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血铅水平与血压的关系:中国江苏省职业人群的一项基于人群的研究。

Association between blood lead level and blood pressure: An occupational population-based study in Jiangsu province, China.

机构信息

Institute of Occupational Disease Prevention, Jiangsu Provincial Center for Disease Control and Prevention, Nanjing, China.

The Affiliated Guangji Hospital of Soochow University, Suzhou, China.

出版信息

PLoS One. 2018 Jul 6;13(7):e0200289. doi: 10.1371/journal.pone.0200289. eCollection 2018.

Abstract

Studies about the association between lead exposure and the elevation of blood pressure and risk of hypertension are varied, while available data on blood lead levels (BLL) in workers with lead-exposure are scarce. This research aimed to evaluate associations between BLL and blood pressure in an occupational population-based study in Jiangsu province, China. We enrolled 21,688 workers in this study. Information on socioeconomic and occupational background was obtained with face-to-face interviews. BLL, systolic blood pressure (SBP) and diastolic blood pressure (DBP) were measured, and hypertension status was confirmed. We found that workers in mini-factories had the highest average BLL (20.3 μg/dL; 95% CI, 19.0-21.6 μg/dL) for overall participants. The employees in private factories had higher BLL (9.6 μg/dL; 95% CI, 9.5-9.8 μg/dL). However, BLL was much lower (4.0 μg/dL; 95%CI, 3.7-4.2 μg/dL) in state-owned factories. Participants working in the electrical machinery and equipment manufacturing industry had higher BLL (9.1 μg/dL; 95% CI, 9.0-9.3μg/dL). Compared to those workers with ≤ 4.6 μg/dL BLL, workers with > 17.5 μg/dL BLL presented 1.34 mmHg and 0.70 mmHg average difference in SBP and DBP, respectively. The adjusted OR for hypertension was 1.11 (95%CI, 1.08-1.15) compared to the workers with > 17.5 μg/dL BLL and to those with ≤ 4.6 μg/dL BLL. In summary, we found that BLL was positively associated with SBP and DBP and with the morbidity of hypertension in occupational populations with a high concentration of lead exposure. It is important to formulate new standards of blood lead levels to screen for elevated lead exposure. In addition, a series of new systems of risk assessment should be established to further reduce and prevent lead exposure.

摘要

关于铅暴露与血压升高和高血压风险之间关联的研究结果不一,而关于接触铅的工人的血铅水平(BLL)的现有数据却很少。本研究旨在评估中国江苏省一项职业人群研究中 BLL 与血压之间的关联。我们共纳入了 21688 名工人。通过面对面访谈获得了社会经济和职业背景信息。测量了 BLL、收缩压(SBP)和舒张压(DBP),并确认了高血压状况。我们发现,小工厂工人的平均 BLL 最高(20.3μg/dL;95%CI,19.0-21.6μg/dL)。私营工厂工人的 BLL 更高(9.6μg/dL;95%CI,9.5-9.8μg/dL)。然而,国有工厂的 BLL 要低得多(4.0μg/dL;95%CI,3.7-4.2μg/dL)。从事电机设备制造业的工人 BLL 更高(9.1μg/dL;95%CI,9.0-9.3μg/dL)。与 BLL≤4.6μg/dL 的工人相比,BLL>17.5μg/dL 的工人的 SBP 和 DBP 分别平均高出 1.34mmHg 和 0.70mmHg。与 BLL>17.5μg/dL 的工人相比,高血压的调整 OR 为 1.11(95%CI,1.08-1.15),与 BLL≤4.6μg/dL 的工人相比。总之,我们发现 BLL 与 SBP 和 DBP 呈正相关,与高浓度铅暴露的职业人群高血压发病率也呈正相关。制定新的血铅水平标准以筛查铅暴露增高非常重要。此外,还应建立一系列新的风险评估体系,以进一步减少和预防铅暴露。

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