砷职业暴露员工尿中价态砷含量与健康相关因素的分析

目的通过职业砷暴露水平与尿中总砷（TAs）和尿价态砷含量的测定，初步分析体内砷代谢产物（价态砷）与健康相关生化指标之间的关联性。方法选择2家有色金属冶炼企业砷暴露作业工人（暴露组）137人，其中砷暴露锡冶炼组97人、铅冶炼组40人。对照组为无砷接触者42人。暴露组及对照组均进行健康监护及收集晨尿，行尿中TAs及尿价态砷含量测定，并检测作业场所空气中砷及其化学物浓度，进行尿中TAs、价态砷与健康相关因素之间的相关分析。结果两厂砷暴露工作环境空气中含TAs浓度（中位数）为0．30（0．01—1．35）mg／m3。其中铅冶炼厂砷浓度为0．46（0．01—1．03）mg／m3，锡冶炼厂砷浓度为0．26（0．06—1．35）mg／m3。暴露组的TAs、二甲苯呻酸监（DMA）含量与对照组比较，差异有统计学意义（P〈0．01）；暴露组TAs与DMA之间呈正相关（相关系数r=0．693，P〈0．01）；DMA与丙氨酸转氨酶、天冬氨酸转氨酶（ALT、AST）之间呈正相关关系（r=0．148，P〈0．05、r=0．268，P〈0．01）、与血常规RBC、HGB呈负相关（r=-0．165，P=0．038、r=-0．149，P=0．015）。结论砷暴露作业工人在无机砷较高浓度下作业，体内无机砷甲基化后主要的代谢产物为DMA与MMA，且价态砷特别是DMA与TAs、ALT、AST呈正相关、与RBC、HGB呈负相关，说明DMA对肝细胞、红细胞存在一定损害作用。

Analysis on valence state arsenic content in urine and related health parameters among occupational arsenic-exposed workers

Objective ] By determining the occupational arsenic-exposed level, and the contents of total arsenic （TAs） and valence state arsenic in urine, preliminarily analyze the correlation between the arsenic metabolites （valence arsenic） and the biochemical parameters related to health. Methods] 137 arsenic-exposed workers from 2 non-ferrous metal smelting enterprises were collected in the exposure group, which included 97 people in tin smelting exposure group and 40 people in lead smelting exposure group. The control group included 42 people without arsenic exposure. Both the exposure group and the control group were given the health sur- veiUance and the morning urine sample collection. The contents of TAs and valence state arsenic in urine were determined, while the concentrations of arsenic and its chemical compound in the air of workplaces were detected. The correlation between the contents of TAs, valence state arsenic in urine and parameters related to health were analyzed. Results ] The median in concentration of TAs in the workplaces of 2 enterprises was 0.30 （ 0.01-1.35 ） mg/m3 , while that in the lead smelting enterprise and tin smelting enter- prise was 0.46 （ 0.01-1.03 ） mg/m3 and 0.26 （0.06-1.35 ） mg/m3, respectively. There were significant differences in contents of TAs and DMA between the exposure group and the control group （ P 〈0.01 ）. There was a positive correlation between TAs content and DMA content （ r = 0. 693, P 〈 0.01 ）. DMA content was positively correlated to levels of ALT and AST （ r = 0. 148, P 〈 O. 05 ; r = O. 268, P 〈 0.01）, and it was negatively correlated to levels of RBC and HGB （r =-0. 165, P = O. 038; r =-0. 149, P = O. 015 ）. Conclusion] When workers are exposed to a high concentration of inorganic arsenic, the main metabolites of inorgan- ic arsenic after methylation are DMA and MMA, while the valence state arsenic, especially DMA, is positively correlated to levels of ALT and AST, and negatively correlated to levels of RBC and HG