Kim Min-Gi, Ryoo Jae-Hong, Chang Se-Jin, Kim Chun-Bae, Park Jong-Ku, Koh Sang-Baek, Ahn Yeon-Soon
Graduate School of Medicine, Wonju College of Medicine, Yonsei University, Wonju, Korea; Departments of Occupational Medicine, Dongguk University Gyeongju Hospital, Gyeongju, Korea.
Departments of Preventive Medicine, School of Medicine, Kyung Hee University, Seoul, Korea.
PLoS One. 2015 Oct 15;10(10):e0140360. doi: 10.1371/journal.pone.0140360. eCollection 2015.
The objective of this study was to identify the association of blood lead level (BLL) with mortality in inorganic lead-exposed workers of South Korea. A cohort was compiled comprising 81,067 inorganic lead exposed workers working between January 1, 2000, and December 31, 2004. This cohort was merged with the Korean National Statistical Office to follow-up for mortality between 2000 and 2008. After adjusting for age and other carcinogenic metal exposure, all-cause mortality (Relative risk [RR] 1.36, 95% confidence interval [CI] 1.03-1.79), digestive disease (RR 3.23, 95% CI 1.33-7.86), and intentional self-harm (RR 2.92, 95% CI 1.07-7.81) were statistically significantly higher in males with BLL >20 μg/dl than of those with BLL ≤10μg/dl. The RR of males with BLL of 10-20 μg/dl was statistically higher than of those with BLL ≤10μg/dl in infection (RR 3.73. 95% CI, 1.06-13.06). The RRs of females with 10-20 μg/dl BLL was statistically significantly greater than those with BLL <10μg/dl in all-cause mortality (RR 1.93, 95% CI 1.16-3.20) and colon and rectal cancer (RR 13.42, 95% CI 1.21-149.4). The RRs of females with BLL 10-20 μg/dl (RR 10.45, 95% CI 1.74-62.93) and BLL ≥20 μg/dl (RR 12.68, 95% CI 1.69-147.86) was statistically significantly increased in bronchus and lung cancer. The increased suicide of males with ≥20 μg/dl BLLs, which might be caused by major depression, might be associated with higher lead exposure. Also, increased bronchus and lung cancer mortality in female workers with higher BLL might be related to lead exposure considering low smoking rate in females. The kinds of BLL-associated mortality differed by gender.
本研究的目的是确定韩国无机铅暴露工人的血铅水平（BLL）与死亡率之间的关联。编制了一个队列，其中包括2000年1月1日至2004年12月31日期间工作的81,067名无机铅暴露工人。该队列与韩国国家统计局合并，以跟踪2000年至2008年期间的死亡率。在调整年龄和其他致癌金属暴露因素后，BLL>20μg/dl的男性在全因死亡率（相对风险[RR]1.36，95%置信区间[CI]1.03-1.79）、消化系统疾病（RR 3.23，95%CI 1.33-7.86）和故意自伤（RR 2.92，95%CI 1.07-7.81）方面在统计学上显著高于BLL≤10μg/dl的男性。BLL为10-20μg/dl的男性在感染方面的RR在统计学上高于BLL≤10μg/dl的男性（RR 3.73，95%CI 1.06-13.06）。BLL为10-20μg/dl的女性在全因死亡率（RR 1.93，95%CI 1.16-3.20）以及结肠癌和直肠癌方面（RR 13.42，95%CI 1.21-149.4）的RR在统计学上显著高于BLL<10μg/dl的女性。BLL为10-20μg/dl（RR 10.45，95%CI 1.74-62.93）和BLL≥20μg/dl（RR 12.68，95%CI 1.69-147.86）的女性在支气管和肺癌方面的RR在统计学上显著增加。BLL≥20μg/dl的男性自杀率增加，这可能由重度抑郁症引起，可能与更高的铅暴露有关。此外，考虑到女性吸烟率较低，BLL较高的女性工人支气管和肺癌死亡率增加可能与铅暴露有关。与BLL相关的死亡率类型因性别而异。
