纳米碳酸钙对作业人群健康影响初步调查分析

Preliminary investigation and analysis on the health effects of workers exposed to nano calcium carbonate

目的：了解纳米碳酸钙生产企业工作场所纳米碳酸钙接触水平以及纳米碳酸钙对工人的健康影响。方法采用整群抽样方法，以某纳米碳酸钙生产企业35名接触纳米碳酸钙的工作人员为接触组，按照年龄和工龄1∶1匹配，以某事业单位35名无接触尘毒的工作人员为对照组。对接触组人群工作场所纳米碳酸钙颗粒计数水平和时间加权平均浓度（ CTWA ）进行检测，计算累积CTWA。通过健康检查比较2组人员的健康状况，并分析接触组肺通气功能减退与纳米碳酸接触水平的剂量－反应关系。结果接触组工作场所纳米碳酸钙颗粒计数水平中位数（M）为15716个／cm3，CTWA的M为2.419 mg／m3，上述2个指标均以包装岗位水平最高。接触组肺通气功能减退率高于对照组（57.1％vs 5.7％，P＜0.01），免疫球蛋白G水平高于对照组（M：13.50 vs 10.70 g／L，P＜0.05），补体3水平高于对照组[（1.15±0.15） vs （1.08±0.13） g／L，P＜0.05]，血磷水平低于对照组[（1.17±0.18） vs （1.27± 0.13） mmol／L，P＜0.05]。接触组和对照组周围血淋巴细胞微核率和微核细胞率M均为0.50‰，2组上述2个指标分别比较，差异均无统计学意义（ P＞0.05）。 Logistic回归分析结果显示，在自变量引入标准为0.10、剔除标准为0.15的条件下，经校正性别、年龄、吸烟和饮酒的影响后，发现肺通气功能减退的发生和纳米碳酸钙累积CTWA存在剂量－效应关系[优势比为2.74，95％可信区间为（0.88～8.56），P＝0.08]。结论纳米碳酸钙接触可导致肺通气功能减退、免疫系统反应和血电解质改变。肺功能检查可作为纳米碳酸钙接触人群的健康检查项目。

Objective To assess the exposure levels of nano-calcium carbonate （ CaCO3 ） in workplace and the health effect on workers exposed to nano-CaCO3 in the production enterprise .Methods According to cluster sampling , 35 workers exposed to nano-CaCO3 in a nano-CaCO3 production enterprise and 35 workers without dust and toxicant exposure in a pu blic institution were chosen as the exposed group and the control group respectively .The two groups were well matched in age and length of service （ exposed ∶control =1∶1 ） .Particle counting level and time weighted average concentration （CTWA） of nano-CaCO3 were detected in the workplace of the exposed group , and the accumulated CTWA level of nano-CaCO3 were calculated .Health examination was conducted and the health status was compared to the two groups .Dose-effect relationship between pulmonary ventilation hypofunction and exposed level of nano -CaCO3 in the exposed group was analyzed.Results The median of particle counting level and CTWA of nano-CaCO3 were 15 716 particles/cm3 and 2.419 mg/m3 respectively .Packaging post showed the highest levels both in the above two detecting indexes .The rates of pulmo-nary ventilation hypofunction in the exposed group was higher than that in the control group （57.1%vs 5.7%, P〈0.01）. The level of immunoglobulin G in the exposed group was higher than that in the control group （ median：13.50 vs 10.70＆amp;nbsp;g/L, P〈0.05）.The level of complement 3 in the exposed group was higher than t〈hat in the control group while the level of serum phosphate was lower [（1.15 ±0.15） vs （1.08 ±0.13） g/L, （1.17 ±0.18） vs （1.27 ±0.13） mmol/L, P〈0.05].The median of micronucleus frequency （MF） and micronucleus cell frequency （MCF） in peripheral blood lympho-cyte in the two groups were all 0.50‰.There was no statistical significant difference in both MF and MCF in the two groups （P〉0.05）.In accordance with the including criteria and exclusive criteria of the independent variables standards were 0.10 and 0.15, respectively, Logistic regression analysis showed dose-effect relationship between the pulmonary venti-lation hypofunction and the accumulation CTWA level of nano-CaCO3 after adjustment by gender , age, smoking and drinking （odds ratio：2.74, 95%confidence interval：0.88-8.56, P=0.08）.Conclusion Exposure to nano-CaCO3 can reduce lung ventilation function , induce immune response and change electrolytes .Pulmonary function tests could be used as a physical examination project in the workers exposed to nano-CaCO3 .