Min Young-Sun, Ahn Yeon-Soon
Department of Occupational and Environmental Medicine, Dongguk University Ilsan Hospital, Goyang-si, Gyeonggi-do, 410-773, South Korea.
Scand J Work Environ Health. 2017 Jul 1;43(4):385-390. doi: 10.5271/sjweh.3631. Epub 2017 Mar 17.
Objective We prospectively evaluated the association between blood lead levels (BLL) and increases in hospital admissions for treatment of cardiovascular diseases among lead-exposed workers in Korea. Methods The study cohort was derived from Korea Occupational Safety and Health Agency data, which included lead-exposed male workers who underwent lead-associated medical check-ups at least once between 2000 and 2004. The adjusted hospital admission hazard ratio (AHR) of cardiovascular diseases for each BLL grade (10-20 and ≥20 μg/dL) was compared with that of the reference grade (<10 μg/dL) using Cox's proportional hazard models. The adjusted variables included age and exposure to other metals. Results AHR of ischemic heart disease [IHD; AHR 1.78, 95% confidence interval (95% CI) 1.17-2.72], angina pectoris (AHR 1.93, 95% CI 1.13-3.29) and cerebral infarction (AHR 2.24, 95% CI 1.14-4.39) were significantly higher among workers with a BLL ≥20 μg/dL than those with a BLL ≤10 μg/dL. The AHR (1.52, 95% CI 1.00-2.31) for cerebrovascular disease was significantly higher among workers with a BLL 10-20 μg/dL than those with a BLL ≤10 μg/dL. IHD, cerebrovascular disease, angina pectoris and cerebral infarction all showed a positive linear relationship with BLL. Conclusions Although we were unable to control for other major risk factors such as smoking, socioeconomic status, and antihypertensive medication, we found an association between BLL and increased hospital admission for IHD, cerebrovascular disease, angina pectoris and cerebral infarction treatment. The BLL standard should be lowered to prevent the cardiovascular effects of lead exposure.
目的 我们前瞻性地评估了韩国铅暴露工人的血铅水平(BLL)与因心血管疾病住院治疗人数增加之间的关联。方法 研究队列来自韩国职业安全与健康局的数据,其中包括在2000年至2004年期间至少接受过一次铅相关医学检查的铅暴露男性工人。使用Cox比例风险模型,将每个BLL等级(10 - 20μg/dL和≥20μg/dL)的心血管疾病调整后住院风险比(AHR)与参考等级(<10μg/dL)进行比较。调整变量包括年龄和其他金属暴露情况。结果 BLL≥20μg/dL的工人中,缺血性心脏病(IHD;AHR 1.78,95%置信区间[95%CI] 1.17 - 2.72)、心绞痛(AHR 1.93,95%CI 1.13 - 3.29)和脑梗死(AHR 2.24,95%CI 1.14 - 4.39)的AHR显著高于BLL≤10μg/dL的工人。BLL为10 - 20μg/dL的工人中,脑血管疾病的AHR(1.52,95%CI 1.00 - 2.31)显著高于BLL≤10μg/dL的工人。IHD、脑血管疾病、心绞痛和脑梗死均与BLL呈正线性关系。结论 尽管我们无法控制吸烟、社会经济地位和抗高血压药物等其他主要风险因素,但我们发现BLL与IHD、脑血管疾病、心绞痛和脑梗死治疗的住院人数增加之间存在关联。应降低BLL标准以预防铅暴露对心血管系统的影响。