铅接触者职业健康监护血锌原卟啉筛选指标值的探讨

目的探讨铅接触者职业健康监护中血锌原卟啉作为筛选指标的可行性。方法以某蓄电池制造企业2000-2001年极板、装配、化成3个车间各工段的作业场所空气铅烟（尘）监测数据456个及上述3个车间198名职工近2年体检结果为资料进行统计分析。结果各浓度组血锌原卟啉、尿铅值均有随接触浓度增高而增大的趋势；浓度与血锌原卟咻、浓度与尿铅及血锌原卟啉与尿铅之间均呈高度正相关（P〈0．01）。从而提示血锌原卟啉值的变化可间接地反映尿铅值的变化，建立血锌原卟啉与尿铅值的数学模型为Pi^=0．1612×Zi0.7354。若将漏诊率控制在1％左右，经模型推算出血锌原卟啉的值为1．7μmol／L（1062．5μg／L），若血红蛋白值取170g／L（本资料平均值）时，血锌原卟啉值约为6μg／g Hb（1062．5／170）。结论建议血锌原卟啉可以作为筛选指标，其下限值应为6μg／g Hb。

Serum Zinc Protoporphyrin as the Screening Index in the Occupational Sanitary Surveillance for the Lead-Exposed Workers

[ Objective ] To explore the feasibility of using serum zinc protoporphyrin as the screening index in the occupational sanitary surveillance for lead-exposed workers. [ Methods] Statistical analysis was made on the physical examination result for 198 working staff exposed to lead dust in the working places of plate, assembling and the workshops in a accumulator enterprise during 2000--2001 and the surveillance data in the working environment. [ Results] Both serum zinc protoporphyrin and urinary lead had an increasing tendency with the increase of exposure concentration in all the concentration groups ; thus, it indicated that the changes of serum zinc protoporphyrin value could indirectly reflect the changes of urinary lead value, the mathematic model of serum zinc pro- toporphyrin and urinary lead value wasPi^ =0. 1612 × Zi 0. 7354; when the misdiagnosis rate was controlled within 1%, the calculated serum zinc protoporphyrin value would be 1.7 μmol/L （ 1062.5 μg/L） ; when the hemoglobin value was 170 g/L, serum zinc protoporphyrin value would be 6 μg/g Hb （1062.51μg/L）. [ Conclusion] Serum zinc protoporphyrin value carl be used as the screening index with the minimum limit of 6 μg/g Hb