五氯酚甲状腺干扰效应的环境流行病学研究

Pentachlorophenol (PCP) has been widely used as molluskacide for controlling the spread of schistosome in the schistosomiasis epidemic areas of China. Due to the potential adverse effects on human, environment and ecology, China has banned the application of PCP. Similar to the trends of PCP in various environment media and human bodies in the world, the domestic environment and human burden of PCP is in the low environment levels. However, the re-emergence of schistosomiasis and the needs of cleaning fish ponds in the aquatic farming areas induce the wide use of PCP with no warrant in recent years. Therefore, the adverse health effects from exposure to PCP should be concerned again. The latest studies show that the risk of thyroid disrupting effects in the population exposed to environmental PCP should not be negligible. Thyroid hormones play critical roles in metabolism of human bodies and in growth and development of children. Therefore, this is the significant public health issue, relevant to the national strategy for population's development, which need be revealed based on the environmental epidemiology on relevant large scale. Therefore, in this study, we will conduct research of environmental epidemiology with relevant large scale in the PCP high exposure, low exposure and control areas. The occurrence of PCP in local environment and human bodies will be investigated and the thyroid functions of population will be tested. The real relationship between environmental exposure to PCP and thyroid disrupting effects will be revealed, based on analyzing potential impacts of bias factors of iodine intake, age and gender disparities.

我国曾大范围使用PCP作为灭螺剂用于控制血吸虫在疫区的流行传播。但因其对于人体、环境以及生态的潜在危害，已对其禁限使用。与PCP在全球环境与人体中消长趋势相似，我国PCP环境与人体负荷也处于低环境暴露水平。由于血吸虫复燃以及水产养殖产业地区清塘需要，致近年来大范围违禁使用PCP，需重新关注PCP环境暴露对于人体的健康危害。最新研究提示，环境暴露PCP致人群甲状腺干扰效应风险不容忽视。甲状腺素在人体的新陈代谢、儿童的生长发育中的作用至关重要，此攸关国家人口发展战略的重大公共卫生问题亟待开展较大规模的人群流行病学研究予以揭示。基于此，本研究将在PCP使用污染的高暴露区、低暴露区以及对照区开展较大规模的环境流行病学研究，分析PCP在当地环境介质以及人体中的分布情况，同时检测人群甲状腺功能状况，在分析摄碘、年龄、性别差异等潜在混杂因素影响下，从而揭示PCP环境暴露与甲状腺干扰效应的真实关系。

环境暴露五氯酚 致人群甲状腺干扰效应风险不容忽视。甲状腺素在人体的新陈代谢、儿童的生长发育中的作用至关重要，此攸关国家人口发展战略的重大公共卫生问题亟待开展人群流行病学研究予以揭示。本研究建立了人体血清五氯酚检测方法，评估了研究现场人群五氯酚的内暴露水平，同时检测了人群甲状腺功能状况和甲状腺疾病情况，在分析年龄、性别、摄碘（尿碘）等因素对人群甲状腺功能和甲状腺疾病影响下，探索了五氯酚暴露与人群甲状腺干扰效应的关系。研究结果表明，调查地区人群血清五氯酚暴露处于纳克水平。性别、年龄、职业这三种因素对患甲状腺结节影响比较显著。人群五氯酚内暴露水平与游离T4水平呈负相关关系（P<0.05），提示纳克水平的五氯酚内暴露水平即可干扰体内的甲状腺激素水平，干扰甲状腺功能。