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目的分析铅作业工人接触生物标志物及生化指标,筛选铅损害的早期监测指标。方法采用职业流行病学调查方法,选取2013—2014年间河北省保定市徐水县的460例蓄电池制造行业接触铅工人作为接铅组,100例非接触铅工人为对照组,对两组人员进行职业健康检查。分析两组人群血铅、尿铅、唾液铅与血液生化指标水平。结果接铅组血铅、尿铅平均水平较对照组高(Z=-7.269,Z=-4.176,P<0.05)。血铅与血尿酸呈正相关[Pearson相关系数(r)=0.257,P<0.05]。控制年龄因素后,血铅与收缩压呈正相关(相关系数为0.216,P<0.01)。血尿酸与丙氨酸转氨酶(ALT)呈正相关(r=0.504,P<0.05),与收缩压呈正相关(r=0.399,P<0.05)。随着年龄增加,血铅与血尿酸、收缩压的相关系数逐渐增大。在低浓度血铅(0.97~1.90μmol/L,未达到观察对象时),接铅组血尿酸水平与对照组差异有统计学意义(t=4.454,P<0.05)。结论职业性铅接触可引起工人血铅、收缩压、血尿酸升高。血尿酸联合ALT、收缩压升高有可能成为铅损害的早期监测指标,随年龄增高铅损害的敏感性增加。
OBJECTIVE: To analyze the exposure of lead workers to biomarkers and biochemical indexes and to screen early monitoring indicators of lead damage. Methods A total of 460 battery manufacturing workers in lead-acid battery manufacturing industry in Xuhui County, Baoding City, Hebei Province were selected as lead-in group and 100 non-contact lead workers as control group during 2013-2014. The two groups of workers Occupational health examination. Analysis of two groups of blood lead, urine lead, saliva lead and blood biochemical indicators. Results The average level of blood lead and urine lead in lead group was higher than that in control group (Z = -7.269, Z = -4.176, P <0.05). Blood lead and serum uric acid were positively correlated [Pearson correlation coefficient (r) = 0.257, P <0.05]. After controlling for age, there was a positive correlation between blood lead and systolic blood pressure (correlation coefficient: 0.216, P <0.01). Serum uric acid and alanine aminotransferase (ALT) were positively correlated (r = 0.504, P <0.05), and systolic blood pressure was positively correlated (r = 0.399, P <0.05). With age, blood lead and blood uric acid, systolic blood pressure increased the correlation coefficient. In low blood lead levels (0.97 ~ 1.90μmol / L, did not reach the observation object), the level of serum uric acid in lead group was significantly different from that in control group (t = 4.454, P <0.05). Conclusion Occupational exposure to lead can cause blood lead, systolic blood pressure and blood uric acid in workers. Serum uric acid combined with ALT, systolic blood pressure may lead to lead early detection of damage indicators, increased sensitivity to age with lead damage.