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二次铅冶炼厂工人的肾功能损害:与锌原卟啉和血铅水平的相关性。

Renal function impairment in secondary lead smelter workers: correlations with zinc protoporphyrin and blood lead levels.

作者信息

Lilis R, Valciukas J, Fischbein A, Andrews G, Selikoff I J, Blumberg W

出版信息

J Environ Pathol Toxicol. 1979 Jul-Aug;2(6):1447-74.

PMID:528851
Abstract

Potential kidney function decrement with long-term lead exposure is important in the overall assessment of adverse health effects of lead in industrial workers or other exposed groups. Two clinical field studies of secondary lead smelter workers have shown that a significant proportion of workers had slightly to moderately elevated BUN and creatinine levels; the prevalence was higher in those with longer lead exposure. Since a decrement of kidney function with age has been documented, and, since duration of lead exposure may also be strongly related to age, it was necessary to assess the age dependent renal function decrement in a control (non-lead-exposed) population. BUN and creatinine levels in the lead-exposed workers showed a much more significant correlation with age than that which was found in the non-exposed population; the correlations between the indicators of renal function, BUN and creatinine, and duration of lead exposure remained statistically significant after removing the age-dependent decrement derived from the control population. Moreover, a highly significant correlation between BUN and zinc protoporphyrin levels was found. The results indicate a sizeable and significant decrement in kidney function in the secondary lead smelter workers studied; this effect was found to be lead-induced, by removing its age-dependency.

摘要

长期铅暴露导致的潜在肾功能减退在全面评估铅对产业工人或其他暴露人群的健康不良影响中至关重要。两项针对二次铅冶炼工人的临床现场研究表明,相当一部分工人的尿素氮(BUN)和肌酐水平轻度至中度升高;铅暴露时间较长者的患病率更高。鉴于已有文献记载肾功能会随年龄增长而减退,且铅暴露时长可能也与年龄密切相关,因此有必要评估对照(未接触铅)人群中与年龄相关的肾功能减退情况。与未接触铅的人群相比,接触铅工人的BUN和肌酐水平与年龄的相关性更为显著;在去除对照人群中与年龄相关的肾功能减退因素后,肾功能指标BUN和肌酐与铅暴露时长之间的相关性仍具有统计学意义。此外,还发现BUN与锌原卟啉水平之间存在高度显著的相关性。研究结果表明,所研究的二次铅冶炼工人的肾功能出现了相当大且显著的减退;通过去除其年龄依赖性,发现这种影响是由铅导致的。

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