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铅暴露工人的缺血性心脏病危险因素:研究报告。

Ischemic heart disease risk factors in lead exposed workers: research study.

机构信息

Occupational Medicine Specialist, Faculty of Medicine, Iran University of Medical Sciences, Tehran, Iran.

Forensic Medicine Specialists, Faculty of Medicine, Iran University of Medical Sciences, Tehran, Iran.

出版信息

J Occup Med Toxicol. 2013 Apr 22;8:11. doi: 10.1186/1745-6673-8-11. eCollection 2013.

Abstract

BACKGROUND

Review of other epidemiological studies reveal inconsistent results of relationships between high blood lead level and risk of hypertension, hyperlipidemia and hyperglycemia. In this study we wanted to find if there is a relationship between blood lead level and these ischemic heart disease risk factors.

METHODS

This cross-sectional study was conducted in a battery recycling plant, and 497 male workers with the mean age of 41.7 (±6.50) years were recruited from all over the plant (those from the products and maintenance sections were classed as "high lead exposed group" and those from amongst the office, laboratory, security services and food services sections as "low lead exposed group"). Personal information such as demographics and work history was obtained through a questionnaire. Mean (±Standard deviation) for quantitative variables, Frequency (Percent) for qualitative variables, and Odd's ratio (OR) with 95% confidence interval (95% CI) for estimating the effect of blood lead level on lipid profile[triglyceride (TG), cholesterol(CHOL), low density lipoprotein - Cholesterol(LDL-C),high density lipoprotein -Cholesterol(HDL-C)], hypertension(HTN) and fasting blood sugar (FBS) level. Logistic regression modeling was used for multivariate analysis and adjusting the effect of different variables (age, body mass index(BMI), eating habits, cigarette smoking).

RESULTS

The mean Blood Lead Level (BLL) was >40 μg/dl in 281 (56.6%) subjects, ≤40 μg in 216 (43.4%) subjects and the mean BLL was 43.3 μg/dl (n = 497). The mean job experience involving lead exposure was 13 years. There was no significant correlation between BLL and FBS (p = 0.68), between BLL and TG (P = 0.32), between BLL and HDL-C (p = 0.49), between BLL and LDL-C (p = 0.17), between BLL and CHOL(p = 0.96), between BLL and systolic blood pressure (p = 0.12). The adjusted Odd's ratio for the effect of BLL >40.0 μg/dl on diastolic blood pressure was1.03 (95% CI: 1.01-1.05) with p = 0.05.

CONCLUSION

This study showed an association of high BLL with diastolic blood pressure but not with TG, FBS, and HDL-C, LDL-C and CHOL . This result persisted even after adjustment was made for age, BMI and job experience, smoking and eating habits. Attention to health-protective policies, individual behavioral changes and regular periodic medical examination with focus on diastolic blood pressure in lead exposed workers is likely to decrease the public health burden of ischemic heart disease.

摘要

背景

其他流行病学研究表明,血液铅水平与高血压、高血脂和高血糖风险之间的关系结果不一致。在这项研究中,我们想研究血液铅水平与这些缺血性心脏病危险因素之间是否存在关系。

方法

这是一项横断面研究,在一家电池回收厂进行,共招募了 497 名平均年龄为 41.7(±6.50)岁的男性工人,他们来自工厂的各个部门(来自产品和维护部门的工人被归类为“高铅暴露组”,而来自办公室、实验室、安保服务和餐饮服务部门的工人被归类为“低铅暴露组”)。通过问卷获得个人信息,如人口统计学和工作史。定量变量的平均值(±标准差)、定性变量的频率(百分比)和血液铅水平对血脂谱[甘油三酯(TG)、胆固醇(CHOL)、低密度脂蛋白胆固醇(LDL-C)、高密度脂蛋白胆固醇(HDL-C)]、高血压(HTN)和空腹血糖(FBS)水平影响的比值比(OR)。使用逻辑回归模型进行多变量分析,并调整不同变量(年龄、体重指数(BMI)、饮食习惯、吸烟)的影响。

结果

281 名(56.6%)受试者的平均血铅水平(BLL)>40μg/dl,216 名(43.4%)受试者的平均 BLL≤40μg/dl,平均 BLL 为 43.3μg/dl(n=497)。平均接触铅的工作经验为 13 年。BLL 与 FBS 之间无显著相关性(p=0.68),BLL 与 TG 之间无显著相关性(P=0.32),BLL 与 HDL-C 之间无显著相关性(p=0.49),BLL 与 LDL-C 之间无显著相关性(p=0.17),BLL 与 CHOL 之间无显著相关性(p=0.96),BLL 与收缩压之间无显著相关性(p=0.12)。BLL>40.0μg/dl 对舒张压的调整比值比为 1.03(95%CI:1.01-1.05),p=0.05。

结论

本研究表明,高 BLL 与舒张压有关,但与 TG、FBS、HDL-C、LDL-C 和 CHOL 无关。即使在调整了年龄、BMI、工作经验、吸烟和饮食习惯后,这一结果仍然存在。关注针对铅暴露工人的健康保护政策、个人行为改变和定期医疗检查,重点关注舒张压,可能会降低缺血性心脏病的公共卫生负担。

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