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目的探讨铅接触对作业工人血压和心脏传导功能的影响。方法对630名研究对象(522名铅作业工人为接触组,108名后勤和管理人员为对照组)进行职业健康检查,应用微分电位溶出法(PbUDPSA法)测定血铅的浓度;采用原子吸收光谱法检测工作场所空气中铅尘、铅烟浓度,并根据接触时间和工龄计算每个工人的累积接触剂量,分析血压异常和心电图异常与铅接触的关系。结果铅作业工人外周血铅浓度为(471.3±184.6)mg/m3,高于对照组的(193.3±87.0)mg/m3,差异有统计学意义(P<0.05)。经多重线性回归分析,环境铅的接触剂量与血铅存在剂量-反应关系(P<0.05);未发现不同累积铅浓度组和血铅浓度组血压异常率存在差异(P>0.05);各累积接触剂量组和对照组心电图异常率比较,差异有统计学意义(P<0.05);心电图异常率随血铅浓度的升高逐渐升高。结论铅可导致心电图的异常,影响心脏传导功能,但还需要进一步深入研究。
Objective To investigate the effects of lead exposure on blood pressure and heart conduction in workers. Methods Occupational health examinations were performed on 630 study subjects (522 lead workers for the exposure group and 108 logistics and management personnel as the control group). The concentrations of lead in blood were determined by the differential elution method (PbUDPSA method). The atomic absorption spectrometry Method to detect the concentration of lead dust and lead smoke in the air of the workplace. The accumulated exposure dose of each worker was calculated according to the contact time and length of service, and the relationship between abnormal blood pressure and electrocardiogram abnormality and lead exposure was analyzed. Results The level of lead in peripheral blood of lead workers was (471.3 ± 184.6) mg / m3, higher than that of the control group (193.3 ± 87.0) mg / m3, the difference was statistically significant (P <0.05). Multiple linear regression analysis showed that there was a dose-response relationship between lead exposure and blood lead (P <0.05). There was no significant difference in blood pressure abnormalities among different cumulative lead concentrations and blood lead concentrations (P> 0.05) There was a significant difference between the exposure dose group and the control group (P <0.05). The abnormal rate of ECG increased with the increase of blood lead concentration. Conclusion lead can lead to abnormal ECG, affecting cardiac conduction, but still need further study.