Robins T G, Bornman M S, Ehrlich R I, Cantrell A C, Pienaar E, Vallabh J, Miller S
Department of Environmental and Industrial Health, University of Michigan School of Public Health, Ann Arbor 48109-2029, USA.
Am J Ind Med. 1997 Oct;32(4):369-76. doi: 10.1002/(sici)1097-0274(199710)32:4<369::aid-ajim8>3.0.co;2-p.
Previous studies of the associations of measures of occupational lead exposure with measures of semen quality and infertility among male workers have produced conflicting results. The current study was undertaken to examine these associations among a population of workers with a broad range of measures of current and historical lead exposure. Ninety-seven lead-exposed workers from a South African lead acid battery facility provided semen samples that were analyzed for sperm density, sperm count, sperm motility, sperm morphology, and presence of antisperm antibodies. Questionnaire data were collected for reported histories of sub- or infertility. Current blood leads ranged from 28 to 93 micrograms/dl. Semen lead ranged from 1 to 87 micrograms/dl. Reasonably consistent and significant associations were found between an increased percentage of sperm with abnormal morphology and higher measures of current blood lead, cumulative blood lead, and duration of exposure. An increased percent of immotile sperm was associated only with zinc protoporphyrin (ZPP) among the lead exposure measures. There were no associations of sperm density or sperm count with any of the lead exposure measures. A weak association of increased percent of sperm with antisperm antibodies with increased semen lead was present. There were no consistent associations of measures of lead exposure with measures of fertility or procreativity. This study, while supporting the association of lead exposure with increased risk of abnormal sperm morphology seen in some previous studies, does not lend support to previously reported associations of sperm density or count or infertility with measures of lead exposure. However, the relatively high range of current blood leads, high prevalence of abnormalities in semen quality, and the lack of a control population, suggest that these negative findings should be interpreted with caution.
以往关于男性工人职业铅暴露量与精液质量及不育指标之间关联的研究结果相互矛盾。本研究旨在调查一群具有广泛当前和历史铅暴露量指标的工人中的这些关联。来自南非一家铅酸电池工厂的97名铅暴露工人提供了精液样本，对其进行精子密度、精子计数、精子活力、精子形态以及抗精子抗体存在情况的分析。收集了关于报告的亚不育或不育病史的问卷数据。当前血铅范围为28至93微克/分升。精液铅范围为1至87微克/分升。在精子形态异常百分比增加与当前血铅、累积血铅及暴露持续时间的较高指标之间发现了合理一致且显著的关联。在铅暴露指标中，仅不动精子百分比增加与锌原卟啉（ZPP）有关。精子密度或精子计数与任何铅暴露指标均无关联。精子抗精子抗体百分比增加与精液铅增加之间存在微弱关联。铅暴露指标与生育力或生殖力指标之间没有一致的关联。本研究虽然支持了一些先前研究中所见的铅暴露与精子形态异常风险增加之间的关联，但并不支持先前报道的精子密度或计数以及不育与铅暴露指标之间的关联。然而，当前血铅的相对较高范围、精液质量异常的高患病率以及缺乏对照人群，表明这些阴性结果应谨慎解释。
