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韓國에서의 鉛吸收判定基準에 關한 硏究

Criteria for the Assessment of Lead Absorption in Korea

최신의학 1969년 12권 2호 p.45 ~ 58
정규철,
소속 상세정보
정규철 (  ) - 가톨릭의대 의학부 예방의학교실

Abstract


For the effective health management on lead workers, a series of 234 male lead workers from d. erent industries and 166 male non-lead workers were studied by means of clinical and biochemical examinations in order to define clearly grades of lead absorption and lead poisoning as well as to find cases of ill-health caused by exposure to lead.
The tests used were blood lead, urinary lead, and coproporphyrin estimations, punctate basophilia count, and hemoglobin, blood specific gravity, hematocrit and red blood cell estimatations.
The subjects were divided into four groups depending on the grade of lead absorptionnon-lead workers, grade 0; healthy lead workers, grade 1; asymptomatic Iead workers, grade 2; and symptomatic lead workers, grade 3.
In non-lead workers, whose lead absorption is within normal limit, blood lead is 40ug/1008. or less, urivary lead 90,ug/l or less, hemoglobin above 14.Og/dl, blood specific gravity above 1.054, hematocrit above 46.O%, and red blood cell count 4.50X10/mm3, and urinary coproporphyrin and punctate basophilia are absent.
In healthy lead workers, whose lead absorption is slightly increased, blood lead is 40ug/100g60ug/ 100g, urinary lead 90ug/l, hemoglobin 14.Og/d113, Og/dl, blood specific gravity 1.053, hematocrit above 450/,, red blood cell count 4.50x 10´/mm3--4.10x 106/mm3 and urinary coproporphyrin is excreted in trace and punctate basophilia is absent.
In asymptomatic lead workers, whose lead absorption is increased to a cautionary level, blood lead is 601g/100gF0ug/100g. urinary lead 160pg/1210ug/l, hemoglobin 13.0g/dl, blood specific gravity 1.052, hematocrit 45´/´o -43 % , and urinary coproporphyrin excretion is one positive(+) and punctate basophilia is found 1 or 2 per 1, 000 red blood cells.
In symptomatic lead workers, whose lead absorption is much increased to a danger level, blood lead is above 80ug/100g, urinary lead above 210ug/l, hemoglobin 12g/dl or less, blood specific gravity 1.051 or less, hematocrit 42% or less and red blood cell count 3.90X106/mm3 or less, and urinary coproporphyrin excretion is strongly positive(-}+ or + -I-+), and punctate basophilia is found 3 or more per 1, 000 red blood cells.
It is extremely important to pay careful attention when evaluating the extent of lead absorption and poisoning based on these biochemical criteria because the individual test has a relatively high (30;040%) false positive and false negative rates. This implies the importance of the periodical medical supervision of lead workers and the combined utilization of tests in the detection of unhealthy
lead workers.

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