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目的探讨职业铅接触对男性工人腰椎骨折的影响。方法以上海某蓄电池厂152名男性铅作业工人为研究人群。采用石墨炉原子吸收分光光度法测定血铅(BPb)、尿铅(UPb),应用单光子骨密度仪(SPA-4)测定工人骨密度,并做Z评分。拍摄腰椎侧位X线平片,并诊断有无腰椎骨折。结果铅作业工人血铅浓度0.85(0.33～1.90)μmol/L,尿铅浓度4.84(0.46～21.31)μg/g Cr,腰椎骨折发病率为19.7%。工人腰椎骨折发病率随年龄和工龄增长而升高,但差异无统计学意义(P>0.05)。工人骨密度随血铅、尿铅水平升高而明显下降,差异有统计学意义(P<0.05)。工人随着体内铅接触水平的升高,腰椎骨折发病率随之明显升高,差异有统计学意义(P<0.05)并呈线性相关(r_(血铅)=-0.977,P<0.05;r_(尿铅)= 0.994,P<0.01)。随着骨量减少,工人腰椎骨折发病率明显升高,差异有统计学意义(P<0.01)并呈线性相关(r=-0.980,P<0.01)。结论职业铅接触可能引起职业人群骨密度下降,腰椎骨折发病率增高,腰椎骨折的发生可能与骨量减少有关。
Objective To investigate the effect of occupational lead exposure on lumbar fractures in male workers. Methods A total of 152 male lead workers in a battery factory in Shanghai were included in the study. Blood lead (Pbb) and urinary lead (UPb) were determined by graphite furnace atomic absorption spectrophotometry. The bone mineral density (BMD) of workers was measured by single-photon bone mineral density spectrometer (SPA-4) Filming of lumbar lateral radiographs and diagnosis of lumbar fracture. Results The blood lead level was 0.85 (0.33-1.90) μmol / L in lead workers and 4.84 (0.46-21.31) μg / g Cr in urine. The incidence of lumbar fractures was 19.7%. The incidence of lumbar fractures in workers increased with age and seniority, but the difference was not statistically significant (P> 0.05). The bone mineral density of workers with blood lead and urine lead levels increased significantly decreased, the difference was statistically significant (P <0.05). With the increase of lead exposure in the body, the incidence of lumbar fractures increased significantly (P <0.05), and there was a linear correlation (r_ (blood lead) = -0.977, P <0.05) (Urinary lead) = 0.994, P <0.01). With the reduction of bone mass, the incidence of lumbar fractures in workers was significantly higher (P <0.01), and the correlation was linear (r = -0.980, P <0.01). Conclusion Occupational exposure to lead may cause a decrease in BMD in the occupational population and an increase in the incidence of lumbar fractures. The incidence of lumbar fractures may be related to bone mass loss.