2. 青岛市疾病预防控制中心
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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2015, Vol. 31

