人體鉛暴露生物指標之回顧與近況發展

Recent Development of Biomarkers on Human Lead Exposure: A Review

鉛為組成地殼之一種天然元素，大量應用於工業製程上，以致在環境中鉛幾乎無所不在。目前已知鉛暴露對人體之造血、神經、心臟血管、腎臟、生殖等系統造成影響，並且可能致癌。生物偵測由於可以測知暴露者之內在劑量，近年來於環境衛生與職業醫學上逐漸受到重視。本文針對文獻上記載之各種鉛暴露生物偵測指標包括血中鉛、尿中鉛、血漿中ALA （ ALAP ）、尿中ALA （ ALAU ） 、尿中CP （ CPU ）、血中ALAD 活性、血中EP、骨中鉛、EDTA 動員試驗、血中同位素比值法、齒中鉛、髮中鉛、指甲中鉛及精液中鉛濃度，就時序性、暴露程度之適用性及實用性上之優缺點進行綜合論述。本研究建議對鉛暴露者進行暴露或健康影響評估時，在生物偵測方法之選擇上，必須就其所代表之時序性與適用之濃度範圍，配合實施之難易程度施與全盤考量，方能獲得正確有效的評估結果。

Lead is a naturally occurring element that has been commonly found in earth and widely used in many industrial activities leading to its ubiquitous distribution in environments, such as automobile exhaust, paint, food, water, soil and working sites. Lead in the human body poses a substantial health threats, including neurologic, hematologic, reproductive, nephretic, endocrine, and cardiovascular effects, and potentially carcinogenic effect, as well. Accurate biological monitoring, capable of determining the internal dose rather than external exposure, has been a continuously important issue in assessing the dose-response relationship of exposure to xenobiotics. This paper tried to compare various biomarkers of lead exposure with respect to temporal sequence, and appropriate lead levels in the application of laboratory tests to evaluate blood lead, urinary lead, plasma ALA(ALAP), urinary ALA (ALAU), urinary CP (CPU), ALAD activity in blood, blood EP, stable isotope lead ratio, EDTA mobilization test, tooth lead, hair lead, nail lead, and seminal lead in the text in details. We concluded that the issues of the corresponding temporal relationship, the applicable concentration, and the eligibility of application should be considered in advance to estimate body burden of lead exposure before any item of lead biological monitoring is conducted.