利用相似接触组研究低浓度苯接触对工人血液指标的影响

目的　研究不同相似接触组 (SEG)工人的血液指标与苯的接触剂量的关系。方法　研究对象为某鞋厂成型车间的制鞋工人 ,采用观察法和采样法相结合的方法划分SEG ,个体采样泵采集每个SEG中 5个工人呼吸带处接触水平 ,体检收集工人的血样、职业史 ,多元回归分析苯的接触水平对血常规的影响。结果　根据SEG的定义及该车间的实际情况 ,划分为 5个SEG ,除年龄有差异外 ,各SEG工人的工龄、吸烟、饮酒、血常规、主诉症状方面差异无显著性 (P >0 .0 5 ) ;多元回归分析发现 ,外周血白细胞计数随空气中苯浓度的增加而减少 ,两者之间呈负相关 (r=- 0 .36 ,P <0 .0 5 ) ;接苯工龄与红细胞计数也存在负相关 (r =- 0 .2 9,P <0 .0 5 ) ;而红细胞和血小板的计数与苯接触之间没有发现类似的相关关系 (P >0 .0 5 )。结论　SEG研究发现 ,苯的接触剂量与白细胞计数之间存在剂量 -反应关系 ,今后应该通过增加样本量 ,进一步研究低浓度的苯接触对工人外周血液指标的影响。     

Hematotoxocity among Chinese workers heavily exposed to benzene

Benzene is a well-established hematotoxin. However, reports of its effects on specific blood cells have been somewhat inconsistent and the relative toxicity of benzene metabolites on peripheral blood cells in humans has not been evaluated. We compared hematologic outcomes in a cross-sectional study of 44 workers heavily exposed to benzene (median: 31 parts permillion [ppm] as an 8-hr time-weighted average [TWA] and 44 age and gender-matched unexposed controls from Shanghai, China. All hematologic parameters (total white blood cells [WBC], absolute lymphocyte count, platelets, red blood cells, and hematocrit) were decreased among exposed workers compared to controls, with the exception of the red blood cell mean corpuscular volume (MCV), which has higher among exposed subjects. In a subgroup of workers who were not exposed to more than 31 ppm benzene on any of 5 sampling days (n = 11, median 8 hr TWA = 7.6 ppm, range = 1–20 ppm), only the absolute lymphocyte count was significantly different between exposed workers (mean [sd] 1.6 [0.4] x 10³ μL) and controls (1.9 [0.4] x 10³ μL, p = 0.03). Among exposed subjects, a dose-response relationship with various measures of current benzene exposure (i.e., personal air monitoring, benzene metabolites in urine) was present only for the total WBC count, the absolute lymphocyte count, and the MCV. Correlations between benzene metabolites and hematologic parameters were generally similar, although hydroquinone was somewhat more strongly associated with a decrease in the absolute lymphocyte count, and catechol was more strongly associated with an increase in MCV. Morphologic review of peripheral blood slides demonstrated an excess of red blood cell abnormalities (i.e., stomatocytes and target cells) only in the most heavily exposed workers, with no differences in granulocyte, lymphocyte, or platelet morphology noted. Although benzene can affect all the major peripheral blood elements, our results support the use of the absolute lymphocyte count as the most sensitive indicator of benzene-induced hematotoxicity. © 1995 Wiley-Liss, Inc.     

A hematology surveillance study of petrochemical workers exposed to 1,3 butadiene

Complete blood counts (CBC) have been recognized as an easy and readily available screen for hematotoxicity following occupational exposure to 1,3-butadiene. This study evaluated hematology data from employees who have ever participated in the Shell Butadiene Medical Surveillance Program (BMSP), compared with employees who have not participated. This study examined potential hematopoietic toxicity in relation to the occupational exposures at two Shell facilities. This study included 404 employees who participated in the BMSP, with mean butadiene exposure (TWA-8, TWA-10, and TWA-12 together) of 4.55 ppm from 1979-1996 and 0.25 ppm from 1997-2003, and 773 comparison employees. The comparison group included employees not participating in either the benzene or butadiene surveillance programs. Abnormality of six CBC parameters, including white blood cell count, red blood cell count, lymphocyte count, hemoglobin concentration, mean corpuscular volume and platelet count, and the adjusted mean values of these parameters in the exposed group were compared with those of the comparison group. We found no significantly increased abnormality for any hematology parameter among exposed employees. The adjusted mean values (adjusted for age, sex, race, length of time between first and last exam, current smoking status, and first exam value) of the exposed employees were similar to those in the comparison group. At current occupational exposure levels for 1,3-butadiene, there is no evidence of adverse hematological effects observed in this study. These findings are consistent with results of three similar studies in the literature.     

职业性苯暴露工人外周血白细胞的变化

目的了解职业性苯暴露工人外周血白细胞潜在的变化规律。方法抽取某石油化工厂1049名苯暴露工人静脉抗凝血与另一非苯暴露工人841例静脉抗凝血，对白细胞记数按差值为0．5×10^9／L分段对比分析；另在白细胞偏低者休养前后再进行对比分析。结果苯暴露工人外周血白细胞低于4．5×10^9／L的人数比对照组要多（P〈0．05），多集中在（3．5—4．0）×10^9／L之间（P〈0．05）；苯职业病检查白细胞偏低者在休养后白细胞可明显提高。结论对苯作业人员进行职业健康监护时对外周血白细胞在（3．5～4．0）×10^9／L的工人应进行早期干预；其中休养也是很好的防治手段。     

高密市制鞋作业工人职业病危害现况调查

目的分析高密市制鞋行业苯及苯系物对作业工人的职业病危害情况,探讨其预防与控制对策。方法按国家职业卫生规范与标准,调查分析制鞋业苯及苯系物职业病危害现状,并对作业工人进行健康检查,对车间空气中苯、甲苯和二甲苯浓度进行监测。结果作业工人对职业卫生知识和职业卫生服务享受情况较低;对不同工龄组工人的舒张压、收缩压、白细胞、红细胞、血红蛋白、血小板以及丙氨酸转氨酶ALT活力均值进行比较,仅有血小板计数和ALT活力2项差异有统计学意义;对不同工种组工人的舒张压、收缩压、白细胞、红细胞、血红蛋白、血小板以及ALT活力均值进行比较,差异无统计学意义。结论苯及苯系物作业环境对工人的血小板计数和ALT活力有影响,并有随工龄增加而增高的趋势,但均未超出正常值范围。     

Hematologic effects of benzene: a thirty-five year longitudinal study of rubber workers

We studied over 17,000 peripheral blood counts, accumulated during surveillance from 1940 through 1975, from a cohort of 459 benzene-exposed workers. Linear regressions demonstrated significant decreases in white and red cell counts, as well as hemoglobin, for workers exposed during the 1940's, without persistent trends over the ensuing 25 years. Strongly positive correlations were observed between these blood count fluctuations and fluctuations in retrospective estimates of benzene exposures for this plant for the earlier periods of surveillance (mean estimated exposure 1940 to 1948, 75 ppm), but not for later years (mean estimated exposure 1948 to 1975, 15 to 20 ppm). These data suggest substantial limitations of hematologic examination of populations to detect abnormalities in populations currently exposed to benzene. The data also demonstrate a novel approach to the biological validation of exposure estimates based upon limited industrial hygiene and historical record data.     

Autonomous growth of committed hematopoietic progenitors from peripheral blood of workers exposed to low levels of benzene

We investigated whether exposure to low levels of benzene (geometric mean of exposures = 0.28-0.41 parts per million) results in perturbations of the hemopoietic system found in patients with myeloproliferative diseases. Erythroid (BFU-E) and granulocyte-monocyte (CFU-GM) colonies from peripheral blood were grown in methylcellulose with and without the addition of cytokines (erythropoietin and granulocyte-stimulating factor). Colony growth from 17 workers exposed to low levels of benzene was compared with 20 healthy control subjects. Exposed workers had significantly increased growth of autonomous BFU-E and unstimulated CFU-GM when compared with the control subjects. Unexposed smokers had increased colony growth without the addition of cytokines. Colony growth was not significantly different between the groups after the addition of cytokines. Workers exposed to low concentrations of benzene and unexposed smokers have increased cytokine-independent hematopoiesis.     

Environmental and biological monitoring of traffic wardens from the city of Rome

A molecular epidemiological study on Roman policemen is ongoing. The results of a first assessment of the occupational exposure to aromatic compounds of 66 subjects engaged in traffic control and of 33 office workers are presented in this paper. Passive personal samplers and urinary biomarkers were used to assess exposure to benzene and polycyclic hydrocarbons during work shifts. The results obtained indicate that benzene exposure in outdoor workers is about twice as high as in office workers (geometric mean 7.5 and 3.4 micrograms/m3, respectively). The distribution of individual exposure values was asymmetrical and skewed toward higher values, especially among traffic wardens. Environmental benzene levels recorded by municipal monitoring stations during work shifts (geometric mean 11.2 micrograms/m3) were in the first instance comparable to or greater than individual exposure values. However, several outlier values were observed among personal data that greatly exceeded average environmental benzene concentrations. Among the exposure biomarkers investigated, only blood benzene correlated to some extent with previous exposure to benzene, while a seasonal variation in the excretion of 1-hydroxypyrene and trans-muconic acid was observed in both study groups. In conclusion, these results suggest that outdoor work gives a greater contribution than indoor activities to benzene exposure of Roman citizens. Moreover, relatively high-level exposures can be experienced by outdoor workers, even in the absence of large-scale pollution episodes.     

钢铁工人血常规指标及尿酸水平与代谢综合征发病风险的相关性

目的研究钢铁工人血常规指标和尿酸水平与代谢综合征(MS)的关联。方法采用病例对照研究方法,选取内蒙古某钢铁企业接触噪声和高温危害因素的男性作业人员607人作为接害组,该企业不接触噪声与高温的行政和管理岗位的男性作业人员312人作为对照组。采集两组血标本,检测血常规和尿酸水平,分析接害组与对照组血常规指标[白细胞计数(WBC)、红细胞计数(RBC)、血小板计数(PLT)、红细胞分布宽度(RDW)及血红蛋白含量(Hb)]和尿酸水平(UA)与MS的相关性。结果接害组和对照组间吸烟、饮酒、腰围(WC)、收缩压(SBP)、甘油三酯(TG)、高密度脂蛋白胆固醇(HDL-C)、空腹血糖(FPG)、WBC、RBC、PLT、Hb、RDW、体质量指数(BMI)及UA方面比较差异均有统计学意义(均P<0.05)。接害组MS总体患病率为39.04%,高于对照组的23.08%,差异有统计学意义(P<0.05)。两组MS患者和非MS患者WBC、RBC、PLT、RDW及UA比较差异均有统计学意义(均P<0.05)0多因素logistic回归分析发现WBC、RBC、RDW、PLT及UA是接害组MS的危险因素(均P<0.05)。结论钢铁工人MS患病率较高,红细胞计数增高、红细胞分布宽度增大及血小板计数升高是MS发生的危险因素。     

短期苯暴露对工人外周血象及淋巴细胞染色体的损伤

[目的]探讨短期苯暴露对鞋厂工人外周血象及淋巴细胞染色体的损伤。[方法]测定作业场所空气中苯浓度,检查203名苯暴露工人（暴露组）与当地未暴露苯和其他有毒有害物质的178名健康工人（对照组）的血常规指标。应用外周血淋巴细胞胞质分裂阻滞微核（CBMN）试验结果评价研究对象外周血淋巴细胞染色体损伤。[结果]暴露组外周血红细胞计数（RBC）、血细胞比（HCT）、血小板计数（PLT）、红细胞分布活力（RDW）降低的阳性率和平均红细胞血红蛋白含量（MCH）、平均红细胞血红蛋白浓度（MCHC）异常率与对照组比较,差异均有统计学意义,χ2值分别为38．21、21．37、18．02、22．17、36．59、41．23,P均〈0．01;将暴露组按接苯工龄分为≤8个月、9～15个月和16～24个月3组,中性粒细胞（GRAN）减少的阳性率随着工龄的增长而有增高的趋势,且差异具有统计学意义（F=7．47,P〈0．05）;进一步按性别分类,发现暴露组女工HCT、平均红细胞体积（MCV）、PLT、血红蛋白含量（HGB）、RDW异常率明显高于男工,矿值分别为21．04、36．26、6．94、71．62、12．91,P均〈0．01。暴露组CBMN率[（2．98±1．49）‰]明显高于对照组[（0．39±0．72）‰],P〈0．001。[结论]短期苯暴露对作业工人的血液系统及染色体损伤有一定影响,并且上述指标的改变早于白细胞的异常,在职业性苯中毒的早期诊断中具有一定意义。     

Relation of serum 2,3,7,8-tetrachlorodibenzo-p-dioxin (TCDD) level to hematological examination results in veterans of Operation Ranch Hand.

The authors studied indices of hematologic function and exposure to 2,3,7,8-tetrachlorodibenzo-p-dioxin (TCDD) in Vietnam War veterans of Operation Ranch Hand--the Air Force unit responsible for the aerial spraying of Agent Orange and other herbicides in Vietnam. The herbicides were contaminated with TCDD. The authors measured TCDD serum levels in 1987 or later and extrapolated the result to the time of service in Vietnam. The authors studied serum TCDD level in relation to red blood cell count, hemoglobin, hematocrit, mean corpuscular volume, white blood cell count, platelet count, and erythrocyte sedimentation rate at each of 4 physical examinations. Compared with veterans not involved in Operation Ranch Hand, those with the highest TCDD levels in Operation Ranch Hand had mean corpuscular volumes that were about 1% higher and platelet counts that were about 4% higher. These small increases were unlikely to be of clinical significance and may not have been caused by TCDD.     

Relation of Serum 2,3,7,8-Tetrachlorodibenzo-p-Dioxin (TCDD) Level to Hematological Examination Results in Veterans of Operation Ranch Hand

The authors studied indices of hematologic function and exposure to 2,3,7,8-tetrachlorodibenzo-p-dioxin (TCDD) in Vietnam War veterans of Operation Ranch Hand–the Air Force unit responsible for the aerial spraying of Agent Orange and other herbicides in Vietnam. The herbicides were contaminated with TCDD. The authors measured TCDD serum levels in 1987 or later and extrapolated the result to the time of service in Vietnam. The authors studied serum TCDD level in relation to red blood cell count, hemoglobin, hematocrit, mean corpuscular volume, white blood cell count, platelet count, and erythrocyte sedimentation rate at each of 4 physical examinations. Compared with veterans not involved in Operation Ranch Hand, those with the highest TCDD levels in Operation Ranch Hand had mean corpuscular volumes that were about 1 % higher and platelet counts that were about 4% higher. These small increases were unlikely to be of clinical significance and may not have been caused by TCDD.     

Genotoxic effects in workers exposed to low levels of benzene from gasoline

To study genotoxic effects of exposure to low levels of benzene, single-strand breaks (SSB) in DNA of leukocytes and urinary levels of the oxidative DNA adduct 8-hydroxydeoxyguanosine (80HdG) were determined in 33 men occupationally exposed to benzene from gasoline and in 33 controls. The average exposure to benzene over a shift was determined by personal air sampling in the breathing zone. The 8-hr time-weighted average exposure to benzene was 0.13 ppm (mean value, range 0.003–0.6 ppm). Exposed workers had a significant increase of SSB (p = 0.04) over the shift compared with controls. Storage time of the samples seemed to affect the results. An analysis of samples with the same storage time showed a nonsignificant increase among the workers compared with controls. Urinary 80HdG increased over the shift among the exposed workers but not among the controls. The highest values among the exposed workers were seen in late evening, with a slight decrease the next morning. Multiple linear analysis adjusting for smoking habits showed a significant association between the exposure level of benzene during the shift and the increase of 80HdG in the urine over the shift among exposed workers (p = 0.02). These findings indicate a genotoxic effect in humans of benzene at relatively low exposure levels, that is, about 0.1 ppm (0.3 mg/m³). © 1996 Wiley-Liss, Inc.     

2006--2008年常熟市部分乡镇箱包企业苯作业工人外周血象分析

目的探讨常熟市箱包企业生产环境中存在的苯系物对作业工人健康的影响,为采取防护措施保护工人身体健康提供依据。方法检测各箱包企业工作场所中的苯系物浓度,对苯接触组以及对照组工人进行体检,检查外周血血红蛋白（Hb）、含量和白细胞（WBC）、血小板（PLT）计数。结果苯作业工人中外周血白细胞、血小板、血红蛋白下降人数明显高于对照组,其中自细胞计数下降差异最为明显,2006-2008年,各年接触组与对照组比较x^2值分别为11．88、22．87、17．49,均P〈0．01。结论长期从事苯作业的工人外周血液系统有较明显的改变,需要依法加强对苯作业工人的健康监护并改善劳动环境。     

Long-term effects of radium exposure in female dial workers: Differential white blood cell count

The long-term effects of bone-seeking radionuclides on bone marrow in humans seem worthy of exploration. Leukocyte counts (total white cells, polymorphonuclears, lymphocytes, eosinophils, and monocytes) were analyzed among 393 female radium dial workers who were first employed between 1913 and 1929 and most recently examined between 1954 and 1975. Mean and median counts were compared by initial intake level (μCi of radium per kg of skeleton) within three age-at-last-examination groups (45–54, 55–64, and 65–74 yr). Median estimated 40-yr average alpha doses to trabecular bone marrow in the highest intake levels compared were 9 rad, 104 rad, and 40 rad, in the three age groups. Spearman rank correlation coefficients between radium intake and white cell counts were also calculated. There was little evidence for long-term or late effects of radium exposure on white cell counts. In the younger age groups, lymphocyte count tended to increase with increasing radium intake. In 65–74 year olds, eosinophil count decreased with increasing intake (Spearman r = ?0.14, P < 0.05). Continued follow-up of this population should help clarify the question of possible long-term effects (direct or indirect) of radium exposure.     

2013年高密市制鞋用胶粘剂对作业工人外周血象影响的调查

目的了解制鞋用胶粘剂对作业工人外周血象的影响,探讨保护工人健康的策略。方法 2013年从高密市66家制鞋企业中选择直接接触胶粘剂的515名工人作为接触组,从食品加工企业中选择年龄、性别具有可比性的600名工人作为对照组,对其外周血象进行比较。结果在作业场所苯、甲苯、二甲苯的平均浓度分别为5.85、30.63、2.52mg/m3的环境下,接触组工人外周血的白细胞、中性粒细胞、红细胞、血小板的绝对平均值较对照组偏低（P〈0.01、〈0.05）,而淋巴细胞和血红蛋白无差异（P〉0.05）,接触组工人不同工龄间比较中,工龄〉3年的作业工人血小板计数明显低于工龄〈1年的。结论工人在接触低浓度苯系化合物的环境中,会对其外周血的白细胞、中性粒细胞、红细胞、血小板造成影响,如长期接触,血小板的降低更为显著。     

苯作业工人淋巴细胞p53相关基因mRNA表达水平分析

目的 了解苯环境作业工人外周血淋巴细胞中,经p53介导的DNA损伤修复路径相关基因表达水平.方法 选择某喷涂厂直接接苯工人46人(直接接苯组)、间接接苯工人26人(间接接苯组)和无苯及其他毒物接触工人29人(对照组),应用SYBR GreenI嵌合荧光法实时RT-PCR分析技术,检测外周血淋巴细胞p53及相关基因mRNA表达水平,比较对照组与作业组问P53及相关基因mRNA表达倍数差异.结果 直接接苯组和间接接苯组p53、Ku80、Ape1和Mdm-2 mRNA表达水平与对照组比较磋异无统计学意义(P＞0.05);p21有增高趋势,但差异无统计学意义(P＞0.05).直接接苯组的Rad51、Bcl-2、Bax、Xpa和Xpc mRNA表达水平下调、间接接苯组Rad51 mRNA表达下调,与对照组比较,差异有统计学意义(P＜0.05或P＜0.01).直接接苯组的白细胞、血红蛋白和血小板分别为(4.93±1.27)×10- /L、(123.97+11.80)g/L和(124.02±41.22)×109 /L,间接接苯组血小板为(135.80±39.44)×109 /L,均低于对照组,差异均有统计学意义(P＜0.05或P＜0.01).结论 长期慢性的低浓度苯接触可使工人淋巴细胞中p53介导的部分DNA损伤修复相关基因mRNA表达水平发生改变,直接接苯工人的外周血白细胞、血红蛋白、血小板减低以及Bcl-2、Bax、Xpa和Xpc mRNA表达水平改变明显.     

职业性苯及苯系物暴露对男性作业人员血常规的影响

目的了解职业性苯及苯系物暴露对男性作业人员血常规的影响。方法对南京市江宁区153名接触苯及苯系物男性员工（暴露组）和184名仅接触低噪声作业男性员工（对照组）的血常规检查结果按年龄／工龄组别进行分层比较,再分析其结果与年龄／212龄组别之间的相关性。结果暴露组和对照组淋巴细胞比率、中性粒细胞数及其比率和血小板计数在21～30a工龄组出现差异（P〈0．05）;而总白细胞计数、红细胞计数和血红蛋白含量与年龄／工龄组别之间存在相关性。结论职业性苯及苯系物暴露可能影响男性作业人员白细胞分类中不同组分间的比率。     

核电站检修工人血象变化情况分析

目的 分析核电站检修工人血象变化情况。方法 本研究采用整群抽样方法对某核电检修公司141名男性检修工人进行调查。采用重复测量资料的方差分析评价历年红细胞、白细胞和血小板计数是否发生改变;不同年龄工人血细胞计数是否有差异以及年龄和时间是否具有交互作用。结果 核电站检修工人红细胞数随时间变化而发生改变（F = 40.89,P < 0.001）,时间与年龄具有交互作用（F = 3.74,P = 0.005）;白细胞数随时间变化而发生改变（F = 5.78,P < 0.001）,时间与年龄无交互作用（F = 0.77,P = 0.578）;血小板数随时间变化而发生改变（F = 30.37,P < 0.001）,时间与年龄无交互作用（F = 0.67,P = 0.668）。不同年龄工人红细胞、白细胞和血小板计数均无差异（P > 0.05）。结论 核电站检修工人各血细胞数随时间变化而发生改变,总体规律为先降低再升高,需要进一步研究。     

933例涉锰企业职工体检结果分析

目的 探讨锰暴露对人体血液及造血系统、心血管系统及神经系统的损害并分析尿锰作为机体损害效应标志物的意义。 方法 对广西靖西县12家涉锰企业职工体检结果进行分析,比较不同性别、接害工龄组神经系统、心血管系统、血液系统相关指标的差异,分析尿锰与各系统损害效应指标的相关性。 结果 本次调查共包含933例涉锰作业工人。男性收缩压、舒张压的异常检出率高于女性(χ2=15.26、8.63,P < 0.01);女性血红蛋白含量、血小板计数及尿锰含量异常率高于男性(χ2=7.58、5.49、22.79,P < 0.05或0.01);女性神经症状检出率是男性的12倍(χ2=27.15,P < 0.01)。男性血小板含量异常检出率随接害工龄增加而增加(r=0.32,P < 0.05);男女两性尿锰异常检出率与接害工龄均不相关(男:r=-0.24,P=0.60;女:r=0.20,P=0.80)。尿锰含量与收缩压、舒张压、白细胞计数、血红蛋白、红细胞计数、血小板均无统计学关联,不同尿锰组间神经症状检出率亦无统计学意义。 结论 提示锰暴露后对神经系统损害及铁代谢的影响在男女两性间可能存在差异,长期锰暴露对男性血小板计数产生影响,尿锰并不能反映体内锰的蓄积,且不能作为机体损害的效应标志物。