Humans ; Occupational Exposure ; Occupational Health ; Risk Factors ; Sanitation

OBJECTIVETo investigate the lead exposure, its effects, and the relationships between biomarkers of susceptibility in the workers with low-level occupational lead exposure, and to explore its sensitivity and practical value to evaluate the health hazard.

METHODSThe concentrations of lead fume and lead dust in workplaces of a lead acid storage battery enterprise in Jiangsu Province, China, were measured by occupational health monitoring method. The blood samples of 233 workers with occupational lead exposure and 76 non-occupational lead exposure were collected to measure the blood lead (Pb-B) level using graphite furnace atomic absorption spectrometry (GFAAS), the zinc Protoporphyrin (ZPP) level with blood fluorescence assay, and the delta-aminolevulinic acid dehydratase (ALAD) concentration by a spectrophotometer, and to determine the gene polymorphism of ALAD with TaqMan real-time polymerase chain reaction. At the same time, their urine samples were collected to measure urine lead (Pb-U) concentration with GFAAS and delta-aminolevulinic acid (ALA-U) concentration with a spectrophotometer. The correlations between the above indices were analyzed by multiple linear regression method.

RESULTSThe concentration of lead fume in 18 testing sites and the concentration of lead dust in 30 testing sites were 0.002-0.019 mg/m3 and 0.004-0.013 mg/m3, respectively. Pb-B level was positively correlated with Pb-U concentration (r=0.62, P<0.01) and ZPP level (r=0.47, P<0.01) and was negatively correlated with ALAD concentration (r=-0.77, P<0.01) in 233 workers with occupational lead exposure. Among 233 workers, 218 (93.6%) had ≤70 µg/L Pb-U, and 15 (6.9%) had ≥400≥g/L Pb-B. Pb-B level was not correlated with ZPP level as Pb-B level was <190 µg/L (r=0.18, P=0.068 ), while Pb-B level was positively correlated with ZPP level as Pb-B level was ≥190 µg/L (r=0.36, P<0.01). Pb-U concentration was positively correlated with ALA-U concentration (r=0.49, P<0.01) and ZPP level (r=0.47, P<0.01). ZPP level was negatively correlated with ALAD concentration (r=-0. 19, P<0.01), and was positively correlated with ALA-U concentration (r=0.27, P<0.01). ALAD concentration was not correlated with ALA-U concentration (r =-0. 11, P>0.05). And in 233 workers with occupational lead exposure, there were no significant differences in Pb-B level, ZPP level, and ALAD activity between the workers with ALAD1-2 genotype and the workers with ALAD1-1 genotype (P>0.05). In 76 workers with non-occupational lead exposure, there was no significant difference in Pb-B level between the workers with ALAD1-2 genotype and the workers with ALAD1-1 genotype (P >0.05). The workers with ALAD1-2 genotype had a significantly lower ALAD activity, and a significantly higher ZPP level compared with those ALAD1-1 genotype (P<0.01).

CONCLUSIONIn the workers with low-level occupational lead exposure, ZPP level is positively correlated with Pb-B level when Pb-B level was ≥190 µ/L. ALAD could be used as an effect biomarker of low Pb-B level. ALAD gene polymorphism shows different effects on the Pb-B level and the toxic effects between the workers with occupational lead exposure and the workers with non-occupational lead exposure.

Aminolevulinic Acid ; blood ; Biomarkers ; blood ; China ; Electric Power Supplies ; Genotype ; Humans ; Lead ; blood ; Linear Models ; Occupational Exposure ; Polymorphism, Genetic ; Porphobilinogen Synthase ; blood ; genetics ; Protoporphyrins ; blood

BACKGROUND: Studies have shown that sodium hyaluronate inhibits cartilage damage in osteoarthritis and accelerates regeneration of cartilage cels, to stabilize and repair the articular cartilage.
OBJECTIVE:To investigate the therapeutic effect of sodium-rich plasma combined with platelet-rich plasma (PRP) on rabbit knee osteoarthritis.
METHODS:Forty New Zealand white rabbits were randomly divided into five groups, control group, combined group, sodium hyaluronate group, PRP group and model group, and then an osteoarthritis model of the right knee was made in each rabbit. After modeling, sodium hyaluronate+PRP, sodium hyaluronate, autologous PRP and normal saline were givenviathe knee joint cavity in the latter four groups, respectively, once a week for 5 weeks. The control group received no treatment, as normal controls. At 1 week after treatment, ELISA assay was used to detect serum interleukin-1, interleukin-6, tumor necrosis factor-α levels, and changes of the articular cartilage were observed under a light microscope.
RESULTS AND CONCLUSION:Compared with the control group, the levels of interleukin-1, interleukin-6 and tumor necrosis factor-α were al increased in the other four groups (P < 0.01). Compared with the model group, the levels of interleukin-1, interleukin-6 and tumor necrosis factor-α were lowered significantly in the combined, sodium hyaluronate and PRP groups (P< 0.01 orP< 0.05), and the most significant decline was in the combined group. Articular cartilage damage was severest in the model group and mildest in the combined group. Experimental findings indicate that intra-articular injection of sodium hyaluronate+PRP can reduce inflammation and protect the articular cartilage in knee osteoarthritis, which is better than a single drug injection.

Objective: To investigate the qualifications current situations of the medical and health institutions and certified doctors for providing occupational disease diagnosis in Jiangsu Province to provide reference for occupational disease prevention and control. Methods: Quantitative and qualitative analysis was carried out on 28 institutionsfor occupational disease diagnosis and 1 278 certified doctors for occupational disease diagnosis in Jiangsu Province between 2012 and 2017, announcement from Jiangsu provincial commission of health and family planning commission, SPSS16.0 was used for statistical analysis. Results: By the end of 2017, there had been 28 medical and health institutions which were qualified for providing occupational disease diagnosis in Jiangsu Province, including 16 centers for disease control and prevention, accounting for 57.14%, 6 general hospitals, accounting for 21.42%, and 6 institutes or centers for occupational disease prevention and control, accounting for 21.42%; a total of 313 occupational disease diagnosis were employed in these 28 diagnostic institutions, with 9.4 certified doctors on average in each institution; In addition, 17.86% of the institutions get all the qualifications for diagnosing 10 occupational diseases, and 10.71% of the institutions get the qualification for diagnosing one tothree occupational diseases. A total of 1278 physicians obtain the qualification of certified doctors for occupational disease diagnosis, the largest number was 221 in Wuxi city, at least 16 in Zhenjiang city, including 599 centers for disease control and prevention, accounting for 46.87%, 118 institutes or centers for occupational disease prevention and control, accounting for 9.23%, 304 general hospitals, accounting for 23.79%, 257 enterprise-owned hospitals, accounting for 20.11%; The highest number of occupational poisoning diagnoses was obtained, accounting for 796 (62.28%) . Conclusion A provincial occupational disease diagnosis network has been established in Jiangsu, but it is far from covering all districts and counties, and the imbalance in regional distribution and specialty programs still exists among the qualified medical and health institutions and certified doctors. It is essential to further strengthen the training of qualified doctors and the development of qualified medical and health institutions.

ObjectiveTo explore the application effect of using the comprehensive index method for occupational health risk assessment in the lead-acid battery enterprises. Methods Convenient sampling method was used to select two lead-acid battery enterprises A and B in Jiangsu Province, with eight key positions including ball grinding, plate casting, pasting, plate coating, plate grinding, plate slicing and brushing, welding and acid charging as the research subjects. Worksite survey of occupational health was conducted in these two lead enterprises, and the levels of lead smoke, lead dust and sulfuric acid in the key positions were detected. The health risk of occupational hazards in the eight key positions was evaluated by a comprehensive index method. Results The time-weighted average concentration (C_TWA) of lead smoke in plate casting and welding positions of enterprise A, the C_TWA of lead dust in plate grinding and plate slicing and brushing positions of enterprise A, the C_TWA of lead dust in plate grinding position of enterprise B, the C_TWA of lead smoke in welding position of enterprise B were exceeded national occupational exposure limits. The risk assessment results of the plate casting, welding, plate grinding and plate slicing and brushing positions were moderate risk, while other positions were low risk in enterprise A. The risk assessment results of the plate grinding and welding positions were moderate risk, while other positions were low risk in enterprise B. Conclusion The results of risk assessment by the comprehensive index method were consistent with the results of occupational hazard factors detection. The comprehensive index method could well evaluate the occupational health risks of lead-acid battery enterprises.

Objective:To understand the occupational health status of a lead-acid battery enterprise in Jiangsu Province, to observe the results of blood lead and bone mineral density (BMD) of the workers exposed to occupational lead, and to explore the effect of occupational lead exposure on BMD, so as to provide basis for the prevention and treatment of occupational lead poisoning and osteoporosis.Methods:An occupational health survey was conducted in a lead-acid battery enterprise in Jiangsu Province in January 2019. Basic information and occupational health examination results of 402 persons exposed to occupational lead were collected, and BMD was measured. Spearman rank correlation test was used to analyze the relationship between blood lead and BMD, and logistic regression analysis was used to analyze the influencing factors of BMD.Results:The blood lead level M ( P25, P75) of 402 occupational lead exposure workers was 220.5 (118.0, 307.0) μg/L, 46 workers (11.4%) had blood lead value ≥400 μg/L, and 5 workers (1.2%) ≥600 μg/L. 124 workers (30.8%) had abnormal BMD. The concentrations of lead dust and lead smoke in the workplace were <0.004-0.027 and <0.021-0.045 mg/m 3, respectively. The positions exceeding the standard point were mainly concentrated in the casting and welding group (44.4%, 4/9) of lead smoke positions. There was a statistically significant difference in the overall distribution of blood lead levels among lead exposure workers with different BMD levels, and there was a positive correlation between blood lead and BMD ( P<0.01) . The results of univariate analysis showed that there were statistically significant differences in the distribution of abnormal BMD among workers exposed to different genders, positions and blood lead levels ( P<0.01) . The results of multivariate logistic regression analysis showed that the risk of abnormal BMD in male workers was 5.069 times of that in female worker (95% CI: 2.906-8.840, P<0.01) . Conclusion:Occupational lead exposure personnel have a high blood lead level and a high abnormal BMD rate. Exposure to lead working environment is an influencing factor for the abnormal BMD of workers, so enterprise managers should pay attention to health protection, occupational health monitoring and supervision of working environment of front-line workers.

Objective: To investigate the incidence of occupational diseases in a province of China during the period of "Twelfth Five-Year Plan" , and to analyze the features of disease spectrum, the characteristics of regional and industrial distribution, and incidence trend. Methods: Data (2011-2015) were collected from the Information System of Occupational Diseases and Occupational Health to analyze the reported cases of occupational diseases during the period of "Twelfth Five-Year Plan". A statistical analysis was performed to identify the characteristics of the disease distribution in terms of sex, age, working years, enterprise type, enterprise scale, and region, as well as the incidence trend. Results: The overall incidence of occupational diseases in this province fluctuated and decreased gradually. There were a total of 5036 new cases of occupational diseases during the period of "Twelfth Five-Year Plan" ; 89.45% of them were male, and 69.78% of them were aged 40-69 years; the most frequently seen occupational diseases were pneumoconiosis (72.48%) and ear, nose, throat, and oral diseases (7.23%). Most cases of pneumoconiosis occurred after 5-10 years of exposure, and other occupational diseases usually developed within 10 years of exposure. New cases of occupational diseases were often seen in small and micro enterprises, as well as Wuxi, Suzhou, and Yancheng. Conclusion During the period of "Twelfth Five-Year Plan" , the incidence of occupational diseases in this province decreased gradually, indicating improved control of occupational diseases, but we still need to pay attention to the high-risk population (male, aged over 40 years) , as well as the prevention of occupational noise-induced hearing loss, and to strengthen the supervision of small and micro enterprises.

Objective To investigate the effects of calcium disodium and water-soluble vitamins on serum T lymphocytes and oxidative stress in patients with occupational lead poisoning.Methods A total of 140 occupational lead poisoning patients in our hospital were randomly divided into control group with 70 cases treated by water soluble vitamins and study group with 70 cases treated with calcium disodium on the basis of the control group.The CD3+, CD4+ and CD8+ activity of T lymphocytes subsets were compared, superoxide dismutase (SOD) and malondialdehyde (MDA) levels, and lead concentration in urine and blood were determined.Meanwhile, the clinical outcomes and adverse reactions of two groups were compared.Results The effective rate of the control group was significantly lower than that of the study group (75.61% vs.92.86%, P<0.05).Compared with the control group, the patients in the study group had lower CD4+ activity, higher CD8+ activity, lower CD4+/CD8+ activity, higher levels of SOD and MDA, and lower lead concentrations in urine and blood, and the differences were statistically significant(P<0.05).Conclusion Calcium disodium and water-soluble vitamins can effectively improve the level of serum T lymphocytes and oxidative stress, decrease the concentration of lead in urine and blood.

Objective To investigate the effects of calcium disodium and water-soluble vitamins on serum T lymphocytes and oxidative stress in patients with occupational lead poisoning.Methods A total of 140 occupational lead poisoning patients in our hospital were randomly divided into control group with 70 cases treated by water soluble vitamins and study group with 70 cases treated with calcium disodium on the basis of the control group.The CD3+, CD4+ and CD8+ activity of T lymphocytes subsets were compared, superoxide dismutase (SOD) and malondialdehyde (MDA) levels, and lead concentration in urine and blood were determined.Meanwhile, the clinical outcomes and adverse reactions of two groups were compared.Results The effective rate of the control group was significantly lower than that of the study group (75.61% vs.92.86%, P<0.05).Compared with the control group, the patients in the study group had lower CD4+ activity, higher CD8+ activity, lower CD4+/CD8+ activity, higher levels of SOD and MDA, and lower lead concentrations in urine and blood, and the differences were statistically significant(P<0.05).Conclusion Calcium disodium and water-soluble vitamins can effectively improve the level of serum T lymphocytes and oxidative stress, decrease the concentration of lead in urine and blood.

Objective:To understand the occupational health status of a lead-acid battery enterprise in Jiangsu Province, to observe the results of blood lead and bone mineral density (BMD) of the workers exposed to occupational lead, and to explore the effect of occupational lead exposure on BMD, so as to provide basis for the prevention and treatment of occupational lead poisoning and osteoporosis.Methods:An occupational health survey was conducted in a lead-acid battery enterprise in Jiangsu Province in January 2019. Basic information and occupational health examination results of 402 persons exposed to occupational lead were collected, and BMD was measured. Spearman rank correlation test was used to analyze the relationship between blood lead and BMD, and logistic regression analysis was used to analyze the influencing factors of BMD.Results:The blood lead level M ( P25, P75) of 402 occupational lead exposure workers was 220.5 (118.0, 307.0) μg/L, 46 workers (11.4%) had blood lead value ≥400 μg/L, and 5 workers (1.2%) ≥600 μg/L. 124 workers (30.8%) had abnormal BMD. The concentrations of lead dust and lead smoke in the workplace were <0.004-0.027 and <0.021-0.045 mg/m 3, respectively. The positions exceeding the standard point were mainly concentrated in the casting and welding group (44.4%, 4/9) of lead smoke positions. There was a statistically significant difference in the overall distribution of blood lead levels among lead exposure workers with different BMD levels, and there was a positive correlation between blood lead and BMD ( P<0.01) . The results of univariate analysis showed that there were statistically significant differences in the distribution of abnormal BMD among workers exposed to different genders, positions and blood lead levels ( P<0.01) . The results of multivariate logistic regression analysis showed that the risk of abnormal BMD in male workers was 5.069 times of that in female worker (95% CI: 2.906-8.840, P<0.01) . Conclusion:Occupational lead exposure personnel have a high blood lead level and a high abnormal BMD rate. Exposure to lead working environment is an influencing factor for the abnormal BMD of workers, so enterprise managers should pay attention to health protection, occupational health monitoring and supervision of working environment of front-line workers.