鉛工人與其對照族群血中多重元素之比較分析

研究背景鉛回收及鉛粉顏料製造業除了是鉛暴露高危險行業之外，這些勞工於鉛回收或鉛粉、鉛料製程中，也可能受到其他非必需元素的暴露。相對於非必需元素對人體的危害，必需元素能協助細胞或組織發揮正常生理、生化功能，對於人體健康扮演重要角色。但非必需元素對人體有害，例如高濃度的鉛和鎘會對免疫系統、腎臟排泄功能造成影響；砷的毒性會影響肝功能。研究目的比較鉛暴露組與其對照族群體內鉛、鎘、砷、硒、鈷、銅、鋅的差異，並分析多種元素和生化值的關係，最後以多元線性迴歸探討元素之間的交互作用。材料與方法收案時間從2009年7月到2010年3月，從台灣的高雄醫學大學附設中和紀念醫院健檢中心收集健檢資料以及全血樣本，總共有109位鉛工人以及對照族群329位。全血鉛以石墨式原子吸收光譜儀偵測，其他六種元素以感應耦合電漿質譜儀分析。最後，以SPSS或SAS統計軟體分析所有的健檢結果和血液中的元素。結果個案平均年齡40.13歲，除了BMI值為24.81，其他的生化值檢測結果皆位於容許範圍，顯示本研究個案的身體健康狀況及營養攝取良好。全血中七種元素的檢測結果：鉛55.17 ug/L、鎘1.06 ug/L、砷6.32 ug/L、硒254.42 ug/L、鈷0.46 ug/L、銅920.97 ug/L、鋅7592.15 ug/L，除了硒元素之外，鉛暴露族群全血中的其他六種元素皆顯著高於對照族群。全血中的各元素彼此呈現正相關，控制可能的干擾變項後，欲探討鉛和其他六種元素的關係，結果顯示鎘和砷、砷和鈷、砷和銅之間有交互作用。結論由以上結果可知，必需元素對於生化值的影響，無法反映出對人體健康有正面效應，另外，對於非必需元素的影響也有限。然而，職業暴露到有毒元素所造成的傷害需要持續關注，體內多重元素之間的交互作用尚需進一步的分析。

關鍵字

鉛；必需元素；非必需元素；多元素； ICPMS

並列摘要

Background Both lead recycle and manufacturing of lead-containing paint are main source of lead exposure. During the industry manufactured lead, these workers exposed to other non-essential elements, which can induce adverse effects to human. Contrasting to non-essential elements, essential elements play important roles for human health, such as maintaining physiological and biochemical functions in cells or tissue. However, the non-essential elements could be toxic to human. For example, high concentrations of lead and cadmium would influence to immune system and renal excretion function, and arsenic may affect liver function. Goal The aim of this study is to compare with lead, cadmium, arsenic, selenium, cobalt, copper, zinc in human whole blood between lead workers and non-exposed group. Secondly, this study analyzed the association between seven elements and physical examination data. Thirdly, multiple linear regressions were used to analyze interaction within elements. Material and Method From July 2009 to March 2010, 109 lead workers and 329 individuals of non-exposed group who received the health examination in Kaohsiung Medical University Hospital, Taiwan. The whole blood concentration of Pb is determined by graphite atomic absorption spectrometer (AAS), while the others (Cd, As, Se, Co, Cu and Zn) were determined by inductively coupled plasma mass spectrometer (ICPMS). Database management and analysis was performed using SPSS 14 and SAS 9.1.3. Results For all subjects, averages for age is 40.13 years old and mean BMI is 24.81. The other physical examination results show the well status of health and nutritional intake. Mean concentrations of seven elements in whole blood are Pb, 55.17 ug/L, Cd, 1.06 ug/L, As, 6.32 ug/L, Se, 254.42 ug/L, Co, 0.46 ug/L, Cu, 920.97 ug/L and Zn 7592.15 ug/L. Except Se, the other six elements are significantly higher in lead workers. Multi-elements data analyses in whole blood showed a positive correlation with each other. To find the relationship of Pb and the other elements, using the interaction variables, the results showed that there are interactions between Cd and As, As and Co, As and Cu. Conclusions From the above results, the positive effect of essential elements to physical examination values are not clear, little does the influence to the other non-essential elements. However, the damage from occupational non-essential elements exposure still needs to be concerned. Interaction to multi-elements also needs further research.