本文選題：鉛 + 血鉛　； 參考：《復(fù)旦大學(xué)》2012年碩士論文

【摘要】：鉛(Pb)是一種重金屬元素,主要用于蓄電池的生產(chǎn),在全世界有大量的職業(yè)接觸人群。IARC將鉛列入人類(lèi)可疑致癌物,在較高劑量的暴露下,鉛對(duì)神經(jīng)系統(tǒng)、腎臟、血液系統(tǒng)和生殖系統(tǒng)都具有毒性作用。多年來(lái),隨著對(duì)鉛毒性認(rèn)識(shí)的加深,各國(guó)都在嚴(yán)格控制工作場(chǎng)所空氣中鉛的濃度,但其危害始終存在,特別是在蓄電池行業(yè),各個(gè)工藝環(huán)節(jié)均存在鉛的污染,到目前為止,其危害仍沒(méi)有得到有效地解決。 本研究對(duì)上海市蓄電池生產(chǎn)、回收企業(yè)進(jìn)行職業(yè)衛(wèi)生調(diào)查,分析鉛接觸人群的外劑量、血鉛、尿鉛等生化指標(biāo)的影響,研究職業(yè)接觸鉛人群健康影響效應(yīng)。在檢測(cè)蓄電池企業(yè)工作場(chǎng)所空氣中鉛煙、鉛塵濃度的基礎(chǔ)上,評(píng)價(jià)鉛危害程度及防護(hù)措施的防護(hù)效果,對(duì)于采取更好的舉措保護(hù)鉛作業(yè)工人的健康具有重要的意義,為蓄電池行業(yè)職業(yè)衛(wèi)生監(jiān)管工作提供科學(xué)依據(jù)。 本研究分為三步,第一步,采用流行病學(xué)調(diào)查方法對(duì)上海市13家蓄電池生產(chǎn)、組裝和回收企業(yè)進(jìn)行職業(yè)衛(wèi)生現(xiàn)狀調(diào)查,了解其生產(chǎn)工藝流程、設(shè)備的密閉化程度、企業(yè)采取的防護(hù)設(shè)施、警示標(biāo)識(shí)的設(shè)置等基本情況。第二步,選擇5家企業(yè),根據(jù)國(guó)家規(guī)定的方法檢測(cè)作業(yè)場(chǎng)所空氣中鉛煙、鉛塵濃度。第三步,選擇防護(hù)設(shè)施較差、作業(yè)環(huán)境惡劣、作業(yè)場(chǎng)所鉛煙濃度較高的回收企業(yè)的92名職業(yè)接觸鉛人群進(jìn)行尿鉛、血鉛檢測(cè),分析和評(píng)估鉛對(duì)職業(yè)接觸人群健康的影響。 流行病學(xué)調(diào)查結(jié)果顯示,在上海市蓄電池行業(yè)中,生產(chǎn)型企業(yè)的規(guī)模相對(duì)較大,部分工序采用了自動(dòng)化、密閉化生產(chǎn),但也存在防護(hù)設(shè)施設(shè)計(jì)不合理、敞開(kāi)作業(yè)等情況,同時(shí)不同企業(yè)之間在現(xiàn)場(chǎng)職業(yè)衛(wèi)生管理等方面也存在較大的差異。組裝型企業(yè)均為小型企業(yè),生產(chǎn)的產(chǎn)品、產(chǎn)量差異較大,生產(chǎn)環(huán)境不理想,廠(chǎng)房設(shè)備簡(jiǎn)陋,主要采用手2122工具進(jìn)行生產(chǎn)�；厥招推髽I(yè)采用敞開(kāi)式作業(yè),生產(chǎn)環(huán)境惡劣,生產(chǎn)設(shè)備簡(jiǎn)陋,防護(hù)設(shè)施缺失或不足,職業(yè)衛(wèi)生管理不規(guī)范。 作業(yè)環(huán)境鉛煙、鉛塵檢測(cè)顯示：按照我國(guó)現(xiàn)行職業(yè)衛(wèi)生標(biāo)準(zhǔn),上海市蓄電池行業(yè)作業(yè)環(huán)境空氣中鉛煙濃度超標(biāo)率為26.5%,最高濃度為0.900mg/m3,為國(guó)家職業(yè)衛(wèi)生標(biāo)準(zhǔn)的10倍,平均濃度(P50)為0.037mg/m3(0.002-0.900mg/m3)；鉛塵濃度超標(biāo)率為21.2%,鉛塵最高濃度為0.899mg/m3,約為國(guó)家職業(yè)衛(wèi)生標(biāo)準(zhǔn)的6倍,平均濃度(P50)為0.031mg/m3(0.001-0.899mg/m3)。不同崗位其濃度差異較大,特別是磨邊崗位,鉛塵平均濃度(P50)達(dá)0.620mg/m3,超過(guò)職業(yè)衛(wèi)生標(biāo)準(zhǔn)的4倍。 生物接觸指標(biāo)檢測(cè)結(jié)果顯示：尿鉛值和血鉛值具有一定的相關(guān)性,相關(guān)系數(shù)為0.882(p0.01)；男性工人尿鉛與血鉛相關(guān)系數(shù)為0.886(p0.01),女性工人尿鉛與血鉛相關(guān)系數(shù)為0.795(p0.01)。性別對(duì)血鉛、尿鉛無(wú)影響。在各年齡組中,女性鉛接觸工人血鉛、尿鉛值分布均衡,不隨年齡增加而變化；男性鉛接觸工人血鉛值隨著年齡的增加而增加,經(jīng)卡方檢驗(yàn)(p=0.014)和趨勢(shì)卡方檢驗(yàn)(p=0.035)有顯著性差異,尿鉛分布均衡。將空氣中鉛接觸外劑量與血鉛和尿鉛值之間進(jìn)行相關(guān)性分析,男性工人外劑量與血鉛相關(guān)系數(shù)為0.335(p=0.003),女性工人外劑量與血鉛無(wú)相關(guān)性；男性工人外劑量與尿鉛相關(guān)系數(shù)為0.353(p=0.002)；女性工人外劑量與尿鉛無(wú)相關(guān)性。隨著工齡的延長(zhǎng),接觸的鉛量越多,男性血鉛、尿鉛值逐漸增大(p0.01),而女性鉛接觸工人血鉛、尿鉛值無(wú)明顯變化。不同崗位鉛接觸工人血鉛分布均衡,尿鉛有顯著性差異(p=0.02)。 以上結(jié)果表明：1、改進(jìn)生產(chǎn)工藝,合理設(shè)置防護(hù)設(shè)施,改善作業(yè)環(huán)境和加強(qiáng)職業(yè)衛(wèi)生監(jiān)管是防治鉛中毒重要手段,加強(qiáng)職業(yè)衛(wèi)生培訓(xùn),提高作業(yè)人員的防護(hù)意識(shí),加強(qiáng)個(gè)體防護(hù)也不容忽視。2、職業(yè)病危害因素檢測(cè)是評(píng)價(jià)作業(yè)環(huán)境優(yōu)劣程度的重要指標(biāo),是判斷職業(yè)衛(wèi)生管理的重要依據(jù)。3、通過(guò)對(duì)鉛接觸工人外劑量、血鉛、尿鉛的分析比較,可以發(fā)現(xiàn)外劑量指標(biāo)和血鉛、尿鉛以及血鉛和尿鉛之間存在著一定的相關(guān)性,有助于職業(yè)健康檢查及職業(yè)病診斷中標(biāo)志物指標(biāo)的選擇。
[Abstract]:Lead (Pb) is a heavy metal element, which is mainly used in the production of batteries. There are a large number of professional contact people around the world,.IARC, as a suspected carcinogen of human beings. Under high exposure, lead has toxic effects on the nervous system, kidney, blood system and reproductive system. For years, with the deepening of the understanding of lead toxicity, countries have been deeply aware of the toxicity of lead. The concentration of lead in the air of the workplace is strictly controlled, but its harm always exists, especially in the battery industry. The pollution of lead in all process links has been found, so far, its harm has not been effectively solved.
In this study, the occupational health survey of Shanghai battery production and recovery enterprises was carried out. The effects of the external dose of lead exposure, blood lead, urine lead and other biochemical indexes were analyzed, and the effects of occupational exposure to lead people were studied. On the basis of the detection of lead smoke and lead dust concentration in the workplace air of battery enterprises, the degree of lead harm and protection were evaluated. The protective effect of the measures is of great significance for taking better measures to protect the health of the lead workers, and provides a scientific basis for the occupational health supervision of the battery industry.
This study is divided into three steps. The first step is to investigate the occupational health status of 13 battery production, assembly and recovery enterprises in Shanghai by epidemiological investigation, to understand the production process, the closed degree of equipment, the protection facilities adopted by the enterprises, the setting of warning signs and so on. The second steps are to select 5 enterprises and base on the basic situation. The state prescribed method was used to detect lead smoke and lead dust concentration in the air in the workplace. Third steps were made to select 92 occupational lead exposed workers in the recovery enterprise with poor protective facilities, poor working environment and high concentration of lead smoke in the workplace. The effects of lead on the health of occupational exposure people were analyzed and evaluated.
The results of epidemiological survey show that in Shanghai battery industry, the scale of production enterprises is relatively large, some processes are automatic and closed production, but there are also unreasonable protection facilities design, open operation and so on, and there are also great differences between different enterprises in the field of occupational health management and so on. Type enterprises are small enterprises, production products, production differences are large, production environment is not ideal, plant equipment is simple, the main use of hand 2122 tools for production. Recycling enterprises adopt open operation, poor production environment, poor production equipment, lack of protection facilities, occupational health management is not standard.
Lead smoke in the working environment and lead dust detection show that, according to our current occupational health standards, the super standard rate of lead smoke in the ambient air of Shanghai battery industry is 26.5%, the highest concentration is 0.900mg/m3, 10 times the national standard of occupational health, the average concentration (P50) is 0.037mg /m3 (0.002-0.900mg/m3), and the super standard of lead dust concentration is 21.2%. The maximum dust concentration is 0.899mg/m3, about 6 times the national standard of occupational health, and the average concentration (P50) is 0.031mg/m3 (0.001-0.899mg/m3). The concentration difference between the different posts is larger, especially in the grinding edge post, the average concentration of lead dust (P50) is 0.620mg/m3, exceeding 4 times of the occupational health standard.
The results of biological contact index showed that the urine lead value and blood lead value had a certain correlation, the correlation coefficient was 0.882 (P0.01), the correlation coefficient of urine lead and blood lead was 0.886 (P0.01) in male workers, and the correlation coefficient of urine lead and blood lead was 0.795 (P0.01) in female workers. Sex had no effect on lead and urine lead. The distribution of lead of blood lead and urine lead did not change with age; the blood lead value of male lead exposed workers increased with the increase of age. There was a significant difference between the chi square test (p=0.014) and the trend chi square test (p=0.035). The distribution of lead in urine was balanced. The correlation between the amount of lead exposure in the air and the value of lead and urine lead in the air was analyzed. The correlation coefficient between the external dose and blood lead was 0.335 (p=0.003), the external dose of female workers was not related to the blood lead, and the correlation coefficient between the external dose and urine lead was 0.353 (p=0.002) for male workers, and the external dose of female workers was not related to urine lead. With the extension of the working age, the more lead amount in contact, the increase of lead in male blood and urine lead (P0.01), and women (P0.01). There was no significant change in blood lead and urine lead level in lead exposed workers. The distribution of blood lead in workers exposed to lead at different posts was evenly distributed, and there was a significant difference in urine lead (p=0.02).
The above results show that: 1, improving the production process, setting up the protective facilities reasonably, improving the working environment and strengthening the occupational health supervision are important means to prevent the lead poisoning, strengthen the training of occupational health, improve the awareness of the protection of the workers, and strengthen the individual protection, which can not be ignored.2. The detection of occupational hazards is the evaluation of the quality of the working environment. The important index is an important basis for judging the management of occupational health. Through the analysis and comparison of the external dose of lead exposed workers, blood lead and urine lead, there is a certain correlation between the external dose index and blood lead, urine lead and blood lead and urine lead, which is helpful to the selection of occupational health and occupational disease diagnosis and the marker index of occupational disease diagnosis.
【學(xué)位授予單位】：復(fù)旦大學(xué)
【學(xué)位級(jí)別】：碩士
【學(xué)位授予年份】：2012
【分類(lèi)號(hào)】：R134

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