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目的探讨血锌原卟啉(ZPP)作为铅作业工人的健康损害效应筛查指标的意义。方法 对某铅酸蓄电池厂478名铅作业工人(接触组)和112名上岗前工人(对照组)进行职业健康检查,包括测定ZPP、血铅(PbB)和血红蛋白(Hb),并进行职业卫生学调查和测定工作场所空气中铅烟、铅尘时间加权平均浓度(CTWA)。结果 工作场所铅烟、铅尘检测点超标率分别为62.5%和37.5%。接触组工人PbB质量浓度中位数(M)为186.4μg/L,ZPP浓度M为0.69μmol/L,与对照组(分别为48.9μg/L、0.58μmol/L)比较,差异均有统计学意义(P<0.001)。接触组Hb水平[(138.08±15.53)g/L]与对照组[(138.00±14.69)g/L]比较,差异无统计学意义(P>0.05)。选用ZPP≥1.57μmol/L(本实验室正常参考值上限)作为指标确定进行诊断性驱铅试验的比率高于以PbB≥400μg/L作为指标的比率(P<0.05),21名ZPP≥1.57μmol/L人员经诊断性驱铅试验后慢性铅中毒和观察对象检出率为38.1%(8/21)。结论 ZPP作为早期筛查铅作业人群职业健康损害指标有重要意义,建议将ZPP作为铅作业人群职业健康检查的必检项目。
Objective To explore the significance of ZPP as a screening index for health effects of lead workers. Methods 478 lead workers (contact group) and 112 pre-job workers (control group) in a lead-acid battery factory were given occupational health examination, including determination of ZPP, PbB and Hb, and occupational health To study and determine the workplace air lead plume, lead dust time weighted average concentration (CTWA). Results The over-standard rates of lead smoke and lead dust in the workplace were 62.5% and 37.5%, respectively. The median concentration (Pb) of PbB in contact group was 186.4μg / L and the concentration of ZPP was 0.69μmol / L, which were significantly different from those in control group (48.9μg / L and 0.58μmol / L, respectively) Significance (P <0.001). The level of Hb in the exposure group [(138.08 ± 15.53) g / L] was not significantly different from that in the control group [(138.00 ± 14.69) g / L] (P> 0.05). The ratio of ZPP≥1.57μmol / L (the upper limit of normal reference value in our laboratory) to the diagnostic lead-removing test was higher than that of PbB≥400μg / L (P <0.05), and 21 ZPP≥1.57 The detection rate of chronic lead poisoning and observation object was 38.1% (8/21). Conclusion ZPP is of great importance as an indicator of occupational health damage in early screening of lead workers. It is suggested that ZPP should be taken as a mandatory item of occupational health examination for lead workers.