2009年度江苏省职业性铅危害哨点首次调查分析

目的 了解江苏省职业性铅危害的现状及趋势,为制定铅中毒防治策略和措施提供科学根据.方法 通过对铅接触岗位空气中铅浓度监测,确定职业接触者铅接触水平,同时对铅职业接触者生物样品中铅水平进行检测.结果 随着铅接触岗位空气中铅尘时间加权平均浓度(TWA)的增加,铅职业接触者生物样品中铅水平超标率分别为7.55%、12.92%、14.94%、75.00%、96.00%,经似然比X2检验差异具有统计学意义(G=97.654,P＜0.001).结论 铅职业接触者生物样品中铅水平超标率与所在岗位TWA之间呈较明显的剂量-反应关系,及时采取各项措施降低工作场所空气中铅的浓度,是防止职业性铅中毒的关键.     

有机磷作业工人全血胆碱酯酶活力分析

有机磷农药污染和中毒是生产和使用这类农药常见的职业病危害。测定全血胆碱酯酶(ChE)活力是生物监测和早期诊断有机磷中毒的重要指标。为了解有机磷农药接触人员ChE活力情况,我们对泰安市某农药厂敌敌畏(DDVP)作业工人进行了ChE活力测定,并对现场进行了职业卫生学调查。     

蓄电池厂铅作业工人的生物监测结果分析

目的 对某蓄电池厂铅作业工人的尿铅、血红蛋白（Hb）和血锌原卟啉（ZPP）进行生物监测分析.方法 检测电池厂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,包括尿铅、血红蛋白和血锌原卟啉测定.结果 部分工作场所空气中铅浓度超过国家职业卫生标准,铅作业工人中具有不同程度的神经衰弱症状和消化系统症状.162名铅作业工人中15人尿铅含量超过职业接触限值（≥0.34 μmol/L）,7人ZPP≥2.91 μmol/L,15人Hb下降,与对照组比较,差异有统计学意义（P＜0.01）.接触组浓度＞0.05 mg/m^3及接铅工龄在2 a～者,生物监测指标明显异常.结论 蓄电池厂的铅作业工人存在明显的职业危害,定期进行尿铅、血红蛋白和血锌原卟啉生物监测十分必要,可以早期发现职业健康损害,预防铅中毒的发生.     

尿中TNT及其代谢物测定方法的研究(二)——乙醇-氢氧化钾法测定尿中TNT代谢物有关问题探讨

近年,劳动卫生领域对生物监测的应用日益受到重视。对接触者进行生物监测,可估算某些化学毒物的真正接触水平及体内负荷,是正确评价职业人群接触毒物水平的手段之一。     

004 ACGIH有关化学物质的BEIs

生物监测提供了一种评估劳动者职业接触和健康危险度的方法。生物监测是测定职业接触者生物材料中化学测定物（determinant）的浓度，是物质吸收的指标。生物接触指数（biological exposure indices，BEIs）是评估生物监测结果的指导值。ACGIH制定了46种化学物质的74个指标。本文对BEIs的相关概念、应用和测定值进行概述。     

职业接触者血铅生物阈限值的研究

本文通过对职业接触环境的铅含量监测，１１０名男性职业接触者的体查和血铅含量测定，综合分析各项资料，研究职业接触者的血铅生物阈限值，其结果为２．９４μｍｏｌ／Ｌ。此值低于国外大多数国家提出的血铅生物接触限值，略高于国内报道的血铅可接受上限值。可为我国职业接触者血铅生物阈限值的深入研究和职业病诊断提供参考。     

TNF作业工人尿中TNF及其代谢物含量的研究

寻找职业接触ＴＮＴ敏感,特异的生物监测指标及制订生物接触限值,方法对车间空气中ＴＮＦ浓度与接触者尿中ＴＮＴ、代谢物４－氨基－２,６－二硝基甲基和２－氨基－４,６－二硝基甲苯（２Ａ）含量的相关性进行了分析,。结论班后尿中４Ａ含量是职业接触ＴＮＴ生物监测的敏感指标。     

1,3-丁二烯生物标志物的研究进展

人类致癌物1,3-丁二烯对职业接触者的健康构成了严重的威胁,其生物标志物常被用来监测接触水平、评价损伤效应及预测可能的作用机制.寻找1,3-丁二烯的特异性生物标志物,有助于揭示1,3-丁二烯暴露与肿瘤发生过程中的重要生物学事件,提高危险度评价的精度.本文回顾了1,3-丁二烯3种生物标志物近期的研究进展,以期为更好地保护职业接触者提供技术依据.     

职业人群生物样本数据库建立初探

目的 建立职业人群生物样本库,收集、保存生物样本,为今后对职业病的深入研究提供资源.方法 根据接触因素的不同,制定不同的生物样本采集方案,对职业接触人群进行样本采集;以计算机软件技术和数据库技术为基础,对职业接触人群的生物样本及其基本信息进行管理.结果 体系建立后收集并保存了1061例职业病病人及职业危害因素接触人群的生物样本及相关信息;建立了将标本相关信息与标本的储存、管理整合在同一平台上的数据管理系统.结论 建立的数据库能够对职业人群生物样本的采集、分离、储存和使用进行管理,可使生物样本资源得到更加科学合理的利用.     

做好职业健康检查工作的"六必须"

职业病防治实行“三级预防“原则,一级预防又称病因预防,是指改进生产工艺和生产设备,合理利用防护设施和个人防护用品,以减少工作接触的机会和程度,从而从根本上杜绝危害因素对人的作用;二级预防又称发病预防,是指早期检测人体受到职业危害因素所致的疾病,其主要手段为定期进行环境中职业危害因素的监测和对接触者进行定期的体检,以早期发现疾病,及时预防;三级预防是在得病以后合理康复处理.……     

职业有害因素对女工健康的影响

该文对国内外有关职业有害因素对女工健康影响的研究进行了综述,阐述了铅、苯、二氧化硫、有机磷农药、汽油、噪声、振动等职业有害因素以及不合理的劳动制度均可对女工的健康产生不良影响,如月经紊乱、早产、流产、低体重儿.另外,职业有害因素还可以影响女工的其他生理功能.     

Occupational and environmental exposures among Alaska Native and American Indian people living in Alaska and the Southwest United States

Most occupational and environmental research describes associations between specific occupational and environmental hazards and health outcomes, with little information available on population-level exposure, especially among unique subpopulations. The authors describe the prevalence of self-reported lifetime exposure to nine occupational and environmental hazards among 11,326 American Indian and Alaska Native (AI/AN) adults enrolled in the Education and Research Towards Health (EARTH) Study in the Southwest U.S. and Alaska. The top three hazards experienced by AI/AN people in Alaska were petroleum products, military chemicals, and asbestos. The top three hazards experienced by AI/AN living in the Southwest U.S. were pesticides, petroleum, and welding/silversmithing. The study described here found that male sex, lower educational attainment, AI/AN language use, and living in the Southwest U.S. (vs. Alaska) were all associated with an increased likelihood of hazard exposure. The authors' study provides baseline data to facilitate future exposure-response analyses. Future studies should measure dose and duration as well as environmental hazards that occur in community settings.     

Occupational hazards and pregnancy outcomes.

This study examined the association between exposure to occupational hazards and pregnancy outcomes using data from a case-control study conducted in 29 hospitals in Shanghai, China. The sample included 1,875 perinatal deaths and newborns with birth defects and the same number of controls. Information on mother's exposure to occupational radiation, chemicals, noise, and pesticides was investigated. Logistic regression analysis controlling for potential confounders showed that exposure to radiation before/during pregnancy was associated with antepartum fetal death, birth defects, small-for-gestational-age (SGA), and threatened abortion. Exposure to chemicals before/during pregnancy was associated with antepartum fetal death, early neonatal death, birth defects, preterm birth, and threatened abortion. Women exposed to pesticides during pregnancy had an increased risk of SGA and threatened abortion. Exposure to occupational noise during pregnancy increased the risk of antepartum fetal death. Furthermore, higher than expected numbers of congenital anomalies in the central nervous system (CNS) were identified among women exposed to chemicals before pregnancy and to pesticides during the first trimester of pregnancy. No significant association was found between occupational exposure and intrapartum fetal death. Although recall bias may be possible in our study, the findings encourage further research.     

Assessing diet as a modifiable risk factor for pesticide exposure

The effects of pesticides on the general population, largely as a result of dietary exposure, are unclear. Adopting an organic diet appears to be an obvious solution for reducing dietary pesticide exposure and this is supported by biomonitoring studies in children. However, results of research into the effects of organic diets on pesticide exposure are difficult to interpret in light of the many complexities. Therefore future studies must be carefully designed. While biomonitoring can account for differences in overall exposure it cannot necessarily attribute the source. Due diligence must be given to appropriate selection of participants, target pesticides and analytical methods to ensure that the data generated will be both scientifically rigorous and clinically useful, while minimising the costs and difficulties associated with biomonitoring studies. Study design must also consider confounders such as the unpredictable nature of chemicals and inter- and intra-individual differences in exposure and other factors that might influence susceptibility to disease. Currently the most useful measures are non-specific urinary metabolites that measure a range of organophosphate and synthetic pyrethroid insecticides. These pesticides are in common use, frequently detected in population studies and may provide a broader overview of the impact of an organic diet on pesticide exposure than pesticide-specific metabolites. More population based studies are needed for comparative purposes and improvements in analytical methods are required before many other compounds can be considered for assessment.     

Use of protective equipment among California farmers

BACKGROUND: Agriculture is a hazardous industry associated with many occupational injuries and illnesses. We describe California farmers' self-reported exposure to five agricultural hazards and their use of protective equipment. METHODS: A telephone survey of 1,947 California farmers recorded information on occupational exposure, health outcomes and use of protective equipment to lessen risk from exposure to dust, sun, noise, pesticides and tractors. RESULTS: Over 93% of respondents reported using personal protection around pesticides; however, fewer than 1/3 used consistent protection against other hazards. Younger age and male sex were associated with better use of protection from dust, noise, pesticide and tractors, but negatively associated with sun protection. There was no consistent relationship of protective behaviors with cigarette smoking, living on the farm, marital status, or time in non-administrative farmwork. Risk perception was strongly associated with behavior; farmers concerned about specific health problems were much more likely to use protective equipment. CONCLUSIONS: Some farmer characteristics are associated with more safe behaviors, but efforts to encourage protective behaviors on farms should be broadly based in view of a lack of a single risk-taking profile among California farmers.     

Implications for epidemiologic research on variation by pesticide in studies of farmers and their families

Epidemiologic studies rely on participants' recall to classify their exposure to specific pesticides. As exposure classification evolves, an important issue is whether the recall of pesticide application details can be used to derive measures of exposure intensity or cumulative exposure. A preliminary analysis of biomonitoring data for farmers before, during, and after a pesticide application suggests variation for different pesticides in the proportion with detectable urinary concentrations, urinary levels, and patterns of uptake and elimination. These findings, and the limited predictive modeling done to date, suggest that chemical-specific differences need to be considered in exposure classification schemes. An analysis of biomonitoring data for farm spouses and children found few with appreciable changes in the urinary concentration after a pesticide application. These findings point to the need to validate assumptions about exposures in studies of people who are not directly involved in pesticide application.     

The Hazards of Organophosphates

ABSTRACT

The study examines aspects of the toxicological and occupational hygiene assessment of organophosphates (OPs) related to the use of sheep dips in the UK. Scientific and agricultural literature produced in the past revealed a range of potential hazards to humans from these veterinary pesticides but health and safety standards failed to address those hazards. The results of the research raise questions about the validity of past risk assessments of OPs in the UK; indicate significant under-reporting of adverse health effects in humans associated with exposure to OPs in sheep dipping; reveal shortcomings in the approval and monitoring of veterinary medicines from an occupational health and safety perspective.     

Occupational and environmental exposure correlates of adverse live-birth outcomes among 1032 US Navy women

The integration of women into non-traditional military occupations raises questions concerning the impact of such jobs on women's reproductive health. This study examines the extent to which US Navy women in their reproductive years report exposures to potential occupational and environmental hazards, and the degree to which such exposures are associated with self-reported adverse live-birth outcomes. Data from a survey of pregnant Navy women provided both maternal and paternal exposure information on more than 1000 active-duty women. Self-reported exposures to heavy metals, pesticides, petroleum products, and other chemicals were associated with adverse live-birth outcomes at the bivariate level. Only a father's exposure to pesticides at work predicted an adverse live-birth outcome (preterm delivery) in multivariate models. Maternal occupational exposures may exert their influence through maternal health and/or pregnancy complications and may act as mediators of health-reproductive outcome relationships.     

生物监测在化学危害物风险评估中的应用

风险评估,是目前国际上推崇的评估暴露于环境化学危害物导致不良人体健康效应概率的科学方法,已在世界各国广泛使用。然而,在大部分的风险评估中,因缺乏人群暴露和剂量的数据而增加了评估的不确定性。生物监测能提高风险评估的准确性和真实性,直接提供人体内暴露和早期效应的信息。目前,许多国际组织和发达国家已建立生物监测项目,并鼓励将生物监测数据应用于风险评估之中。本文将阐述生物监测的定义和发展,详细描述化学危害物风险评估和暴露评估中生物监测的作用,举例说明风险评估中生物监测数据的解释,以及整合生物监测的局限性。总之,随着各类数据的积累,生物监测有能力使化学危害物风险评估更完善。     

Farmworker exposure to pesticides: methodologic issues for the collection of comparable data

The exposure of migrant and seasonal farmworkers and their families to agricultural and residential pesticides is a continuing public health concern. Pesticide exposure research has been spurred on by the development of sensitive and reliable laboratory techniques that allow the detection of minute amounts of pesticides or pesticide metabolites. The power of research on farmworker pesticide exposure has been limited because of variability in the collection of exposure data, the predictors of exposure considered, the laboratory procedures used in analyzing the exposure, and the measurement of exposure. The Farmworker Pesticide Exposure Comparable Data Conference assembled 25 scientists from diverse disciplinary and organizational backgrounds to develop methodologic consensus in four areas of farmworker pesticide exposure research: environmental exposure assessment, biomarkers, personal and occupational predictors of exposure, and health outcomes of exposure. In this introduction to this mini-monograph, first, we present the rationale for the conference and its organization. Second, we discuss some of the important challenges in conducting farmworker pesticide research, including the definition and size of the farmworker population, problems in communication and access, and the organization of agricultural work. Third, we summarize major findings from each of the conference's four foci-environmental exposure assessment, biomonitoring, predictors of exposure, and health outcomes of exposure-as well as important laboratory and statistical analysis issues that cross-cut the four foci.