Irwig L M, Harrison W O, Rocks P, Webster I, Andrew M
Lancet. 1978 Jul 1;2(8079):4-7. doi: 10.1016/s0140-6736(78)91319-3.
Many laboratory tests have been recommended for monitoring factory workers exposed to lead. To select the most useful test the best predictor of selected measures of morbidity was sought. 639 lead-exposed workers in several factories were questioned about abdominal ache, constipation, and fatigue and were examined for hand tremot. Packed-cell volume, blood-lead, urinary lead, and delta-aminolaevulinic acid were estimated in 489 workers. About half of the values for the latter three tests fell into the "excessive" or "dangerous" category of lead absorption. Blood-lead was a better predictor of morbidity than any other laboratory test, and further information did not add appreciably to morbidity prediction. The findings suggest that blood-lead measurement is the most meaningful test for monitoring workers exposed to lead. The effect of lead on morbidity does not appear to depend on its action on the porphyrin metabolic pathway.
许多实验室检测方法被推荐用于监测接触铅的工厂工人。为了选择最有用的检测方法，研究人员寻找了所选发病指标的最佳预测指标。对几家工厂的639名接触铅的工人询问了腹痛、便秘和疲劳情况，并检查了手部震颤。对489名工人进行了红细胞压积、血铅、尿铅和δ-氨基乙酰丙酸的检测。后三项检测的约一半结果属于铅吸收的“过量”或“危险”类别。血铅比其他任何实验室检测都更能预测发病情况，进一步的信息对发病预测并没有显著增加。研究结果表明，血铅检测是监测接触铅工人最有意义的检测方法。铅对发病的影响似乎并不取决于其对卟啉代谢途径的作用。
