Smolensky Michael H, Reinberg Alain E, Fischer Frida Marina
Department of Biomedical Engineering, Cockrell School of Engineering, The University of Texas at Austin, USA.
Unité de Chronobiologie, Fondation A. de Rothschild, France.
Ind Health. 2019 Apr 1;57(2):158-174. doi: 10.2486/indhealth.SW-2. Epub 2019 Jan 31.
The circadian time structure (CTS) has long been the subject of research in occupational medicine, but not to industrial toxicology, including methods of setting threshold limit values (TLVs) and employee biological monitoring. Numerous animal and human investigations document vulnerability to chemical, contagion, and other xenobiotics varies according to the circadian time of encounter. Permanent and rotating nightshift personnel are exposed to industrial contaminants in the same or higher concentration as dayshift personnel, and because of incomplete CTS adjustment to night work, contact with contaminants occurs during a different biological time than day workers. Thus, the amount of protection afforded by certain TLVs, especially for employees of high-risk settings who work night and other nonstandard shift schedules, might be inadequate. The CTS seems additionally germane to procedures of employee biological monitoring in that high-amplitude 24 h rhythms in biomarkers indicative of xenobiotic exposure may result in misjudgment of health risks when data are not gathered in sufficient frequency over time and properly interpreted. Biological reference values time-qualified for their rhythmic variation, currently of interest to laboratory medicine practice, are seemingly important to industrial medicine as circadian time and work-shift specific biological exposure indices to improve surveillance of personnel, particularly those working nonstandard shift schedules.
昼夜时间结构(CTS)长期以来一直是职业医学研究的主题,但在工业毒理学领域却并非如此,包括设定阈限值(TLV)的方法和员工生物监测。大量动物和人体研究表明,对化学物质、传染病原体及其他外源性物质的易感性会因接触的昼夜时间不同而有所差异。长期和轮班的夜班人员接触工业污染物的浓度与白班人员相同或更高,而且由于昼夜时间结构对夜班工作的调整不完全,与污染物的接触发生在与白班工人不同的生物时间。因此,某些阈限值所提供的保护程度,尤其是对于从事夜间及其他非标准轮班工作的高风险环境中的员工而言,可能并不充分。昼夜时间结构似乎与员工生物监测程序也密切相关,因为当生物标志物中指示外源性物质暴露的24小时高振幅节律的数据未随时间以足够的频率收集并得到正确解释时,可能会导致对健康风险的误判。目前实验室医学实践所关注的具有节律变化时间限定的生物参考值,作为昼夜时间和轮班特定的生物暴露指标,对于工业医学而言似乎很重要,有助于改善对人员的监测,尤其是那些从事非标准轮班工作的人员。