通州市铅作业工人职业危害程度分析

为了全面贯彻执行《中华人民共和国职业病防治法》,准确地掌握我市铅生产企业的职业危害状况,并为今后更好地开展铅生产企业的职业卫生工作提供科学依据,我们于2002年对全市所有乡镇接触铅的生产企业进行了生产环境铅浓度监测和接触铅作业工人的职业健康检查,并对血铅浓度较高者进行了驱铅试验治疗,现将收集的资料报告如下。     

万州区262名铅作业工人职业健康调查

目的:了解重庆万州区铅作业工人的健康状况。方法:对万州区262名铅作业工人进行职业健康检查和血铅含量测定。结果:262名铅作业工人中血铅含量超过≥600μg/L诊断值达到铅中毒水平有8人,含量在400μg/L～599μg/L铅中毒观察对象30人。年龄越大工龄越长的工人血铅异常率越高。女性神经衰弱症状、血常规、尿常规、心电图异常率均高于男性。结论:铅作业工人存在职业危害,企业应采取有效的职业病防治措施,对劳动者进行职业健康监护,血铅超标者驱铅治疗,预防控制铅中毒发生。     

高邮市某铅蓄电池企业工人血铅调查结果

目的调查某铅蓄电池企业工人铅接触浓度及工人血铅水平,为采取预防措施提供依据。方法现场开展铅烟尘浓度监测,对铅作业人员进行血铅检测,采用描述性流行病学方法分析资料。结果现场监测铅尘合格率44.44%,铅烟合格率62.5%;224名铅作业工人中有5人血铅超过限值;是否直接接触铅岗位工人血铅值差异有统计学意义(P0.05)。结论该企业铅作业工人的血铅水平与工种有关,建议加强职业卫生监督管理。     

濮阳某蓄电池厂铅作业工人血铅检测结果

目的对濮阳某蓄电池厂铅作业工人进行血铅分析,了解该厂工人体内铅含量水平,筛查观察对象,发现铅中毒患者,为制定预防和干预措施提供依据。方法采集该蓄电池厂735名铅作业工人静脉血,采用石墨炉原子吸收光谱法进行血铅检测,按照GBZ 37-2002《职业性慢性铅中毒诊断标准》进行评价。结果 735名铅作业工人中血铅超标者51人,超标率为6.94%。其中,含量在400~600μg/L的观察对象有46人,占6.26%;血铅含量超过600μg/L,诊断值达到铅中毒水平的有5人,占0.68%。涂片岗位观察对象和铅中毒的检出率分别为21.74%和4.35%,包片岗位分别为20.83%和4.17%,明显高于其他岗位。结论该蓄电池厂存在职业危害,企业应采取有效的职业病防护措施,加强个体防护,同时提高铅作业工人在生产岗位上的自我防护意识,对血铅超标者进行复查和驱铅治疗,坚持定期开展职业健康检查,预防控制职业铅中毒的发生,保护工人身体健康。     

某蓄电池厂铅作业工人职业健康检查结果分析

目的了解某蓄电池厂职业性铅危害情况,探索职业卫生预防模式。方法接触铅作业的工人按《中华人民共和国职业病防治法》的要求进行职业健康检查,内容包括内科、耳鼻喉、听力、心电图、血常规和尿常规,并测定其血铅、尿铅浓度。结果361名接触铅作业工人有143人尿铅含量超过职业接触限值(≥70μg/L),53人血铅含量超过职业接触限值(≥400μg/L),与对照组比较,差异有统计学意义(P0.01)。28人血红蛋白下降,44人耳鼻喉检查发现异常,68人听力异常,与对照组比较,差异有统计学意义(P0.05)。血铅、尿铅浓度与铅接触浓度有关,随着铅接触浓度的增加,血铅、尿铅平均浓度增加。血铅、尿铅超标率与接铅工龄有相关性,接铅工龄在5年以上组血铅、尿铅超标率明显高于0～1年组,差异有统计学意义(P0.01);与1～5年组比较,差异有统计学意义(P0.05)。结论该厂铅作业工人受铅危害影响情况较重,工作场所中高浓度的铅烟、铅尘是造成铅作业工人血铅、尿铅含量增加的重要因素,该厂应进行工艺改革,采取有效措施控制铅污染,定期进行职业健康检查,以及时发现问题,预防铅中毒的发生。     

通州市铅作业工人职业危害程度分析

为了全面贯彻执行《中华人民共和国职业病防治法》,准确地掌握我市铅生产企业的职业危害状况,并为今后更好地开展铅生产企业的职业卫生工作提供科学依据,我们于2002年对全市所有乡镇接触铅的生产企业进行了生产环境铅浓度监测和接触铅作业工人的职业健康检查,并对血铅浓度较高     

铅作业工人293名血铅水平的调查

目的了解铅作业工人体内铅含量水平。方法采用石墨原子吸收法测定血铅含量,采用希斯美康1000 i血球仪测定血红蛋白含量。结果 293名铅作业工人中血铅超过1.9μmol/L有192人;超标率为65.53%;男工和女工的血铅水平和血红蛋白水平都存在负相关。结论 293铅作业工人血铅水平较高,企业应改进生产工艺,增强防护措施,对血铅超标者进行驱铅治疗,定期对工人进行体检。     

2005-2010年某蓄电池厂铅接触职业危害的情况

目的 对某蓄电池企业铅作业场所铅污染状况及其对工人血铅、血锌原卟啉影响因素分析,为加强职业卫生监督管理和制定防治策略提供科学依据.方法 检测蓄电池企业工作场所空气中铅浓度,对接触铅作业的工人进行职业健康检查,包括血铅、血锌原卟啉等项目测定.结果 ①2005-2010年共检测样本数205份,该蓄电池企业铅浓度超过国家职业接触限值的166份,超标率达80.98％.但超标率呈现逐年下降趋势.②在岗职工定期健康检查中发现血铅异常检出率高达77.05％,铅中毒率为27.86％,铅中毒发生率呈现逐年升高趋势.③铅作业车间不同工人铅中毒率不同,各工龄组工人的铅中毒率有明显差异.结论 该企业工作场所铅污染比较严重,工人血铅水平仍较高,企业必须采取有效的职业病防治措施,卫生监管部门对职业接触铅劳动者需采取多方面干预措施,预防控制铅中毒发生.     

某企业630名铅作业工人职业健康监护分析

目的了解铅酸蓄电池生产企业铅作业工人的健康情况。方法收集2018年1-12月某铅酸蓄电池生产企业630名铅作业工人在岗期间的职业健康检查资料,及该企业职业病危害因素检测评价报告资料进行分析。结果铅烟、铅尘超标的岗位中,出现神经衰弱症状的工人检出率较高,血铅异常率较高。检出疑似职业性慢性铅中毒16名;检出中度贫血4名,为铅作业职业禁忌证。接触铅的工龄越长,血铅异常率越高;男性接铅工人血铅异常率明显高于女性;女性接铅工人血红蛋白异常率明显高于男性,差异均有统计学意义(P<0.01)。结论该铅酸蓄电池企业铅作业工人存在明显职业健康损害,职业卫生监管部门应当加强监督执法力度,督促企业做好职业健康检查工作和职业病危害因素控制,从而预防控制职业性慢性铅中毒。     

职业性铅接触对作业人员血铅和肝功能及血常规的影响

目的了解职业性铅接触人员血铅水平和血常规及肝功能状况,分析其影响因素。方法以某铅酸蓄电池厂1 449名铅接触者为研究对象进行问卷调查及职业健康检查,收集作业人员基础信息并进行数据分析。结果职业性铅接触工人血铅水平在10～770μg/L,平均为170.5μg/L,血铅异常率为8.2%,≥5 a工龄组ALT升高率高于5 a工龄组(P0.01)。≥5 a工龄组血铅异常率高于5 a工龄组(P0.01)。女性Hb降低率高于男性(P0.01)。男性ALT升高率高于女性(P0.01)。男性血铅异常率高于女性(P0.01)。40岁年龄组Hb降低率高于≥40岁年龄组(P0.05)。不同血铅水平组的Hb降低率在4.0%～8.9%,血铅水平100μg/L组Hb降低率高于300～400μg/L组高于400μg/L组高于200～300μg/L组高于100～200μg/L组(P0.05)。女性铅作业人员Hb降低的风险是男性铅作业人员的4.2倍(P0.01)。男性铅作业人员ALT升高的风险是女性铅作业人员的5.6倍(P0.01),接害工龄为≥5 a的铅作业人员ALT升高的风险是接害工龄5 a铅作业人员的1.8倍(P0.01)。接害工龄为≥5 a的铅作业人员血铅异常的风险是接害工龄5 a铅作业人员的2.2倍(P0.01)。结论职业性铅接触者随工龄增加ALT升高率增加;体内血铅水平增加,女性血红蛋白降低率高于男性;体内血铅水平对ALT影响不明显。     

Chelated lead and bone lead.

In this study a close correlation [correlation coefficient (r) = 0.86, P less than 0.001] was found between the blood lead level of 20 lead workers and their urinary excretion of lead for 24 h after intravenous infusion with 1 g of the chelating agent calcium disodium edetate. In addition, there were significant associations between lead levels in different bones (tibia/calcaneus: r = 0.93, P less than 0.001; tibia/phalanx: r = 0.67, P less than 0.002; calcaneus/phalanx: r = 0.80, P less than 0.001), as measured by in vivo X-ray fluorescence. Chelation produced no significant change in the lead level in either tibia or calcaneus. There was a significant correlation between chelated lead and bone lead (eg, for calcaneus, r = 0.62) in currently exposed workers. However, there was no significant relationship when a retired worker and an inactive worker were included (r = 0.14). It was concluded that chelatable lead mainly reflects the blood and soft-tissue lead pool, which is only partly dependent upon the skeletal lead content that comprises the biggest share of the total body burden.     

Predictors of DMSA chelatable lead, tibial lead, and blood lead in 802 Korean lead workers

OBJECTIVES—To examine the interrelations among chelatable lead (by dimercaptosuccinic acid, DMSA), tibial lead, and blood lead concentrations in 802 Korean workers with occupational exposure to lead and 135 employed controls with only environmental exposure to lead.
METHODS—This was a cross sectional study wherein tibial lead, DMSA chelatable lead, and blood lead were measured. Linear regression was used to identify predictors of the three lead biomarkers, evaluating the influence of age, job duration, sex, education level, alcohol and tobacco use, creatinine clearance rate, and body mass index.
RESULTS—DMSA chelatable lead concentrations ranged from 4.8 to 2102.9 µg and were positively associated with age, current smoking, and creatinine clearance rate. On average, women had 64 µg less DMSA chelatable lead than men. When blood lead and its square were added to a model with age, sex, current smoking, body mass index, and creatinine clearance rate, blood lead accounted for the largest proportion of the variance and sex became of borderline significance. Tibial lead concentrations ranged from −7 to 338 µg/g bone mineral and were positively associated with age, job duration, and body mass index. Women had, on average, 9.7 µg/g less tibial lead than men. Blood lead concentrations ranged from 4.3 to 85.7 µg/dl and were positively associated with age and tibial lead, whereas current smokers had higher blood lead concentrations and women had lower blood lead concentrations.
CONCLUSIONS—The data suggest that age and sex are both predictors of DMSA chelatable lead, blood lead, and tibial lead concentrations and that tibial lead stores in older subjects are less bioavailable and may contribute less to blood lead concentrations than tibial lead stores in younger subjects. Although blood lead concentrations accounted for a large proportion of the variance in DMSA chelatable lead concentrations, suggesting that measurement of both in epidemiological studies may not be necessary, the efficacy of each measure in predicting health outcomes in epidemiological studies awaits further investigation.


Keywords: dimercaptosuccinic acid; bone lead; x ray fluorescence     

Urinary non-precipitable lead in lead workers.

Sixty-six workers engaged in lead-glazing pottery with a presumed moderate exposure to lead were studied. The group comprised 20 men with long-term exposure to lead and positive laboratory signs of increased lead absorption (Group A); 22 with long-term exposure and negative laboratory signs (Group B); 11 with short-term exposure and positive laboratory signs (Group C); and 13 with short-term exposure and negative laboratory signs (Group D). In addition, 14 workers employed in casting the kelmet alloys with presumed heavy exposure to lead (Group E) and seven healthy individuals (Group F) were included. Urine samples from all the subjects were analysed to determine, first, the total lead using the ashing technique, and then the precipitable lead using the coprecipitation technique of Cholak, Hubbard, and Burkey (1948), but modified slightly by us. Thus, the non-precipitable lead fraction in urine was the difference between the two measurements and this was also expressed as a percentage of the total lead. The mean total lead and the mean proportion of non-precipitable lead were 0.62 mumol/l and 48.7%, 0.35 mumol/l and 44.9%, 0.40 mumol/l and 48.9%, 0.17 mumol/l and 24.6%, 1.43 mumol/l and 44.3%, 0.14 mumol/l and 18.8% for Groups A, B, C, D, E, and F respectively, showing that a large part of urinary lead was eliminated as precipitable lead in Groups D and F who had normal lead excretion, while about half was eliminated as non-precipitable lead in the other four groups who had excessive lead excretion. No essential difference in the proportion of non-precipitable lead among Groups A, B and C excluded the possibility that the proportion might be directly related to the period of exposure to lead and to the laboratory findings of excessive lead absorption. The mean proportion of non-precipitable lead for the physiological (up to 0.240 mumol/l), intermediate (0.241 to 0.721 mumol/l), and excessive (above 0.722 mumol/l) total lead levels was 26.7, 41.3, and 52.3% respectively, in the lead workers comprising Groups A, B, C, and E each showing increased lead excretion when grouped together. these data suggested that, when urinary lead is within the normal range, it is excreted largely as precipitable lead even in individuals exposed to lead, and that the principal conditions determining the excretion of non-precipitable lead would be the current or recent degree of lead absorption. The excretory mechanisms and the biological significance of the non-precipitable lead are also discussed.     

职业铅接触者血铅、发铅、尿铅相关性的研究

本文通过对32名铅蓄电池制造工和36名排字工的血铅、发铅、尿铅的相关性研究,发现血铅/发铅(r=0.604),血铅/尿铅(r=0.548)均呈高度显著性相关(P<0.0005),故认为血铅是铅接触工人较好的健康监护指标。文章还进一步探讨了发铅作为铅接触者活体生物检测材料的应用前景。     

Associations of patella lead and other lead biomarkers with renal function in lead workers

OBJECTIVE: We sought to compare associations of patella lead, which may represent a unique cumulative and bioavailable lead pool, with other lead measures in models of renal function. METHODS: Renal function measures included blood urea nitrogen, serum creatinine, measured and calculated creatinine clearances, and urinary N-acetyl-beta-D-glucosaminidase (NAG) and retinol-binding protein. RESULTS: In 652 lead workers, mean (SD) blood, patella, and tibia lead were 30.9 (16.7) microg/dL, 75.1 (101.1) and 33.6 (43.4) microg Pb/g bone mineral, respectively, and were correlated (Spearman's r = 0.51-0.74). Patella lead was associated (P < 0.05) with NAG in all lead workers. In models of effect modification by age, higher patella lead also was associated with higher serum creatinine in older participants. Similar associations were observed for blood and tibia lead. CONCLUSIONS: Associations between patella lead and adverse renal outcomes were not unique; this may be due, in part, to high correlations among the lead biomarkers in this study.     

Past occupational exposure to lead: association between current blood lead and bone lead

Mobilization of lead from bone is known to increase with age. The authors performed the current study to determine whether there was an association between current blood lead and bone lead in workers with no current exposure but with significant past workplace exposure. The authors assessed 58 men, aged 40 to 76 years, who had earlier exposure to lead and determined both current blood lead levels and bone lead levels. At the time of the current assessment, the average blood lead level was 10.9 microg/dL and tibia bone lead concentrations ranged from -12.5 to 223.3. The authors divided workers into 3 groups by age (40-49, 50-59, and 60-76). Correlations between blood lead and bone lead were highest in the 2 oldest age groups (.49 and .75, respectively). Hierarchical regression analysis was significant for an interaction between bone lead and age in predicting blood lead (the combination of age and bone lead significantly predicted an increase in current blood lead levels). The results support the hypothesis that lead stored in bone is a significant source of blood lead later in life. Older workers with past occupational exposure may face a particular risk for recirculation of lead in blood with advancing age.     

Blood lead and the symptoms of lead absorption

ABSTRACT Eighty-one percent of all hourly paid men who had been employed for more than six months in a factory making lead acid batteries and plastics completed a modified Cornell medical index health questionnaire. Blood lead and erythrocyte protoporphyrin (EPP) were also measured. The questions were grouped into symptom categories as follows: all physical, all psychological, “potentially lead induced,” pulmonary, cardiovascular, gastrointestinal, skin, nervous system, genitourinary, and fatigue. For each symptom category the pooled percentages of men whose symptom scores were above the common median of the three blood lead groups 10-, 40-, and 60 and over μg/100 ml (0·48-, 1·93-, and 2·90 and over μmol/l) within age/smoking subgroups were calculated. In every symptom category the percentages in the two lower blood lead groups differed little, but the percentages were consistently higher in men with blood concentration of 60 μg/100 ml (2·90 μmol/l) and over. Differences between a combined 10-59 μg/100 ml (0·48-2·85 μmol/l) blood lead group and the 60 and over μg/100 ml (≥2·90 μmol/l) group were statistically significant at the 0·01 level for “potentially lead induced” symptoms and at the 0·05 level for skin and psychological symptoms. Broadly similar results were obtained with four log₁₀ EPP groups 0·6-, 1·5-, 1·7-, and ≥2·0, but differences did not reach statistical significance. There was no obvious explanation as to why symptoms that are not found in classic lead poisoning should be increased almost as much as those that are. It was thought that these results could be biased due to the men's knowledge of the symptoms associated with lead exposure, but the possibility that they may be partly due to lead absorption cannot be excluded.