铅作业工人血铅水平和肝功能状况及其影响因素

Blood lead level and liver function status of occupationally lead-exposed workers and their influence factors

[目的]了解铅作业工人血铅水平及肝功能状况,分析其影响因素,为保护工人健康提供依据。[方法]选择某铅酸蓄电池公司1 179名体检工人为研究对象。接触组为一线接触铅的801名工人,对照组为该企业行政、后勤类等378名非铅接触者。采用问卷调查和健康体检相结合的方法,收集工人基础信息并进行数据分析。[结果]铅作业工人血铅水平范围为89～463μg/L,其M(P^(25),P^(75))为152.2(65.4,356.7)μg/L,血铅超标率(血铅值≥400μg/L)为10.2%。铅接触组血铅异常率高于对照组,差异有统计学意义(P <0.01)。logistic回归分析发现接触组血铅升高的风险是对照组的7.321倍(P <0.01);血铅水平> 200～300μg/L组、> 300～400μg/L组及> 400μg/L组发生肝功能异常的风险为<100μg/L组的1.775倍、2.659倍和3.114倍(P均<0.05),10～13年工龄组及5～<10年工龄组发生肝功能异常的风险是<5年组的1.454倍和1.122倍(P <0.05);血铅水平> 200～300μg/L组、> 300～400μg/L组及> 400μg/L组发生肝脏B超异常的风险为<100μg/L组的1.650倍、2.219倍和2.658倍(P均<0.05),铅接触组B超异常风险是对照组的2.235倍(P <0.05)。[结论]职业铅接触引起工人血铅水平升高,血铅是肝功能和肝脏B超异常的独立危险因素,故应加强工人健康监护。

[Objective]To understand blood lead level(BLL)and liver function status of occupationally lead-exposed workers and to analyze their influence factors so as to provide orientation for protecting workers’health.[Methods]Totally 1 179 workers in a lead-acid battery company were studied,including 801 workers exposed to lead and 378 non-exposed workers(administrative and logistic workers).They were surveyed with questionnaire and occupational health examination.[Results]The levels of blood lead ranged from 89 to 463μg/L and the M(P25,P75)was 152.2(65.4,356.7)μg/L among these workers,and 10.2%workers had higher BLL than biological exposure limit(400μg/L).The abnormal rate of blood lead in exposure group was significant higher than that in non-exposure group with the risk of 7.321-fold(P<0.01).Logistic regression analysis showed that the risk of abnormal liver function among workers with LLB of 200-300μg/L,301-400μg/L and more than 400μg/L was 1.775,2.659 and 3.114(P<0.05),respectively,compared with workers with LLB of lower than 100μg/L.The risks of abnormal liver function among workers with employed time of 10-13 years and 5-9 years was 1.454 and 1.122(P<0.05),respectively,compared with workers with employed time of less than 5 years.The risk of abnormal ultrasonic B examination among workers with LLB of 200-300μg/L,301-400μg/L and more than 400μg/L was 1.650,2.219 and 2.658(P<0.05),respectively,compared with workers with LLB of lower than 100μg/L.The risk of abnormal B-mode ultrasonography among lead-exposed workers was 2.235 times higher than non-exposed workers(P<0.05).[Conclusion]Occupational lead exposure induced the blood lead level increase,and BLL was an independent risk factor for abnormality of liver function and ultrasonic B examination.Health surveillance should be strengthened in routine occupational health work.