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目的探讨低水平职业性苯接触人群的健康效应,初步筛选效应生物标志物。方法采用整群抽样方法,以某石油化工厂532名低水平职业性苯接触工人[工作场所空气中苯的时间加权平均浓度(CTWA)中位数(M)低于3.25 mg/m3]为接触组,根据性别及年龄1∶1配对,选择同厂532名非苯作业人员为对照组。采用气相色谱法测定工作场所空气中苯的水平;通过健康检查比较2组人员的健康状况;采集2组人群周围静脉血,分离血清,采用酶联免疫吸附法测定血清中纤维蛋白溶酶原(PLG)和血小板碱性蛋白(PBP)水平,采用透射比浊法在全自动生化仪上测定载脂蛋白B100(Apo B100)水平。结果接触组人群工作场所空气中苯CTWA的M为0.04 mg/m3,对照组人群工作场所空气中未检出苯。接触组人群失眠、头晕和头痛检出率均高于对照组(6.95%vs 2.82%,5.64%vs2.63%,3.20%vs 0.94%,P<0.05);接触组人群红细胞计数和血红蛋白水平均高于对照组(M:5.01×1012/L vs4.83×1012/L,147 g/L vs 145 g/L,P<0.05);接触组人群血清中天冬氨酸氨基转移酶、碱性磷酸酶、总胆汁酸和免疫球蛋白M水平均高于对照组(M:25 U/L vs 23 U/L,73 U/L vs 69 U/L,5.80μmol/L vs 5.45μmol/L,1.23 g/L vs1.15 g/L,P<0.05)。接触组人群血清中PLG水平高于对照组(M:6.48μg/L vs 5.64μg/L,P<0.05);多元线性回归分析结果显示,低水平苯接触对PLG水平有影响(P<0.05)。接触组和对照组人群PBP和Apo B100水平比较,差异均无统计学意义(M:48.00 ng/L vs 44.00 ng/L,0.83 g/L vs 0.83 g/L,P>0.05)。结论低水平职业性苯接触可对作业人群的神经系统、血液系统、肝功能和免疫功能产生一定影响;血清PLG水平可作为潜在的职业性低水平苯接触的效应生物标志物。
Objective To investigate the health effects of exposure to benzene in low-level occupational benzene and to screen effective biomarkers. Methods Using a cluster sampling method, 532 low-level occupational benzene-exposed workers in a petrochemical plant (median time-weighted average concentration of benzene in the workplace air (CTWA) of less than 3.25 mg / m3] Group, according to the gender and age 1: 1 pairing, select the same plant 532 non-benzene workers as the control group. The levels of benzene in the air of the workplace were determined by gas chromatography. The health status of the two groups was compared by health examination. Blood was collected from peripheral venous blood of 2 groups and serum was collected. Serum plasminogen activator PLG) and platelet basic protein (PBP) levels were measured by transmission turbidimetry in the automatic biochemical analyzer apolipoprotein B100 (Apo B100) levels. Results In the exposure group, the M in the air of benzene in the workplace was 0.04 mg / m3, while benzene in the air of the control group was not detected in the workplace. The detection rate of insomnia, dizziness and headache in the contact group were significantly higher than those in the control group (6.95% vs 2.82%, 5.64% vs 2.63%, 3.20% vs 0.94%, P <0.05). In the exposure group, both the red blood cell count and the hemoglobin level Was higher than that of the control group (M: 5.01 × 1012 / L vs4.83 × 1012 / L, 147 g / L vs 145 g / L, P <0.05) The levels of phosphatase, total bile acid and immunoglobulin M were higher than those of the control group (M: 25 U / L vs 23 U / L, 73 U / L vs 69 U / L, 5.80 μmol / L vs 5.45 μmol / L, 1.23 g / L vs 1.15 g / L, P <0.05). The level of PLG in the exposed group was higher than that in the control group (M: 6.48μg / L vs 5.64μg / L, P <0.05). Multiple linear regression analysis showed that PLT level was affected by low level benzene exposure (P <0.05) . There were no significant differences in PBP and Apo B100 between the two groups (48.00 ng / L vs 44.00 ng / L, 0.83 g / L vs 0.83 g / L, P> 0.05). Conclusion Low level of occupational benzene exposure may affect the nervous system, hematological system, liver function and immune function of working population. Serum PLG level may be used as potential biomarker of low-level benzene exposure in occupational groups.