铅对作业工人甲状腺功能的影响

目的　了解铅对作业工人甲状腺功能的影响。方法　选择暴露于铅作业环境下的人群 ,了解工人作业工龄 ,采用火焰原子吸收光谱法测定其作业环境中铅浓度 ,用原子吸收光谱法测定作业工人血铅 (PbB)浓度 ,用血液锌原卟啉测定仪测定血锌原卟啉 (ZPP)浓度 ,用放射免疫分析法检测血清中促甲状腺素 (TSH)、三碘甲状腺原氨酸 (T3)、甲状腺素 (T4 )、游离T3(FT3)、游离T4 (FT4 ) 5项甲状腺功能指标。结果　血铅 >2 .88μmol/L时 ,T3[(1 .54± 0 .39)nmol/L]、FT3[(5 .50± 1 .2 6)pmol/L]含量明显低于血铅 (1 .92～ 2 .88) μmol/L组 [T3(1 .71± 0 .45)nmol/L、FT3(6 .1 2± 1 .64)pmol/L] ,差异有显著性(P <0 .0 5)。铅作业工龄长短对甲状腺激素 (TH)含量未见明显影响。结论　高浓度血铅可能抑制了T4 的脱碘 ;铅作业工龄对甲状腺功能未见明显影响     

大连市部分儿童血铅水平调查及“派其安”防治铅蓄积效用的研究

目的:探讨大连市儿童目前铅污染状况及“派其安”驱铅效果。方法:用溶出分析法对大连市1250名儿童进行血铅浓度筛查,用石墨炉原子吸收光谱法,检测儿童血铅偏高或轻度儿童慢性铅中毒者60例,服用派其安驱铅治疗,随机抽取10年前有血铅偏高或慢性铅中毒者服用硒锌制剂拮抗铅毒的30名儿童作对照;同时对服派其安的时差与效用关系相比较。结果:普查组血铅值≥100μg/L者计292例(23.4%),服派其安驱铅1~2月血铅呈下降趋势;连服3个月派其安驱铅有显效(P<0.01)。     

慢性铅接触者胸腺输出近期功能的研究

目的分析铅接触者外周血T细胞受体删除DNA环(TRECs)的含量,了解其初始T细胞含量和胸腺近期输出功能,从而研究其免疫功能的情况。方法采用实时定量PCR方法检测10例铅接触者外周血TRECs含量,与11例非铅接触者进行比较;采用双变量相关分析法和偏相关分析法分析铅接触组TRECs水平与年龄、工龄、血铅、尿铅、血锌原卟啉(ZPP)和尿δ-氨基-γ-酮戊酸(δ-ALA)浓度的关系。结果10例铅接触者TRECs水平[(2.44±1.87)/1000]明显低于非铅接触者[(5.60±3.96) /1000];TRECs水平与尿δ-ALA浓度呈负相关,有统计学意义(r=-0.754,P<0.05),但控制血铅或尿铅因素后,TRECs水平与尿δ-ALA浓度则无相关性(P>0.05)。结论铅对胸腺输出功能可能造成一定程度的损伤,且TRECs与血铅和尿铅存在相关性,提示低水平的铅接触早已损伤人体的免疫功能。     

子宫内铅暴露对仔鼠牙齿萌出和釉质发育的影响

目的观察母鼠妊娠期间不同剂量铅暴露对仔鼠牙齿萌出情况和釉质发育的影响。方法27只怀孕SD大鼠随机分为铅暴露高剂量组、低剂量组和对照组,每组9只。铅暴露组饮用去离子水中加入醋酸铅进行染毒[以铅(Pb2+)含量计算高剂量组200mg/L、低剂量组50mg/L],对照组饮用去离子水。染毒自大鼠孕第1天持续至自然分娩。仔鼠出生后第26天在下切牙龈乳头水平进行第1次标记,并于出生后第36天在同一牙龈乳头水平行二次标记。第2次标记当日取全血测定血铅并处死仔鼠。测定切牙铅含量,应用立体显微镜观察牙齿形态并测量切牙两次标记间距离,应用电子探针测定切牙釉质钙、磷含量并计算比值。结果高、低剂量铅暴露仔鼠组血铅较对照仔鼠组增高,差异有统计学意义(P<0.01);高、低剂量铅暴露仔鼠组齿铅[(77.3±6.3)、(27.8±4.5)μg/g]与对照仔鼠组[(6.6±0.8)μg/g]相比,差异有统计学意义(P<0.01)。铅暴露仔鼠组切牙较小,牙尖磨耗明显并多见舌侧髓腔暴露,高铅剂量组更为明显。高、低剂量铅暴露仔鼠组切牙萌出速率[(0.25±0.08)、(0.30±0.09)mm/d]与对照仔鼠组[(0.39±0.09)mm/d]比较,铅暴露组萌出较为缓慢,三组间差异有统计学意义(P<0.01)。仔鼠釉质钙/磷比分析显示,随铅染毒剂量的增加,钙/磷比(1.68±0.54、1.37±0.47)降低,     

The effect of mixed exposure to lead and zinc on ALA level in urine

Summary Investigations were performed on 97 subjects occupationally exposed to lead and zinc. The levels of lead in blood and zinc in plasma were used as measures of exposure. All subjects were divided into nine groups according to lead blood levels, and the excretion of S-aminolevulinic acid in urine was investigated in each group. Additionally, the criterion of zinc level in plasma was applied. Mixed exposure to lead and zinc leads to a decrease of ALA levels in urine in comparison with single exposure to lead alone.     

孕期低水平铅暴露对婴儿生长发育的影响

目的:探讨孕期低水平铅暴露对婴儿生长发育以及社会情感技能发展的影响,早期发现不利因素,开展健康教育,从社会、环境医学角度为培养全面发展的新一代探索更广的途径。方法:对110例母婴进行问卷调查,社会情感技能ASQ:SE婴幼儿社会情感问卷,新生儿神经行为评分,体检。采用原子吸收石墨炉法测定脐血铅水平。前瞻性观察足月新生儿脐血铅与体格发育、神经发育、父母职业、生活方式等指标的等级相关性,开展防铅健康教育。结果:110例新生儿脐血铅中位数(M):18·8μg/L,均数(x):23·84μg/L,标准差(s):20·43;血铅与出生体重、身长、头围相关系数分别为0·142、0·005、0·019,无显著相关性;与情商相关系数为0·827(P<0·01);与父母职业、交通情况相关系数分别为0·106(P<0·05)、0·228(P<0·05)、0·220(P<0·05)、0·228(P<0·05);与母亲被动吸烟、家庭装修相关系数分别为0·224(P<0·05)、0·203(P<0·05)。结论:提示孕期低水平铅暴露新生儿脐血铅水平与父母交通情况、母亲职业、母亲被动吸烟、家庭装修、婴儿日后情商有显著相关性。环境干预、健康教育是防治儿童铅中毒的有效途径。     

父母职业接触铅对其子女智力行为的影响

目的　评价铅对作业工人子女智力、神经行为的影响。方法　选择父亲和 (或 )母亲从事铅作业的 14 7名某市区儿童 (6～ 10岁 )为接触组 ,父母亲均不接触铅及其它化学毒物、居住在同一市区的儿童 99名为对照组。测定两组儿童血铅、发铅、血锌卟啉、智商和神经行为功能。结果　父母职业性接触铅其子女发铅、血铅、锌卟啉明显高于对照组 (P<0 0 1) ,血铅、发铅水平与智商水平基本呈负相关关系。行为功能简单反应时、数字跨度得分 ,接触组明显低于对照组(P <0 0 1) ;上述改变以父亲母亲同时接触铅影响最大、父亲接触铅次之、母亲接触铅影响最小。结论　父母职业接触铅增加其子女铅负荷 ,造成儿童的智力和神经行为不良影响     

甘肃省人群高氯酸盐暴露水平及对甲状腺功能影响分析

目的  对甘肃省人群高氯酸盐暴露水平进行评估并探讨其与甲状腺功能的关系,为该地区高氯酸盐污染防控提供依据。方法  采用现况研究设计,选取兰州市城关区和定西市陇西县的随机两个社区中参与义诊的居民作为研究对象,采用问卷调查、体格检查和生化检查收集研究对象的基本资料及相关信息。应用多因素线性回归分析模型和限制性立方样条分析高氯酸盐暴露水平与甲状腺功能的关联及剂量-反应关系。结果  本研究共纳入研究对象100名,包括男性48名和女性52名。尿高氯酸盐浓度的中位数(四分位间距)为23.90(13.30~43.54)μg/g Cr。多因素线性回归分析发现,调整混杂因素后,高氯酸盐暴露水平与血清总三碘甲状腺原氨酸(total triiodothyronine, TT3)、游离三碘甲状腺原氨酸(free triiodothyronine, FT3)和游离甲状腺素(free thyroxine, FT4)水平呈正相关趋势(均有P < 0.05)。限制性立方样条分析发现高氯酸盐暴露水平与血清TT3和FT4水平呈非线性剂量-反应关系(均有P < 0.05)。结论  甘肃省地区人群的高氯酸盐暴露水平较高。高氯酸盐暴露水平与血清TT3、FT4水平有相关关联。     

Longitudinal associations between lead dose and renal function in lead workers

Background

Existing research on the lead dose range associated with nephrotoxicity in the occupational setting is inconsistent and primarily cross-sectional in design.

Objective

To determine if lead dose predicts change in renal function in a large population of current and former lead workers.

Methods

Three evaluations were performed between 1997 and 2001. Lead dose was assessed with blood and tibia lead. Renal outcomes included blood urea nitrogen, serum creatinine, and calculated creatinine clearance. We used generalized estimating equations to model change in renal function between each evaluation in relation to tibia lead at the beginning of each follow-up period and concurrent change in blood lead, while adjusting for baseline lead dose and other covariates.

Results

At baseline, mean (SD) age and duration of occupational lead exposure were 42.0 (9.3) and 8.8 (6.3) years, respectively, in 537 current and former lead workers followed over a mean of 2.1 years. Mean (SD) blood and tibia lead were 31.3 (14.4) μg/dl and 35.0 (37.8) μg/g bone mineral, respectively. Women (25.9%) were older and more likely to be former lead workers than men. In males, serum creatinine decreased and calculated creatinine clearance increased over the course of the study. Mean blood lead was not significantly different between evaluations 1 and 3 in either sex, however, tibia lead decreased in women. Blood and tibia lead were significantly associated with change in renal function. In males, serum creatinine decreases and calculated creatinine clearance increases were greatest in participants whose blood lead declined.

Conclusions

Both acute and chronic occupational lead dose measures were associated with change in renal function measures prospectively.     

铅接触对工人神经行为功能的影响

目的评价铅接触对工人精神及神经行为功能的改变及其接触水平-效应关系.方法采用 SCL-90症状自评量表和计算机化神经行为评价系统(NES-C)对65名铅接触工人和65名对照工人进行精神及神经行为功能状况调查,同时测定铅接触工人血铅、尿铅浓度.结果 SCL-90症状自评量表结果显示,铅作业工人阳性项目数平均57.2,对照工人为15.0,两者差异有非常显著意义(P＜0.001);神经行为功能测试结果显示,与对照组相比,信息感知、记忆能力差异有非常显著意义(P＜0.001);尿铅浓度与躯体化、强迫、焦虑和偏执因子分间存在正相关.结论职业性铅接触可影响工人的精神和神经行为功能,尿铅浓度与心理卫生状态存在一定接触水平-效应关系.     

Thyroid function in lead smelter workers: absence of subacute or cumulative effects with moderate lead burdens

Objective: To evaluate the effect of low to moderate occupational lead exposure on thyroid function we conducted a cross-sectional study of 151 male lead smelter workers. Methods: Parameters of thyroid function were assessed in relation to both subacute and cumulative lead exposure over a 10-year employment period. Blood lead levels, obtained from plant surveillance records, were used to establish four ordinal levels of current and cumulative exposure (<15, 15–24, 25–39, and ≥40 μ g/dl). Results: Mean values for the lowest as compared with the highest current exposure group were similar for thyroxine (T₄: 6.8 versus 6.1 μ g/dl), estimated free thyroxine (EFT₄: 1.6 ng/dl in both groups), and thyroid-stimulating hormone (TSH: 1.8 versus 1.7 mIU/l); there was no evidence of a significant trend for diminished thyroid function associated with increasing current lead exposure. Similarly, no significant difference was observed for T₄, EFT₄, or TSH in relation to the 10-year cumulative exposure or for adjusted analyses controlling for potential confounders, including age and alcohol use. Conclusion: In contrast to studies observing thyroid dysfunction in the setting of high lead exposure and related clinical poisoning, our findings weigh against a significant physiologic effect on thyroid function at lower levels (<60 μ g/dl) of occupational lead exposure. Received: 3 August 1997 / Accepted: 8 July 1998     

无锡市某私营铅蓄电池厂铅作业危害分析

目的监测与评价某私营铅蓄电池厂铅作业相关的职业病危害因素,为后续铅作业人员的个人防护和健康监护提供科学依据。方法采用现场调查方法了解该企业职业卫生管理现状,按GBZ159—2004、GBZ／T160．10～2004和GBZ2．1—2007等对工作场所中铅烟、铅尘进行检测和分析并结合职业健康检查分析影响工作人员血铅浓度的潜在因素。结果该企业存在铅烟、铅尘等职业病危害因素;铅烟、铅尘超标率为92．1％,铅作业人员血铅浓度增高比例为77．5％;铅作业人员血铅浓度与工龄、学历、下班前是否沐浴以及铅作业相关卫生知识知晓率有关（均P〈0．05）。结论该私营企业存在明显的铅作业危害,应改善工作环境,加强作业人员健康宣教及健康防护。     

Occupational and environmental human lead exposure in Brazil

The purpose of this paper is to present a review of data on assessment of exposure and adverse effects due to environmental and occupational lead exposure in Brazil. Epidemiological investigations on children lead exposure around industrial and mining areas have shown that lead contamination is an actual source of concern. Lead in gasoline has been phasing out since the 1980s, and it is now completely discontinued. The last lead mining and lead refining plant was closed in 1995, leaving residual environmental lead contamination which has recently been investigated using a multidisciplinary approach. Moreover, there are hundreds of small battery recycling plants and secondary smelting facilities all over the country, which produce focal urban areas of lead contamination. Current regulatory limits for workplace lead exposure have shown to be inadequate as safety limits according to a few studies carried out lately.     

Correlation between lead in plasma and other indicators of lead exposure among lead-exposed workers

In order to clarify the bioavailability of lead in plasma (PbP), we performed a study on five workers in a Japanese factory manufacturing lead glass-based paints. Blood and urine samples were obtained over a period of 15 months, during which time the workers took it in turns to perform sifting work (with the highest level of lead exposure) for 1-month periods. A total of 75 sets of blood and urine samples were thus obtained. We determined whole blood lead (PbB), PbP, Urinary coproporphyrin (CPU), urinary -aminolevulinic acid (ALAU), urinary lead (PbU) and ALA in plasma (ALAP). In the 15 sets of samples obtained at the end of the period with a high level of lead exposure, PbP correlated significantly with ALAU, CPU, PbU and ALAP, but PbB correlated significantly only with PbU. In the 60 sets of samples obtained following a low level of lead exposure, correlation coefficients between the concentrations of PbP and of ALAU, CPU and PbU exceeded those between the concentrations of PbB and of ALAU, CPU and PbU. These findings indicate that PbP is a better dose indicator of lead biochemically available for heme synthesis and that PbU has a closer correlation with PbP than with PbB.     

不同孕期碘营养水平对甲状腺功能激素的影响

目的:探讨孕早、中、晚期妇女不同碘营养水平对甲状腺功能激素水平影响。方法:选取2018年5月-2019年2月本院产科门诊孕妇210例为研究对象,孕早、中、晚期分别为72例、70例、68例,检测所有孕妇的尿碘、血清促甲状腺激素(TSH)、游离三碘甲状腺原氨酸(FT3)和游离甲状腺素(FT4)并比较分析。结果:孕早期组碘缺乏率(38.9%)高于孕中期和孕晚期组(P<0.05);孕早、中期妇女甲状腺功能异常主要表现为低FT4血症和亚临床甲状腺功能减退症,极少数孕晚期孕妇存在甲亢;孕早期碘缺乏妇女甲状腺功能异常率(66.7%)高于孕中和孕晚期妇女(P<0.05);孕晚期碘过量妇女甲状腺功能异常率(30.0%)高于孕早期和孕中期组(P<0.05)。结论:妊娠中、晚孕妇碘营养基本处于适宜水平,但孕早期妇女普遍存在碘缺乏。应密切监测妊娠期妇女,特别是孕早期妇女的碘营养水平,对尿碘<150μg/L或>250μg/L的孕妇均应给与甲状腺功能筛查。     

父母职业接触铅对其子代某些形态和血液指标的影响

目的　评价铅对作业工人子代健康的影响。方法　选择父亲和 (或 )母亲从事铅作业的 14 7名城区儿童 ( 6～10岁 )为接触组 ,父母亲均不接触铅及其它化学毒物的儿童 99名为对照组。测定两组儿童身高、体重、胸围、发铅、血铅、血锌卟啉及智商和部分血液指标。结果　接触组发铅、血铅、血锌卟啉明显高于对照组 (P <0 0 1) ,血红蛋白、红细胞数明显低于对照组 (P <0 0 1) ,女性胸围发育明显落后于对照组 (P <0 0 1) ;上述改变以父亲母亲同时接触铅影响最大、父亲接触铅次之、母亲接触铅影响最小。结论　职业接触铅对子代健康有不良影响     

儿童铅暴露与哮喘发病风险的病例对照研究

背景:环境中某些因素会明显影响儿童哮喘的发生以及转归。铅是显著影响儿童生长发育的主要环境因素之一。目的:探讨儿童不同程度铅暴露水平与哮喘发病风险之间的关系。方法:使用成组的病例对照研究方法,主要采用问卷调查方式对调查数据进行单因素和多因素条件Logistic回归分析。结果:哮喘儿童血铅水平明显高于正常健康儿童,而不同哮喘发作程度儿童的血铅水平无显著差异。单因素Logistic回归分析结果显示,有9个因素与儿童哮喘有关联;多因素条件Logistic回归分析显示5个因素被纳入方程,分别为儿童过敏史和特异性体质(OR为15.76)、家族哮喘病史(OR为11.59)、家族同居人员吸烟(OR为4.02)、儿童血铅水平(OR为3.17)和父母铅职业暴露(OR为1.98)。结论:哮喘儿童与健康儿童血铅水平存在差异,且铅暴露可能增加儿童哮喘的发病风险。     

围产期铅暴露对新生大鼠血铅含量的影响

目的　了解铅通过母体对生长发育期仔代血铅的影响。方法　对不同浓度低水平铅暴露后的大鼠仔代的血铅进行测定。结果　铅可由母体经胎盘和乳汁传递给仔代。结论　胚胎期和哺乳期经胎盘和乳汁“染铅” ,是导致子代铅蓄积的重要原因。     

铅对作业女工子代神经行为的影响

目的 评价铅对其作业女工子代神经行为的影响。方法 对某冶炼厂职工子弟学校学生的母亲孕前至调查时从事铅作业的９４名１～４年级小学生（６～１０岁）作为接触组和无铅污染的农村小学９４名学生作对照,其年龄、性别、年级、家庭情况两组基本相同。用原子吸收光谱测定血铅;用ＺＰＰ－２０００荧光仪测定锌卟啉;用ＷＨＯ推荐的神经行为核心测试组合（ＮＣＴＢ）测定神经行为功能;用高压不认相,１３４０型电化学仪测定尿中ＨＶ     

Influence of chronic low-level exposure to lead on plasma immunoglobulin concentration and cellular immune function in man

Summary The immunological status of individuals occupationally exposed to low levels of inorganic lead has been examined and compared with that of non-exposed, age and sex-matched controls. At the time of testing the exposed population had a mean (± SD) blood lead concentration of 38.4 ±5.6 g · 100 ml^–1 (n = 39) compared witha mean value of 11.8 ±g · 100 ml^–1 (n = 21) for the control group. No differences in the serum concentrations of IgG, IgA and IgM between the populations were observed and there existed no correlation between blood lead concentration and serum immunoglobulin levels. In addition assessment was made of the capacity of peripheral blood mononuclear cells to respond to the mitogen phytohaemagglutinin (PHA), a correlate of T cell function, and to spontaneously lyse cells of the erythroleukaemic cell line K562, a measure of NK cell function. In neither case was there a difference between exposed and control populations and no correlation between reactivity and blood lead concentration. Although previous studies in rodents have indicated that exposure to inorganic lead resulting in similar blood lead concentrations may compromise immune competence our data suggest that no similar effect occurs in man.