摘要
接触生产性粉尘引发的职业性尘肺病(以下简称"尘肺病")是我国危害最严重的职业病.对接触粉尘的职业人群进行生物监测,对尘肺病的预防、诊断和治疗具有重要意义.生物监测是一项系统性工程,包括生物监测的样品选择、生物监测指标的选择、检测方法的选择等一系列过程.生物监测选择的生物样品主要包括尿液、血液、呼出气、支气管肺泡灌洗液、唾液和痰液等;生物监测指标的选择涉及尘肺病形成的氧化应激、炎症反应、胶原合成/退化和吞噬细胞凋亡等多个通路;针对不同的监测指标需要选择合适的检测方法,包括酶联免疫吸附法、高效液相色谱法、高效液相色谱-串联质谱法和电感耦合等离子体-质谱法等.目前尚缺乏真正有临床价值、能反映粉尘接触与职业人群健康危害关联性的生物监测指标,也未报道有系统、完整的生物监测方法;尚需进一步规范生物监测流程,寻找具有特异性的生物监测指标.
Abstract
Occupational pneumoconiosis(referred to as"pneumoconiosis")caused by exposure to occupational dust is the most serious occupational disease in China.Biological monitoring on occupational populations exposed to dust is important for the prevention,diagnosis,and treatment of pneumoconiosis.Biological monitoring is a systematic engineering process that includes a series of processes such as biological samples selection,selection of biological monitoring indicators,and selection of detection methods.The biological samples for biological monitoring mainly include urine,blood,exhaled breath gas,bronchoalveolar lavage fluid,saliva,sputum,and more.The indicators of biological monitoring involve multiple pathways such as oxidative stress,inflammatory response,collagen synthesis/degradation,phagocytic cell apoptosis,and pathways related to the formation of pneumoconiosis.Suitable detection methods need to be determined upon different biological monitoring indicators,including enzyme-linked immunosorbent assay,high-performance liquid chromatography,high-performance liquid chromatography-tandem mass spectrometry,inductively coupled plasma mass spectrometry,etc.Currently,there is a lack of true clinically valuable biological monitoring indicators that can indicate the correlation between dust exposure and the hazards of occupational populations,and there are no systematic and complete biological monitoring methods reported.It is necessary to further standardize the biological monitoring process and search for specific biological monitoring indicators.
基金项目
国家卫生健康委职业安全卫生研究中心自管项目(2019009)
NETL
NSTL
万方数据