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射击场慢性职业性铅暴露的病例系列。

Case series of chronic occupational lead exposure in shooting ranges.

机构信息

Vilnius University, Faculty of Medicine, Lithuania; Republican Vilnius University Hospital, Toxicology Centre, Lithuania.

Vilnius University, Faculty of Medicine, Lithuania.

出版信息

J Trace Elem Med Biol. 2022 Jan;69:126886. doi: 10.1016/j.jtemb.2021.126886. Epub 2021 Oct 29.

Abstract

INTRODUCTION

Despite existing occupational lead exposure prevention regulations, Lithuanian shooting range workers still complain of chronic lead poisoning related symptoms. This indicates a poor understanding of occupational safety when working in lead-polluted environments.

CASE PRESENTATION

20 men, whose age ranged from 32 to 57 (mean 41.8 ± 10 years), were consulted at the Toxicology Centre at the Republican Vilnius university hospital in Vilnius, Lithuania in the 2016-2019 year period. All of the patients were working as shooting instructors, with their work experience varying from 2 to 30 years. Clinical examination showed blood lead levels ranging from 5.64 μg/dL to 45.8 μg/dL (norm for occupational exposure - <40 μg/dL). Main symptoms were fatigue (12 patients out of 20), dizziness (5/20), arthralgia (5/20). Other symptoms included impaired memory (3/20), nausea (3/20), sleep disorders (3/20), metallic or sweet taste (3/20), dermatological disorders (3/20), coxarthrosis (2/20), balance disorders (2/20), paresthesia (2/20), abdominal pain (2/20) and others. 4 patients were asymptomatic.

DISCUSSION

Shooting range employees are highly vulnerable to daily lead exposure. Even low constant elevated blood lead concentrations can have significant toxic effects over time.

摘要

简介

尽管存在职业性铅暴露预防法规,但立陶宛射击场工人仍抱怨与慢性铅中毒相关的症状。这表明他们在铅污染环境中工作时对职业安全的理解不足。

病例介绍

2016 年至 2019 年间,在立陶宛维尔纽斯的共和维尔纽斯大学医院毒理学中心,有 20 名年龄在 32 至 57 岁之间(平均 41.8 ± 10 岁)的男性接受了咨询。所有患者均为射击教练,工作经验从 2 年到 30 年不等。临床检查显示,血液中铅含量在 5.64μg/dL 至 45.8μg/dL 之间(职业暴露的正常值<40μg/dL)。主要症状有疲劳(20 例中有 12 例)、头晕(20 例中有 5 例)、关节痛(20 例中有 5 例)。其他症状包括记忆力减退(20 例中有 3 例)、恶心(20 例中有 3 例)、睡眠障碍(20 例中有 3 例)、金属味或甜味(20 例中有 3 例)、皮肤病(20 例中有 3 例)、髋关节炎(20 例中有 2 例)、平衡障碍(20 例中有 2 例)、感觉异常(20 例中有 2 例)、腹痛(20 例中有 2 例)和其他症状。4 例患者无症状。

讨论

射击场员工极易受到日常铅暴露的影响。即使是低水平的持续升高的血铅浓度,随着时间的推移也会产生显著的毒性作用。

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