Y HOC VIET NAM THANG 2 - SO 2/2014

DAC DIEM PHAN UNG BIODOSE VA COPROPOPHYRIN NIEU

C O A CONG NHAN XANG DAU T I N H H A NAM

Tran "Van Tuan*

T O M TAT
Nghien cffu de cap den anh hi/dng ciia tdi sffc
khoe ngUdi lao dong trUc tiep tiep xuc vdi xang dau tai
Ha Nam, Doi tu'dng la 252 cdng nhan tru'c tiep lam
viec tai kho xang dau va cac cffa hang ban xang dau.
Qua nghien cffu thay ty le cdng nhan co ket qua
biodose du'dng tinh (< 3 phut) la 9,5 %. NhUng tfnh
rieng thi ty le nay d khdi kho 135 cao hdn khoi cffa
hang (15,5 % /4,4 %) vdi p < 0,05. Neu tfnh theo tuoi
nghe thi d nhom cd thdi gian cong tac lau nSm cd so
ngUdi cd Biodose dUtfng tinh cao hdn. Tu'dng tu', ket
qua do Co-propophyrin nieu d khdi kho cd ty le du'dng
tfnh cao hOn khdi cffa hang, sd nay cung tang theo
tudi nghe (vdi p < 0,05). Sff khac biet khong cd y
nghia d nam va nff.
SUMMARY
THE CHARACTERISTICS OF THE BIODOSE
AND URINARY COPROPOPHYRIN
RESPONSE OF GASOLINE WORKER
I N HA NAM PROVINCE
The study refers to the influence of petrol-run
health workers directly exposed. The Subjects were
252 directed workers worked at petroleum storages
and filling stations. The results showed that the
percentage of workers with positive biodose (< 3
minutes) was 9.5%. But alone, this rate is higher than
in 135 petroleum storage when compared with gas
station worker (15.5% / 4.4%) with p <0.05. If
seniority is calculated at the time, the work perennial
group had posibve Biodose higher number. Similarly,
the measurement of Co-propophyrin urinary volume
results in petroleum storage positive rate also higher in
compare with the stations, these also increased with
age (p <0.05). The difference is not significant in
males and females.
Keywords: petroleum, biodose, Co-propophyrin
unnary, health worker

I. DAT VAN D 1
Xang dau la nguon nang Iffdng da dffpc con
ngffdi biet den va dffa vao sff dung phuc vu ddi
sdng tff lau nhffng phai den the ky XV-XVI ngffdi
ta mdi phat hien ra nhffng tac hai cd ban cua

* Hpc vien Quan Y

Phan bign khoa hgc: PGS. TS Le Van Bao

chiing len sffc khoe con ngffdi, gay ra nhffng bien

ddi cap ti'nh va man tfnh khac nhau.
Xang dau co chffa nhieu hoa chat cd kha
nang tac ddng gay nen cac roi loan benh ly, dac
biet la cac chat chffa Iffu huynh, cacbuahydro,
benzen...[2]. Hien nay cd nhieu loai xang dau,
thanh phan hoa hpc ciia xang dau phu thupc vao
tffng md dau va cac san pham trffng cat ciia
chiing. Tuy nhien chung deu cd net chung la
chffa cac hpp chat loai Hydrocacbon chiem thanh
phan chii yeu (97% - 98%), trong dd Cacbon
chiem ty le 85 - 87%, Hydro chiem 11 - 14%,
ngoai ra cdn cd Lffu huynh (S), Nitd (N) va Oxy
(O2). Trong dau md chffa it Iffu huynh ham Iffdng
chi chffa dffdi 1%, dau mo co nhieu Iffu huynh thi
ham Iffdng co the chiem tdi 2 -5%. Ngoai cac
chat tren trong dau md con chffa cac hdp chat cO
kim, cac chat nhffa va asphal [5].
Xang dau cd the gay nen cac benh dffdng ho
hap nhff viem phoi xang, viem mui hpng do hft
phai cac tap chat va hdi xang dau....[2],
0 Viet Nam trong nhffng nam gan day, viec
san xuat va kinh doanh xang dau da phat trien
manh me theo cd che thj trffdng. Xang dau ngay
cang dffdc sff dung rpng rai trong nhieu nganh
kinh te qudc dan, cac nganh san xuat cdng
nghiep, giao thdng van tai, tong hdp hoa
chat....Trong ddi sdng sinh hoat ciia mpi tSng Idp
nhan dan, xang dau la nguon nhien lieu dac biet
quan trpng ddi vdi cac phffdng tien giao thdng,
van tai, cac loai may mdc sff dyng trong ndng
nghiep va thii cdng nghiep, chat dot va bao
dffdng cac vat dung trong gia dinh. Chi'nh vi vay
ma cac nguy cd ve mdi trffdng lao dpng, hdi
xang dau ddi vdi sffc khoe ngffdi tiep xiic ngay
cang gia tang.
Tai Viet Nam noi chung. Ha Nam ndi rieng,
sd Iffdng cac cff^a hang ban xang dau ngay cang
tang de dap ffng vdi nhu cau phat trien kinh t l
xa hpi. Cung vi vay sd ngffdi tiep xuc vdi xSng
dau ngay cang tang. Vi vay chiing toi thffc hien
nghien cffu nay vdi myc dich: "Oanh gia d k
diem ve phan ffng biodose va Coporphyrin nieu
ciia cong nhan chi nhanh xang dau - Ha Nam"

Y HQC VIET NAM THANG 2 - SO 2/2014

II. DOI TU'ONG VA PHLTOfNG PHAP NGHIEN CUU
Thdi gian nghien cihi: nam 2012
2 . 1 . B o i tu'dng n g h i e n cu'u:
Nghien cffu du'dc tien hanh tren toan bd 252
can bp cdng nhan trffc tiep tiep xiic vdi xang dau
ciia chi nhanh xang dau Ha Nam, dffdc chia ra
cac nhdm nghe sau:
- Can bp cdng nhan ban le xang dau (khdi
CH): 136 cdng nhan
- Can bd cdng nhan van hanh kho xang dau
(kh6iK135): 116 cdng nhan
2.2. Phu'dng p h a p n g h i e n cu'u:
Ap dyng phffdng phap nghien cffu md ta, cat
ngang cd phan tich
Ky thuat do: Viec do Biodose dffdc do bang
may do lieu sinh hpc Y(t)0-03-250H ciia Nga. Ap
dung theo thffdng quy ky thuat ve y hpc lao
ddng va ve sinh mdi trffdng ciia Vien Y hpc lao
dpng va Ve sinh mdi trffdng, Bd y te (2002) [3].
Oanh gia ket qua: Phan ffng tren da xuat
hien dat dd sau 6-8 gid, dpc ket qua sau 24-48
gid, lieu sinh hpc d cffa so nao cd mau dd hdng
in dii gdc canh hinh chff nhat ciia cffa sd thffdc
do thi dffdc ghi nhan dpc de danh gia ket qua.

Cach tinh nhu" sau:

Cffa sd'sd 1: 6 phut;
Cffa so sd 2; 5 phut;
Cffa so sd 3: 4 phiit;
Cffa sd sd 4: 3 phut;
Cffa so so 5; 2 phut;
Cffa sd sd 6: 1 phiit [vien],
Chi so Biodose dffpc coi ta dffdng tinh khi
thdi gian < 3 phut va am tfnh khi thdi gian > 3
phut.
- Chi tieu Coproporphyrin nieu.
Ap dung theo thffdng quy ky thuat ve y hpc
lao ddng va ve sinh mdi trffdng ciia Vien Y hoc iao
ddng va Ve sinh mdi trffdng, Bd y te (2002) [3]
Nguyen tac; Chiet xuat Coproporphyrin trong
nffdc tieu bang ete d mdi trffdng acid acetic. Sau
dd chuyen Coproporphyrin thanh dang mudi
chlohydrat, cd quang pho hap thu rieng. Nong dp
Coproporphyrin dffdc xac dinh khi do quang.
Nhan dinh ket qua:
Nhffng ngffdi cd nong dp Coproporphyrin
nieu >34,94 pg/24h du'dc gpi la nhffng ngffdi cd
ndng dd Coproporphyrin nieu dffdng tinh [3]

III. KETQUA NGHIEN c C r u

Ket qua do phan ffng biodose ciia cdng nhan
Ket qua do phan ffng Biodose ciia cdng nhan iSiXOc trinh bay trong bang sau:
Bang 1: Phan ffng biodose ciia cdng nhan khoi cffa hang va kho K135

Biodose
Du'(Jnq tinh
Am ti'nh
Tonq

Khoi cira hang (n=136J

So [tfdng
Tyle
6
4,4
130
95,6
136
100

Khoi kho 135 (n= 116)

So lu'dnq
Tyle
18
15,5
98
84,5
116
100

P
<0,05

Qua bang tren thiy ty li cong nhan chi nhanh xang dau Ha Nam cd kit qua biodose d&dng tfnh (< 3
phut) la 9,5 %. Nhuhg tinh riing thi ty li nay d khdi kho 135 cao hdn khdi c&a hang (15,5 % /^,'^ %)
S& chenh lech nay cd y nghia thdng ki vdi p < 0,05%.
Ket qua phan ffng biodose cua cdng nhan theo tudi nghe dffdc trinh bay trong bang sau:
Bang 2: Ket qua phan ffng Biodose ciia cdng nhan theo tudi nghe

"
^-______^ Biodose
NSm cong t^c
"-__
< 5 nam (n=69)
5 - 1 0 nam (n=66)
11 - 15 nam (n=60)
16-20 nam (n=28)
> 20 nam (n=29)
Tong

< 3 phut

> 3 phut

p (ANNOVA)

3
2
6
6
7
24

66
64
54
22
22
228

<0,05

Qua bang tren thiy ty li cdng nhan cd kit qua phan ting biodose d&dng tinh cd xu hu'dng tang dan
theo thdi gian cong tac vdi p < 0,05

Y HOC VIET NAM THANG 2 - SO 2/2014

Ket qua phan ffng biodose theo gidi dffdc trinh bay trong hinh sau:
Hinh 1: Ty le (%) cd phan ffng Biodose (+/-) giffa nam va nff

Kit qua hinh 1 cho thay: Ty le cdng nhan cd kit qua phan dng biodose (+) d nam cao hdn nu: Nhuhg
s&khac biit nay ch&a cd y nghia thong ke (p>0,05)
Ket qua Coproporphyrin nieu (Co-N):
Cac ket qua do Co-N ciia cdng nhan dffdc trinh bay trong cac bang sau:
gafffir J/Ketqua do Co-N cua cdng nhan
Khoi CL^a hang (n=136] Khoi l<ho (n=116)
P
Co-N
n
n
Du'dnq tfnh
36
26.5
49
42.2
<0.05
Am tinh
100
73.5
57.8
67
Tong
136
100
116
100
Qua bang trin thiy: ty li cong nhan co kit qua Co-N d&dng tfnh (> 34,94 pg/24h) ia 33,7 %. Tyle
Co-N d&dng tfnh d khoi kho cao hdn khdi c&a hang vdi p < 0,05.

Bang 4^; Ket qua Co-N ciia cong nhan theo tudi nghe
7 ~ - - _ _ _ ^ Co-N Du'<jng tinh
Am tinh
P
Tuoi nghe ^^^ - - . _
< 5 nam (n=69)
13
56
5 - 1 0 nam(n=66)
20
46
ll-15nam(n=60)
20
40
<0,05
16-20 nam (n=28)
13
15
> 20 nam (n=29)
19
10
To'ng
85
167
Kit qua tren thay ty le cong nhan co ket qua Co-N difang tinh co xu hu'dng tang dan theo thc/i gian
cong tac (vdi p < 0,05).

Bang 5: Ket qua Co-N theo gidi tinh

~~~----^^ Gidi
Nam
NO'
P
Co-N^~~~~-^
SolUdnq
SS lu'dnq
Tyle
Tyle
19
Du'dnq tinh
66
36.9
26.0
>0.05
Am tinh
54
113
63.1
74.0
73
Tong so
179
100
100
Kit qua trin cho thiy ty le cd Co-N d&dng tinh d nam cd xu h&dng cao hdn n& nhung ch&a co siT
khac biit (p > 0,05).

Y HOC VIST NAM THANG 2 - SO 2/2014

IV. BAN LUAN
Vdi cdng nhan tiep xuc vdi xang dau, mot
trong nhffng benh du'dc tat ca cac nha nghien
ciJu ve y hpc lao dpng thong nhat la cd the dan
den benh xam da nghe nghiep. Theo thdng tff sd
12 ciia Bd y te nam 2006, de chan doan benh
xam da nghe nghiep thi bat budc phai do lieu
sinh hpc (Biodose) [1]. Nam 1975, My chfnh thffc
phe chuan quyet dinh cat giam ham Iffpng chi
tetra-ethyl trong xang, va den nam 1986 cam
hoan toan viec sff dung xang pha chi. 6 chau Au,
xang pha chi bj cam sff dyng vao nhffng nam
1990. Cdn d Viet Nam, ngay 1/11/2001, Thii
tffdng cting da ra quyet dinh cam sff dung xang
pha chi tren pham vi toan qudc. Nhieu cdng trinh
nghien cffu cdn cho biet cd nhieu trffdng hPp bj
ngd ddc chi do tiep xuc vdi xang dau [6].
Benh xam da nghe nghiep kha pho bien va
de nhan biet. Benh khdng gay chet ngffdi cap
tinh nhffng lam sffc khde suy giam, nang suat lao
dpng giam. Benh thffdng phat d nhffng vimg da
hd nhff tay, cd, mat rat mat my quan dac biet la
cac nam, nff thanh nien. Benh thffdng gap khi
tiep xuc vdi xang, dau, benzen, parafin, luyen
coc.Sff thay ddi sac to da chfnh la nguyen nhan
dan den xam da d ngffdi benh [4J[2].
Trong nghien cffu nay, chiing tdi thay ty le
cong nhan cd phan ffng biodose ( + ) la 9,5 %.
Khoi kho 135 cd ty le ( + ) cao hdn - 15,5 % so
vdi khoi cffa hang - 4,4 % vdi p < 0,05.
Ngoai phan ffng Biodose, chiing tdi cdn tien
iianh kiem tra Co-N ciia cdng nhan. Ket qua cho
thay ty le cd Co-N ( + ) la 33,7 % trong dd khdi
kho 135 la 42,2 %, cao hdn khoi cffa hang - 26,5
% vdi p < 0,05. Dieu nay cung phii hdp vdi thffc
trang tiep xiic vdi mdi trffdng lao ddng ciia cdng
nhan khoi kho 135 va khoi cffa hang. Khi kiem tra
hcfi x3ng trong mdi trffdng lao dpng cho thay khoi
kho cd 8/12 mau vffdt TCCP, trong khi khoi cifa
hang la 3/12 mau. Khi xac djnh tudi nghe chung
toi cung thay khoi cifa hang nhdm cd tuoi nghe >
S nSm chiem 5 9 % trong khi khdi kho la 88,9%.

Chfnh nhffng yeu to dd dan den cdng nhan

kho cd b/ ie phan ffng Biodose va Co-N (+)
hdn khdi cffa hang. Ty le nay tang dan theo
gian cdng tac. Dieu nay cho thay anh hu'dng
hdi xang dau tdi sffc khde ngffdi lao ddng.

khdi
cao
thdi
cua

V . KET LUAN
Lao dong trong mdi trffdng phai tiep xuc vdi
hdi xang dau da tac dpng nhat dinh den sffc
khde cdng nhan. Ty le cdng nhan co phan ffc
biodose ( + ) d khdi kho la 15,5 % cao hdn khdi
cffa hang - 4,4 % (p < 0,05). Tudi nghe cang
cao thi sd ngffdi cd biodose ( + ) cang Idn. Dien
bien Co-N ciia cdng nhan cd ket qua tffdng tff;
khdi kho cd Co-N ( + ) cao hPn khdi cffa hang, so
nay cung tang theo tuoi nghe.
TAI LIEU T H A M KHAO
1. Bp y te (2006). Thong tU so 12 ve hUdng dan
kham benh nghe nghiep so 12/2005/TT- BYT cua
Bp tru'dng Bo y te.
2. Le Trung (2000). Benh nghe nghiep, NXB y hpc
Ha Noi 2000, 809 tr
3. Vien Y hoc lao dpng va ve sinh mdi tru'dng
(2002), Thudng quy ky thuat y hpc lao dpng, ve
smh mdi tru'dng, s&c khe tru'dng hpc, Nha xuat
ban y hpc.
4. Jumpponen
M, RonkkomSki
H, Pasanen
P, Laitinen 3 (2013). Occupational exposure to
solid chemical agents in biomass-fired power
plants
and
associated
health
effects.
Chemosphere. 2013
Nov
27. pii: S00456535(13)01425-2.
5. Li PH, Kong SF, Geng CM, Han B, Lu B, Sun
RF, Zhao RJ, Bai ZP (2013). Health nsk
assessment for vehicle inspection workers
exposed
to
airborne
polycyclic
aromatic
hydrocarbons (PAHs) in their work place. Environ
Sci Process Impacts. 2013 Mar;15(3):623-32.
6. Tunsaringkarn T, Sinwong W, Rungsiyothin
A, Nopparatbundit
S
(2012).
Occupational exposure of gasoline station workers
to BTEX compounds in Bangkok, Thailand, Int J
Occup Environ Med. 2012 Jul;3(3):117-25.