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接触无机铅的工人的不良反应。

Adverse effects in workers exposed to inorganic lead.

作者信息

Stoleski Saso, Karadzinska-Bislimovska Jovanka, Stikova Elisaveta, Risteska-Kuc Snezana, Mijakoski Dragan, Minov Jordan

机构信息

Institute of Occupational Health, WHO Collaborating Center for Occupational Health, Skopje, Macedonia.

出版信息

Arh Hig Rada Toksikol. 2008 Mar;59(1):19-29. doi: 10.2478/10004-1254-59-2008-1866.

Abstract

This paper describes a retrospective cohort study comparing 60 workers occupationally exposed to inorganic lead and 60 matched controls. All subjects were assessed using data obtained from a specially designed Questionnaire for lead exposure and toxic effects assessment, physical examination, spirometry, ECG, and laboratory tests including blood lead level (BLL) and biomarkers of lead toxic effects. Muscle pain, droopiness, and work-related nasal symptoms were significantly more frequent in lead workers. The prevalence of lung symptoms was higher in lead workers than in controls, but not significantly (20 % vs. 6.6 %, respectively). Mean values of BLL and delta-aminolevulinic acid (ALA) were significantly higher in lead workers. The activity of delta-aminolevulinic acid dehydratase (ALAD) in lead workers was significantly lower than in controls. Abnormal of BLL, ALAD, and ALA were more frequent in lead workers, with statistical difference for BLL and ALAD. Inverse correlation was found between BLL and ALAD, and positive correlation between BLL and age, years of employment, and years of exposure. Inverse correlation was found between ALAD and age, years of employment, years of exposure, blood pressure, alcohol consumption, and years of alcohol consumption. Changes in spirometry correlated inversely with BLL. A positive correlation was found between BLL and erythrocyte count and haemoglobin concentration, whereas it was inverse for ALAD and haemoglobin concentration. A significant difference was found for BLL and ALAD, with a very high odds ratio (14.64 and 7.23, respectively) and high relative risk (4.18 and 3.08, respectively). Our data have confirmed the association between occupational lead exposure and deviation in specific biological markers of lead effect and between the role of occupational exposure in the development of adverse effects.

摘要

本文描述了一项回顾性队列研究,该研究比较了60名职业性接触无机铅的工人和60名匹配的对照组。所有受试者均通过从专门设计的铅暴露和毒性效应评估问卷、体格检查、肺功能测定、心电图以及包括血铅水平(BLL)和铅毒性效应生物标志物在内的实验室检查中获得的数据进行评估。铅作业工人中肌肉疼痛、乏力和与工作相关的鼻部症状明显更为常见。铅作业工人肺部症状的患病率高于对照组,但差异无统计学意义(分别为20%和6.6%)。铅作业工人的BLL和δ-氨基乙酰丙酸(ALA)平均值显著更高。铅作业工人的δ-氨基乙酰丙酸脱水酶(ALAD)活性显著低于对照组。铅作业工人中BLL、ALAD和ALA异常更为常见,BLL和ALAD存在统计学差异。发现BLL与ALAD呈负相关,BLL与年龄、就业年限和暴露年限呈正相关。发现ALAD与年龄、就业年限、暴露年限、血压、饮酒量和饮酒年限呈负相关。肺功能测定的变化与BLL呈负相关。发现BLL与红细胞计数和血红蛋白浓度呈正相关,而ALAD与血红蛋白浓度呈负相关。BLL和ALAD存在显著差异,优势比非常高(分别为14.64和7.23),相对风险也很高(分别为4.18和3.08)。我们的数据证实了职业性铅暴露与铅效应特定生物标志物偏差之间的关联,以及职业暴露在不良反应发生中的作用。

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