Williams M K
Br J Ind Med. 1966 Apr;23(2):105-11. doi: 10.1136/oem.23.2.105.
In an analysis of blood lead and haemoglobin estimations from 655 lead workers, there was no indication of any change in the haemoglobin until the blood lead exceeded 110 μg./100 ml.; the slight fall at higher levels of blood lead was not significant at the 5% level of confidence. Sixty-seven men who had blood leads greater than 90 μg./100 ml. were examined clinically. One had a low haemoglobin but none had symptoms or signs that were likely to be due to lead absorption. A further 18 men had haemoglobins of 89% (13 g./100 ml.) or less. None was thought to be low due to lead absorption. The absence of symptoms, signs, and low haemoglobins in association with relatively high blood leads is unlikely to be due to errors in blood lead or haemoglobin estimation. Alternative possibilities are that there were no susceptible workers among those studied; or that the stable conditions of exposure in this population allowed the development of relatively high blood leads without other evidence of high lead absorption. When the haemoglobin is abnormal, blood lead observations may be more meaningful if a correction factor, approximately equal to [Formula: see text] is used. It is concluded that in a population where sophisticated lead control is practised no purpose is served by estimating haemoglobins in all lead workers every three months, but only in those whose blood lead is likely to be in excess of 110 μg./100 ml. It may also be of value in the first year of exposure to detect susceptible workers.
在对655名铅作业工人的血铅和血红蛋白测定结果进行分析时发现,在血铅超过110μg/100ml之前,没有迹象表明血红蛋白有任何变化;在血铅水平较高时血红蛋白略有下降,但在5%的置信水平下并不显著。对67名血铅大于90μg/100ml的男性进行了临床检查。其中1人血红蛋白水平较低,但没有人有可能是铅吸收所致的症状或体征。另有18名男性血红蛋白水平为89%(13g/100ml)或更低。没有人被认为是因铅吸收导致血红蛋白水平低。血铅水平相对较高但没有症状、体征和低血红蛋白,这不太可能是由于血铅或血红蛋白测定错误。其他可能性是,在研究对象中没有易感性工人;或者该人群中稳定的接触条件使得血铅水平升高,但没有其他高铅吸收的证据。当血红蛋白异常时,如果使用一个近似等于[公式:见原文]的校正因子,血铅观察结果可能更有意义。得出的结论是,在实施了精密铅控制的人群中,每三个月对所有铅作业工人进行血红蛋白测定没有意义,而只应对那些血铅可能超过110μg/100ml的工人进行测定。在接触的第一年检测易感性工人可能也有价值。