职业性铅接触生物监测指标的选择

本文对154名铅接触工人,空气铅浓度0.05～5.0mg/m~3(TWA)和163名非铅接触者的血铅(PbB)、红细胞游离原卟啉(FEP)、红细胞锌原卟啉(ZPP)、和尿铅(PbU)的测定结果进行了统计分析。接触-效应和接触-反应之间均有很好相关。用判别分析求得PbB35μg/dl,FEP 45μg/dl,ZPP 70μg/dl,PbU 35μg/L作为检测基准是适宜的。对这些指标的检测效能作了检验,并表明两个检测指标合用比单用一个指标的分辨效果为好。建议取FEP,PbU两项指标合用作铅接触者的检测较为理想。用FEP(X_1),PbU(X_2)两项指标计算得到的判别式Z=0.01901 X_1+0.0001096 X_2,和临界值Z_0=0.035作为对空气铅浓度的监测判别初筛;以Z=0.01477 X_1+0.0000558 X_2,Z_0=0.0278监测判别接触者的血铅。     

太原市某企业2008年238名铅作业人员尿铅结果分析

国的：了解铅作业人员尿铅含量，从而采取有效的防护措施。方法：回顾性分析太原市某企业2008年238名铅作业人员体检中尿铅检测和车间中的铅烟、铅尘监测资料。结果：铅浓度范围为O．026mg／m^3-0．240mg／m^3标准样品25份，超标率为30．49％。238名铅作业工人中尿铅超标者共20人，超标率8．4％，其中化成作业工人中尿铅超标率20．6％，其次是涂膏工，为14．0％，尿铅超标检出率最低是板栅工为2．3％。各工种尿铅超标检出率差异有统计学意义。结论：尿铅超标率随着接铅时间的延长而升高．随着车间空气中铅浓度的降低，工人尿铅浓度也随着下降。     

某化工总厂铅作业职业危害调查

本文通过对某化工总厂的劳动卫生学调查,探讨了铅对工人健康的危害及其浓度与危害之间的关系。发现作业场所铅尘浓度最高达44.37mg/m~3。超过国家规定的卫生标准886.4倍。平均超标率为84.21％。34名工人尿铅均值为0.116mg/L,超标率为61.76％。铅中毒检出率为22.22％。铅吸收检出率为8.33％。结果表明:(1)尿铅含量与接触空气铅浓度高低有关。铅作业工令越长,铅中毒检出率越高。(2)慢性铅吸入对血压影响不明显。(3)该厂铅危害是比较严重的,在县以下工厂企业中具有一定的代表性,应引起足够的重视。     

铅中毒诊断标准及铅卫生标准对铅接触者健康保护意义的探讨

目的：探讨铅中毒诊断标难及铅卫生标难对铅接触者健康保护效果。方法：测定某铅冶炼厂158名铅接触工人的血铅(PbB)、尿铅(PbU)、锌gLDb(ZPP)、游离原卟啉(FEP)、δ—氨基乙配丙酸(δ—ALA)含量及车间空气中铅浓度并计算血铅等五项指标超过诊断值的超标率。结果：工人在超过国家卫生标难(铅烟：0．03mg／m^3)726倍、180倍及ll倍的环境中工作，其各项指标的超标率：726倍的为29．6％～57．4％，180倍的为10．0％～48．0％，ll倍的为0～3．7％。结论：现行铅中毒诊断标难及铅卫生标难是安全的，对接触者的身体健康有较好的保护效果。     

职业性铅中毒(铅吸收)148例临床分析

本文对三个不同铅浓度148例铅中毒(铅吸收)临床症状、体征、化验指标进行分析和讨论。提出铅作业体检、尿铅、尿紫质或δ-ALA、血红蛋白、驱铅试验应作为必查指标,δ-ALA正常上限修改为2mg/L     

职业性铅接触与生物效应关系分析

目的 探讨劳动环境中铅浓度与机体血铅含量的关系，以及血铅与其他生物监测指标间的相关性。方法 回顾性调查了256名铅接触工人和82名对照者，根据铅接触工人劳动环境中空气铅浓度分为高、中、低浓度接触组。结果 接触组的症状计分、血铅、尿铅和卟啉代谢(如血锌原卟啉、尿δ-氨基酮戊酸)皆显著升高，并呈接触效应关系，锌原卟啉与空气铅、血铅和尿铅较其他指标关系密切。结论 血铅和血锌原卟啉测定可作为职业性铅接触者可靠的生物监测指标。     

在成年男子中测定游离红细胞原卟啉可作为铅的生物学作用的指示指标

作者对一组接触不同浓度铅的成年男子,进行了游离红细胞原卟啉(FEP)与血铅、尿铅、尿铅-EDTA络合物之间的关系的探讨,当血铅含量在15～150μg/100ml时,FEP与铅含量有高度的相关,相关系数分别为0.904(FEP与血铅),0.889(FEP与尿铅)和0.894(FEP与PbU-EDTA)。作者认为FEP的测定在评价“铅吸收”以及体内铅的活性沉积(active deposit),     

宁夏职业人群铅接触水平的检测与分析

目的反映我区铅作业场所和接触人群铅浓度水平的检测情况,并提出防治建议。方法分别用原子吸收分光光度法和双硫腙比色法测定空气铅及尿铅含量。结果车间空气铅浓度高低直接影响铅接触人群尿铅浓度异常率。冶炼、蓄电池制造、某钢厂热处理车间铅接触水平较高,分别为0.138mg/m3、0.121mg/m3和0.150mg/m3,相对应接触人群的尿铅异常率分别为71.9%、27.3%和53.4%。对热处理车间工人不同年份的尿铅测定结果比较有显著性差异(P<0.01)。提示在一定浓度内尿铅值随接触工龄增长呈上升趋势。结论宁夏铅污染较严重的行业为热处理、冶炼、蓄电池,尤其值得关注的是铅污染较严重且接触人群集中的某热处理车间,其防治工作应引起高度重视。     

云南某锌业公司职业铅中毒现状及影响因素分析

目的 探讨某锌业公司在职员工尿铅超标影响因素,为今后制定切实可行的预防措施提供依据.方法 收集3 420名职工晨尿,按照WS/T17-1996方法进行尿铅检测.参照GBZ37-2002《职业性慢性铅中毒诊断标准》,尿铅≥＞0.07 mg/L为超标,采用秩和检验比较不同工作场所、性别、年龄段、文化程度、工作年限间尿铅超标率的差异,分类非条件Logistic回归分析其影响因素.结果 3 420名职工尿铅水平范围在0.01 ～ 2.18 mg/L,几何均数为0.04 mg/L,尿铅检测超标31人,超标率为0.96％.不同性别、工作场所间超标率间差异无统计学意义.不同年龄段、文化程度与工作年限间超标率差异有统计学意义(P＜0.05),尿铅超标的主要影响因素为性别、年龄段和文化程度.结论 某锌业公司尿铅超标不明显;男性尿铅超标率高于女性;年龄轻和文化程度高者易发生尿铅超标.     

陶瓷厂铅作业对工人免疫功能的影响

对陶瓷厂铅作业工人的尿铅,唾液IgG,IgA和α-醋酸萘脂酶(ANAE)进行了测定。结果表明:在作业环境空气铅不超标(x=0.0193 mg/m~3),尿铅也不增加的状态下,观察组与对照组的唾液IgG、IgA和外周血ANAE比较,差异均有显著性。提示长期低剂量铅接触可引起免疫功能的改变。     

红细胞嘧啶5‘核苷酸酶筛选职业性铅中毒的价值

评价红细胞嘧啶５’核苷酸酶筛选职业性铅中毒的准确性。方法连续性收集１５７例铅接触工人及３０名健康对照组的血标本,同时测定红细胞嘧啶５′核苷酸酶的活性、血铅、红细胞游离原卟啉、锌卟啉、尿铅、尿δ－氨基酮戊酸。以血铅≥１．９３μｍｏｌ／Ｌ、≥Ｓ     

THE RISK OF OCCUPATIONAL LEAD EXPOSURE

We conducted a field survey on 53 workers in a battery factory, 52 solder workers, and 50 embroidery workers (control group). The average air lead levels at the workplaces of these three groups were 0.578 mg/nt, 0.0015 mg/m:3 and 0.006 mg,iml respectively. Clinical and biochemical studies re vealed that the workers in Shanghai Navigation Battery Factory were affected somewhat by the toxic effects of lead. The solder workers showed no signi- ficant abnormalities compared with the control group. A significant dose-response relationship ex isted between air lead levels and toxic effects. The early clinical manifestations observed were dysfunction of the central nervous system, dyspcpsia, joint pain, and myalgia in the extremities. A positive association was observed between the prevalences of fatigue, mild abdominal pain, and joint pain and the blood lead (PbB), urine lead (PbU), and zinc protoporphyrin (ZPP) levels. The symptomatic threshold values for PbB, PbU, and ZPP were 30 u.g/dl, 0.045 mg/'I, and 40 Ug/dl, respectively Although the PbB, PbU, 6-aminolevulinic acid dehydratase (ALAD), free erythrocyte protoporphyrin (FEP), and ZPP levels could be used as criteria of lead exposure, the measurement of ZPP is the first- choice screening test for a preventive monitoring program. The motor and sensory conduction velocities in the median nerve were slower in the exposure group than the control group (p<0.05). Conduction velocity and intensity of lead exposure were not significantly correlated. No apparent effects on behavioral func tion were observed among the solder workers.     

空气铅浓度与铅接触人员肾功能改变的多元分析

目的：探讨职业环境空气中铅浓度与铅接触人群肾功能的关系。方法：测定11家印刷厂,4家冶炼厂和2家铅矿工作场所的空气铅浓度,并以尿糖、尿蛋白和尿沉渣为1 190名铅接触人员作肾损害筛选检查,有一项以上损害者进一步作肾功能检查。将空气铅浓度与肾功能各项指标作多元线性相关分析。结果：印刷厂空气铅为0.07 mg/m3,冶炼厂为0.26 mg/m3,铅矿为0.66mg/m3,157人有一项以上肾功能损害占13%。职业环境空气铅浓度与铅接触人员的肾功能指标的复相关系数R=0.894,P<0.001,决定系数R2=0.799,偏相关系数显示,空气铅与血铅、尿铅、Bun、Scr、尿糖、尿β2MG呈正相关,P值在<0.01~0.001之间;与内生肌酐清除率呈负相关,r=-0.18, P=0.05,与尿蛋白、尿白蛋白和血清β2MG的相关系数无显著性意义。结论：铅接触人员肾功能改变与空气铅浓度有关,降低环境铅对于预防肾损害极为重要。     

MR imaging features of fibroepithelial ureteral polyp in a patient with duplicated upper urinary tract

We describe the magnetic resonance (MR) imaging features of a rare case of fibroepithelial polyp (FEP) in a duplicated upper urinary tract. The FEP appeared as a T2-hyperintense and T1-isointense filling defect within the dilated lower moiety ureter. Post gadolinium-enhanced images revealed enhancement of the FEP without ureteral wall-thickening or enhancement. Retrograde ureterography confirmed the findings, and the patient underwent ureterotomy and removal of the polyp. Histopathological findings were consistent with an FEP. It may be possible to differentiate FEP from an ureteric carcinoma based on MR imaging features. MR imaging may be useful for preoperative diagnosis of a benign ureteric tumour, and may thus prevent an unnecessary nephroureterectomy.     

Lead exposure among mothers and their newborns in Toronto.

Recent studies have suggested that a fetal blood lead level of 0.48 mumol/L (much lower than 1.21 mumol/L, which is the level previously believed to be toxic to the developing brain) may impair brain development permanently. We measured the maternal and umbilical cord blood levels of lead and free erythrocyte protoporphyrin (FEP) among 95 consecutive mother-infant pairs to determine whether neonates in Toronto are in the high-risk group. There was a significant correlation between the maternal and the cord blood lead levels (r = 0.59, p less than 0.0001). Most (99%) of the infants had cord blood lead levels below 0.34 mumol/L; in 11 cases the levels were below the detection limit of 0.01 mumol/L. The cord blood FEP levels were higher than the maternal levels. The US Centers for Disease Control, Atlanta, currently finds acceptable a blood FEP level of 0.62 mumol/L among children up to 10 years of age; however, this is not applicable to newborns since their higher FEP levels apparently reflect immature heme synthesis and increased erythrocyte volume rather than lead poisoning. Our data suggest that living in Toronto does not impose increased teratogenic risk from intrauterine exposure to lead; however, residents in high-risk areas should be followed up.     

血红蛋白和红细胞内游离原卟啉滤纸片微量测定法

我们应用滤纸片采集末梢血作血红蛋白(Hb)氰化法测定及红细胞内游离原卟啉(FEP)荧光分析,具有方法简便可靠,标本易携带,邮寄等优点;与FEP直接荧光法和Hb氰化法比较,其重复性,回收率均符合要求,相关良好。FEP是筛查缺铁性贫血(IDA)及铅中毒的重要指标,FEP与Hb的比值更能精确地反映IDA的严重程度。我们应用本法测定FEP、Hb及PEP/Hb[结合血清铁蛋白(SF)放射免疫测定,见另文]调查377例3月～6岁幼托健康小儿铁营养状况,其中铁缺乏(FEP/Hb>4.5)及IDA分别占3～6月组的57.6％及15.2％;6～12月组的85.0％及39.0％;1～2岁组的77.8％、及21.0％;2岁以上患病率显著降低。     

Preventive and therapeutic role of vitamin E in chronic plumbism

The ability of vitamin E to prevent or treat experimental lead intoxication was investigated in rats. Lead ingestion (10 mg/kg, lead as lead acetate, orally for 6 weeks) significantly inhibited the activity of blood delta-aminolevulinic acid dehydratase (ALAD), reduced the brain dopamine (DA) contents, enhanced the blood zinc protoporphyrin, and enhanced the urinary excretion of delta-aminolevulinic acid (ALA). Lead exposure also elevated brain norepinephrine, homovanillic acid, and 5-hydroxyindole acetic acid (5-HIAA) levels and concentration of lead in blood and tissue. Simultaneous supplementation of vitamin E along with lead significantly reduced the inhibition of blood ALAD activity, brain DA and 5-HIAA levels, and elevation of urinary ALA excretion. Blood and liver lead concentrations were also significantly reduced by simultaneous supplementation with vitamin E. Postlead exposure treatment with vitamin E was ineffective in reducing the lead-induced effects, except that the inhibition of blood ALAD activity was slightly reduced. The present results suggest that vitamin E given simultaneously with lead is effective in reducing the severity of lead intoxication.     

时间加权平均浓度在煤矿井下粉尘监测中的应用

目的 :探索煤矿井下煤矿粉尘浓度的监测方法与计算方法。方法 :在某煤矿井选 1个综采采面和 1个炮采采面 ,每个采面设 5个测尘点 ;选 1个炮掘掘进头和 1个综掘掘进头 ,每个掘进头设 2个测尘点。用采样器分别在各测尘点于每个生产工序采样 2次或 2次以上。根据测定的数值计算出每个测尘点的时间加权平均浓度(TWA)。然后再分别计算出各采面或掘进头中测尘点TWA的算术平均数 ,用来表示采面或掘进头各自的平均粉尘浓度。结果 :综采采面的煤矿粉尘平均浓度为 :5 1 6mg/m3 ;炮采采面为 :2 6 1mg/m3 ;炮掘掘进头为 16 5mg/m3 ;综掘掘进头为 2 4 3mg/m3 。结论 :①在煤矿井下工作场所中 ,TWA能反映作业者的实际接尘水平。②采面或掘进头中测尘点TWA的算术平均值不仅可表示采面或掘进头的平均粉尘浓度 ,而且还可用来进行不同采掘工艺、不同煤矿、不同年度之间以及工艺改进前后的粉尘危害或预报措施优劣之比较     

人群环境镉接触肾功能损害剂量反应关系

调查和分析居住在不同程度镉污染区的居民镉摄取量和肾功能的情况。用荧光分析法和石墨炉原子吸收法分别测定尿Ｎ－乙酰－β－氨基葡萄糖苷酶（ＮＡＧ）和尿镉。结果：镉接触人群中高ＮＡＧ尿和高白蛋白尿的发生率随尿镉排泄增高而增高，同时也随镉摄取量的增加而增高，尤以ＮＡＧ表现明显。结论：环境镉接触与人群肾功能损害之间存在着明显的剂量反应关系，而尿ＮＡＧ可作为镉肾损害的早期监测指标。     

妊娠期妇女缺铁性贫血诊断指标一致性的探讨

目的 评价以血红蛋白为指标诊断孕妇缺铁性贫血(IDA)与血清铁蛋白和红细胞游离原卟啉变化的符合程度。方法 对506名不同孕周孕妇的血红蛋白、血清铁蛋白和红细胞游离原卟啉进行检测,分别以血红蛋白<100g/L、<105g/L和<110g/L作为诊断IDA的界限值,应用Kappa分析方法分别分析了血红蛋白与血清铁蛋白和红细胞游离原卟啉检测的一致性。结果 21孕周前,血红蛋白的3种界限值与血清铁蛋白、红细胞游离原卟啉诊断的一致性普遍较差;21孕周后,以血红蛋白<105g/L和<110g/L为界值,血红蛋白与血清铁蛋白和红细胞游离原卟啉诊断的一致性普遍较好,但以血红蛋白<100g/L为界限值与血清铁蛋白、红细胞游离原卟啉诊断的一致性相对较差。结论 血红蛋白与血清铁蛋白和红细胞游离原卟啉检测孕妇IDA的一致性,与孕周以及血红蛋白的界限值有关。