职业性铅暴露与椎体骨折的关系

孙东红; 周宏东; 朱国英

职业性铅暴露与椎体骨折的关系

Research on the Relationship between Occupational Lead Exposure and the Vertebral Fractures

摘要

摘要:
目的利用铅暴露工人楔形骨折、终板骨折、压缩性骨折等轻度腰椎椎体骨折的腰椎摄片资料,调查职业性铅暴露与椎体骨折的关系。

方法以上海某蓄电池厂175名铅作业工人为暴露组,同时选取该厂无职业性铅暴露史的工人60名为对照组,对2组进行腰椎摄片和血铅浓度检测,统计分析腰椎椎体骨折的发生特点及铅暴露与骨折发生的关系。

结果铅暴露组中发生轻度及以上椎体骨折的人数为112人,发生率64%;中度及以上椎体骨折30人,发生率17%。暴露组175人中,楔形骨折者42人,占24.0%;终板骨折者91人,占52.0%;压缩性骨折者27人,占15.0%。对照组中发生有轻度及以上椎体骨折的人数为27人,占45.0%;中度及以上椎体骨折者2人,占3.3%。其中楔形骨折者9人,占15.0%;终板骨折者20人,占33.3%;压缩性骨折者6人,占10.0%。经统计学检验,轻度及以上和中度及以上椎体骨折发生率,暴露组均明显高于对照组,差异有统计学意义(χ²=6.68,P=0.014;χ²=7.24,P=0.008)。在轻度及以上骨折的3种表现类型上,终板骨折在暴露组和对照组中有明显差异(χ²=6.25,P=0.016)。铅暴露工人中随着体内铅暴露水平的升高,轻度及以上椎体骨折的发生率和严重程度呈增加趋势,高血铅(≥1.21 μmol/L)组椎体轻、中度及以上骨折的发生率均明显高于低血铅(<1.21 μmol/L)组,P值分别为0.000和0.008。

结论职业性铅暴露工人中椎体骨折发生率增加。

Abstract:
Objective To investigate the effects of occupational lead exposure on the vertebral fracture.

Methods A total of 175 lead exposure workers and 60 non-lead exposure workers in a storage battery plant were chosen as research subjects and controls. Data were gained by the abdominal vertebra X-ray photographs and measurement of blood lead concentration.

Results Among 175 lead expusure workers, there were 112(64%) light vertebral fractures, 30(17%) moderate vertebral fractures. There were 42 (24.0%) wedge fractures, 91 (52.0%) endplate fractures and 27 (15.0%) compression fractures in 112 light vertebral fractured lead exposure workers. Among 60 non-lead expusure workers, there were 27(45.0%) light vertebral fractures, 2(3.3%) moderate vertebral fractures. There were 5(15.0%) wedge fractures, 20(33.3%) endplate fractures and 6(10.0%) compression fractures in 27 light vertebral fractured non-lead exposure workers.The vertebral fracture rate in the occupational lead exposure group were higher than that in the control group with significantly statistical difference(χ²=6.68, P=0.014). Among lead exposure workers and those who had high blood lead concentration, the vertebral fracture rate was significantly increased in the groups of ≥250 μg/L blood lead concentration.

Conclusion Occupational lead exposure can cause the increase of the vertebral fracture.

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