职业性铅接触工人血铅及肝功能指标的变化

目的]研究职业性铅接触对工人的肝脏毒性,探讨血铅浓度变化和肝脏损害效应指标之间的关系,寻找铅对肝毒性的早期敏感指标。方法]以蓄电池制造企业108名铅作业工人作为接触组,以同一企业非铅接触的76名工人和行政人员作为对照组。车间空气中铅烟、铅尘的短时接触浓度采用火焰原子吸收光谱法检测。选择丙氨酸氨基转移酶（ALT）和总胆红素（TBIL）作为肝毒性的效应指标,分析不同血铅水平和肝损害效应指标的变化。结果]①车间空气中铅烟和铅尘的短时接触浓度分别为0.89mg/m3和0.25mg/m3,超标率分别为50.00%和60.00%。②随着环境铅接触水平的增加,ALT和TBIL的异常率增加无统计学意义（P〉0.05）。两者平均浓度变化也无统计学意义（P〉0.05）。③超职业限值组存在血铅超标现象,异常率为31.03%。超职业限值组和职业限值组血铅平均浓度明显高于对照组（P〈0.01）。④随着铅作业工龄的增加,血铅、ALT和TBIL的异常率无统计学意义（P〉0.05）。⑤血铅水平的变化和ALT、TBIL异常率的变化不存在相关关系。结论]职业性铅接触引起血铅明显升高,肝功能效应指标ALT和TBIL不能敏感的反映铅对肝脏的毒性。

Blood Lead Level and Hepatotoxicity in Workers Occupationally Exposed to Lead

Objective] To study the liver toxicity induced by occupational lead exposure;to analyze the relationship between blood lead level and indexes for hepatotoxicity;and looking for the early sensitive indexes of hepatotoxicity.Methods] Total of 108 workers exposed to lead in a battery factory were selected as subjects and 76 non-lead-exposed workers in the same factory as control.The lead concentration in workshop was measured by flame atomic absorption spectrometry（AAS）,blood lead was measured with graphite vessel AAS,and seral alanine aminotransferase（ALT）and total bilirubin（TBIL）as the effect indexes of hepatotoxicity were determined,then the relationship between level of lead concentration and liver function indexes was analyzed.Results] ①The lead fume and dust concentrations in workshop were 0.89 mg/m3 and 0.25 mg/m3 respectively;and the rates exceeded National Standard were 50.00% and 60.00%,resprctively.②There were no significant increase in ALT and TBIL level with the increase of air lead concentration.③Blood lead concentration of the exposed groups,either exceeded limit or below the standard limit,were higher that control group significantly（P 0.01）.The rate of over-limit group was 31.03%.④There were no significant changes of the ALT and TBIL levels with the prolongation of lead exposure.⑤There were no significant relationship between blood lead and the seral level of ALT and TBIL.Conclusion] Occupational lead exposure caused elevation of blood lead concentration,however,seral ALT and TBIL were not the sensitive effect indexes for hepatotoxicity among these exposed workers.