PHN TCH V NH GI HM LNG CH TRONG MU V NC TIU

PHN TCH V NH GI HM LNG CH TRONG MU V NC TIU

CA NG DN THN CNH DNG, PH LC, THA THIN HU

H Vn Hong, Nguyn nh Sn, Nguyn Ngc Din,

H Xun V, L Vn Hon, L Vn Qung, Nguyn Vn Hp1 Trung tm Y t D phng Tha Thin Hu

1 Khoa ho Trng HKH Hu

TM TT

p dng phng php DP-ASV dng in cc mng bismut in situ xc nh hm lng ch trong mu v nc tiu 24 h ca ng dn thn Cnh Dng.

Hm lng ch trong mu ca nhm nghi vn (ng dn) thn Cnh Dng (trung bnh l 34,7 (g/dL) cao hn so vi nhm i chng (trung bnh l 16,3 (g/dL). Mt khc, i vi c 2 nhm, 37/40 mu mu (92,5%) c hm lng ch trong mu cao hn mc khuyn co ca WHO, tc l > 10 (g/dL. t bit, c 6/40 mu mu (chim 15%) c hm lng ch ln hn 50 (g/dL. iu ny l c s lo lng v mc nhim ch trong cng ng dn c kho st.

Hm lng ch trong nc tiu 24 h ca nhm nghi vn c xu th cao hn nhm i chng nhng khng nhiu (khong1,2 ln). Hm lng ch trong nc tiu 24 h ca c 2 nhm u cao hn so vi mc bnh thng.

T kho: Ch v c, ch mu, ch niu, ng dn thn Cnh Dng,phn tch in ho.

I. T VN

Vit nam, c nhiu nghin cu xc nh ch trong mu, trong thc phm v mi trng [1] [2] [3]. Song cho n nay, vn cha c nhng nghin cunh gi mc nhim ch trong cng ng ng dn, ang v su cha li nh bt thu sn.Hin c khong 300.000 dn sinh sng quanh vng m ph Tam Giang - Cu Hai, Tha Thin Hu bng vic khai thc cc ngun li thy sn. Trong qu trnh an sa cha cc li chi li nh bt thu sn, ngi dn tip xc thng xuyn vi ch, thm ch ngm ch vo ming v do vy, c th c nguy c nhim c ch trong cng ng dn c .

Gn y, Bnh vin Trung ng Hu pht hin c nhiu ca (nhng ngi sng vng m ph v ven bin c an li nh bt thu sn) nhp vin vi hi chng au bng cp khng tm thy nguyn nhn. Vn t ra l nhng bnh nhn c thc s b nhim c ch khng v cng ng dn c ca h c nguy c tim n b nhim ch khng ?... R rng nhng nghin cu lin quan n vic nh gi mc nhim ch trong dn c vng ven bin Tha Thin - Hu v xy dng gii php phng nga ng c ch l rt cp thit.

Xut pht t nhng vn trn, ti ny c thc hin nhm ba mc ti u:(1) Nghin cu xc nh lng vt ch theo phng php von-ampe ho tan anot, dng in cc BiFE.

(2) p dng thc t xc nh lng vt ch trong mu v nc tiu ca ng dn thn Cnh Dng.

(3) xut cc gii php phng nga nhim c ch trong cng ng kho st.

II. I T NG, NI DUNG V PHNG PHP NGHIN CU

2.1. i tng nghin cu

Ng dn thn Cnh Dng, Ph Lc, Tha Thin Hu.2.2. Ni dung nghin cu2.2.1. Kho st nh hng ca oxy ho tan (DO) v cc nguyn t cn (Cu, Cd, Zn) khi xc nh theo phng php DP-ASV dng in cc BiFE [2] [3].2.2.2. nh gi tin cy ca phng php bao gm: lp li, nhy, gii hn pht hin, khong tuyn tnh [4]2.2.3. Phn tch v nh gi hm lng ch trong mu v nc tiu 24 h bng phng php DP-ASV dng in cc BiFE [2] [5][6].2.2.4. xut cc gii php kim sot nhim c ch.2.2 Phng php nghin cu Nghin cu ct ngang c i chng

K thut thu thp s liu: Khm pht hin cc du hiulin quan n thm nhim ch.iu tra theo bng cu hi v phng vn trc tip.

K thut ly mu- Ly mu mu v nc tiu: ( 2 t)t 1 (ngy 10/8/2004): ly mu mu t 25 ngi trong c 19 mu nhm NV, 6 mu nhm C, thn Cnh Dng.t 2 (ngy 24/10/2005): ly 15 mu mu (ly lp li 10 mu t nhm NV v 5 mu t nhm C) v 15 mu nc tiu 24 h.

X l mu: Mu mu nc tiu v mu trng c phn hu trong bom teflon. - Phng php nh lng Ch

p dng phng php thm chun (3-4 ln thm) nh lng ch.

Phng php GF-AAS xc nh ch

Phng php GF-AAS xc nh ch c thc hin ti Trung tm kim nghim M phm, Dc phm Tha Thin

nh gi tin cy ca phng php phn tch[4] [5][6].III. KT QU V BN LUN3.1. Kho st cc yu t nh hng n tn hiu ho tan ca ch

Cc kt qu thu c cho thy, nh hng ca DO l khng ng k. nh hng ca cc yu nguyn t cn, xc nh c khong nng khng nh hng n php xc nh ch ca cc nguyn t cn ZnI, Cd II v CuII.3.2. nhy, gii hn pht hin (GHPH) v khong tuyn tnh

Vi cc iu kin th nghim th nghim thch hp phng php DP-ASV dng in cc BiFE in situ xc nh ch t c GHPH thp ng k (GHPH = 0,65 ppb). Gii hn nh lng (GHL) ca phng php c ( 2 ppb (GHL = (3 ( 4)xGHPH). Vi GHL , phng php ny c th xc nh lng vt ch trong cc mu sinh ho v mi trng. Mt khc, phng php DP-ASV dng in cc BiFE in situ xc nh ch t c lp li tt RSD < 6.5% (n =20, n l s php o lp li).

Kt qu xc nh khong tuyn tnh cho thy: gia dng nh ho tan Ip v [PbII] c tng quan tuyn tnh tt trong khong [PbII] = 1 ( 100 ppb vi R = 0,9991.

3.3. Kt qu thc t 3.3.1. ng v lp li ca pp DP-ASV dng in cc BiFE

Phng php t lp li tt (RSD < 4,5% vi n = 2) v ng tt (khong 97 ( 101%).

Hnh 3.1. Cc ng von-ampe ho tan v cc ng thm chun tng ng, khi xc nh ng ca php xc nh ch trong mu M6-1, M6-2 v M10-1 bng phng php DP-ASV dng in cc BiFE in situ (vit tt l DP-ASV/BiFE). ng v lp li ca pp GF-AAS

Kt qu phn tch ch trong 3 mu mu v 2 mu nc tiu cho thy, phng php GF-AAS t c lp li v ng rt tt: RSD < 2,3% (n=3) v thu hi khong 98 - 100,6%

So snh phng php DP-ASV/ BiFE in situ v GF-AAS

p dng phng php hiu s khi phn tch ch trong cc 7 mu mu v 3 nc tiu c chn ngu nhin. Kt qu cho thy:

(di = 8,95 ( d = 0,09 (g/dL ( Sd = 3,05 (g/dL ( ttnh= 0,93

V t tnh = 0,93 < t 0,05; 9 = 2,26 nn khng c s sai khc v mt thng k gia cc kt qu thu c khi phn tch theo hai phng php vi P > 0,05. Nh vy, nu cho rng phng php GF- AAS l phng php tiu chun, th phng php DP-ASV/BiFE cng t c ng tt khi phn tch ch trong mu v nc tiu.

3.32. Hm lng ch trong mu v nc tiu 24 h ca ng dn thn Cnh Dng

Bng 1. Cc i lng thng k thu c khi nh gi hm lng ch trong mu (xc nh theo phng php DP-ASV/BiFE)

Nhm kho stCc i lng thng k

Min ( Max ((g/dL)TB

((g/dL)Median ((g/dL)S

((g/dL)CV

(%)

Nghi vn (m1 = 30)5,9 - 118,934,724,728,281,3

i chng (m2=10)8,0 - 25,716,316,75,131,2

V ttnh = 3,43 > t0,05; 4 = 2,01, nn c th cho rng, 2 gi tr trung bnh ca 2 nhm khc nhau c ngha v mt thng k vi P < 0,05 (hay tin cy > 95%).

Bng 2. Cc i lng thng k thu c khi nh gi hm lng ch trong nc tiu (xc nh theo phng php DP-ASV/BiFE)

Nhm kho stCc i lng thng k

Min ( Max ((g/dL)TB

((g/dL)Median ((g/dL)S

((g/dL)CV

(%)

Nghi vn (n1 = 11)5,0 - 21,812,910,06,046,5

i chng (n2 = 4)8,5 - 13,110,610,52,119,8

V ttnh = 1,1 (vi TB1 = 12,9 (g/dL v TB2 = 10,6 (g/dL) < t0.05,15 = 2,13 nn 2 gi tr trung bnh hai nhm nh nhau c ngha v mt thng k vi P > 0,05.

Theo chng ti, c th do s mu nc tiu t, nn cc kt qu thu c cha phn bit r s khc nhau v hm lng ch trong nc tiu ca 2 nhm.

Kt qu trn cho php nghi ng v s thm nhim ch cao trong nhm nghi vn. Nhiu mu c mc ch trong mu cao hn 30 (g/dL (11/30 mu), chim 36,6%. y l mc cn c s can thip v lm sng. c bit mt s mu c hm lng ch rt cao, cao hn 50 (g/dL (6/40 mu), chim 15%. y l mc ch c th gy ri lon chc nng ca thn, ph hu no. Mt khc, iu ng ch l phn ln cc gi tr trung bnh (TB) v median ca c 2 nhm u cao hn mc khuyn co (mc khuyn co ca T chc Y t Th gii (WHO) l 10 (g/dL): c 37/40 mu mu c hm lng ch ln hn 10 (g/dL, chim 92,5%.So snh hm lng ch trong mu qua hai t ly mu:

Phn tch theo ch phng php DP-ASV/BiFE trong cc mu mu c ly qua hai t: 15 mu mu ly t 1 v 15 mu mu ly lp li t 2. p dng phng php hiu s, kt qu cho thy:

V ttnh = 1,67 < t0.05,14 = 2,14, nn c c s kt lun rng hm lng ch trong mu qua 2 t ly mu khng khc nhau vi P > 0,05.

3.3.3. Tng quan gia hm lng ch trong mu v nc tiu 24 h

Xem xt tng quan tuyn tnh gia hm lng ch trong mu v trong nc tiu 24 h cho thy: khng c tng quan tuyn tnh vi R = 0,24.

3.3.4. Tm hiu quan h gia hm lng ch trong mu v cc yu t khcTin hnh iu tra cc thng tin lin quan ti 37 x vng m ph v ven bin thuc 5 huyn Phong in, Qung in, Hng Tr, Ph Vang, Ph Lc vi tng s dn l 289.570 thuc 55.695 h.

Kt qu iu tra cho thy: t 2003 n nay c 11.953 trng hp au bng (chim 4,1%), trong nghi nhim c ch l 26 trng hp, khng r nguyn nhn l 3004 trng hp, cn li l cc nguyn nhn khc.

Kt qu iu tra 200 ngi dn ca thn Cnh Dng, hnh 3.4 cho thy:

Hnh 2.Cc triu chng lm sng ca ng dn thn Cnh Dng- Cc triu chng lm sng in hnh trong chn on bnh nhim c ch ngh nghip cng c th hin y nh: nhc u, mt ng, da ti, km n, au bng, lit ngn tay, au c xng, t bit l ng vin ch burton xut hin kh r nt mt s trng hp. Ngoi ra, c nhiu trng hp mc bnh bm sinh, tm thn, bi lit v cao huyt p, (cao huyt p chim 35%) trong s 200 ngi iu tra .

Nh vy, kt hp kt qu iu tra cc thng tin lin quan v hm lng ch trong mu ca cc i tng nghin cu, cho php nhn nh rng kh nng nhim c ch mn tnh trong cng ng ng dn vng kho st l rt cao.IV. KT LUN

T cc kt qu thu c ca ti, chng ti i n cc kt lun sau:

4.1. p dng thnh cng phng php DP-ASV dng in cc mng bismut in situ xc nh hm lng ch trong mu v nc tiu 24 h. - Phng php t c ng tt vi thu hi 97-101% v lp li cao vi RSD < 4,5% (n = 2);

- Phng php t c ng tt khi so snh vi phng php quang ph hp th nguyn t (P > 0,05)4.2. Hm lng ch trong mu ca nhm nghi vn (ng dn) thn Cnh Dng (trung bnh l 34,7 (g/dL) cao hn so vi nhm i chng (trung bnh l 16,3 (g/dL). Mt khc, i vi c 2 nhm, 37/40 mu mu (92,5%) c hm lng ch trong mu cao hn mc khuyn co ca WHO, tc l > 10 (g/dL. t bit, c 6/40 mu mu (chim 15%) c hm lng ch ln hn 50 (g/dL. iu ny l c s lo lng v mc nhim ch trong cng ng dn c kho st.

4.3 Gia hm lng ch trong mu v nc tiu 24 h (i vi c 2 nhm, trung bnh l 10,6 ( 12,9 (g/dL) khng c tng quan tuyn tnh (R = 0,24). Hm lng ch trong nc tiu 24 h ca c 2 nhm u cao hn so vi mc bnh thng. C l do s mu cn t.4.4. Kt qu iu tra cc thng tin lin quan (tui i, tui ngh, thi gian tip xc vi ch qua ng ming v cc triu chng lm sng...) cng cho thy, nguy c nhim ch mn tnh trong cng ng kho st l rt cao. Cui cng, tuy cc kt qu trn ch l ban u, v s lng mu cn t, nhng mc nhim ch trong ng dn vng kho st l ng lo ngi. Theo chng ti, nht thit phi sm c nhng nghin cu chi tit hn, trn c s c nhng gii php kp thi nhm ngn nga nhim c ch v bo v sc kho cho cng ng. Cc kt qu nghin cu ny gp phn cung cp thng tin cho ngnh y t sm c chng trnh nghin cu v s nhim ch trn din rng trong cng ng c dn vng m ph v ven bin tnh Tha Thin Hu ni ring v Vit Nam ni chung.

xut cc gii php phng nga nhim c ch

- C bin php tuyn truyn thch hp nng cao nhn thc cho cng ng v c tnh ca ch v cc nguy c nhim c ch.

- Khuyn co ng dn tuyt i khng c ngm ch vo ming khi an chi li v tm cc gii php khc thay.

- T chc khm v xt nghim nhim c ch cho cng ng, c bit l i vi nhng i tng c nguy c nhim c ch cao nh ngh an v sa cha li. - Tip tc thc hin cc nghin cu chi tit hn v trn din rng hn xc nh mc nhim ch trong cng ng ng dn vng m ph v ven bin Tha Thin Hu.TI LIU THAM KHO

[1]. B Y t - Vin Y hc Lao ng v V sinh Mi trng. Thng quy k thut, Nxb Y hc, H Ni, 1993 tr. 586 - 591.[2]. B Y t (2002), Tiu chun v sinh nc n ung, khng kh, H Ni.[3] Nguyn Vn Hp. Bc u nh gi mc nhim ch trong c dn vng m ph Tha Thin

Hu, ti NCKH cp B m s B2003-07-03. 2004.[4]. T Vng Nghi, Trn Chng Huyn, Phm Lun. Mt s phng php phn tch in ho hin i. Ti liu ging dy ca chng trnh VH2, i hc Tng hp H Ni, 1990, tr. 62 - 126.

[5]. L Trung.21 Bnh ngh nghip c bo him, Nxb Y Hc, H Ni. 1997.tr 20-25[6]. Agnieszka Krlicka et al. Bismuth - film - plated carbon paste electrodes", Electrochemistry Communications, 4,2002, pp. 193 - 196.

[7]. G. Kefala, A. Economou, A. Voulgaropoulos, M. Sofoniou. A study of bismuth - film electrodes for detection of trace metals by anodic stripping voltammetry and their application to the determination of Pb and Zn in tapwater and human hair", Talanta, 61, 2003, pp. 603 - 610.ANALYSIs AND ASSESSMENT OF BLOOD AND URINE LEAD LEVEL OF FISHERMEN IN Canh Duong village , Loc Vinh commune, Phu loc district, thua thien Hue province

Ha Van Hoang, Nguyen Dinh Son, Nguyen Ngoc Dien,

Ho Xuan Vu, Le Van Hoan, Le Van Quang, Nguyen Van Hop1 Preventive Health Center, Thua Thien Hue Province

1College of Sciences, Hue University

ABSTRACT

The method differential pulse - anodic stripping voltammetry (DP-ASV) using Bismuth Film Electrodic in situ for measuring lead level in blood and 24h urine of fishermen in Canh Duong village. On one hand, the mean level of lead in blood of the suspected group (fisherman) in Canh Duong village was 34,7(g/dL was higher than that of the control group (16,3 (g/dL). On the other hand, for both groups, 37 of 40 samples (92,5%), had lead level higher than WHO,S recommendation level (10 (g/dL). Especially, 6 of 40 blood samples (15%) had lead level higher 50 (g/dL. These results attract our attention about lead poisoing status in the studied area.

The lead level in 24h urine of suspected group had slightly higher (about 1.2 times) than that in the control group . The lead level of the two groups was much higher than that the normal level.

M6-1

M6-2

M10-1

T l mc bnh (%)

Triu chng

Lit ngn tay

au c xng

au bng

au d dy

Km n

Da ti

Mt ng

Nhc u

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