中华皮肤科杂志 ›› 2023, Vol. 56 ›› Issue (7): 636-641.doi: 10.35541/cjd.20220717

• 论著 • 上一篇    下一篇

湖南省某砷尾矿地区居民砷中毒皮肤损害患病率及相关因素调查

黄晓燕1    肖易2    敬丹榕2    陈明亮2    沈敏学2，3   

  1. 1中南大学湘雅医院病理科，长沙  410008；2中南大学湘雅医院皮肤科，长沙  410008；3中南大学湘雅公共卫生学院社会医学与卫生事业管理学系,长沙  410013
  • 收稿日期:2022-10-12 修回日期:2023-04-20 发布日期:2023-07-04
  • 通讯作者: 沈敏学 E-mail:shenmx1988@csu.edu.cn
  • 基金资助:
    国家科技基础性工作专项项目（2015FY111100）；湖南省青年科技人才项目（2022RC1014）

A survey on the prevalence and associated factors of arsenic poisoning-related skin lesions in an arsenic tailing area in Hunan Province, China

Huang Xiaoyan1, Xiao Yi2, Jing Danrong2, Chen Mingliang2, Shen Minxue2,3   

  1. 1Department of Pathology, Xiangya Hospital, Central South University, Changsha 410008, China; 2Department of Dermatology, Xiangya Hospital, Central South University, Changsha 410008, China; 3Department of Social Medicine and Health Management, Xiangya School of Public Health, Central South University, Changsha 410013, China
  • Received:2022-10-12 Revised:2023-04-20 Published:2023-07-04
  • Contact: Shen Minxue E-mail:shenmx1988@csu.edu.cn
  • Supported by:
    National Project on Basic Work in Science and Technology （2015FY111100）; Youth Science and Technology Talent Program of Hunan Province （2022RC1014）

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摘要： 【摘要】 目的 了解湖南省某砷尾矿地区居民砷中毒皮肤损害的现况。方法 本研究为横断面设计，2016年10月至2017年1月采用整群抽样的方法招募湖南省石门县白云乡3个村庄所有18岁以上的村民（孕妇除外），通过问卷调查获取人口学信息，由皮肤科医师检查调查对象有无砷中毒皮肤损害，收集血液、尿液和头发样本测定砷含量。采用非条件Logistic回归分析砷中毒皮肤损害的相关因素。结果 本研究共纳入1 092名砷尾矿地区村民，756名（69.2%，95% CI：66.5% ~ 72.0%）村民有砷中毒皮肤损害，表现为角化过度、色素减退或色素沉着。发砷含量为0.31（0.14，0.74） μg/g，血砷含量为0.84（0.67，1.10） μg/L，尿砷含量为60.31（41.71，91.52） μg/L。多因素分析表明，砷中毒皮肤损害的发生与年龄、居住地和职业暴露史存在显著相关性，与性别、民族、文化程度、迁移史、发砷、血砷和尿砷浓度无相关性。以18 ~ 39岁组为对照，40 ~ 59岁和 ≥ 60岁组的调整OR值分别为11.34（95% CI：5.98 ~ 21.50，P < 0.001）和71.82（95% CI：35.81 ~ 144.05，P < 0.001）。以望羊桥村村民为对照，鹤山村和磺厂社区村民的调整OR值分别为2.89（95% CI：2.05 ~ 4.08，P < 0.001）和4.13（95% CI：1.94 ~ 8.78，P < 0.001）。以无职业暴露史（村民）为对照，有职业暴露史村民的调整OR值为1.99（95% CI：1.04 ~ 3.83，P = 0.039）。结论 湖南省某砷尾矿地区仍有近70%居民呈现砷中毒皮肤损害改变。砷暴露时间和既往砷暴露水平与皮肤损害患病风险相关。

关键词: 砷中毒, 皮肤表现, 患病率, 环境暴露, 职业暴露, 年龄因素, 砷暴露, 砷皮肤损害

Abstract: 【Abstract】 Objective To investigate epidemiological characteristics of arsenic poisoning-related skin lesions in an arsenic tailing area in Hunan Province. Methods A cross-sectional study was conducted. From October 2016 to January 2017, all residents aged over 18 years （except pregnant women） were enrolled from 3 villages in Baiyun Town, Shimen County, Hunan Province by using a cluster-sampling method. Demographic information was collected through a face-to-face questionnaire interview. All residents received skin examination performed by professional dermatologists, and blood, urine, and hair samples were collected for the measurement of arsenic levels. Non-conditional logistic regression analysis was performed to analyze factors associated with arsenic poisoning-related skin lesions. Results A total of 1 092 eligible residents in the arsenic tailing area were recruited in this study, and 756 （69.2%, 95% CI: 66.5%, 72.0%） presented with arsenic poisoning-related skin lesions, including hyperkeratosis, hypo- or hyper-pigmentation. The median (Q1, Q3) arsenic levels were 0.31 （0.14, 0.74） μg/g in hair samples （n = 1 079） , 0.84 （0.67, 1.10） μg/L in blood samples （n =1 091）, and 60.31 （41.71, 91.52） μg/L in urine samples （n =1 092）. Multivariable analysis showed that the occurrence of arsenic poisoning-related skin lesions was associated with age, residential location, and occupational arsenic exposure history, but was not associated with gender, ethnicity, education levels, migration history, arsenic levels in hair, blood, or urine. Compared with the group aged 18 - 39 years, the group aged 40 - 59 years and the group aged over 60 years showed significantly higher risks of arsenic poisoning-related skin lesions （adjusted OR = 11.34, 95% CI: 5.98, 21.50, P < 0.001; adjusted OR = 71.82, 95% CI: 35.81, 144.05, P < 0.001, respectively）. Compared with the residents in the Wangyangqiao village, residents in the Heshan village and Huangchang village showed significantly higher risks of arsenic poisoning-related skin lesions （adjusted OR = 2.89, 95% CI: 2.05, 4.08, P < 0.001; adjusted OR = 4.13, 95% CI: 1.94, 8.78, P < 0.001, respectively）. The risk of arsenic poisoning-related skin lesions was significantly higher in residents with occupational exposure history than in those without （adjusted OR = 1.99, 95% CI: 1.04, 3.83, P = 0.039）. Conclusion Nearly 70% of the residents presented with arsenic poisoning-related skin lesions in an arsenic tailing area in Hunan Province, and the duration and previous degree of arsenic exposure were associated with the risk of arsenic poisoning-related skin lesions.

Key words: Arsenic poisoning, Skin manifestations, Prevalence, Environmental exposure, Occupational exposure, Age factors, Arsenic exposure, Arsenic-related skin lesions

引用本文

黄晓燕 肖易 敬丹榕 陈明亮 沈敏学. 湖南省某砷尾矿地区居民砷中毒皮肤损害患病率及相关因素调查[J]. 中华皮肤科杂志, 2023,56(7):636-641. doi:10.35541/cjd.20220717

Huang Xiaoyan, Xiao Yi, Jing Danrong, Chen Mingliang, Shen Minxue, . A survey on the prevalence and associated factors of arsenic poisoning-related skin lesions in an arsenic tailing area in Hunan Province, China[J]. Chinese Journal of Dermatology, 2023, 56(7): 636-641.doi:10.35541/cjd.20220717