摘要：Ba c k g r o u n d: A considerable part of the worldwide production of surgical instruments takes place in Sialkot, Pakistan. Many children work in hazardous conditions in this industry.oB j e c t i v e: We investigated exposure to metals and possible health effects among children working in surgical instruments manufacturing units compared with schoolchildren from the same city.Me t h o d s: In a cross-sectional study we studied a convenience sample of 104 male children (10–14 years of age) working in surgical instruments manufacturing units and 75 male children of similar age from a school in Sialkot, Pakistan. A respiratory questionnaire was administered, spirometry was performed, and blood pressure was measured. In a spot urine sample, concentra-tions of metals were measured by inductively coupled plasma mass spectrometry and 8-hydroxyde-oxyguanosine (8OHdG, reflecting oxidative DNA damage) by ELISA.re s u l t s: The working children reported more asthma (10% vs. 0%; p = 0.005) and dry cough at night (36% vs. 20%; p = 0.02) than did the schoolchildren, but there were no significant differ-ences in pulmonary function or blood pressure. The urinary concentration of chromium was 35 times higher in working children [geometric mean, 23.0 μg/L; 25th–75th percentile, 8.38–58.6] than in schoolchildren [0.66 μg/L; 0.38–1.09)], and largely in excess of the occupational Biological Exposure Index for adult workers (25 μg/L). Urinary 8-OHdG concentrations were not significantly higher in working children than in schoolchildren (19.3 vs. 17.6 μg/g creatinine, p = 0.4), but were significantly correlated with urinary nickel (r = 0.41; p < 0.0001) and with a composite index of metal exposure (r = 0.46; p < 0.0001).co n c l u s i o n s: Children working in the surgical instruments manufacturing industry had substan-tial exposure to several metals, especially chromium and nickel, which are established carcinogens. Exposure to nickel was associated with evidence of increased oxidative DNA damage
关键词：metal exposure; nickel; oxidative DNA damage; Pakistan; Sialkot; surgical instru-;ments
