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铅相关制造业中与铅暴露相关的贫血风险。

Anemia risk in relation to lead exposure in lead-related manufacturing.

作者信息

Hsieh Nan-Hung, Chung Shun-Hui, Chen Szu-Chieh, Chen Wei-Yu, Cheng Yi-Hsien, Lin Yi-Jun, You Su-Han, Liao Chung-Min

机构信息

Department of Veterinary Integrative Biosciences, College of Veterinary Medicine and Biomedical Sciences, Texas A&M University, College Station, TX, 77845, USA.

Institute of Labor, Occupational Safety and Health, Ministry of Labor, New Taipei City, 22143, Taiwan, ROC.

出版信息

BMC Public Health. 2017 May 5;17(1):389. doi: 10.1186/s12889-017-4315-7.

Abstract

BACKGROUND

Lead-exposed workers may suffer adverse health effects under the currently regulated blood lead (BPb) levels. However, a probabilistic assessment about lead exposure-associated anemia risk is lacking. The goal of this study was to examine the association between lead exposure and anemia risk among factory workers in Taiwan.

METHODS

We first collated BPb and indicators of hematopoietic function data via health examination records that included 533 male and 218 female lead-exposed workers between 2012 and 2014. We used benchmark dose (BMD) modeling to estimate the critical effect doses for detection of abnormal indicators. A risk-based probabilistic model was used to characterize the potential hazard of lead poisoning for job-specific workers by hazard index (HI). We applied Bayesian decision analysis to determine whether BMD could be implicated as a suitable BPb standard.

RESULTS

Our results indicated that HI for total lead-exposed workers was 0.78 (95% confidence interval: 0.50-1.26) with risk occurrence probability of 11.1%. The abnormal risk of anemia indicators for male and female workers could be reduced, respectively, by 67-77% and 86-95% by adopting the suggested BPb standards of 25 and 15 μg/dL.

CONCLUSIONS

We conclude that cumulative exposure to lead in the workplace was significantly associated with anemia risk. This study suggests that current BPb standard needs to be better understood for the application of lead-exposed population protection in different scenarios to provide a novel standard for health management. Low-level lead exposure risk is an occupational and public health problem that should be paid more attention.

摘要

背景

在当前规定的血铅(BPb)水平下,接触铅的工人可能会遭受不良健康影响。然而,缺乏关于铅暴露相关贫血风险的概率评估。本研究的目的是调查台湾工厂工人中铅暴露与贫血风险之间的关联。

方法

我们首先通过健康检查记录整理了血铅水平和造血功能指标数据,这些记录涵盖了2012年至2014年间的533名男性和218名女性铅暴露工人。我们使用基准剂量(BMD)模型来估计检测异常指标的关键效应剂量。基于风险的概率模型用于通过危害指数(HI)来表征特定工作工人铅中毒的潜在危害。我们应用贝叶斯决策分析来确定BMD是否可作为合适的血铅标准。

结果

我们的结果表明,所有铅暴露工人的危害指数为0.78(95%置信区间:0.50 - 1.26),风险发生概率为11.1%。采用建议的血铅标准25μg/dL和15μg/dL,男性和女性工人贫血指标的异常风险可分别降低67 - 77%和86 - 95%。

结论

我们得出结论,工作场所铅的累积暴露与贫血风险显著相关。本研究表明,需要更好地理解当前的血铅标准,以便在不同场景中应用于保护铅暴露人群,为健康管理提供新的标准。低水平铅暴露风险是一个职业和公共卫生问题,应予以更多关注。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/a25c/5420139/f7f6f165ec37/12889_2017_4315_Fig1_HTML.jpg

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