Gerhardsson L, Attewell R, Chettle D R, Englyst V, Lundström N G, Nordberg G F, Nyhlin H, Scott M C, Todd A C
Department of Environmental Medicine, University of Umeå, Sweden.
Arch Environ Health. 1993 May-Jun;48(3):147-56. doi: 10.1080/00039896.1993.9940813.
In-vivo measurements of lead concentrations in calcaneus (mainly trabecular bone) and tibia (mainly cortical bone) were performed by x-ray fluorescence (XRF) in 70 active and 30 retired lead smelter workers who had long-term exposure to lead. Comparison was made with 31 active and 10 retired truck assembly workers who had no known occupational exposure to lead. After physical examination, all participants provided blood and urine samples and answered a computerized questionnaire. Since 1950, blood lead has been determined repeatedly in lead workers at the smelter, which made it possible to calculate a time-integrated blood lead index for each worker. Lead concentrations in blood, urine, calcaneus, and tibia in active and retired lead workers were significantly higher than in the corresponding control groups (p < .001). The highest bone lead concentrations were found among retired lead workers (p < .001), which was the result of considerably higher lead exposure during 1940 to 1960. Lead concentrations in calcaneus in active lead workers were significantly higher than in tibia when expressed in ug of lead per gram of bone mineral, which suggests a quicker absorption over time in this mainly trabecular bone. The estimated biological half-times were 16 y in calcaneus (95% confidence interval [95% CI] = 11-29 y) and 27 y in tibia (95% CI = 16-98 y). A strong positive correlation was found between lead concentrations in calcaneus and tibia for all lead workers (r = 0.54; p < .001). A strong positive correlation was also found between the bone lead concentrations and the cumulative blood lead index. Blood lead, at the time of study, correlated well with bone lead concentrations in retired--but not in active--workers, reflecting the importance of the endogenous (skeletal) lead exposure. The findings in this study indicate that bone lead measurements by XRF can give a good index of long-term lead exposure. Tibia measurements offer a higher precision than calcaneus measurements. The method is of particular interest in epidemiologic studies of adverse health effects caused by long-term lead exposure.
采用X射线荧光法(XRF)对70名长期接触铅的在职铅冶炼工人和30名退休铅冶炼工人的跟骨(主要为松质骨)和胫骨(主要为皮质骨)中的铅浓度进行了体内测量。并与31名在职和10名退休的卡车装配工人进行了比较,这些工人无已知的职业性铅接触史。体格检查后,所有参与者均提供了血液和尿液样本,并回答了一份计算机化问卷。自1950年以来,对冶炼厂的铅作业工人多次测定血铅,从而能够为每名工人计算一个时间积分血铅指数。在职和退休铅作业工人的血液、尿液、跟骨和胫骨中的铅浓度均显著高于相应的对照组(p < 0.001)。退休铅作业工人的骨铅浓度最高(p < 0.001),这是1940年至1960年期间铅接触量显著更高的结果。以每克骨矿物质中铅的微克数表示时,在职铅作业工人跟骨中的铅浓度显著高于胫骨,这表明在这种主要为松质骨的骨骼中,随着时间推移吸收更快。估计的生物半衰期在跟骨中为16年(95%置信区间[95%CI]=11 - 29年),在胫骨中为27年(95%CI = 16 - 98年)。所有铅作业工人跟骨和胫骨中的铅浓度之间存在强正相关(r = 0.54;p < 0.001)。骨铅浓度与累积血铅指数之间也存在强正相关。在研究时,血铅与退休工人(而非在职工人)的骨铅浓度相关性良好,这反映了内源性(骨骼)铅接触的重要性。本研究结果表明,通过XRF测量骨铅可提供长期铅接触的良好指标。胫骨测量比跟骨测量具有更高的精度。该方法在长期铅接触所致不良健康影响的流行病学研究中特别有意义。