我国地方性砷中毒研究进展

地方性砷中毒是特定地区的居民由于环境的自然污染或人为污染摄入过量的砷化物所引起的一种地方病.饮用砷天然污染的地下水是人体高砷暴露的主要途径.20世纪末发生在孟加拉、印度和中国的饮水型慢性砷中毒引起了世界范围的广泛关注,在南北美洲等20余个国家也有不同程度的砷中毒流行.     

大同市饮水型地方性砷中毒病区环境生态中砷暴露水平调查

目的调查山西省大同市饮水型地方性砷中毒病区外环境中砷暴露水平。方法从山西省大同市某地方性砷中毒病区抽取85名常住人口作为调查对象,慢性砷中毒按照《地方性砷中毒诊断标准》进行诊断,并采集暴露人群的日常饮用水、土壤和瓜果蔬菜。日常饮用水和土壤通过原子荧光分光光度计定量检测其中砷含量,瓜果蔬菜中的总砷含量采用电感耦合等离子体质谱联用仪(ICP-MS)测定。结果在抽取的85名居民日常饮用水中,水砷范围14.41~90.34μg/L,中位数为43.88μg/L。采集的瓜果蔬菜砷含量范围为0.001~0.771 mg/kg,均数为0.0598 mg/kg,超标率为43.04%,其中瓜果蔬菜中砷超标率呈现叶菜类>根茎类>果菜类的趋势。食用污染严重的叶菜类蔬菜中摄入砷引起的健康风险达到71.77%。本地方性砷中毒病区东南西北4个方向的土壤砷含量未超过国家标准。结论山西省大同市饮水型地方性砷中毒病区饮用水、自产瓜果蔬菜砷含量均高,饮用砷污染的水是引起慢性砷中毒的主要因素,通过食用自产瓜果蔬菜染砷这一途径也不可忽视。     

地方性砷中毒

地方性砷中毒是指由于长期饮用含高砷地下水,或暴露于燃用高砷煤,引起以皮肤色素沉着或(和)脱失、掌跖角化等皮肤改变为主要表现,同时伴有中枢神经系统、周围神经、血管、消化系统等多方面症状的全身性疾病。地方性砷中毒多为慢性中毒,是地方病中发现历史最短、了解最少的一种地方病。由于其危害不只限于摄入砷的一段时期,在中止摄入后,仍可持续较长时间,尤其砷可引起恶性肿瘤等,因此引起广泛关注。1病因和分类地方性砷中毒可分为饮水型和燃煤污染型。饮水型最常见,燃煤型仅见于我国的某些地方。饮水型是由于饮用高砷水,直接由消化道摄入过…     

河北省饮水砷含量现况调查

目的：掌握河北省居民饮水砷含量现状以及是否存在地方性砷中毒，以便科学的制定防治措施。方法：在重点地区采取随机抽样方法选取调查点进行饮水砷含量测定及地方性砷中毒调查。结果：2003～2005年在河北省7个县35个乡175个村共采集722份居民生活饮用水，最高值为0.048mg/L。未发现砷中毒病人，也未发现饮水型砷中毒病区。结论：河北省饮用水砷含量全部在安全范围内。     

以转化应用为导向加强砷毒作用机制研究

砷是一种环境毒物,多以化合物的形式广泛存在于自然界中,地球化学元素分布不均和工农业用途均会造成环境污染,导致环境中居民发生急慢性砷中毒甚至癌症.地球化学性因素导致的地方性砷中毒(以下简称地砷病)是影响面广、后果严重的世界性公共卫生问题,包括因长期饮用高砷地下水导致的饮水型砷中毒和因燃用高砷煤导致空气和食物污染而引起的燃煤型砷中毒.目前地砷病至少威胁着22个国家和地区的5000多万人口;其中饮水型砷中毒在我国大陆地区9个省(自治区)存在,受威胁人口约185万,燃煤型砷中毒是全球惟一存在于我国贵州和陕西两省的病型,受威胁人口122万[1].     

MT2A基因多态性与新疆饮水型地方型砷中毒的关联研究

目的 探讨金属硫蛋白(MT)2A基因多态性与饮水型地方性砷中毒易感性的关系.方法 于2007年选择新疆奎屯饮水型地方性砷中毒病区饮用高砷水5年以上的慢性砷中毒患者共96人作为病例组;选择该病区饮用砷含量正常水源5年以上的健康人群共73人作为内对照组;选择非病区正常健康人群共89人作为外对照组.应用聚合酶链反应-限制性片...     

2020年四川省饮水型地方性砷中毒消除评价结果分析

目的 评估四川省饮水型地方性砷中毒防控成效,为调整防控措施提供依据。方法 按照《四川省饮水型地方性砷中毒消除评价实施方案》的要求,2020年在甘孜州稻城县、雅江县和阿坝州金川县3个县10个高砷村调查改水工程运转情况、水砷含量情况、地砷病患病情况等,开展饮水型地方性砷中毒消除评价工作。结果 饮水型地方性砷中毒高砷村改水率为100%,改水工程正常运转率为100%,饮用水水砷含量中位数为0.003 mg/L,水砷含量合格率为100%,检查了1 955人,检出病人6人,患病率为0.31%,病人均为轻度,无中、重度病人,未发现新发病人。结论 四川省饮水型地方性砷中毒防控措施有效,已达到消除标准,还应继续采取积极的防控措施,确保保持持续消除状态。     

江汉平原高砷地下水区水、沉积物砷含量及饮水型地方性砷中毒调查

目的通过对水砷、沉积物砷含量及饮水型地方性砷中毒的调查,进一步掌握江汉平原饮水型地方性砷中毒发病动态。方法 2010-2013年以江汉平原中部的仙桃市、洪湖市作为典型研究区,水砷、沉积物砷含量检测采用二乙基二硫代氨基甲酸银分光光度法,砷中毒诊断采用地方性砷中毒诊断标准。结果 2010-2013年间水砷均值呈逐年递减,但年间差异无统计学意义(F=0.76,P=0.52);各监测点沉积物砷含量与土层深度均呈负相关(r值分别为-0.674、-0.519、-0.571,P值均0.05)。结论江汉平原饮水型地方性砷中毒区土层深度与砷含量呈负相关。     

四川省金川县饮水型砷中毒流行病学调查

目的　了解金川县砷中毒的病情及流行特征 ,查明引起砷中毒的高砷来源。方法　对经检测饮水砷含量超标的村进行病情调查 ,同时对该村的地理、地貌、饮用水源及环境中砷污染情况进行调查 ,测定内环境和外环境介质中砷含量。结果　饮水砷含量检测有 3个共饮泉水源超标 ,最高饮水砷含量达 0 2 87mg/L ,超标 5倍多 ;共调查 375人 ,查出患者 6 2人 ,患病率为 16 5 3% ,其中年龄最小 11岁 ,最大 83岁。结论　四川省存在地方性砷中毒。共饮泉水中砷含量超标是引起该病流行的主要因素。由于没有其他环境砷污染 ,水砷含量高是自然形成的 ,因此属于饮水型地方性砷中毒     

我国各型砷中毒临床表现特点及高砷环境成因

我国地方性砷中毒分布很广，截止１９９５年已先后在台湾、新疆、内蒙、贵州、山西等省、自治区发现砷中毒流行。其中台湾、新疆、内蒙、山西为饮水型砷中毒，贵州为燃煤型砷中毒。饮水及燃煤型砷中毒均存在氟砷联合型的砷中毒。由于饮水或燃煤中各种形态的砷含量、理化性...     

蚌埠市高砷水源筛查及地方性砷中毒病情分析

目的调查蚌埠市高砷水源的分布和地方性砷中毒患病情况,为改水和砷中毒防治提供依据。方法在2003年和2005年调查的基础上,对已知高砷区的周边和蚌埠市淮河沿岸的行政村进行水源筛查和病情调查。在被调查自然村的东、西、南、北、中5个不同方位,按被调查村的总水源数的10%的进行采样。对饮水砷含量较高（超过0.15mg/L）的村进行居民病情普查。结果在调查的400份水样中,65份水样砷超标,最高达0.62mg/L,平均水砷0.14 mg/L,超标水井的平均井深24.69m;病情调查共调查2 411人,发现157例地方性砷中毒病例,患病率为6.51%,男女之间无差异（χ^2=1.02,P〉0.05）,随着年龄增加,患病率增高（χ^2=190.84,P〈0.01）。结论蚌埠市沿淮河两岸存在地方性砷中毒病区,形成原因还有待进一步研究;对于水砷超标严重、患病率高的村庄应尽快实施改水;对于水砷超标和患病率没有出现正相关关系这一现象,应做进一步研究分析。     

陕西省饮水型砷中毒病区和高砷区改水降砷现状调查

目的 研究我省已查明饮水型地方性砷中毒病区和高砷区改水降砷防治措施落实和工程运转情况,为进一步落实防治措施提供理论依据.方法 本研究于2011年6月采用询问法对陕西省商洛市、汉中市和咸阳市每个病区村和高砷水区进行调查,调查改水降砷防治措施落实和工程运转情况,并记录调查人、被调查人的身份和联系方式以便核实;现场查看改水降砷工程水源地,采集水源水水样,采用北京吉天仪器有限公司生产的AFS-930双道原子荧光光度计检测,依据GB5749-2006进行评价.结果 在80个自然村或村民小组中,有61个自然村或村民小组已经改水,改水率为76.25％(61/80),未改水的有19个,占23.75％(19/80);检测17份水样,水砷含量在0.000 4～0.008mg/L之间.结论 我省饮水型砷中毒病区和高砷水区基本实施改水降砷,已改水的自然村水砷均符合国家饮用水卫生标准.建议有关部门尽快落实未改水自然村的防治措施,实施全面改水;对于居住分散,一时无法找到合适水源,而现有的供水网络无法纳入的农户,建议实施搬迁,使病区百姓早日脱离高砷危害.     

Urinary Arsenic Speciation and its Correlation with 8-OHdG in Chinese Residents Exposed to Arsenic Through Coal Burning

In contrast to arsenicosis caused by consumption of water contaminated by naturally occurring inorganic arsenic, human exposure to this metalloid through coal burning has been rarely reported. In this study, arsenic speciation and 8-hydroxy-2′-deoxyguanosine (8-OHdG) levels in urine were determined in the Chinese residents exposed to arsenic through coal burning in Guizhou, China, an epidemic area of chronic arsenic poisoning caused by coal burning. The urinary concentrations of inorganic arsenic (iAs), monomethylarsonic acid (MMA), dimethylarsinic acid (DMA) and total arsenic (tAs) of high-arsenic exposed subjects were significantly higher than those of low-arsenic exposed residents. A biomarker of oxidative DNA damage, urinary 8-OHdG level was significantly higher in high-arsenic exposed subjects than that of low exposed. Significant positive correlations were found between 8-OHdG levels and concentrations of iAs, MMA, DMA and tAs, respectively. In addition, a significant negative correlation was observed between 8-OHdG levels and the secondary methylation ratio (DMA/(MMA + DMA)). The results suggest that chronic arsenic exposure through burning coal rich in arsenic is associated with oxidative DNA damages, and that secondary methylation capacity is potentially related to the susceptibility of individuals to oxidative DNA damage induced by arsenic exposure through coal burning in domestic living.     

石门雄黄矿地区居民砷暴露研究

目的：研究砷污染地区居民砷暴露水平的分布特征。方法：分析污染区和对照区环境样品和居民头发砷含量。结果：污染区三个村土壤砷含量８４．１７～２９６．１９ｍｇ／ｋｇ。河水砷含量达０．５～１４．５ｍｇ／Ｌ，井水、自来水、食物含砷量一般符合国家卫生标准。砷摄入量１９５～１１２９μｇ／ｄ。居民头发砷含量中位数为０．９７２～２．４５９μｇ／ｇ。发砷值随年龄增加而增加。结论：石门雄黄矿附近地区河水砷污染严重，以河水为饮用水源的居民砷暴露水平达到甚至超过国内外重大慢性砷中毒案例的暴露水平，应引起重视     

Urinary arsenic metabolites of subjects exposed to elevated arsenic present in coal in Shaanxi Province, China

In contrast to arsenic (As) poisoning caused by naturally occurring inorganic arsenic-contaminated water consumption, coal arsenic poisoning (CAP) induced by elevated arsenic exposure from coal combustion has rarely been reported. In this study, the concentrations and distributions of urinary arsenic metabolites in 57 volunteers (36 subjects with skin lesions and 21 subjects without skin lesions), who had been exposed to elevated levels of arsenic present in coal in Changshapu village in the south of Shaanxi Province (China), were reported. The urinary arsenic species, including inorganic arsenic (iAs) [arsenite (iAsIII) and arsenate (iAsV)], monomethylarsonic acid (MMAV) and dimethylarsinic acid (DMAV), were determined by high-performance liquid chromatography (HPLC) combined with inductively coupled plasma mass spectroscopy (ICP-MS). The relative distributions of arsenic species, the primary methylation index (PMI=MMAV/iAs) and the secondary methylation index (SMI=DMAV/MMAV) were calculated to assess the metabolism of arsenic. Subjects with skin lesions had a higher concentration of urinary arsenic and a lower arsenic methylation capability than subjects without skin lesions. Women had a significantly higher methylation capability of arsenic than men, as defined by a higher percent DMAV and SMI in urine among women, which was the one possible interpretation of women with a higher concentration of urinary arsenic but lower susceptibility to skin lesions. The findings suggested that not only the dose of arsenic exposure but also the arsenic methylation capability have an impact on the individual susceptibility to skin lesions induced by coal arsenic exposure.     

中国地方性砷中毒分布调查(总报告)

为查清我国地方性砷中毒的基本分布 ,指导和推进我国的地方性砷中毒的防治工作 ,采用环境流行病学调查方法 ,包括回顾性环境流行病学调查 ,重点病区调查和面上抽样调查 ,搜集掌握病情资料。采用环境化学标准方法与质量控制分析环境砷水平 ,回顾性调查中利用己有的环境砷资料 ,重点调查与面上抽样现况调查中检测环境砷含量。最后对二者结果进行计算机统计分析。饮水型地方性砷中毒分布于 8省市区 ,40个县旗市 ,受影响人口 2 3 4 3 2 3 8人 ,其中饮水砷 >0 .0 5mg L高砷暴露人口 52 2 566人 ,查出砷中毒 782 1人。内蒙、山西仍为我国饮水型地方性砷中毒重病区 ,新疆乌苏市的生产建设兵团与乌苏中的大部分高砷地区集中改水 ,病情减轻。内蒙、山西的一些乡村集中改水降砷效果较好。新确认吉林、宁夏各 1县饮水型地方性砷中毒 ,其中以吉林省病区为典型。新发现山西 11县市、内蒙 1旗、吉林 1市、宁夏 1县、青海 1县和安徽 2县市的饮水型地方性砷中毒。新发现北京顺义区仍有饮水高砷暴露乡镇。未发现其它省、市、自治区有饮水高砷暴露地区。确认辽宁省曾报道的饮水高砷点现已消除 ;浙江桐乡市已有的饮水高砷地区现已降至饮水砷卫生标准以下 ;并发现北京市顺义区天竺乡天竺村连续 2 0余年的饮水高砷井自然转变?     

饮水高含砷地区新生儿畸形的调查分析

目的 探讨饮水高含砷地区新生儿畸形发生率水平及特点.方法 采用横断面调查方法,对饮水高含砷地区1998-2004年7年间的新生儿出生情况进行调查,畸形诊断分类以国际疾病分类为基础(ICD-10),参考我国常规监测的先天畸形分类诊断,确定了6类24种先天畸形分类软件.结果 本次共调查新生儿2467例,发现新生儿畸形49例,检出率为198.62/万;饮水高含砷地区新生儿畸形率明显高于一般人群;检出类型中按照系统划分依次为中枢神经系统畸形、肢体畸形、先天性心脏病.结论 饮水高含砷地区新生儿的畸形发生率高于一般人群.     

Chronic arsenic poisoning from burning high-arsenic-containing coal in Guizhou, China

Arsenic is an environmental hazard and the reduction of drinking water arsenic levels is under consideration. People are exposed to arsenic not only through drinking water but also through arsenic-contaminated air and food. Here we report the health effects of arsenic exposure from burning high arsenic-containing coal in Guizhou, China. Coal in this region has undergone mineralization and thus produces high concentrations of arsenic. Coal is burned inside the home in open pits for daily cooking and crop drying, producing a high concentration of arsenic in indoor air. Arsenic in the air coats and permeates food being dried producing high concentrations in food; however, arsenic concentrations in the drinking water are in the normal range. The estimated sources of total arsenic exposure in this area are from arsenic-contaminated food (50-80%), air (10-20%), water (1-5%), and direct contact in coal-mining workers (1%). At least 3,000 patients with arsenic poisoning were found in the Southwest Prefecture of Guizhou, and approximately 200,000 people are at risk for such overexposures. Skin lesions are common, including keratosis of the hands and feet, pigmentation on the trunk, skin ulceration, and skin cancers. Toxicities to internal organs, including lung dysfunction, neuropathy, and nephrotoxicity, are clinically evident. The prevalence of hepatomegaly was 20%, and cirrhosis, ascites, and liver cancer are the most serious outcomes of arsenic poisoning. The Chinese government and international organizations are attempting to improve the house conditions and the coal source, and thereby protect human health in this area.     

Current status and prevention strategy for coal-arsenic poisoning in Guizhou, China

Arsenic exposure from burning coal with high arsenic contents occurs in southwest Guizhou, China. Coal in this region contains extremely high concentrations of inorganic arsenic. Arsenic exposure from coal-burning is much higher than exposure from arsenic-contaminated water in other areas of China. The current status and prevention strategies for arsenic poisoning from burning high-arsenic coal in southwest Guizhou, China, is reported here. Over 3,000 arsenic-intoxicated patients were diagnosed based on skin lesions and urinary arsenic excretion. Non-cancerous toxicities and malignancies were much more common and severe in these patients than in other arsenic-affected populations around the world. The high incidence of cancer and arsenic-related mortality in this cohort is alarming. Chelation therapy was performed but the long-term therapeutic effects are not satisfactory. The best prevention strategy is to eliminate arsenic exposure. Funds from the Chinese Government are currently available to solve this arsenic exposure problem. Strategies include the installation of vented stoves, the use of marsh gas to replace coal, health education, the improvement of nutritional status, and the use of various therapies to treat arsenic-induced skin and liver diseases.     

砷的职业接触生物监测指标

砷是一种自然界中多以化合物形式存在的常见类金属元素,在生产中应用广泛。随着职业接触人群越来越多,砷中毒越来越受到人们的重视。环境中的砷主要通过消化道、呼吸道和皮肤黏膜等进入人体,长期暴露于无机砷环境中可引起人体多种脏器损伤及其功能障碍,严重时可引发癌前病变。本文将对职业接触人群有关砷的生物监测指标予以综述。