Pezzagno G
Fondazione Clinica del Lavoro, IRCCS, Centro Medico di Pavia.
G Ital Med Lav. 1993 Sep-Nov;15(5-6):91-8.
Workplace pollutants, inhaled by exposed people, can be subsequently excreted by the kidney as biotransformed or by the lung as parent substances. In both cases the concentration values need to be corrected to a given hydration level (the urinary metabolites) or to a value adjusting the effects of respiratory manoeuvres and those of the mixing between alveolar and dead space air (the volatile substances eliminated through the respiratory tract). The classical methods of standardization of urinary values lie in expressing the data as a value adjusted to a constant specific gravity of urine (1.020) or as a creatinine-adjusted concentration (amount of a compound in urine per gram of urinary creatinine). In the light of the recent researches, such adjustment would not be sufficient to correct the effects of the variability due to urinary volume or flow rate. New formulas to standardize the crude values of urinary concentration have been proposed; such adjustment should be more suitable. The concentration of volatile compounds present in expiratory air samples can be modified by hyperventilation or hypoventilation during sampling manoeuvres (1st factor) and by the mixing between dead space and alveolar air (2nd factor). These two factors similarly affect the CO2 concentration or CO2 partial pressure. Then, a proper standardization of the concentration of the pollutants in expired air samples might be their adjustment to a value corresponding to the normal level of alveolar CO2 partial pressure (PACO2 = 40 mmHg) or alveolar CO2 concentration (FACO2 approximately 0.055 or 5.5%).
工作场所污染物被接触者吸入后,随后可经肾脏以生物转化后的形式排出,或经肺部以母体物质的形式排出。在这两种情况下,浓度值都需要校正到给定的水合水平(尿代谢物),或者校正到一个能调节呼吸动作以及肺泡气与死腔气混合影响的值(通过呼吸道排出的挥发性物质)。尿液值标准化的经典方法是将数据表示为校正到尿液恒定比重(1.020)的值,或表示为肌酐校正浓度(每克尿肌酐中尿中某化合物的量)。根据最近的研究,这种校正不足以纠正由于尿量或流速变化所产生的影响。已经提出了标准化尿浓度原始值的新公式;这种校正应该更合适。在采样过程中,呼气空气样本中存在的挥发性化合物浓度可因过度通气或通气不足(第一个因素)以及死腔气与肺泡气的混合(第二个因素)而改变。这两个因素对二氧化碳浓度或二氧化碳分压有类似影响。那么,对呼出空气样本中污染物浓度进行适当标准化的方法可能是将其校正到与肺泡二氧化碳分压正常水平(PACO2 = 40 mmHg)或肺泡二氧化碳浓度(FACO2约为0.055或5.5%)相对应的值。