【作者】 李明峰；

【导师】 刘克俭；

【作者基本信息】 华中科技大学 ， 劳动卫生与环境卫生学， 2008， 硕士

【摘要】 氟是人体的必需微量元素,但过量摄入可引起机体以骨骼改变为主的全身性损害。随着对健康要求的提高,国内外学者越来越关注筛选导致高氟的危险因素,以及确定氟性骨损伤的早期灵敏指标。本文通过现场职业人群调查和实验室检测相结合,系统探讨了影响体内氟负荷的相关因素,以及氟对骨损伤的早期灵敏指标,为氟暴露人群提供早期、灵敏、经济实用的健康监测指标。第一部分氟负荷(血氟,尿氟含量)与相关因素的调查分析目的调查铝厂不同的车间五年以上工龄的男性工人的氟负荷情况,并分析年龄、工龄、吸烟、饮酒、工种共五个相关因素与血清氟浓度、尿氟浓度的关系。内容与方法本次研究对象来自湖北某铝业集团的电解车间、铝杆车间和机关的男性从业人员共212人以及在当地无迁徙史、年龄为25～45岁、无工业氟接触史的男性50名。测定各车间和集镇空气中氟浓度和研究对象血清氟、尿氟浓度。并调查研究对象的年龄、工龄、吸烟、饮酒、工种共5个相关因素的分布。结果电解车间和铝杆车间空气中氟浓度(2.31±1.01mg/m3;0.26±0.10mg/m3)明显高于对照组(0.10±0.05mg/m3),差异有显著性(P<0.01)。电解车间研究对象的血清氟浓度和尿氟浓度(0.22±0.06mg/L;7.96±8.41mg/L)明显高于对照组(0.16±0.03mg/L;2.19±1.02mg/L),差异有显著性(P<0.01)。铝杆车间研究对象的血清氟浓度和尿氟浓度(0.22±0.07mg/L;4.39±5.21mg/L)明显高于对照组(0.16±0.03mg/L;2.19±1.02mg/L),差异有显著性(P<0.01)。高年龄组研究对象的血清氟浓度和尿氟浓度(0.22±0.08mg/L;5.10±4.01mg/L)明显高于低年龄组(0.19±0.05 mg/L;4.27±4.92mg/L),差异有显著性(P<0.05)。高工龄组研究对象的血清氟浓度和尿氟浓度(0.22±0.07mg/L;6.01±7.05mg/L)明显高于低工组(0.20±0.06mg/L;3.22±4.32mg/L),差异有显著性(P<0.05)。经常吸烟组研究对象的血清氟浓度和尿氟浓度(0.22±0.04mg/L;5.73±4.92mg/L)明显高于不吸烟组(0.19±0.05mg/L;4.33±3.96mg/L),差异有显著性(P<0.05)。各饮酒组之间血清氟、尿氟浓度比较差异无显著性(P>0.05)。结论电解车间和铝杆车间研究对象的血清氟浓度和尿氟浓度明显增高,年龄、工龄、工种、吸烟4个因素对血清氟、尿氟浓度的影响差异有显著性,可以认为是影响血清氟、尿氟浓度的危险因素;饮酒对血清氟、尿氟浓度的影响差异有显著性,尚不能认为是影响血清氟、尿氟浓度的危险因素。第二部分氟负荷与血清骨钙素、降钙素含量的分析目的通过血清骨钙素、降钙素浓度的检测,探讨工业氟性骨损伤早期指标,进一步阐述骨钙素、降钙素在工业氟性骨损伤的作用机理。通过对该指标的监测,以筛选高危人群,评估人群健康风险,以便对高风险人群进行重点预防。内容与方法在第一部分对血清氟、尿氟浓度分析的基础上,把90个接氟人员按照血清氟、尿氟浓度的高低分为低氟负荷组:尿氟浓度≤2.0mg/L并且血清氟浓度≤0.17mg/L;中氟负荷组:2.0mg/L<尿氟浓度≤4.0mg/L并且0.17mg/L<血清氟浓度≤0.20mg/L;高氟负荷组:尿氟浓度>4.0 mg/L并且血清氟浓度>0.20mg/L。采用放射免疫法测定血清中的骨钙素、降钙素浓度。结果高氟负荷组的血清骨钙素浓度和降钙素浓度(7.37±2.18ng/mL;84.11±25.45 pg/mL)明显高于对照组(4.87±1.85ng/mL;59.96±21.16pg/mL),差异有显著性(P<0.01)。中氟负荷组的血清骨钙素浓度和降钙素浓度(5.99±2.03ng/mL;71.92±13.29pg/mL)明显高于对照组(4.87±1.85ng/mL;59.96±21.16pg/mL),差异有显著性(P<0.05)。高氟负荷组的血清骨钙素浓度和降钙素浓度(7.37±2.18ng/mL;84.11±25.45pg/mL )明显高于正常参考浓度( 5.40±3.30ng/mL ; 72.00±7.00pg/mL),差异有显著性(P<0.01)。结论各氟负荷组的血清骨钙素、降钙素浓度之间的比较差异有显著性,与正常参考浓度比较差异也有显著性。认为血清骨钙素、降钙素浓度可作为工业性氟性骨损伤的早期诊断的参考指标。更多还原

【Abstract】 Fluoride is an essential element for human body, but excess intake of fluoride in human body can mainlycause damage of teeth and bone. Many scholars paid close attention to screening risks factors of high fluoride in organism and it is very essential to indentify the primary sensitive indicatrix for forecasting fluoride bone injury. Experimental study and field research were used to explore influencing factors for fluoride concentration in organism and search for early sensitive index for fluoride bone injury. The purpose of the study is to provide early, sensitive, economical and practical indexes for the people exposed to fluoride.Part I Analysis of about fluoride burden(serum fluoride , urine fluoride)and influnencing factorsObjective This study is cohort study to examine fluoride burden state among male workers whom were from different aluminiun factory workshop with five yeare length of service, And analyze association of five risk factors-Workmen’s age, length of service, smoking, drinking and workshop.Method and Content 212 male subjects from an aluminiun factory in HUBEI province were selected, whom come from institution ,aluminum pole workshop and potroom . 50 male subjects without exposure history of industry fluoride (age25～45) from the same region were recruited. The subjects with the diseases of liver and kidney what influence fluoride absorption and egestion were excluded. The subjects who take medicine hormone in three month were excluded. Evaluate atmosphere fluoride of workshops and town, serum fluoride and urine fluoride of objects. Observe five risk factors-Workmen’s age, length of service, smoking, drinking and workshop.Results The atmosphere fluoride of aluminum pole workshop and potroom(2.31±1.01 mg/m3; 0.26±0.10 mg/m3) is more than atmosphere fluoride of control group(0.10±0.05 mg/m3)with a significant difference(P<0.01). The urine fluoride and serum fluoride of potroom (0.22±0.06 mg/L;7.96±8.41 mg/L) is more than urine fluoride and serum fluoride of control group(0.16±0.03 mg/L;2.19±1.02 mg/L)with a significant difference(P<0.01). The urine fluoride and serum fluoride of aluminum pole workshop (0.22±0.07mg/L;4.39±5.21mg/L)is more than urine fluoride and serum fluoride of control group(0.16±0.03 mg/L;2.19±1.02 mg/L)with a significant difference(P<0.01). The urine fluoride and serum fluoride of the high age group(0.22±0.08mg/L;5.10±4.01mg/L)is more than urine fluoride and serum fluoride of control group(0.19±0.05 mg/L;4.27±4.92 mg/L)with a significant difference(P<0.05). The urine fluoride and serum fluoride of the long length of service group(0.22±0.07mg/L;6.01±7.05mg/L)is more than urine fluoride and serum fluoride of control group(0.20±0.06mg/L;3.22±4.32mg/L)with a significant difference(P<0.05).The urine fluoride and serum fluoride of the quaque smoking group(0.22±0.04mg/L;5.73±4.92mg/L)is more than urine fluoride and serum fluoride of control group(0.19±0.05mg/L;4.33±3.96mg/L)with a significant difference(P<0.05). The urine fluoride and serum fluoride of all drinking groups without a significant difference(P>0.05).Conclusions Urine fluoride and serum fluoride of object whom come from potroom and aluminum pole workshop more than the control group. The factors- Workmen’s age, length of service, smoking and workshop influence urin fluoride and serum fluoride with a significant difference. The risk factors-drinking influence urin fluoride and serum fluoride without a significant difference.we cannot think. The factor-drinking is a risk factor what influence urine fluoride and serum fluoride.Part II Analysis about fluoride burden and serum osteocalcin, serum calcitioninObjective This study is to investigate the early indexes of industry bone injury by examine serum osteocalcin and serum calcitonin, to explain the mechanism of action of serum osteocalcin and serum calcitonin about industry bone injury. We will discover high-risk group and evaluate risk-health by examine serum osteocalcin and serum calcitonin.so that we will focal point safeguard the crowd whom with high risk-health.Method and Content We group 90 hapto-fluoride subjects into three groups according to urine fluoride and serum fluoride, base on the analysis of urine fluoride and serum fluoride in part I: low fluoride burden group(urine fluoride≤2.0 mg/L and serum fluoride≤0.17mg/L); midst fluoride burden group(2.0 mg/L< urine fluoride≤4.0 mg/L and 0.17mg/L<serum fluoride≤0.20mg/L); high fluoride burden group(urine fluoride>4.0 mg/L and serum fluoride>0.20mg/L)。we examine serum osteocalcin and serum calcitonin by radio-immunity method.Results The serum osteocalcin and serum calcitonin of high fluoride burden group (7.37±2.18ng/mL;84.11±25.45 pg/mL)is more than serum osteocalcin and serum calcitonin of control group(4.87±1.85ng/mL;59.96±21.16pg/mL)with a significant difference(P<0.01). The serum osteocalcin and serum calcitonin of midst fluoride burden group (5.99±2.03ng/mL;71.92±13.29 pg/mL)is more than serum osteocalcin and serum calcitonin of control group(4.87±1.85ng/mL;59.96±21.16pg/mL)with a significant difference(P<0.05). The serum osteocalcin and serum calcitonin of high fluoride burden group (7.37±2.18ng/mL;84.11±25.45 pg/mL)is more than serum osteocalcin and serum calcitonin of normal reference group(5.40±3.30ng/mL;72.00±7.00pg/mL)with a significant difference(P<0.01).Conclusions The serum osteocalcin and serum calcitonin of all fluoride burden groups with a significant difference, and compare with serum osteocalcin and serum calcitonin of normal reference group with a significant difference.So we think that the serum osteocalcin and serum calcitonin are early diagnosis reference indexes of industry bone injury.更多还原