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。     

Evaluation of studies of the relationship between blood lead and air lead

Summary An evaluation of the major studies of the effects of airborne lead on blood lead levels of male and female adult and child populations is presented. Analysis of these studies shows that the blood lead-air lead slope for adults is approximately 1.0 for both men and women. This implies that an exposure to an additional 1 g Pb/m³ of air can result in an increase of approximately 1 g Pb/100 ml of blood. The precision of the slope for adults is rarely better than ±0.5 to ±0.7 and can be as large as ±1.0. A large portion of this uncertainty in the calculated slope is due to blood lead measurement error. The slope of the blood lead-air lead response for children ranges from 0.7 to 1.4 and is approximately the same as that for adults. The accuracy of this number is less clear for children than adults due to the small data base. Many of the studies of children have been on populations living in the vicinity of smelters. It is questioned whether these data are representative of the air lead exposure of children living in urban and suburban communities.     

铅作业工人血铅、尿铅和锌原卟啉测定结果分析

目的比较铅作业工人和非铅作业工人血铅、尿铅浓度、红细胞锌原卟啉和血常规的差异,探讨铅作业工人红细胞锌原卟啉和血铅、尿铅浓度的相关性。方法以蓄电池企业的252名铅作业工人作为接铅组,电子厂205名非铅作业工人作为对照组,测定血铅、尿铅浓度、红细胞锌原卟啉和血常规,并对结果进行统计学处理。结果接铅组血红蛋白含量低于对照组(P0.05),白细胞和红细胞、血小板则无差异(P0.05),接铅组红细胞锌原卟啉、血铅、尿铅浓度均显著高于对照组(P0.01),尿铅与红细胞锌原卟啉的相关系数(r)=0.166,血铅与红细胞锌原卟啉的相关系数r=0.406。结论长期接触铅可导致血铅、尿铅浓度和红细胞锌原卟啉升高,血红蛋白降低,对白细胞、红细胞、血小板无明显影响,血铅与红细胞锌原卟啉的相关性较尿铅与红细胞锌原卟啉的相关性好。     

Urinary lead as a possible surrogate of blood lead among workers occupationally exposed to lead

Objectives: The aim of the present study is to investigate whether lead (Pb) in urine (Pb-U) can be a valid surrogate of lead in blood (Pb-B), the traditional biomarker of exposure to lead in occupational health. Methods: Blood and spot urine samples were collected from 258 workers of both sexes occupationally exposed to lead. The samples were analyzed for lead by graphite furnace atomic absorption spectrometry, and the correlation between Pb-B and Pb-U was examined by linear regression analysis before and after logarithmic conversion. Results: The correlation coefficient (0.824; P < 0.01) was largest when the relationship between Pb-B and Pb-U was examined with 214 cases of one sex (i.e., men) after Pb-U was corrected for a specific gravity (1.016) of urine (Pb-Usg) and both Pb-B and Pb-Usg were converted to logarithms. The geometric means (GMs) of Pb-B and Pb-Usg for the 214 men were 489 μg/l and 81 μg/l, respectively. When Pb-Usg was assumed to be 100 μg/l in this set of correlations, the 95% confidence range of Pb-B for the group mean was narrow, i.e., 543–575 μg/l (with GM of 559 μg/l), whereas that for individual Pb-B values was as wide as 355–881 μg/l. Conclusions: The correlation of Pb-U with Pb-B among workers occupationally exposed to Pb was close enough to suggest that Pb-U may be a good alternative to Pb-B on a group basis, but not close enough to allow Pb-U to predict Pb-B on an individual basis. Received: 6 April 1999 / Accepted: 17 July 1999     

Impact of lead transport on children's blood and environmental lead levels

Introduction: A lead monitoring project was established in 1996 to monitor the environmental and health effects of lead being transported through a remote town in tarpaulin‐covered trucks. Methods: Dust samples from sites on the transport route were collected at 3–6 monthly intervals between 1996 and 1999. Annual blood lead testing clinics, offering voluntary testing to children, were conducted from 1997 to 1999. Results: Of the 55 dust samples analysed, only nine contained particles of lead concentrate and these were present at very low levels. During the project 167 children were tested. The geometic mean of blood lead levels in 1997, 1998 and 1999 were 4.5 μg/dL, 5.0 μg/dL and 5.1 μg/dL, respectively (all within the normal range). Residence on the transport route was not associated with higher lead levels (P > 0.05). Conclusions: Lead transport was not associated with any detectable environmental contamination or increase in children's blood lead levels.     

Partition of circulating lead between serum and red cells is different for internal and external sources of lead

Serum lead, whole blood lead, and lead in both tibia and calcaneus were measured in each of 49 active lead workers. Serum lead correlated more strongly with both in vivo bone lead measurements than did whole blood lead. The ratio of serum lead to whole blood lead varied from 0.8% to 2.5% and showed a positive correlation with tibia, and an even stronger correlation with calcaneus lead. This implies that lead released from bone (endogenous exposure) results in a higher proportion of whole blood lead being in serum than is the case for exogenous exposure. This observation needs to be confirmed, and the relationships amongst the parameters must be studied further, particularly in former or retired lead workers. If confirmed, since at least a portion of lead in serum is readily diffusible and thus toxicologically more immediately significant than lead bound to red cells, the health implications of endogenous exposure may have to be reassessed. © 1996 Wiley-Liss, Inc.     

儿童高铅血症及轻度铅中毒的药物干预

铅在人体内是一种具有多系统毒性的重金属元素,铅对儿童的损害更敏感。对于高铅血症及轻度铅中毒的防治尚缺乏公认显著有效的药物,但铅中毒对儿童的智力和身体发育都存在不利影响。近年来,临床使用一些维生素、金属硫蛋白、微量元素和中药等对儿童轻度铅中毒进行治疗,这些药物在减少铅在胃肠道的吸收、降低血铅水平、改善铅中毒症状方面发挥作用。     

食物中铅及营养素摄入对儿童血铅的影响

目的:探讨食物中铅摄入及营养素摄入对儿童血铅的影响.方法:随机选择263名儿童进行血铅测定和膳食调查,并用原子吸收分光光度法测定食物中的铅含量,了解儿童铅及营养素的摄入量.根据血铅值分为高血铅组(≥100μg/L)及低血铅组(＜100μg/L),对比两组食物中铅及营养素摄入量,采用Logistic回归分析各营养素摄入与血铅的相关性.结果:263名儿童血铅平均值为(80.84±42.79)μg/L,其中血铅值≥100μg/L的儿童有55名(20.91%).食物中铅摄入量范围为3.99～43.9μg/(kg·d),均高于暂定每周摄入量(PTWI),高血铅组儿童铅摄入量较高,但总能量、糖类、纤维素、视黄醇、维生素B1、维生素B2、镁、磷等摄入量相应较低.Logistic回归分析显示,糖类、视黄醇是降低儿童血铅的因素.结论:机体血铅增高可能与铅摄入量较多,总能量、纤维素、维生素B1、B2、镁、磷,尤其是糖类、视黄醇摄入量相应较低有关.     

A study of the relationship between ambient lead and blood lead among lead battery workers

 Objective: To examine the relationship between ambient lead levels and blood lead levels and to explore the modifiers of the relationship between ambient lead and blood lead. Method: A cross-sectional study was conducted in two lead battery factories. Blood lead level and ambient lead concentration were measured for each participant concurrently. A structured questionnaire was administered to collect sociodemographic characteristics and occupational history. Design: Biological and personal environmental measurements of 219 lead-exposed workers were analyzed by both simple and multiple linear regression. A regression model was selected for interpretation. Results: A high correlation (r=0.62) between ambient lead (PbA) and blood lead (PbB) was observed. In addition, numerous factors, including age, sex, alcohol consumption, personal hygiene practice and type of lead exposure, were also found to influence blood lead levels. Although PbB was highly correlated with PbA, blood lead level may not be effectively lowered by reducing ambient lead level. Based on the regression coefficients, improvement of hygienic practice was more effective at lowering PbB than reducing ambient lead level. Good hygienic practice may be the preferential way to reduce lead exposure in current conditions. Conclusion: Education of correct work practice may be more important than engineering control in the developing countries to lower blood lead levels in lead battery factories. Received: 28 May 1996/Accepted: 30 August 1996     

儿童高铅血症及轻度铅中毒的药物治疗

铅在人体内没有任何功能,儿童受铅的损害比成人更敏感。对于高铅血症和轻度铅中毒尚没有公认有效的治疗药物,但高铅血症和轻度铅中毒对儿童的智力和身体发育都存在影响。近年来,临床上用微量元素、维生素、金属硫蛋白和中药对高铅血症和轻度铅中毒进行治疗,这些药物可以减少铅在胃肠道的吸收,降低铅的毒性,改善症状。     

Relationship of air lead and blood lead for workers at an automobile battery factory

Summary Air lead and blood lead data, recorded over a period of 3 years for 972 employees at an automobile battery factory as part of a lead control program, were summarized and statistically analyzed. The air lead values were measured by mobile area samplers for approximately 2 years and then by personal samplers for approximately 1 year. Blood lead analyses were usually performed once a month for most of the workers.The trend in air lead levels was significantly upward in the 1st year and significantly downward in the 2nd year while the trend in blood lead levels was significantly downward in the 1st year and in the 3rd year. There were no other significant trends.To assess the relationship between air lead and blood lead, data were used whenever an air lead obtained by personal sampler was followed within 1 month by a blood lead on the same worker. The variables age, job tenure, and department identity were included in an analysis of covariance. Only air lead and departments were significant, accounting for 9% and 13% of the variance in blood lead, respectively. From these data 95% confidence limits were calculated for predicting blood leads from given air leads for an individual worker. These were 30–68 g/100 ml at 200 g/m³; 25–62 g/ 100 ml at 100 g/m³, and 22–60 g/100 ml at 50 g/m³.     

Longitudinal associations between lead dose and renal function in lead workers

Background

Existing research on the lead dose range associated with nephrotoxicity in the occupational setting is inconsistent and primarily cross-sectional in design.

Objective

To determine if lead dose predicts change in renal function in a large population of current and former lead workers.

Methods

Three evaluations were performed between 1997 and 2001. Lead dose was assessed with blood and tibia lead. Renal outcomes included blood urea nitrogen, serum creatinine, and calculated creatinine clearance. We used generalized estimating equations to model change in renal function between each evaluation in relation to tibia lead at the beginning of each follow-up period and concurrent change in blood lead, while adjusting for baseline lead dose and other covariates.

Results

At baseline, mean (SD) age and duration of occupational lead exposure were 42.0 (9.3) and 8.8 (6.3) years, respectively, in 537 current and former lead workers followed over a mean of 2.1 years. Mean (SD) blood and tibia lead were 31.3 (14.4) μg/dl and 35.0 (37.8) μg/g bone mineral, respectively. Women (25.9%) were older and more likely to be former lead workers than men. In males, serum creatinine decreased and calculated creatinine clearance increased over the course of the study. Mean blood lead was not significantly different between evaluations 1 and 3 in either sex, however, tibia lead decreased in women. Blood and tibia lead were significantly associated with change in renal function. In males, serum creatinine decreases and calculated creatinine clearance increases were greatest in participants whose blood lead declined.

Conclusions

Both acute and chronic occupational lead dose measures were associated with change in renal function measures prospectively.     

29种元素含量及比值与大鼠铅蓄积水平及铅暴露时间相关性研究

目的:通过对29种无机元素定量分析,探讨非铅元素含量及比值与铅染毒大鼠体内铅蓄积水平及铅暴露时间之间的关系。方法:选取健康的4周龄雄性SD大鼠75只,随机分成25组,采取"大剂量范围,小浓度间隔"的短、中、长期染毒方法。在实验开始后,第40、80、120天分别从各组随机选取1只大鼠,经乙醚麻醉后股动脉取血,并留发样待测。用电感耦合等离子体质谱法(ICP-MS)测定血和毛发中的29种元素含量。结果:血铅、发铅含量和灌胃剂量呈良好的剂量趋势;血铅和发铅在不同染毒时间有差异,随着染毒时间的延长,含量增加;血铅和发铅存在相关性,但随着时间相关性变差;铅与多种元素之间存在相关性;某些元素对的比值在40,80和120天有统计学差异。结论:血铅和发铅含量均与灌胃剂量和染毒时间呈现良好相关关系;非铅元素浓度及其比值有可能被用作估算生命体铅蓄积水平的综合指标;铅暴露时间延长会导致某些非铅元素对比值的变化;发铅可能更适合用作铅染毒的生物标志物。     

无锡市某私营铅蓄电池厂铅作业危害分析

目的监测与评价某私营铅蓄电池厂铅作业相关的职业病危害因素,为后续铅作业人员的个人防护和健康监护提供科学依据。方法采用现场调查方法了解该企业职业卫生管理现状,按GBZ159—2004、GBZ／T160．10～2004和GBZ2．1—2007等对工作场所中铅烟、铅尘进行检测和分析并结合职业健康检查分析影响工作人员血铅浓度的潜在因素。结果该企业存在铅烟、铅尘等职业病危害因素;铅烟、铅尘超标率为92．1％,铅作业人员血铅浓度增高比例为77．5％;铅作业人员血铅浓度与工龄、学历、下班前是否沐浴以及铅作业相关卫生知识知晓率有关（均P〈0．05）。结论该私营企业存在明显的铅作业危害,应改善工作环境,加强作业人员健康宣教及健康防护。     

同体儿童血、发铅浓度及同位素比值研究

目的探讨儿童血、发铅同位素比值的指纹特征,为寻找人体可蓄积性铅源做数据积累。方法随机抽取北京城市和农村儿童各14名,男女各半,用ICP-MS测定其血样及发样的铅浓度及同位素比值。结果城市和农村儿童的血铅同位素比值不同,而发铅同位素比值则无显著性差异;发铅同位素比值与血铅同位素比值有显著性差异,即同体血、发铅指纹存在差异现象。结论北京市城乡两地的血铅污染程度近似,但铅源不完全相同;人体不同组织器官对不同铅同位素可能具有选择性蓄积。     

Efficacy of a lead based paint XRF analyzer and a commercially available colorimetric lead test kit as qualitative field tools for determining presence of lead in religious powders

The performances of a portable X-Ray Fluorescence (XRF) lead paint analyzer (RMD LPA-1, Protec Instrument Corp., Waltham, MA) and a commercially available colorimetric lead test kit (First Alert Lead Test Kit, eAccess Solutions, Inc., Palatine, IL) were evaluated for use by local or state health departments as potential cost-effective rapid analysis or “spot test” field techniques for tentative identification of lead content in sindoor powders. For both field-sampling methods, sensitivity, specificity and predictive values varied widely for samples containing <300,000 µg/g lead. For samples containing ≥300,000 µg/g lead, the aforementioned metrics were 100% (however, the CIs had a wide range). In addition, both field sampling methods showed clear, consistent positive readings only for samples containing ≥300,000 µg/g lead. Even samples with lead content as high as 5,110 µg/g were not positively identified by either field analysis technique. The results of this study suggest the XRF analyzer and colorimetric lead test kit cannot be used as a rapid field test for sindoor by health department inspectors.     

The continuing impact of lead dust on children's blood lead: Comparison of public and private properties in New Orleans

Background

Compared with a maximum collective lead (Pb) estimate of ∼1811 metric tons (MT) in exterior paint on 86,000 New Orleans houses, Pb additives in gasoline were estimated at ∼12,000 MT in New Orleans, yielding ∼9100 MT Pb exhausted as aerosols from vehicles; ∼4850 MT were particles >10 μm and ∼4200 MT were particles <0.25 μm.

Objectives

To evaluate pre-Hurricane Katrina soil Pb and children's blood Pb at public housing and private residential properties in the inner-city compared with the outer city of New Orleans.

Methods

This study includes 224 soil samples from 10 public housing properties and 363 soil samples from residential private properties within an 800 m radius of centroids of public housing census tracts. The Louisiana Childhood Lead Poisoning Prevention Program data from 2000 to 2005 (pre-Hurricane Katrina) was the source for 9807 children's blood Pb (μg/dL) results. Soil and blood Pb data were grouped by public housing census tracts and private residential properties. This study uses Multi-Response Permutation Procedures for statistical analysis.

Results

Brick public properties in the city core had significantly more soil Pb contamination and higher prevalence of elevated children's blood Pb than same-aged brick public properties in the outer areas of the city. The pre-Hurricane Katrina New Orleans concentration of Pb dust in the inner-city soil displayed a median of 438 mg/kg or 3.7 times larger than Pb dust in outlying areas where the median soil Pb was 117 mg/kg (p-value=2.9×10⁻¹⁵). Also, the pre-Hurricane Katrina prevalence of children's blood Pb ≥10 μg/dL was 22.9% within the inner-city compared with 9.1% in the outer areas of New Orleans (p-value=3.4×10⁻⁷⁴).

Conclusions

Comparing the quantities of Pb dust from paint and Pb additives to gasoline, this study supports the later source as a more plausible explanation for the differences in soil Pb and children's blood Pb within public and private housing in the higher traffic congested inner-city core compared with the lower traffic congested outer areas of New Orleans. Similar patterns of environmental Pb dust contamination and childhood Pb exposure are expected in all cities.     

Lead exposure in starter battery production: investigation of the correlation between air lead and blood lead levels

The threshold limit value (TLV) for lead (in Germany, the MAK value) is based on a certain blood lead concentration (in Germany BAT value = biological tolerance value for working materials) that is not to be exceeded; thereby a statistically significant association between air lead (PbA) and blood lead (PbB) is assumed. On the basis of a 10-year period of (1982–1991) biological and ambient monitoring of 134 battery factory staff and their workplaces, a PbA/PbB correlation with the regression equation PbB = 62.183 + 21.242 × Log 10 (PbA) (n = 1089, r = 0.274, P < 0.001) was calculated. These results are in line with those of several other investigations. The shape of the regression curve and the wide scattering of values led to the assumption that PbA values above the MAK value (0.1 mg/m³) do not necessarily result in increased PbB values. Similarly, PbA values lower than the MAK value do not guarantee PbB levels below the BAT value in every case. These observations are influenced by numerous confounders and intervening variables. It is concluded that lowering MAK values as a consequence of lowering BAT values is not mandatory.