P<0.01),不同暴露水平组间白细胞减少异常率、尿酮体阳性率、尿蛋白阳性率、尿胆原阳性率差异无统计学意义(P>0.05)。结论铅作业工人体内铅水平的增高可导致血液系统、消化系统损伤的加重,导致血红蛋白、红细胞、血小板减少,尿胆红素阳性率增高。

[ Objective ] To analyze the occupational health examination results of 1 134 lead exposed workers from 14 lead-acid bat- tery manufacturers in Wuxi City in 2012, and understand the dose-response relationship between lead exposure level and main bio- logical monitoring indicators. [ Methods ] Health surveillance results were classified according to blood lead concentrations. The dose-response relationship between lead exposure level and main biological monitoring indicators in serum and urine were analyzed by SPSS 15. 0 under different concentrations. [ Results] A total of 1 134 workers with lead exposure were investigated, 573 were male and 561 were female. The age ranged from 19- 66 （ 38.2± 8.87 ） years, and service length ranged from 1 month-35 years. The blood lead concentration range were 0.01-7.60μmol/L. The analysis of effect of different exposure levels on the main biological monitoring indicators with blood lead concentration as internal exposure dose showed that the abnormal rates of hemoglobin decrea- sing, erythrocyte decreasing and thrombocyte decreasing and the positive rate of urine bilirubin were significantly different between groups with different exposure levels, while the abnormal rate of leukocyte decreasing, and positive rates of ketone, urinary protein and urobilinogen were not significant（ P 〉 0. 05）. [ Conclusion] The elevated lead levels of workers can lead injury aggravated in blood and digestive system, cause deceasing of hemoglobin, erythrocyte and thrombocyte, and the increasing of positive rate of u- rine bilirnbin.