接触低浓度硫化氢对工人健康的影响

选取某公司577名接触硫化氢的作业工人(其中有114名工人参加1999年和2004年体检)作为接触组,以条件相当的不接触任何毒物的373名商贸职工作为对照组,分析硫化氢对作业工人健康状况的影响。结果显示,长期接触低浓度硫化氢对作业人群的影响主要表现为上呼吸道的刺激作用。     

Cumulative effects of daily toluene exposure

Summary To study the elimination of toluene under irregular long-term exposure conditions, we investigated eight workmen who were exposed to concentrations of toluene between 184 ppm and 332 ppm in a plastic processing factory during 2 consecutive weeks. Besides the daily toluene concentrations in ambient air, the toluene concentrations in blood before and after the shifts were determined three times a week.The average concentrations in blood before the shift during the 2 weeks increased 10-fold and in some cases to 20 times the initial value. At average concentrations in the ambient air about the MAC-value the increase was found to be nearly the same. The relevance of these findings concerning the accumulation in other organs of the human body is discussed.     

氧疗对急性硫化氢中毒大鼠的心肌和肺及肝组织形态学的影响

目的 评价不同氧疗技术(常压下不同浓度吸氧及高压氧)对急性硫化氢(H2S)中毒大鼠的心肌、肺、肝组织形态学的影响.方法 雄性健康Wistar大鼠100只随机分为5组:正常对照组(吸入空气)、染毒组(H2S静式染毒60 min)、33%氧疗组及50%氧疗组(染毒结束后20 min内,将大鼠移置常压下含氧浓度为33%、50...     

硫化氢中毒致8例患者周围神经损害的临床分析

目的：探讨硫化氢中毒患者周围神经损害的临床特征和肌电图表现。方法：回顾性分析温岭医院收治的8例渔舱硫化氢中毒患者周围神经损害的临床资料。结果：硫化氢中毒致患者双侧正中神经、尺神经、腓总神经运动端潜伏期和神经传导速度明显慢于健康对照组，但诱发电位波幅无明显变化。结论：渔舱硫化氢中毒可致患者周围神经的亚急性损伤，提示在抢救急性硫化氢中毒的同时应早期发现和治疗周围神经的损害。     

高铁血红蛋白生成剂(MFA)对急性硫化氢中毒动物治疗作用的实验研究

目的 通过动物实验探讨MAF对急性硫化氢中毒的治疗作用。方法 将40只大鼠分为正常对照组、染毒对照组、美蓝求治组、4－DMAP救治组。以致死浓度的硫化氢染毒2min,对两组救治组动物分别给以美蓝和4－DMAP进行急救,2h后做相应生化及病理检查。结果 两救治组MHb、SMHb显著高于两对照组,4－DMAP组MHb、SMHb明显高于美蓝组;染毒对照组肺组织明显充血、水肿,两救治组主要表现为充血。结论 MFA对急性硫化氢中毒动物起到解毒作用,而4－DMAP效果优于美蓝。     

Occupational exposure to hydrogen sulfide in the sour gas industry: some unresolved issues

Occupational exposure to hydrogen sulfide (H₂S) and the medical management of H₂S-associated toxicity remains a problem in the sour gas industry and some other industrial settings. The acute effects of exposure to H₂S are well recognized, but accurate exposure-response data are limited to acutely lethal effects, even in animal studies. Odor followed by olfactory paralysis and kerato-conjunctivitis are the characteristic effects of H₂S at lower concentrations. H₂S-induced acute central toxicity leading to reversible unconsciousness is a knockdown; it is controversial whether repeated or prolonged knockdowns are associated with chronic neurologic sequelae but the evidence is suggestive. Knockdowns can be acutely fatal as a consequence of respiratory paralysis and cellular anoxia. Pulmonary edema is also a well-recognized acute effect of H₂S toxicity. Human studies of sublethal exposure with satisfactory exposure assessment are almost nonexistent. There are indications, poorly documented at present, of other chronic health problems associated with H₂S exposure, including neurotoxicity, cardiac arrhythmia, and chronic eye irritation but apparently not cancer. Rigorous and comprehensive studies in the sour gas industry are difficult, in part because of confounding exposures and uncertain end points.     

白细胞内源性硫化氢产生速率与高血压及炎性因子的关系

目的调查高血压患者白细胞内源性硫化氢产生速率的变化，并探讨其影响高血压发生的可能机制。方法选取初诊高血压及有高血压病史者90例高血压组，又分为两个亚组，即高血压未治疗组（高血压未治疗亚组）45例、高血压血压控制良好组（高血压控制组）45例，选取同期、同科室血压正常患者90例为正常对照组（正常对照组），通过测量白细胞内源性硫化氢产生速率及血浆高血压相关炎性因子的浓度，分析各组自细胞内源性硫化氢产生速率的变化，并探讨其对高血压相关炎性因子的影响。结果高血压未治疗亚组白细胞内源性硫化氢产生速率明显低于高血压控制亚组及正常对照组[高血压未治疗亚组（0．142±0．064）nmol／μg、高血压控制亚组（0．202±0．085）nmol／μg、正常对照组（0．214±0．085）nmol／μg，P〈0．011，且血浆高血压相关炎性因子明显高于高血压两个亚组（P〈0．01），白细胞内源性硫化氢产生速率与高血压相关炎性因子-存在明显负相关（P〈0．01）。结论白细胞内源性硫化氢产生减少可能是高血压发生的原因之一，它可能通过影响高血压相关炎性因子的产生导致血压升高。     

硫化氢对大鼠肝窦内皮细胞凋亡影响

目的 观察硫化氢对肝窦内皮细胞(SEC)凋亡的影响.方法 利用胶原酶灌注、Percoll密度梯度离心、选择性贴壁培养去除Kupffer细胞方法分离SEC.原代培养SEC分成为正常对照组、过氧化氢诱导组、硫氢酸钠预处理+过氧化氢组、PPG处理组和PPG预处理+过氧化氢组,各组培养24h再行实验研究.经相应的过氧化氢(200 μmol/L)、硫氢酸钠(200 μmol/L)、PPG(2 mmol/L)处理后,应用流式细胞仪检查各组细胞凋亡、线粒体跨膜电压及easpase-3活化情况.结果 SEC在过氧化氢诱导下,细胞线粒体跨膜电压降低,细胞荧光强度增加(t =5.56,P ＜0.01),caspase-3活化,细胞发生凋亡,并以早期凋亡较为明显(t=4.68、7 26,P＜0.01);硫氢酸钠预处理后,过氧化氢诱导作用降低,细胞荧光强度降低(t=4.391,P＜0.01),caspase-3活化程度降低,细胞凋亡显著减少(t=3.776、5 626,P＜0.01);应用PPG抑制内源性硫化氢产生后,caspase-3轻度活化,SEC凋亡增加,且以早期凋亡增加为主(t=5.109,P＜0.01);加过氧化氢诱导后,细胞线粒体跨膜电压减少,细胞内荧光强度显著增加(t=10.635,P＜0.01),caspase-3活化程度增强,SEC的早、晚期凋亡率均显著增加(t=8.036、9.112,P＜0.01).结论 硫化氢可能通过抑制肝窦内皮细胞的线粒体跨膜电压变化,进而抑制caspase-3的活化而抑制肝窦细胞凋亡.     

职业性急性硫化氢中毒救治现状

硫化氢是我国威胁劳动者生命及健康的重要职业病危害因素,急性硫化氢中毒发病率高,病情发展迅猛,救治比较困难,病死率极高.现场救治措施及综合治疗对硫化氢中毒的康复至关重要.心肺复苏、特效解毒药物DMAP的使用,早期大剂量糖皮质激素的使用、超声雾化吸入、莨菪碱类药物、纳洛酮的使用、高压氧治疗、维持重要脏器功能、纠正酸碱失衡及电解质紊乱等综合治疗,是提高抢救成功率、降低死亡率、减少后遗症发生的有效治疗措施.     

Respiratory effects of chronic hydrogen sulfide exposure

A cross-sectional study investigated whether the exposure of sewer workers to hydrogen sulfide (H₂S) was associated with reduced lung function. Sixty-eight sewer workers and 60 water treatment workers performed spirometric tests. Job titles were used to classify the sewer workers according to presumed H₂S exposure, and water treatment workers served as a comparison population presumed to have no occupational exposure to H₂S. There was a statistically significant difference in mean FEV₁/FVC values between sewer and water treatment workers of similar age, height, race, and smoking habits (?3.1, s.e. = 1.4). This deficit was greatest (?5.7, s.e. = 2.0) for sewer workers presumed to have high H₂S exposure. Nonsmoking sewer workers presumed to have high H₂S exposure achieved only 89% of their predicted FEV₁/FVC value, whereas nonsmoking water treatment workers achieved nearly 98% of their predicted FEV₁/FVC value. In conclusion, this study found evidence that chronic low level exposure to H₂S may be associated with reduced lung function. © 1995 Wiley-Liss. Inc.     

某硫黄回收装置硫化氢泄漏事故模拟与应急救援评估

目的对某硫黄回收装置硫化氢泄漏事故进行模拟,并提出应急救援的措施建议。方法分析装置生产工艺,结合原辅材料、主要设备、职业卫生现场调查等资料,找出最有可能造成急性中毒的职业病危害因素及典型设备,假设事故场景,利用事故后果模拟软件对急性中毒事故扩散影响范围和毒物扩散浓度进行模拟。结果若硫黄回收装置酸性气分液罐发生硫化氢泄漏事故,ERPG－3和IDLH等值线位于下风向距离约60m处;ERPG－2等值线位于下风向距离约148m处;ERPG－1等值线位于下风向距离约5980m处。结论进行泄漏事故模拟能够较好地给出有毒云团影响程度和范围,对应急救援有一定的指导意义。     

内源性硫化氢在大鼠截肢术后肺损伤中的变化及意义

目的研究内源性血浆硫化氢（H2S）／肺胱硫醚-γ-裂解酶（CSE）体系在截肢术后肺损伤中的变化及作用。方法雄性Wistar大鼠63只，构建大鼠截肢模型，按照不同时间点随机分为9组：正常对照组7只；手术后1、2、4、6、12、24、48、72h组，各7只。观察各组大鼠肺湿／干重比值（W／D）的变化及血浆H2S、肺CSE活性的变化。结果与正常对照组肺湿／干重比（4．931±0．334）比较，术后4h，肺湿／干重比值即开始明显上升，6h到最高5．9341±0．457（P〈0．01），后逐渐下降，48h恢复正常5．051±0．251（P〉0．05）。血浆H2S水平正常值为55．654±6．334μmol／L，手术后4h，血浆H2S水平开始明显下降。6h到最低39．286±6．525μmol／L（P〈0．01），24h恢复正常50．000±8．244μmol／L（P〉0．05）。肺CSE活性正常对照组为14．006±0．720pmol·min^-1·mg^-1,术后2h明显下降，6h达最低值11．340±1．436pmol·min^-1·mg^-1（P〈0．01）；后逐渐回升，4h恢复正常14．031±0．804pmol·min^-1·mg^-1（P〉0．05）。结论截肢术后可造成肺损伤，术后6h肺湿／干重比最高。内源性血浆H2S／肺CSE体系的下调可能在创伤致肺损伤的病理生理改变中具有重要作用。     

慢性心力衰竭患者血浆硫化氢水平的变化及临床意义

目的 检测慢性心力衰竭(CHF)患者血浆硫化氢水平变化情况,并探讨其相关临床意义.方法 选择118例CHF患者,按照NYHA心功能分级标准分级:Ⅱ级34例、Ⅲ级54例、Ⅳ级30例,按随机数字表法分为常规治疗组和硝普钠治疗组,每组59例.另选择30例健康体检者作为对照组.治疗前后采用去蛋白法测定血浆硫化氢水平.结果 CHF患者血浆硫化氢水平为(32.45±3.86) μ mol/L,低于健康体检者的(54.26±5.63)μmol/L,差异有统计学意义(P＜0.05).心功能Ⅱ、Ⅲ、Ⅳ级CHF患者血浆硫化氢水平分别为(43.26±4.73)、(31.87±4.12)、(23.66±3.54)μ mol/L,各分级间比较差异有统计学意义(P＜0.05).常规治疗组和硝普钠治疗组治疗前血浆硫化氢水平分别为(31.66±3.75)、(33.04±4.02)μmol/L,两组比较差异无统计学意义(P＞0.05);常规治疗组和硝普钠治疗组治疗后血浆硫化氢水平分别为(36.83±4.32)、(44.54±4.68)μmol/L,两组比较差异有统计学意义(P＜0.05);两组治疗后血浆硫化氢水平均较本组治疗前显著升高,差异有统计学意义(P＜0.05).常规治疗组显效11例,有效14例,总有效率为42.4％(25/59);硝普钠治疗组显效22例,有效18例,总有效率为67.8％(40/59),两组总有效率比较差异有统计学意义(P＜0.05).结论 血浆硫化氢水平的异常可能参与了CHF的发生、发展过程,并与CHF病情的严重程度密切相关,升高血浆硫化氢水平可以显著改善CHF患者的临床预后.     

接触低浓度硫化氢对听力的影响

本文对某化工厂有硫化氢密切接触史并连续工作八年以上的７７名工人进行了听力检查，同时与５０名非硫化氢接触人员进行了比较分析。结果表明：长期接触低浓度硫化氢对听力有一定的影响，且随接触硫化氢工龄的增加，对听力的损害逐渐加重     

Sensory and cognitive effects of acute exposure to hydrogen sulfide

Background

Some epidemiologic studies have reported compromised cognitive and sensory performance among individuals exposed to low concentrations of hydrogen sulfide (H₂S).

Objectives

We hypothesized a dose–response increase in symptom severity and reduction in sensory and cognitive performance in response to controlled H₂S exposures.

Methods

In separate exposure sessions administered in random order over three consecutive weeks, 74 healthy subjects [35 females, 39 males; mean age (± SD) = 24.7 ± 4.2; mean years of education = 16.5 ± 2.4], were exposed to 0.05, 0.5, and 5 ppm H₂S. During each exposure session, subjects completed ratings and tests before H₂S exposure (baseline) and during the final hour of the 2-hr exposure period.

Results

Dose–response reduction in air quality and increases in ratings of odor intensity, irritation, and unpleasantness were observed. Total symptom severity was not significantly elevated across any exposure condition, but anxiety symptoms were significantly greater in the 5-ppm than in the 0.05-ppm condition. No dose–response effect was observed for sensory or cognitive measures. Verbal learning was compromised during each exposure condition.

Conclusions

Although some symptoms increased with exposure, the magnitude of these changes was relatively minor. Increased anxiety was significantly related to ratings of irritation due to odor. Whether the effect on verbal learning represents a threshold effect of H₂S or an effect due to fatigue across exposure requires further investigation. These acute effects in a healthy sample cannot be directly generalized to communities where individuals have other health conditions and concomitant exposures.     

涵洞内氧、二氧化碳、硫化氢的检测与分析

〔目的〕检测分析涵洞内环境空气中氧和二氧化碳、硫化氢浓度及影响因素 ,为科学防治提供依据。〔方法〕选取涵洞内外空气中氧、二氧化碳、硫化氢等气体为检测项目 ,探讨引起缺氧和二氧化碳、硫化氢浓度增高的原因 ,对其主要影响因素和变化规律加以统计分析。〔结果〕水库涵洞在夏秋季放水运行状态下 ,氧含量下降到 7.8% (比涵洞外降了 1.64倍 ) ,二氧化碳和硫化氢浓度分别增高至 0 .95 8%和 11.5mg/m3(增高 2 7倍和 114倍 ) ,其浓度的降、升变化与洞内距离密切相关 ,拟合指数 (R2 ) :O2 、CO2 、H2 S分别为 0 .9819、0 .9942、0 .92 95 ;并指出环境温度和水是影响洞内氧、二氧化碳和硫化氢浓度的主要因素。〔结论〕涵洞内在夏秋季放水状态下严重缺氧和二氧化碳、硫化氢浓度较高 ,极易发生危害事故 ,需采取通风等防护措施。     

Short-term effects of subchronic low-level hydrogen sulfide exposure on oil field workers

Objectives

To investigate the short-term effects of low-level hydrogen sulfide (H₂S) exposure on oil field workers.

Materials and methods

Observational study included 34 patients who work at an oil field. All patients were males with age range of 22–60 years (mean 37 years). The data were collected by systematic questionnaire about symptoms. The inclusion criteria of patients were symptoms related to inhalation of H₂S gas in the oil field. The complaints should be frequent and relapsed after each gas exposure and disappeared when there was no gas exposure. Exclusion criteria were the symptoms which experienced with or without H₂S exposure. The presence of H₂S gas was confirmed by valid gas detector devices.

Results

The most frequent presenting symptom was nasal bleeding. It was revealed in 18 patients (52.9 %). This followed by pharyngeal bleeding, gum bleeding, and bloody saliva (mouth bleeding) which were encountered in five cases for each complaint (14.7 %). Other less frequent presenting symptoms were tongue bleeding, bloody sputum, headache, abdominal colic, pharyngeal soreness, fatigue, and sleepiness.

Conclusions

Nasal mucosa was the most vulnerable part to H₂S effect. Inhalation of H₂S produced upper respiratory tract epithelial damage that led to bleeding from nose, pharynx, gum, tongue, trachea, and bronchi. There were no complaints of asthmatic attack upon exposure to low level of H₂S. Sunlight had a significant role in reduction of ambient air H₂S level.     

聚乙二醇辛基苯基醚(OP)-硝酸银分光光度法测定作业场所空气中的硫化氢

目的:建立稳定、灵敏、可靠的聚乙二醇辛基苯基醚(OP)–硝酸银分光光度法测定作业场所空气中的硫化氢的方法。方法:OP体系中硝酸银与硫化氢反应生成稳定的硫化银,用于测定作业场所空气中硫化氢。结果:硫化氢浓度在0.05 mg/m3～8.00 mg/m3范围内呈良好的线性关系(R2)=0.9995,回收率在99.4%～100%范围,相对标准偏差在0.86%～3.5%(n=6)范围。结论:用聚乙二醇辛基苯基醚(OP)-硝酸银分光光度法测定作业场所空气中的硫化氢,具有操作简便、稳定、灵敏、准确等特点,结果满意。     

截肢创伤对大鼠心肌硫化氢／胱硫醚-γ-裂解酶体系的影响

目的研究创伤后新型气体信号分子硫化氢（H2S）血液浓度及心肌胱硫醚-γ-裂解酶（CSE）活性的动态变化，探讨创伤致心血管系统损伤的机理。方法采用手术的方法建立大鼠左后肢断肢创伤模型，雄性Wistar大鼠63只，随机分为正常对照组和截肢后1h、2h、4h、6h、12h、24h、48h、72h组，每组7只。各组分别于相应的时间点处死，测定血液H2S浓度及心肌CSE的活性。并观察光镜下心肌组织形态学变化。结果肢体创伤后血浆H2s浓度逐渐下降，至创伤后6h达最低值（40．714±7．135μmol／L），与对照组（55．654±6．332μmol／L）比较P〈0．05，而后逐渐恢复；心肌CSE活性创伤后初期变化不明显，而后逐渐下降，至创伤后12h达最低值（14．211±1.311pmol·min^-1·mg^-1），与对照组（16．242±1．220pmol·min^-1·mg^-1）比较P〈0．05，而后逐渐恢复。结论肢体创伤可以导致心肌H2S／CSE体系下调，提示新型气体信号分子H2S可能参与了创伤导致的心肌损伤。     

Relation between malodor, ambient hydrogen sulfide, and health in a community bordering a landfill

Background

Municipal solid waste landfills are sources of air pollution that may affect the health and quality of life of neighboring communities.

Objectives

To investigate health and quality of life concerns of neighbors related to landfill air pollution.

Methods

Landfill neighbors were enrolled and kept twice-daily diaries for 14 d about odor intensity, alteration of daily activities, mood states, and irritant and other physical symptoms between January and November 2009. Concurrently, hydrogen sulfide (H₂S) air measurements were recorded every 15-min. Relationships between H₂S, odor, and health outcomes were evaluated using conditional fixed effects regression models.

Results

Twenty-three participants enrolled and completed 878 twice-daily diary entries. H₂S measurements were recorded over a period of 80 d and 1-h average H₂S=0.22 ppb (SD=0.27; range: 0–2.30 ppb). Landfill odor increased 0.63 points (on 5-point Likert-type scale) for every 1 ppb increase in hourly average H₂S when the wind was blowing from the landfill towards the community (95% confidence interval (CI): 0.29, 0.91). Odor was strongly associated with reports of alteration of daily activities (odds ratio (OR)=9.0; 95% CI: 3.5, 23.5), negative mood states (OR=5.2; 95% CI: 2.8, 9.6), mucosal irritation (OR=3.7; 95% CI=2.0, 7.1) and upper respiratory symptoms (OR=3.9; 95% CI: 2.2, 7.0), but not positive mood states (OR=0.6; 95% CI: 0.2, 1.5) and gastrointestinal (GI) symptoms (OR=1.0; 95% CI: 0.4, 2.6).

Conclusions

Results suggest air pollutants from a regional landfill negatively impact the health and quality of life of neighbors.