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[对接触磷酸酯和氨基甲酸酯类的农场工人及商人的胆碱酯酶监测]

[The monitoring of cholinesterases in farm workers and tradesmen exposed to phosphoric esters and carbamates].

作者信息

Faustini A, Arpaia F, Pagliarella P, Forastiere F, Papini P, Perucci C A

机构信息

Servizio di Igiene Pubblica, ULS LT/1, Aprilia.

出版信息

Med Lav. 1992 Mar-Apr;83(2):135-45.

PMID:1630402
Abstract

Cholinesterase (ChE) levels (Ellman method) were monitored in 90 subjects (69 males and 21 females) exposed to carbamate and organophosphate pesticides (78 agricultural workers and 12 pesticide vendors). Pre-exposure baseline values of plasma and red blood cell cholinesterase activities were defined for each subject with two blood samples (23 workers) or three blood samples (59 workers) taken almost thirty days after the last exposure. After control of intra-individual variation, 8 subjects with only one pre-exposure value and 13 with a coefficient of variation above 30% were excluded. For the other 59 subjects, the intra-individual variation of erythrocyte ChE (16%) was similar to the inter-individual one (15%), whereas the inter-individual variation of plasma ChE (21%) was higher than the intra-individual one (14%). Laboratory variation for plasma ChE measurements was 8%. Baseline values were analyzed (ANOVA) for sex, age, task and hour and season of sampling. Both erythrocyte and plasma enzymes, corrected for hematocrit, were lower in females. Plasma cholinesterase activity was lower in "re-entry" agricultural workers and in pesticide vendors. Post-exposure cholinesterase activity was measured in 54 workers within a few (1-21) days after last handling. Average relative reduction was 15.2% (95% C.I. = 4.9%-25.5%) in erythrocyte cholinesterase activity and 29.1% (95% C.I. = 18.2%-40.1%) in plasma cholinesterase activity. The one-way variance analysis showed marked plasma ChE reduction in mixers, loaders and appliers (36%, 95% C.I. = 24%-48%) and in parathion handlers (35%, 95% C.I. = 21%-49%. No significant reduction in blood cell cholinesterase activity in relation to task and to pesticide handled was observed. We conclude that the intra-individual variations of the baseline values were higher for three repetitions (88% and 84% of the population were within a variability of less than 30%, for AChE and for ChE respectively) than for two repetitions (91% and 88% of the population were within 30% of variability for AChE and for ChE respectively). The figures show a greater sensitivity of plasma ChE activity in acute exposure, probably due to a poor reliability in detection of erythrocyte ChE by local laboratories. The maximum reduction (38%, 95% C.I. = 22%-53%) in plasma ChE activity was observed within six days of the last exposure in loaders and appliers.

摘要

采用埃尔曼法对90名接触氨基甲酸酯类和有机磷酸酯类农药的受试者(69名男性和21名女性,其中78名农业工人和12名农药销售商)的胆碱酯酶(ChE)水平进行了监测。在最后一次接触农药近30天后,采集两份血样(23名工人)或三份血样(59名工人),为每位受试者确定血浆和红细胞胆碱酯酶活性的暴露前基线值。在控制个体内变异后,排除了仅具有一个暴露前值的8名受试者以及变异系数高于30%的13名受试者。对于其他59名受试者,红细胞ChE的个体内变异(16%)与个体间变异(15%)相似,而血浆ChE的个体间变异(21%)高于个体内变异(14%)。血浆ChE测量的实验室变异为8%。对基线值进行了性别、年龄、任务以及采样时间和季节的方差分析(ANOVA)。校正血细胞比容后,女性的红细胞和血浆酶活性均较低。“重新进入”的农业工人和农药销售商的血浆胆碱酯酶活性较低。在最后一次接触农药后的几天内(1 - 21天),对54名工人进行了接触后胆碱酯酶活性测量。红细胞胆碱酯酶活性的平均相对降低率为15.2%(95%置信区间 = 4.9% - 25.5%),血浆胆碱酯酶活性为29.1%(95%置信区间 = 18.2% - 40.1%)。单因素方差分析显示,混合工、装载工和施药工(36%,95%置信区间 = 24% - 48%)以及处理对硫磷的工人(35%,95%置信区间 = 21% - 49%)的血浆ChE显著降低。未观察到血细胞胆碱酯酶活性与任务和所接触农药之间有显著降低。我们得出结论,基线值的个体内变异在进行三次重复测量时(分别有88%和84%的人群AChE和ChE的变异小于30%)高于两次重复测量时(分别有91%和88%的人群AChE和ChE的变异在30%以内)。这些数据表明,在急性暴露中血浆ChE活性的敏感性更高,这可能是由于当地实验室检测红细胞ChE的可靠性较差。在装载工和施药工中,最后一次接触农药后6天内观察到血浆ChE活性的最大降低(38%,95%置信区间 = 22% - 53%)。

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