中国公共卫生  2015, Vol. 31 Issue (7): 977-980   PDF    
非职业暴露人群尿中多环芳烃接触生物标志物浓度水平
王德杰1, 孙治涛2, 杨超2, 王炳玲2, 逄淑涛2     
1. 青岛大学公共卫生学院流行病与卫生统计教研室, 山东 青岛 266021;
2. 青岛市疾病预防控制中心
摘要:多环芳烃(PAHs)作为一类化学物质,广泛存在于环境中,长期暴露具有潜在致癌性,而单一的接触生物标志物并不能完全代表暴露者体内的暴露水平;有关职业暴露人群中多种接触生物标志物已多有研究,而一般人群暴露研究则相对较少,本文自2000年以后14年间报道的一般暴露人群尿中PAHs接触生物标志物进行综述,重点对主要的生物标志物及其浓度水平进行描述,为一般环境中PAHs类化学物质暴露的生物学检测提供理论依据。
关键词多环芳烃(PAHs)     尿     生物标志物     环境暴露    
Urinary biomarker levels of polycyclic aromatic hydrocarbons in general population
WANG De-jie, SUN Zhi-tao, YANG Chao, et al    
Department of Epidemiology and Health Statistics, School of Public Health, Qingdao University, Qingdao, Shandong Province 266021, China
Abstract: Polycyclic aromatic hydrocarbons(PAHs),as members of a family of environmental pollutants widely existing in the environment,showed potential carcinogenicity.Single biomarker cannot completely represent the internal body burden.Many studies for the biomonitoring of occupational PAHs exposure have been reported.However,less studies have been published relatively for the general population exposed to PAHs.This article reviewed the urinary biomarkers,with focus on their levels of PAHs exposure in general population from studies published after the year of 2 000.
Key words: polycyclic aromatic hydrocarbons     urine     biomarker     environmental exposure    

多环芳烃(polycyclic aromatic hydrocarbons,PAHs)是来源于煤 、石油 、木材等不完全燃烧或热裂解产物,可以通过呼吸道、皮肤和消化道进入人体,由于其较强的致突变和致癌性而受到人们广泛关注。研究PAHs在人体的暴露水平和风险评价可为有效控制环境中的PAHs污染提供基础数据。由于个体差异,外暴露水平往往不能反映体内实际暴露水平,生物学检测就成为了重要的检测手段。尿液中PAHs的羟基代谢产物(hydroxy-PAH,OH PAHs)作为PAHs体内的代谢产物,一直被作为常用的接触生物标志物。秦晓蕾等[1]对尿中OH PAHs的分析方法进行了综述;范瑞芳等[2]对检测方法进行了综述,本文着重对2000年后14年间非职业暴露的一般人群尿液中PAHs常见接触标志物的种类和暴露水平进行综述。 1 PAHs代谢产物

一直以来,芘(pyrene,Pyr)的羟基代谢产物1-OH Pyr由于其稳定性好、灵敏度高、与总PAHs的关联性强且易于检测等优点,常被用来衡量个体短期PAHs的实际暴露量,是目前使用最广泛的PAHs代谢生物标志物,但近来的研究表明,1-OH Pyr与尿中其他OH PAHs的相关性不强,仅使用1-OH Pyr作为生物标志物来反应人体尿中总PAHs 暴露水平存在不足,其他OH PAHs如1-,2-OH-Nap、9-OH Phe、2-OH Flu、3-OH BaP和6-OH Chr 等作为生物标志物具有其不同的应用价值。为了便于不同文献间的比较,统一使用尿肌酐(creatinine,Cr)(单位:μmol/mol)对尿中PAHs代谢产物浓度进行重新计算,并假定每人尿液1.5 L/d[3],其尿中肌酐13 mmol/L[4]1.1 Pyr羟基代谢产物

1-OH Pyr是报道最多、最为认可、最常用的生物标志物。在中国,反映集中趋势的参数浓度(例如中位数、算术均数、几何均数)大部分<1.0 μmol/mol Cr,其中又主要集中在0.3 μmol/mol Cr[5, 6, 7, 8]左右;但是,报道的孕妇则均>0.7 μmol/mol Cr[9, 10, 11],2011年报道的中位数浓度水平甚至达到1.1 μmol/mol Cr[12]。考虑到报道的高浓度对象均来自太原市,而太原市的大气中PAHs污染远远高于其他地区,可以解释这种异常高浓度现象。与中国相比,世界其他地区虽然也有高浓度报道,如美国重度成年吸烟者的算术均数浓度达1.16 μmol/mol Cr[13],但其他各国主要集中在0.05 μmol/mol Cr左右或更低[5, 14, 15, 16, 17, 18, 19, 20, 21],远低于中国。美国的研究表明,吸烟程度与1-OH Pyr水平呈线性关系,吸烟越多,1-OH Pyr浓度越高[13],提示吸烟是非职业人群 PAHs水平浮动的重要来源,与德国[15]和日本[22]的相关报道一致。美国非重度吸烟者(算术均数:0.20~0.46 μmol/mol Cr)[23, 24]、德国的吸烟者(几何均数:0.10 μmol/mol Cr)[25]以及印度(算术均数:0.25μmol/mol Cr)[26]、越南(算术均数:0.23 μmol/mol Cr)[26]、土耳其(算术均数:0.16 μmol/mol Cr)[27]、朝鲜(算术均数:0.15)[28]和中国[7, 8, 26, 29]的轻污染区报道的浓度(中位数或算术均数:0.23~0.35μmol/mol Cr)相近,而阿富汗报道的则接近0.7 μmol/mol Cr[30],与中国重污染区太原市的浓度相近。 1.2 萘(naphthalene,Nap)羟基代谢产物

Nap是挥发性很高的2环PAHs,无论是职业暴露还是非职业暴露,环境Nap的浓度水平均高于其他 PAHs,而且在人体尿液中总 PAHs 羟基代谢物中也占很大比例 。自2002年国际癌症研究会重新将Nap列为潜在致癌物后,其尿中代表性的羟基代谢产物(hydroxy Nap,OH Nap)1-,2-OH Nap作为生物学标志物更受关注。在成年人中,已报道的1-OH Nap中位数浓度中最高的是德国报道的吸烟者,为12.87 μmol/mol Cr[31],其次是泰国农村[32]和德国办公室人员[33]的算术均数浓度,分别达7.58和5.87 μmol/mol Cr。中国汕头市污染严重村中位数浓度[8]与南韩[5]和德国非吸烟者[31]的算术均数浓度大体相近,均在3 μmol/mol Cr左右。中国部分地区[8]、越南[26]、印度[26]、科威特[26]和美国[20]的集中趋势参数浓度在1~2 μmol/mol Cr,而 中国部分地区[26, 29, 34]、日本[26, 35]和马来西亚[26]报道的集中趋势参数浓度则<1 μmol/mol Cr。2-OH Nap的报道浓度水平高于1-OH Nap,其集中趋势参数浓度(例如中位数、算术均数、几何均数)以>1.0 μmol/mol Cr为主,最高的是王春华等[36]报道的中度污染城市8~14岁未成年人中的算术均数浓度,为40 μmol/mol Cr。中国报道的大部分地区[8, 36, 37, 38]、中国[37]和泰国[32]报道的农村地区以及越南[26]、德国[31]和美国[39]的吸烟者中的集中趋势参数浓度均在10 μmol/mol Cr左右。未成年人中报道的浓度与成年人相当,甚至可能高于成年人,可能是因为Nap主要来自室内环境而非室外的大气,王春华等[36]的报道也支持这种解释,他们比较了不同污染程度的城市居民2-OH Nap浓度,发现不同城市居民的浓度水平并无统计学差异。特殊群体中,中国报道的不孕症患者[40]的浓度水平(几何均数:5.39 μmol/mol Cr)远高于癌症患者(浓度范围:0.50~1.18)[41],提示PAHs与不孕症间的可能关联。 1.3 菲(phenanthrene,Phe)羟基代谢产物

Phe羟基代谢产物1-OH Phe、2-OH Phe、3-OH Phe、4-OH Phe、9-OH Phe均有报道,其集中趋势参数浓度多数<1.00 μmol/mol Cr,仅有岳强[42]报道了中国某地区幼儿园4~6岁儿童的9-OH Phe算术均数浓度接近2.0 μmol/mol Cr。5种代谢产物中,以3-OH Phe浓度为最高,4-OH Phe为最低,但是亚洲一些国家如泰国、越南等地的2-OH Phe显示了相对高的浓度[20, 25, 26, 32, 43, 44, 45, 46]。吸烟与否[25, 44, 45, 46]和不同年龄段[46]均不能明显影响5种代谢产物的浓度水平。 1.4 芴(fluorene,Flu)的羟基代谢产物

Flu的生物学标志物2-OH Flu的报道相对较多。虽然国内报道的浓度有<1.0 μmol/mol Cr[7, 26, 29, 34],与其他大部分国家报道的浓度相近[20, 26, 47, 48],但是大部分国内报道的集中趋势参数浓度均>1.0 μmol/mol Cr[37, 40, 41, 42, 49, 50],浓度范围最高浓度达到29.26 μmol/mol Cr[42],靠近焦化厂的中学生更是高达55.86 μmol/mol Cr[49]。显然中国区别于其他国家的高浓度Flu暴露的来源值得进一步探讨,Guo等[26]比较了美国和亚洲一些国家Flu的代谢产物后也提出了同样的问题。虽然Flu的致癌性未被确认,但最近有报道2-OH Flu浓度与暴露者的血清甲状腺激素水平呈负相关[51]。因此,在研究PAHs暴露所致心血管等慢性疾病方面[52],2-OH Flu有重要的参考价值。 1.5 其他PAHs羟基代谢产物

屈(chrysene,Chr)常用的生物学标志物为6-OH Chr。中国曾在2011年报道了345名一般人群6-OH Chr的浓度范围为0.03~0.59 μmol/mol Cr,算术均数为0.04 μmol/mol Cr[7]。美国有使用苯并(a)蒽(benzo[a]anthracene,BaA)的1-OH BaA,3-OH BaA来描述一般人群暴露水平的报道,其中位数和浓度范围分别为0.10(0.007~0.72)和0.16(0.005~0.82)μmol/mol Cr[53]。3-OH BaP作为苯并(a)芘(benzo[a]pyrene,BaP)的羟基代谢产物,也有被用来评价PAHs的暴露。中国在2011和 2012年报道了一般人群的3-OH BaP暴露水平(算术均数:0.007~0.050 μmol/mol Cr;中位数:0.08~0.15 μmol/mol Cr)[7, 37, 54],法国也在2011年报道了一般人群中吸烟人群和非吸烟人群暴露水平(中位数浓度:吸烟者0.023为μmol/mol Cr,非吸烟者为0.009 μmol/mol Cr)[55]。荧蒽(fluoranthene,Flo)的3-OH Flo和茚并芘(indeno[1,2,3-cd]pyrene,IP)的6-OH IP也有报道,算术均数浓度分别达到了0.05和0.07 μmol/mol Cr[53]。由于高环PAHs的羟基代谢产物量少,检出率偏低,对仪器设备的要求也高,从而影响了其作为生物学标志物的应用。 2 多环芳烃未代谢单体化合物

4-6环PAHs在体内一般经粪便排出体外,少数通过肾脏系统,其中有相当数量的未代谢单体也经尿液排出。随着检测技术的发展,有报道使用未代谢单体作为生物标志物进行PAHs暴露评价。早在2003年,Waidyanatha等[56]和Campo等[57]分别报道了中国和意大利一般成年人群尿中的PAHs原型化合物Nap、Phe和Pyr。除了上述3类物质,意大利的Campo等[57]还报道了本国的苊(acenaphthylene,Acy)、二氢苊(acenaphthene,Ace)、Flu、蒽(anthracene,Ant)和Flo等8种PAHs原型的中位数浓度和其浓度范围。从报道的结果看,中国一般人群的Nap和Phe 暴露水平为0.859(0.107~3.170)和 0.062(0.008~0.690)μg/L[56],均高于意大利的0.155[JP4](0.099~0.191)和0.026(0.021~0.059)μg/L[57],但Pyr的暴露水平[0.001(0.000 3~0.005 0)μg/L][56]低于意大利[0.006(0.004~0.008)μg/L][57],进一步说明多标志物检测的必要性。同时,Acy、Ant和Ace的检出率较低,浓度多在定量限以下,其可行性值得进一步探讨。 3 小结及展望

PAHs是最具特征的环境毒物之一,一些PAHs是致突变、致癌和生殖发育毒物。虽然1-OH Pyr仍是最常用的PAHs接触生物标志物,但越来越多的研究倾向于多标志物联合使用,其中Nap和Phe羟基代谢产物的使用越来越多。高环PAHs的羟基代谢产物(尤其是单羟基BaP)也有使用,并在致癌性PAHs暴露评价中意义更大。与其他国家或地区相比,中国PAHs暴露羟基代谢产物,尤其是致癌性PAHs的羟基代谢产物的浓度普遍较高。虽然某些4~6环PAHs的羟基代谢产物或其未代谢单体也有使用,但是低的检出率限制了低浓度暴露定量的要求。即使在较高浓度PAHs暴露条件下,Nap的羟基代谢产物仍能够受到吸烟行为的明显影响;同时母婴体内均有大量PAHs存在,儿童也是高危人群,其潜在的健康影响需要引起关注。Nap、Flu等不同PAHs的代谢产物在不同研究目的的调查中可以根据需要有所选择。随着分析技术的发展,未代谢PAHs的优势会增强,其使用也将更为普遍。

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