TRNH TH THANH

C HC, MI TRNGV SC KHE CON NGI (In ln th 3) I HC KHOA HC THI NGUYN KHOA KHOA HC T NHIN V X HI TH VIN

NH XUT BN I HC QUC GIA H NI 1

Chu trch nhim xut bn

Gim c : Nhn xt:

PHNG QUC BO

Tng bin tp: NGUYN THIN GIP GS TS O NGC PHONG PGS. TS BI LAI PGS.TS NGUYN QUC KHANG Bin tp v sa bi: Trnh by ba: TS LNG LNG NGC ANH LAN HNG

C HC MI TRNG V SC KHE CON NGI M s:01.89.H.2003 In 1000 cun ti nh Xut Bn i Hc Quc Gia H Ni S xut bn:182/27/CXB. S trch ngang 118 KH/XB In xong np lu chuyn vo qu II nm 2003 2

Preface The textbook on "Toxicology and environmental health" has been established in the framework of the prDject "Capacity building for environmental management in Vietnam". The educational component of the proect targets the Master programme, organised by the Faculty of Environmental Sciences at the Hanoi University of Science, Vietnam National University. A specific project objective was to dev.elop reference materials for the students. The result is five textbooks, including this one, wltich have been published with the Vetnam National University Publishing House, whse co- operation enabled 750 copies to be published, instead of the original target of 250 copies. Peer review is crucial for quality control and has been a structural component of the textbook development. The main obiective of the peer review process was to generate comments and detailed suggestions to improve the manuscripts. Dr. Trinh Thi Thanh completed a draft textbook in January 1999. In March 1999, the Hanoi University of Science organised a review workshop, in which twenty-seven academics participated. The review was based on the following main criteria, set by the ~university: l) scientific quality; 2) up-to- dateness; 3) pedagogical quality. In addition, an extnsive external peer review was completed, including scientists from universities and research institutes in Hanoi and Ho Chi Minh City A final review was organised by the publishing house. The authors have adapted their manuscripts according to the comments expressed. Acknowledgments On bhalf of the Project Advsory Committee, we would like to congrat'ulate the author, Dr. TRN TH THANH of the Faculty of Envirnmental Sciences, fur successfully completing the 3

development of this textbook. We take the aportunity kindly thank Prof Dao Ngoc Phong, Hanoi University of Medicine, Ass. Prof Bui Lai, Institute of Tropical Biology at the National Centre for Natural Science and Technology in Ho Chi Minh city and Ass. Prof Nguyen Quoc Khang, Faculty of Biology, Hanoi Umversity of Science, Vietnam National Umversity, for their active participation in the peer review process. Also, we acknowledge the constructive co-operation of the Vietnam National University Publishing Hou8e. inally, we express our sincerest gratitude to the European Commis81on for funing the project on "Capacity building for environmental management in Vietnam" and enabling th development and publication of the textbook on "Toxicology and environmental health". The editors, Prof. Mai Dinh Yen, Faculty of Biology, Hanoi University of Science, Vietnam National University Prof. Luc Hens, Department of Human Ecology, Free University of Brussels (VUB) Mr. Eddy Nierynck, Deparllent of Human Ecology, Free University of Brussels (VUB)

Li gii thiu
Cun sch "c hc Mi trng v Sc khe con ngi" c bin son trong khun kh ca n:. "Xy dng Nng lc Qun l mi trng Vit Nam. Mc tiu o to ca n l chng trnh o to Thc s do Khoa hc mi trng Trng i hc Khoa hc T nhin. i hc Quc gia H Ni thc hin. Mc tiu c bit ca n l tng cng cung cp cc ti liu tham kho cho sinh vin. Kt qu l 5 cun sch gio trnh c Nh xut bn i hc quc gia H Ni xut bn v c th in c 750 cun thay v nhim v lc u l 250 cun. Cng vic nhn xt nh gi l quan trng cho cht lng cun sch c ch trong sut qu trnh bin son. Mc ch chnh ca cng vic ny l phn bin v ng gp cc kin nhm nng cao cht lng cc bn tho. Sau khi TS Trnh Th Thanh hon thnh bn tho vo thng 1 nm 1999, thng 3 nm 1999, Trng i hc Khoa hc T nhin i hc Quc gia H Ni t chc Hi tho nh gi nghim thu vi s tham d ca 27 nh khoa hc Mi trng. Vic nh gi nghim thu cn c vo 3 tiu chun chnh ca sch gio trnh m Trng ra l:1) Tnh khoa hc; 2) Tnh cp nht hin ti v ;3) Tnh s phm. Ngoi ra, cun sch cn c s tham gia nhn xt nh gi ca cc nh khoa hc Trng i hc v Vin nghin cu thnh ph H Ch Minh. c bit Nh xut bn i hc Quc gia H Ni trc tip tham gia sa cha bn tho mt cch cng phu cun sch c hon thin hn. Thay mt hi ng c vn ca n, chng ti xin chc mng tc gi TS Trnh Th Thanh - Khoa Mi trng hon thnh c kt qu cun sch. Nhn dp ny chng ti cng xin by t li cm n chn thnh ti GS o Ngc Phong - Trng i hc Y khoa H Ni, PGS Bi Lai - Vin Sinh hc Nhit i Trung tm Khoa hc T nhin v cng ngh Quc gia Thnh 5

ph H Ch Minh, PGS Nguyn Quc Khang, Khoa Sinh hc Trng i hc Khoa hc T nhin H Ni tch cc tham gia vo qu trnh nhn xt nh gi cho ni dung ca cun sch. Chng ti cng xin cm n v s hp tc xy dng ca Nh xut bn i hc Quc gia H Ni. Sau cng chng ti xin by t s cm n chn thnh ti Hi ng chu u ti tr ngn sch cho n "Xy dng Nng lc Qun l Mi trng Vit Nam" cun sch "c hc v Sc khe con ngi"c bin son v xut bn. Cc bin tp: GS Mai nh Yn - Khoa Sinh hc, Trng i hc Khoa hc T Nhin, i hc Quc gia H Ni. GS Lc Hens - B mn Sinh thi Nhn vn Trng i hc T do Brussels, Vng quc B (VUB). Eddy Nierynck - B mn Sinh thi Nhn vn trng i hc T do Brussels, Vng quc B (VUB).

CC CH VIT TT DNG TRONG CUN SCH ADI Lng tip nhn hng ngy c th chp nhn c EPA Hi bo v mi trng M. LD50 lng c cht gy t vong 50% ng vt th nghim. IARC C quan nghin cu ung th quc t JECFA U ban chuyn vin IAO/WHO v ph gia thc phm JMPR Hi ngh lin hp FAO/WHO v d lng ha cht bo v thc vt FEL Nng trc tip gy hi LOAEL Mc thp nht c ghi nhn l c nh hng bt li NOAEL Mc c ghi nhn l khng gy nh hng bt li no PTWI Lng tip nhn hng tun c th chu ng c TDI Lng tip nhn hng ngy c th chu ng c TLm Mc c cht gy t vong 50% s lng c th sinh vt th nghim trong khong thi gian nht nh RfD Liu lng nn (liu lng c tnh con ngi tip xc trong mt ngy m khng xy ra mt nguy c no i vi sc khe trong sut c i) UF Ch s khng chc chn MF Ch s bin i

Li ni u

Cc cht nhim gy ra nhng tc ng lm suy thoi cht lng mi trng trong c mi trng sng ca con ngi. Cc loi c cht l, ha v sinh hc t cc ngun nhim khc nhau gy nh hng xu cho mi trng v sc kho con ngi. y cng chnh l mt trong nhng vn trng tm c lnh vc mi trng quan tm v gii quyt. c bin php kim sot, qun l tt vn trn. Cn thit phi c s o to c bn v lnh vc ny. V vy Gio Trnh c Hc. Mi ngi v Sc kho con ngi c bin son nhm mc ch o to hc vin v.v..v.. C ch xm nhp cc c cht vo c th con ngi thng qua cc con ng hp th, phn b v o thi. Lin kt cc kin thc v thc t mi trng (Ngun, tnh cht v.v... cc loi c cht) vi cc kin thc khoa hc c lin quanv c hc. Cc nguyn tc c bn xy dng, t k cc nghin cu v c hc, mi trng v sc kho con ngi.

Ni dung ca gio trnh c th hin qua 6 chng: Chng 1 - Mt s khi nim v c hc, mi trng v sc kho con ngi. Chng 2 - Cc dng c cht Chng 3 - S hp th, phn b v o thi Chng 4 - Cc yu t nh hng n c tnh 8

Chng 5 nh gi an ton Chng 6 - nh gi nguy c ca c cht Chng 7 - nh hng ca mt scht nguy hi ti sc kho con ngi. Tc gi xin chn thnh cm n GS. Lusc Hens, GS. Mai nh Yn, GS. o Ngc Phong c nhng ng gp qu bu v chuyn mn cho gio trnh. Trong qu trnh bin son, chc chn s khng trnh khi thiu st, tc gi rt mong nhn c kin ng gp ca bn c. TRNH TH THANH

Chng I. MT S KHI NIM, C BN V C HC, MI TRNG V SC KHE CON NGI

1.1. NH NGHA C HC, C HC, MI TRNG V SC KHE CON NGI c hc-mn khoa hc nghin cu nh tnh v nh lng tc hi ca cc tc nhn ha hc, l hc, sinh hc i vi mt c th sng. c hc cng c th c nh ngha nh l "mn khoa hc xc nh gii hn an ton ca nhng tc nhn ha hc". c hc l mn khoa hc ca cc c cht mang tnh khoa hc c bn v ng dng. Tm li c th hiu: c hc l mn khoa hc nghin cu nhng mi nguy him ang xy ra hay s xy ra ca cc c cht ln c th sng c hc, mi trng v sc kho con ngi (hay cn gi l c hc mi trng) - Mn khoa hc nghin cu v nh hng ca mi trng b nhim bi cc c cht ln sc kho cng ng. Mc d cc mn khoa hc trn c lin quan cht ch vi nhau, song mc ch,i tng, phng php nghin cu c th ca chng th li c s khc nhau, v d: Mc ch ca mn c hc l bo v sc kho con ngi trong cng ng c th. Mc ch chnh ca mn c hc, mi trng v sc kho con ngi khng phi ch bo v nhng c th m cn 10

bo tn cu trc v chc nng ca cc h sinh thi. Bn cnh , c hc, mi trng v sc khe con ngi cn c mc ch nghin cu thit lp tiu chun mi trng. nh gi v suy on nng ca cc c nhn trong mi trng. nh gi ri ro cho nhng qun th sinh vt trong thin nhin (k c qun th loi ngi) trong nhng iu kin b tip xc vi cc cht gy nhim mi trng. 1.2. MT S KHI NIM V NGUYN TC C BN Cht nguy hi (c cht) Cht nguy hi l cht khi xm nhp vo c th gy nn cc bin i sinh l, sinh ha, ph v cn bng sinh hc, gy ri lon chc nng sng bnh thng, dn ti trng thi bnh l cua cc c quan ni tng, cc h thng (tiu ha, tun hon. thn kinh...) hoc ton b c th. Theo Quy ch qun l cht thi nguy hi ca Chnh ph Vit Nam (ban hnh 7/1999) quy nh: Cht thi nguy hi l nhng cht thi c cha cc cht hoc hp cht c mt trong cc c tnh gy nguy hi trc tip (d chy, d n, lm ng c, d n mn, d ly nhim v cc c tnh gy nguy hi khc) hoc tng tc vi cc cht khc g nguy hi ti mi trng v sc kho con ngi. Cht nguy hi c trong mi trng lao d c th lin quan ti mt loi ngh nghip no gi l c cht ngh nghip, cn bnh do c cht gy ra gi l bnh ngh nghip. Cht nguy hi ph thuc vo nhiu yu t trong c liu lng hay nng ca cht. Liu lng l n v c kh nng phn ng ca cht ha hc, l hc hay sinh hc. Lllng c th l khi lng trn th trng (mg, g, ml/ trng lng c th) hoc l khi lng trn n v b mt tip xc ca c th (mg, g, ml/ din tch da). Nng trong khng kh c th c biu din nh n v trng lng hay khi lng trn mt th tch khng kh nh ppm (mg/ha khng kh). Nng trong nc c th biu din bng n V khi lng/ lt nc (mg/l = ppm hay g/l = ppb). 11

Cc tc hi mc nh c th phc hi, cn mc nng trm trng i khi khng th khc phc c. V d, sng phi hay thay i ha tnh ca huyt thanh mc nh th c kh nng cha c, nhng ung th th rt nng v kh c th cha khi. Nhng thay i bt li mc nh bao gm nh thay i tiu ha thc n, tng trng lng c th, thay i hot tnh enzym v.v... Cc tc ng nng bao gm nhng thay i cu trc, chc nng ca m lm cho cc chc nng bnh thng b thay i c th dn ti t vong. Cc dng tc nhn c hi tim tng bao gm cc tc nhn ha hc (t nhin, tng hp, hu c hay v c), vt l (sng in t, vi sng) v sinh hc (cc- c cht vi nm, thc v ng vt). Cc tc nhn ha hc, l hc c th gy ra nhng tc ng c hi bng vic thay i s thng nht, cu trc, chc nng ca m cng nh lm thay i qu trnh sinh trng, pht trin,. . . Cc tc hi c th khc phc c hoc i khi khng th khc phc dn n t vong. p ng l phn ng ca ton b c th hay ca mt hoc vi b phn ca c th sinh vt i vi cht kch thch (cht gy p ng). Cht kch thch c th c rt nhiu dng, v cng ca p ng thng l hm s ca cng cht kch thch. Cht kch thch cng nhiu th cng p ng xong c th xy ra cng ln. Khi cht kch thch l ha cht, th p ng thng l hm s ca liu lng v mi quan h ny c gi l mi quan h liu lng - p ng. Nhng p ng i vi cc tc nhn ha hay l hc c th xy ra ngay lp tc hoc xy ra mun hn; c th nh, nng; phc hi hoc khng phc hi; trc tip hoc gin tip; c th c li hoc bt li (c hi). Cc p ng i vi cc tc nhn ph thuc vo iu kin tip xc nh thi gian, liu lng tip xc v.v 12

Cc p ng ti ch xut hin ti ng im tip xc gia c th v cht gy kch thch. p ng d ng hay mn cm l phn ng c hi lin quan n h thng min dch. p ng l phn ng bt bnh thng hay khng u n, c th lin quan n h thng min dch hoc c th gy ra nhng s thay i v en ti nhng im lng ng ha cht. Cc yu t c th nh hng n kt qu ca s tng tc gia cc tc nhn ha hc v l hc bao gm liu lng, c tnh ha, l ca tc nhn, thi gian tip xc vi tc nhn v tnh trng sc kho ca c th ti thi im tip xc. Liu lng ph hp ca dc phm c th c tc dng cha c bnh. Tc nhn ha hc hay vt l thng kt hp vi nhau m, cc c quan tip nhn. C quan tip nhn c th coi l cc, bn nh v ca ha cht". Khi tc nhn ha hc to ra p ng khng lin quan n mt c quan tip nhn ring bit no, phn ng gi l p ng khng c trng. C quan tip nhn l im nhy cm hay im p ng, nm ti t bo i tng m cc tc nhn vt l v ha hc cng tc ng ln. C quan tip nhn c th c trng cho tc nhn ha hc hay mt nhm cc ha cht. Khi liu lng ha cht tng, lng ha cht nhim vo cc c quan tip nhn c th cng tng theo. Khi s lng cc phc ha cht - c quan tip nhn tng th p ng ca c th tng t l thun vi hm lng tip xc cho n khi khng cn mt c quan tip nhn nao cn t do tip nhn na v..s n nh c thit lp. Mc p ng ca c th t l trc tip vi s lng c quan tip nhn c gn vi ha cht. Ha cht gn vi c quan tip xc c th l lin kt ha tr, lin kt tn, hydrogen hay lc Van d Waals. Bn cht ca s lin kt s nh hng n thi gian ca phc ha cht - c quan tip nhn v thi gian ca tc ng to ra. Lin kt ha tr thng l khng phc hi c cn lin kt tn, hyrogen, Van d Waals thng l phc hi c. 13

 c quan tip nhn c th gy ra c phn ng, trc ht n phi gn vi ha cht. Lin kt ny thng khng phi l lin kt ha tr v c th phc hi c. Tip theo, cc c quan tip nhn phi c kch hot v qu trnh ny c gi l ',chuyn ha tn hiu', qu trnh ny xc nh hot ng ni lc Sau l hng lot cc hin tng v cui cng l to ra s p ng ca c th. Qu trnh ny gi l qu trnh lin kt gia c quan tip nhn - p ng. S lun chuyn ca ha cht xy ra bn ngoi v bn trong c th sng. S lun chuyn ngoi c th lin quan n cc tc nhn mi trng nh cc iu kin kh hu v c tnh ha, l ca ha cht, k c tan nu nh ha cht tm thy trong mi trng nc. S khuch i sinh hc c th cng xut hin. V d: Metyl thy ngn tham gia vo dy truyn thc phm thng qua sinh vt ph du v khuch i o tch ng c vi nng ln gp khong loa ln hoc hn so vi lc u (hnh 1).

Hnh 1. S lan truyn thy ngn theo mt xch thc n Cc con ng tip xc gia ha cht vi c th ng vt v con ngi: qua ng tiu ha, h hp, tip xc qua da v.v 14

S lu chuyn ha cht trong c th lin quan n cc yu t nh hng n s lng ng sinh hc cht trong c th. iu ny bao gm c cc tnh cht ha - l nh: c ht, iu kin tip xc v tnh trng sc kho ca c th. Ha cht vn chuyn t im tip xc vo h ch mu. Trong mu, ha cht c th tn ti t do, khng cn lin kt, hoc lin kt vi protein (thng l lin kt vi albumin). Ha cht c th t mu vo cc m v t bo ( gan), tch ng li ( m m), o thi ra khi c th (qua thn), hay s to nn phn ng (trong no). Bin ca phn ng ph thuc vo nng ca ha cht ti c quan tip nhn, i lc ca chng V hot ng trong c th. Ha cht qua mng t bo, qua cc lp phospholipid bng mt qu trnh i hi tith nng lng c gi l qu trnh vn chuyn ch ng, hay bng mt qu trnh khng i hi tiu th nng lng, c gi l qu trnh vn chuyn th ng. C nhiu dng phn ng to thnh do s tng tc gia ha cht v b phn tip nhn. Chng bao gm nhng thay i hnh dng trng thy c v khng trng thy c, hoc nhng thay i trong cc chc nng sinh l v sinh ha. Cc phn ng c th khng c trng nh vim nhim, hoc c trng nh t bin trn, d hnh, ung th... Cc phn ng c th quan st c ngay lp tc hay phi mt khong thi gian sau ; phn ng c th phc hi c, hoc khng phc hi c; c th ti ch, c th lin quan n mt hay nhiu b phn v n c th c li hoc c hi. Cc phn ng ny c th lin quan n tnh thng nht, chc nng, s pht trin v lin h gia cc t bo. Tuy nhin, bn cht c bn ca t bo khng th no b thay i do ha chn v d: t bo c khng th b bin i thnh t bo bi tit. Cc yu t gy nh hng n phn ng ha cht Cc yu t nh hng i vi ha cht do gm: c tnh ha l, tinh khit, bn, iu kin tip xc (liu lng, thi 15

gian, mt ), th trng di truyn, loi, gii tnh, trng lng c th, tnh trng sc khe ca c th ti thi im tip xc, s c mt ca nhng ha cht khc (s tng tc), cc iu kin mi trng (nhit , m, p sut, nh sng...), tnh thch ng v tnh nhy cm ca tng c th. nh hng ca mt ha cht ln hot ng ca mt ha cht khc gi l mi tng tc (tc dng phi hp). Trong mi trng, khi c nhiu c cht cng tn ti th tnh c s thay i. Phn ng thu c c th mang tnh khuch i c (tnh cng: cht A + cht B c 2 ln cao hn), thm ch nhiu trng hp, khuch i c ln gp bi (ti mc cht A + cht B c 5 ln cao hn) v thng khng th d bo c. Bn cnh , phn ng cn c th mang tnh tiu c (cht A + cht B < 1 ln c, hoc cng c th c trng hp tiu c hon ton). Phn ng i vi mt tc nhn ha hc hay l hc ph thuc vo liu lng v s lng b phn tip nhn b nhim v b kch hot. Liu lng thp, phn ng c th khng quan st c Khi liu lng tng, phn ng to thnh mc c th quan st c. Liu lng thp nht gy ra phn ng m ta bt u quan st c gi l liu lng ngng. Di liu lng ngng, khng th quan st c phn ng. Mi mt liu lng ngng ng vi mi hin tng sinh hc. Trong mt chui nhng phn ng, tn ti tng ngng cho mi bc phn ng. Vic xc nh ngng da vo cht kch thch hay tc nhn c kh nng gy nn phn ng v cng ca phn ng l hm s ca cng cht kch thch hay nng ca tc nhn. Vic pht hin ra phn ng, phng php nh lng v nhy ca chng c th gy nh hng n vic xc nh ngng. C th xc nh ngng ti nhiu mc nh ti t bo, ti m, ti cc c quan chc nng. Cc yu t gy nh hng n ngng bao gm: liu lng 16

v kh nng lng ng ca ha cht, s nhy cm ca c th c phn ng, bn cht ca phn ng c to thnh... nhy ca phng php dng xc nh phn ng nh hng n ngng quan st. Khi nim khng ngng. C gi nh cho rng bnh ung th v cc bnh khc lin quan n thay i vt liu di truyn khng ngng. iu ny c ngha l kh nng gy ra phn ng t l vi cc tc hi ngay c khi liu lng tip xc thp nht. Vic gi nh khng ngng ch ra rng khng c mt mc tip xc no m kh mang li nguy c cho sc kho. S lin h gia liu lng -p ng th hin mi tng quan gia liu lng v p ng quan st c. th l ng cong lin h gia cng ca p ng v liu lng. 1.3. PHN LOI CHT THI NGUY HI C nhiu cch phn loi cht thi nguy hi: theo gc, c, cch bo qun v s dng cht thi... Cch phn loi cn ph thuc vo cc quc gia khc nhau do cc yu t x hi kinh t, mi trng v sc kho cng ng. Sau y l mt s dng phn loi hin ang c s dng: Phn loi da theo tnh cht cht nguy hi 1. Ha cht phng x 2. Cc cht nguy hi thuc cc nhm k loi nng, thuc bo v thc vt, cc cht dc liu... thuc 2 nhm: Cc cht tng hp Mui kim loi, axit v kim v c 3. Cht thi bnh vin, cc phng th nghim sinh hc. 4. Cht gy chy 17

5. Cht gy n Phn loi da theo bn vng Da vo tnh bn vng ca cht nguy hi c th phn ra 4 nhm sau: 1 Khng bn vng: bn vng 1-2 tun (Phu c, carbonate...) 2. Bn vng trung bnh: bn vng t 3 thng n 18 thng 3. Bn vng: thi gian bn vng ko di t 2 - 5 nm (DDT, aldnn, chlordane...) 4. Rt bn vng: Lu tn rt lu trong c th sinh vt (Kim loi nng,...) Phn loi da trn loi c quan b tc ng 1. Cc cht gy nh hng tp trung, im Cl2, O3, kim, mui kim loi nng, formol, F,... 2. Cc cht gy nh hng h thn kinh CO2 Phenol, F, formol,... 3. Cc cht gy c hi mu Zn, P,... 4. Cc cht gy c hi nguyn sinh cht 5. Cc cht gy c hi h enzym Phe Na2SO4, F,... 6. cc cht gy m Chlorofoc, CCl4, te,... 7. Cc cht gy tc ng tng hp Formol, F,... Mt s c cht c hm lng khc nhau gy nh hng 18

khc nhau V d: phenol hm lng thp h thn kinh phenol hm lng cao mu Phn loi theo mc tc dng sinh hc Ti hi ngh quc t nm 1969 v c hc sinh thi, cc chuyn gia ngh phn loi sinh hc cc cht cng nghip. Vic phn loi ny da vo 4 mc tc dng. ca cht nguy hi: Loi A (Tip xc khng nguy him): Tip xc khng gy nh hng ti sc kho. loi B: Tip xc c th gy tc hi n sc kho nhng c th hi phc c. c. Loi C: Tip xc c th gy bnh nhng hi phc

Loi D: Tip xc c th gy bnh khng hi phc c hoc cht. S phn loi ny ph hp vi thi gian tip xc 8 gi/ngy v 5 ngy/tun. Tuy nhin, phn loi ny kh i vi nhng cht gy ung th hoc t bin gen. Phn loi da trn mc gy c cho c th thy sinh vt Mt kiu phn loi c xut da trn nng c cht v mc gy c cho c th ng vt thy sinh (da trn ch s TLm: mc c cht gy t vong 50% s lng c th sinh vt th nghim trong khong thi gian nht nh). 1. Nhm c cht cc mnh: TLm < 1mg/l 2. Nhm c cht mnh: 1 < TLm < 10 mg/l 3. Nhm c cht trung bnh: 10 < TLm< 100mg/l 4. Nhm c cht yu: TLm > 100mg/l 19

5. Nhm c cht cc yu: TLm > 1000 mg/l. Nhm 1 gm: DDT, phentachlophenolate nam,... Nhm 5 gm: HBr, CaCl2... Phn loi cc ha cht da vo nguy c gy ung th ngi Da trn nhng chng c r rng, IARC (c quan nghin cu ung th quc t) phn cc cht ha hc theo 4 nhm c kh nng gy ung th: Nhm 1: Tc nhn l cht gy ung th ngi Nhm 2A: Tc nhn c th gy ung th ngi Nhm 2B: Tc nhn c l gy ung th ngi Nhm 3: Tc nhn khng th phn loi da trn tnh gy ung th ngi Nhm 4 : Tc nhn c l khng gy ung th ngi. IARC xem xt ton th cc chng c nh gi ton din v kh nng gy ung th ngi ca cc tc nhn, hn hp v tnh hung gy nhim. Vic phn nhm cc yu t ny mang tnh khoa hc da trn thng tin s liu tin cy, chng c thu c t nhng nghin cu ngi, ng vt th nghim. Nhm 1: Tc nhn (hoc hn hp) chc chn gy ung th cho ngi y l nhng cht m kh nng gy ung th ngi ca chng c nhng chng c chc chn. Ngoi ra, mt tc nhn (hn hp) c th xp vo nhm ny khi bng chng gy ung th cho ngi cha hon ton y nhng chc chn l gy ung th trn ng vt th nghim v c lun c cho thy khi vo c th n s c tc ng theo c ch dn n ung th. Nhm 2 20

Nhm ny bao gm cc tc nhn, hn hp, tnh hung nhim m trong mt s trng hp th c y bng chng v tnh gy ung th ngi, trong nhng trng hp khc khng c d liu v tnh gy ung th ngi nhng c bng chng trn ng vt th nghim. Cc tc nhn hn hp trong. trng hp ny phn thnh 2 nhm: nhm A v nhm B da trn c s cc chng c th nghim v dch t hc v kh nng gy ra ung th hoc nhng d liu thch hp khc. Nhm 2A: Tc nhn (hoc hn hp c th gy ung th cho ngi ) l nhng cht m c mt s bng chng cha hon ton y v tnh gy ung th cho ngi nhng c bng chng xc nhn l gy ung th cho ng vt th nghim. Trong mt vi trng hp, mt tc nhn (hn hp) c th xp vo nhm ny khi cc bng chng v tnh gy ung th trn ngi khng tho ng, nhng bng chng xc nhn l gy ung th trn ng vt th nghim v c lun c vng chc cho thy tin trnh gy ung th tng- t nh c ch gy ung th ngi. Mt s trng hp ngoi l, mt s tc nhn thn hp) c th xp vo nhm ny ch v l do c mt bng chng cho thy c th gy ung th ngi. Nhm 2B: Tc nhn hn hp c l gy ung th cho ngi l cc tc nhn (hn hp) m c mt s bng chng (nhng cha y hon ton) v kh nng gy ung th cho ngi v gn bng chng v tnh gy ung th trn ng vt th nghim. Cng xp vo nhm ny l nhng cht m chng c gy ung th cho ngi khng tho ng nhng c bng chng thch hp v tnh gy ung th ng vt th nghim. Trong mt vi trng hp, mt tc nhn (hn hp) cng c xp vo nhm ny khi bng chng gy ung th cho ngi khng tho ng, nhng c mt s bng chng gy ung th ng vt th nghim i km vi nhng chng c b sung t nhng ngun thng tin, s liu ng tin cy. 21

Nhm 3: Tc nhn hoc hn hp cha th xp vo nhm cht gy ung th cho ngi l cc tc nhn (hn hp) khng c bng chng r rng gy ung th ngi nhng li c y bng chng gy ung th ng vt th nghim, song c ch gy ung th y khng ging nh i vi ngi. Nhm 4: Tc nhn hn hp c th khng gy ung thu cho ngi l nhng tc nhn (hn hp) m bng chng cho thy khng c tnh gy ung th cho ngi v ng vt th nghim. Trong mt s trng hp, nhng tc nhn (hn hp) c bng chng khng chc chn l gy ung th cho ngi, nhng t nhiu thng tin, s liu r rng chng minh l khng gy ung th cho ng vt th nghim cng c xp vo nhm ny.

22

Chng II CC CHT C HI

2.1. C CHT L, HA 2.1.1. Nhit Nhit c tc ng r rt n c th. p ng (phn ng) vi nhit mi trng, c th c th tng tit m hi, tng tun hon mu di da (khi nhit cao) hoc gim tun hon mu di da (khi nhit thp). Khi nhit mi trng xp x hoc cao hn nhit c th c bit kt hp vi m cao, c th c th b say nng" hoc c cc triu chng nguy him khc v c th b t vong. 2.1.2. Asen Asen l kim loi c th tn ti nhiu dng hp cht v c v hu c. Trong t nhin, Asen c trong nhiu loi khong cht. Trong nc Asen thng dng Asenic hoc Asenat. Cc hp cht Asen methyl c trong mi trng do chuyn ha sinh hc. Arsenic phn b rng ri trong v qu t v c s dng trong thng trng trc ht lm tc nhn hp kim ha. Arsenic xm nhp vo nc t cc cng on ho tan cc cht v qung m, t nc thi cng nghip v t s lng ng khng kh. mt vi ni, i khi Arsenic xut hin trong nc ngm do s n mn cc ngun khong vt thin nhin. Ba nh hng chnh ca a sen ti sc kho con ngi l: lm ng keo protein, to phc vi Asen(III) v ph hy qu trnh photpho ha. Asen gy ung th biu m da, ph qun, phi, cc xoang...do Asen vcc hp cht ca Asen c tc dng ln nhm Sulphydryl (-SH) ph v qu trnh photphoryl ha. Cc enzym sn sinh nng lng ca t bo trong chu trnh axit xc b nh hng rt ln. Enzym b c ch do vic to phc vi As(III), lm ngn cn 23

s sn sinh phn t ATP. Do Asen c tnh cht ha hc tng t vi Photpho, nn cht ny c th lm ri lon Photpho mt s qu trnh ha sinh. IARC xp Arsenic v c vo nhm 1 (Phn loi cc ha cht da vo nguy c gy ung th ngi) - l cht gy ung th cho ngi. T l mc bnh ung th da tng i cao. Trong nhng nghin cu s ngi dn ung nc c nng Arsenic cao cho thy, t l mc bnh ung th gia tng theo liu lng Arsenic v thi gian ung nc. Gi tr hng dn tm thi i vi Arsenic c nhiu quc gia a ra l 0,01 mg/l. 2.1.3. Crom. Crom c th tn ti dng ha tr +3 hoc +6. Nng Crom trong nc ung thng thp hn 2 tg/l (mc d thc t c trng hp nng Crom trong nc ung cao ti 120 g/l). Nhn chung, thc phm l ngun chnh a Crom vo c th ngi. S hp th Crom ty thuc trng thi oxy ha ca cht . Crom (VI) hp thu qua d dy, rut nhiu hn Crom (III) v cn c th thm qua mng t bo. Cc ha cht ha tr 6 ca Crom gy vim lot da, xut hin mn cm, vim gan, vim thn, thng vch ngn gia hai l ma, ung th phi,... IARC xp Crom (VI) vo nhm 1 v Crom (III) vo nhm 3. 2.1.4. Niken Nng Niken trong nc ung thng di 0,02 mg/l. Trong mt s trng hp c bit, lng Niken xm nhim t cc ngun thin nhin hoc do cc cht cn lng trong cc ngun thi cng nghip vo t, khi nng c th tng ln cao hn na. Lng Niken i vo c th hng ngy trung bnh khong 0,1-0,3 mg, nhng nu n mt s loi thc phm c bit lng Nicken c th tng ln hn. Niken gy ung th phi, vim xong mi, ph qun,... 24

Theo nhiu quc gia,Niken trong nc ung cho php tm thi l 0,02 mg/l. 2.1.5. Cadimi Kim loi Cadimi c dng trong cng nghip luyn kim v ch to nha. Hp cht ca Cadimi c dng ph bin lm phi. Cadimi xm nhp vo mi trng qua nc thi v pht tn nhim do xm nhim t phn bn... Cadimi xm nhim vo nc ung do cc ng nc m km khng tinh khit hoc t cc mi hn v vi loi cht gn kim loi. Tuy vy, lng Cadimi trong nc thng khng qu 1g/l. Thc phm l ngun Cadimi chnh nhim vo c th ngi. Theo nhiu nh chuyn gia, th ht thuc cng l nguyn nhn ng k gy nhim Cadimi. S hp th hp cht Cadimi ty thuc vo ha tan ca chng. Cadimi tch t phn ln thn v c thi gian bn hy sinh hc di, t 10 - 35 nm. c chng c cho bit Cadimi l cht gy ung th qua ng h hp. Cadimi c c tnh cao i vi ng vt thy sinh v con ngi. Khi ngi b nhim c Cadimi, tu theo mc nhim s b ung th phi, thng vch ngn mi, c bit l gy tn thng thn dn n protein niu. Ngoi ra cn nh hng ti ni tit, mu, tim mch... Nhim c Cadimi xy ra ti Nht dng bnh itai itai" hoc "Ouch Ouch" lm xng tr nn gin. nng cao, Cadimi gy au thn, thiu mu v ph hy ty xng. IARC xp Cadimi v hp cht ca n vo nhm 2A. Phn ln Cadimi thm nhp vo c th ngi c o thi qua thn. Mt phn nh c lin kt mnh vi protein ca c th thnh metallothionein c thn, phn cn li c gi trong c th v dn dn c tch ly theo thi gian. Khi lng Cd2 c tch tr ln, n s th ch Zn2+ cc enzym quan trng v gy ri lon tiu ha. Lng a vo c th hng tun c th chu ng c (PTWI) c n nh l 7 g/kg th trng. 25

2.1.6. Thy ngn Thy ngn l kim loi c th to mui dng ion: Thy ngn (I) v thy ngn (II). Thy ngn cng c dng cc hp cht hu c thy ngn, s dng trong nng nghip (thuc chng nm) v cng nghip (lm in cc...). Thy ngn cn c trong cc cht thi cng nghip, phn ha hc, xt do, bt giy v.v... Thy ngn thng c trong nc b mt v nc ngm dng v c vi nng . thng < 0,5 g/l. Lng thy ngn trong khng kh khong 2-10 mg/m3. Thy ngn trong mi trng nc c th hp th vo c th thy sinh vt, c bit l c v cc loi ng vt khng xng sng. C hp th thy ngn v chuyn ha thnh methyl thy ngn (CH3Hg+) rt c i vi c th ngi. Cht ny ho tan trong m, phn cht bo ca cc mng v trong no ty. Thy ngn v c tc ng ch yu n thn, trong khi methyl thy ngn nh hng chnh n h thn kinh trung ng. Sau khi nhim c, ngi bnh d b kch thch, cu gt, xc ng, ri lon tiu ha, ri lon thn kinh,vim li, run chn. Nu b nhim c nng c th t vong. c tnh.do thy ngn tc dng ln nhm Sulphydryl (- SH) ca cc h thng enzym. S lin kt thy ngn vi mng t bo ngn cn vn chuyn ng qua mng v cho php dch chuyn kim ti mng. iu ny dn n thiu.ht nng lng trong t bo v gy ri lon thn kinh. y l c s gii thch v sao nhng tr s sinh t m nhim methyl thy ngn s b tc ng ln h thn kinh trung ng (tm thn phn lit, km pht trin tr tu v co git). Nhim c methyl thy ngn cn dn ti phn lp th nhim sc, ph v th nhim sc v ngn cn phn chia t bo. Nm 1972, JECFA thit lp gi tr tm thi cho lng tip nhn hng tun c th chu ng c i vi thy ngn l 5 tg/kg th trng, trong methyl thy ngn khng c hn 3,3 g/kg th trng. 26

2.1.7. ng Lng ng trong nc ung thng thp ch vi g/l nhng ng nc v vt dng cha nc c mi hn bng ng c th lm tng nng ng. Nng ng trong nc ung c th tng ln n nhiu mn sau mt thi gian nc ng trong ng. ng l nguyn t c bn, lng a vo c th t thc phm vo khong 1-3 mg/ngy. Cc hp cht ca ng khng c lm, cc mui ng gy tn thng ng tiu ha, gan, thn v nim mc. c nht l mui ng xuanua. i vi ngi ln, t l hp thu v lu gi ng tu thuc lng a vo c th hng ngy. S kch thch d dy cp tnh c th xy ra mt s ngi sau khi ung nc c nng ng trn 3 mg/l. ng c th gy v cho nc. ngi ln, v s thoi ha gan nhn u (hepatolenticular degeneration), c ch iu chnh ng b suy gim hiu qu v do n ung lu di nc c nng ng cao s lm tng nguy c b x gan. Nm 1982, JECFA ngh gi tr tm thi cho lng tip nhn ti a hng ngy c th chu ng c l 0,5 mg/kg th trng. ngh ny cn c trn nhng nghin cu ch trc . Ngi ta tnh ra gi tr hng dn bo v sc kho l 2mg/l. 2.1.8. Km Km l nguyn t vi lng c tm thy trong nhiu loi thc phm v nc ung di hnh thc cc phc cht hu c. Cc mui km ha tan u c. Khi ng c km s cm thy ming c v kim loi, au bng, mch chm, co git... Ch n thng l ngun cung cp km chnh cho c th. Mc d lng km trong nc ngm thng khng vt qu 0,01 - 0,05 mg/l, nhng ring nc my c nng km cao hn nhiu o s ho tan km t ng dn nc. 27

JECFA ngh gi tr tm thi cho lng km tip nhn ti a hng ngy c th chu ng c l 1 mg/kg th trng. Nhu cu dinh dng v km hng ngy ngi ln l 12 -20 mg/l. 2.1.9. St St l mt trong nhng kim loi c nhiu trong v qu t. Nng ca n trong nc thin nhin c th t 0,5 - 50 mg/l. St cn c th hin din trong nc ung do qu trnh keo t ha hc bng hp cht ca st do s n mn ng dn nc. St l mt nguyn t cn bn trong dinh dng ca con ngi. Nhu cu ti thiu v st hng ngy tu thuc vo tui, gii tnh, th cht thay i 10 - 50 mg/ngy. phng trnh s lu gi mt lng st qu thc trong c th, nm 1983, JECFA thit lp gi tr tm thi. cho lng tip nhn ti a hng ngy c th chu ng c l 0,8 mg/kg th trng. 2.1.10. Mangan V mt inh dng ma ngan l mt nguyn t vi lng, nhu cu dinh dng mi ngy t 30-50 g/kg th trng. T l hp th ma ngan trong c th tu thuc vo s lng ma ngan thm nhp, s hin din ca cc kim loi khc nh st v ng trong ch n ung v.v... Ngi ta ghi nhn c chng c v tnh nhim c thn kinh cng nhn m do tip xc lu di vi bi c cha ma ngan. c tnh mnh vi nguyn sinh cht ca t bo, c bit l tc dng ln h thn kinh trung ng, gy tn thng thn v b my tun hon, phi, ng c nng c th dn ti t vong. Tm thi quy nh gi tr cho php ca ma ngan l 0,5 mg/l. 2.1.11. Ch Ch c s dng sn xut c quy ch hn... Cc hp cht hu c ch nh tetraethyl v tetramethyl ch c s dng rng 28

ri lm cht chng kch n v cht lm trn trong xng. Tuy vy, hin nay mt s nc khng cn dng loi xng cha ch. Phn ln lng ch c trong nc ung l do ng dn nc l hp kim ch, cc vt dng hn bng ch trong ngnh xy dng... Lng ch ho tan t h thng dn nc c ch ty thuc cc yu t nh pH, nhit , cng ca nc v thi gian nc lu trong ng. Nc mm c tnh axit ha tan nhiu ch. S thm nhim ch qua nhau thai ngi xy ra rt sm t tun th 20 ca thai k v tip din sut thi k mang thai. Tr em c mc hp th ch gp 4-5 ln ngi ln. Mt khc thi gian bn hy sinh hc ch tr em cng lu hn nhiu so vi ngi ln. Ch tch ng xng. Tr em t 6 tui tr xung v ph n c thai l nhng i tng mn cm vi nhng nh hng nguy hi n sc kho do ch gy ra. Ch cng km hm chuyn ha can xi bng cch trc tip hoc gin tip thng qua km hm s chuyn ha vitamin D. Ch gy c c h thng thn kinh trung ng ln thn kinh ngoi bin. Ch tc dng ln h thng enzym, nht l enzym vn chuyn hydro. Khi b nhim c, ngi bnh c mt s ri lon c th, trong ch yu l ri lon b phn to huyt (ty xng). Tu theo mc nhim c c th gy ra nhng tai bin nh au bng ch, ng vin en Burton li, u khp, vim thn, cao huyt p vnh vin, lit, tai bin no, nu b nng c th dn ti t vong. Tc dng ha sinh ch yu ca ch gy nh hng n s tng hp mu, ph v hng cu. Ch c ch mt s enzym quan trng ca qu trnh tng hp mu do tch ng cc hp cht trung gian ca qu trnh trao i cht. Ch km hm vic s dng O2 v glucoza sn xut nng lng cho qu trnh sng. S km hm ny c th nhn thy khi nng ch trong mu khong 0,3 mg/l. Khi nng ch trong mu > 0,8 mg/l c th gy nn hin tng thiu mu do thiu hemoglobin. Nu hm lng ch trong mu trong khong 0,5-0,8 mg/l s gy ri lon chc nng ca thn v ph hy no. 29

JECFA thit lp gi tr tm thi cho lng ch a vo c th hng tun c th chu ng c i vi tr s sinh v thiu nhi l 25 g/kg th trng (tng ng vi 3,5 g/kg th trng/ngy). 2.1.12. Cht ty ra b mt Cht ty ra b mt c thnh phn ch yu l mui nam phosphate, carbonate. Khi dng nguyn cht n l loi bt trng, khng dn v pht la, khng gy n, khng gy chy, khng bc hi, khng phn ng vi nc, khng t gy phn ng v rt n nh trong mi trng. Khi dng dung dch n c th gy au hng, au phi, khi dnh vo mt n gy tn thng gic mc. Khi tip xc vi da c th gy ra hin tng n mn da v ph hy t bo m. Ngoi ra n cn c kh nng kch thch da, mt v nim mc. Trong trng hp ung phi loi dung dch ny nu khng c cu cha kp thi c th gy t vong. 2.1.13. Aming Lng aming ln nht c dng lm vt liu xy dng di cc dng sn phm nh: Tm lt sn vinyl (dng aming lm cht n cho polime, v d PVC lm cc tm sn lt sn, p tng). Va trt tng Tm cch m, vch ngn (p vi xi mng) Lp cch nhit (p tng nhng x lnh) Lp bo v (Cho cc ng ng dn nc nng, lp cch nhit quanh cc l si, lt sau tng hoc lp trn) Hin nay Vit Nam c 26 c s vi 30 dy chuyn ang hot ng sn xut tm lp ny vi tng cng sut t xp x 40 triu m3/nm. Theo s liu iu tra ca Trung tm Y t b Xy dng nm 1995 th nng bi aming chrysotel ti mt s c s sn xut tm lp fibroximng v m phanh t dao ng t 5 - 10 si/cm3 n 80 - 100 si/cm3 khng kh. Nh vy si pht 30

tn trong khng kh vt qu cao so vi tiu chun nhiu nc (Canada 1 si/ cm3 Philipin 2 si/ cm3, Thai lan 5 si/ cm3). T chc Sc kho Mi trng Th gii khuyn co p dng i vi cng nhn trc tip sn xut l 2 si/ chia trong 8 gi. Amimng chia thnh 2 nhm: Nh khong secpentin ch yu l Chrysotil (3MgO.SiO2.H20) Cn gi l aming trng, chim ti 90% sn lng th gii. Nhm khong amphibol gm actinolit (2CaO.4MgO.Fe2O3 8Si02.H2o) hay aming nu; Anthophylit (7MgO.8SiO2.H2O), crociolit (Na2O.FeO2.H2O) hay aming xanh. Do c im cu trc, si aming d b gy (nht l nhng cu kin xy dng lu nm) thnh nhng si rt nh, pht tn trong khng kh. Si c kch thc chiu rng 3m, chiu di thng gp 3 ln chiu rng. Qua ng h hp, si aming thm nhp vo phi, tch ng v gy nh hng ti sc kho ngi. Asbestosis (nhim bi hoc si aming) l bnh ngh nghip nguy him. T l mc bnh lin quan n thi gian v hm lng tip xc. Vit Nam bnh bi phi aming xp vo mt trong cc bnh ngh nghip theo quy ch an ton lao ng ca nh nc. 2.1.14. Ammonia (amoniac) Thut ng Ammonia bao gm c 2 dng: dng khng ton ha (NH3) v dng ion ha (NH4) Ammonia c mt trong mi trng c ngun gc t cc qu trnh chuyn ha, nng nghip, cng nghip v t kh trng nc bng chloramine. Lng ammoma t nhin trong nc b mt v nc ngm thng thp hn 0,2 mg/l. Cc ngun nc him kh c th c nng ammonia ln n 3 mg/l. Vic chn nui gia sc qui m ln c th lm gia tng lng ammoriia trong nc b mt. S nhim ammonia c th tng ln do cc on ni ng bng va xi mng. Ammonia c trong nc l th hin s nhim do cht thi 31

ng vt, nc cng v kh nng nhim khun. Tc hi ca n ch xut hin khi tip xc vi mt liu khong 200 mg/kg th trng. Ammonia trong nc khng phi l nguyn nhn gy nh hng trc tip n sc kho. Tuy vy, ammonia lm nh hng qu trnh kh trng nc, to ra nht trong h thng phn phi, lm nh hng qu trnh tch loi mangan v to ra mi v.v... 2.1.15. Carbon monocide Carbon monocide tn cng hemoglobin v th ch ca O2 to ra carboxyhemoglobin. O2Hb + CO COHb + O2 Carboxyhemoglobin l phc bn do vy m kt qu l gim kh nng ti O2 ca mu. Bng 1: Hu qu ca s nhiu c CO nng khc nhau Nng CO, ppm 10 100 250 750 1000 32 %chuyn ha O2Hb-> COHb 2 15 32 60 66 nh hng i vi con ngi Lm gim kh nng phn on v gic quan, au u, chng mt, mt mi au u, chng mt, mt mi nhiu bt tnh cht sau vi gi cht rt nhanh

2.1.16. Kh cacbonic CO2 Kh CO2 gy ri lon h hp v t bo do chim mt ch ca oxy. Mt s c trng gy c ca CO2 nh sau: Nng CO2 Biu hin c tnh ((((( (%)(%)(%) 5% Kh th, nhc u 10% Ngt, ngt th Nng CO2trong khng kh sch chim 0,003 - 0,006 %. Nng ti a cho php ca CO2 l 0,1%. Kh CO2 cn gy nn hin tng hiu ng nh knh, lm cho bu kh quyn nng ln. 2.1.17. NO2 Nc oxit (NO) t c hn so vi dioxit nit (NO2). Ging nh CO, NO to lin kt vi hemoglobin v lm gim hiu sut vn chuyn oxy. Trong khng kh b nhim th NO c mt nng thp hn nhiu so vi CO v v vy tc ng n hemoglobin l nh hn nhiu. NO2 c hi hn i vi sc kho ngi. Hu qu ca nhim c NO2 cc mc nng khc nhau nu bng sau: Bng 2. nh hng nhim c NO2 vi nng khc nhau i vi ngi Nng NO2, Thi gian Hu qu n sc kho PPm u c ngi vim phi trong 6 - 8 tun 50 - 100 di 1h 150 -200 di 1h0 ph hy dy kh qun, s cht nu thi gian u c l 3-5 tun. cht 33

500 hoc ln hn 2- 10 ngy

2.1.18. Sulphur Kh SO2 khng mu, khng chy, c v hng, cay. Hu ht mi ngi b kch thch nng 5 ppm. Thm ch mt s ngi nhy cm b kch thch khi nng 1 - 2 ppm v i khi xy ra co tht thanh qun khi b nhim c nng 5-10 ppm. Nhng triu chng ca hin tng nhim c SO2 l co hp dy thanh qun km theo s tng kch thch khi th SO2, NO2 tip xc vi nim mc m p to thnh axt. Kh SO2, NOX vo c th qua ng h hp hoc ha tan vo nc bt ri vo ng tiu ha, sau phn tn vo ng tun hon mu. Ngoi ra, SO2 cn c th gy ra s ri lon chuyn ha protein v ng, gy thiu vitamin B v C, c ch enzym oxyaza. Tip xc lu i vi kh SO2 nng cao c th b bnh h to huyt, v khi methemoglobin to ra s tng cng qu trnh oxy ha Fe(II) thnh Fe (III). 2.1.19. Hidro Sulphur H2S l kh khng mu, c mi c trng (mi trng thi), tan trong nhiu dung mi khc nhau nh: nc, ru, ete, dung mi alkali cacbonat bcacbonat. H2S c th tham gia phn ng xy ha to thnh SO2, H2SO4 dng nguyn t. H2S sinh ra trong qu trnh hot ng ca ni la v sn phm ca qu trnh phn hy protein ng vt v thc vt ca vi khun. Rt nhiu loi vi khun, nm, thi ra H2S trong qu trnh phn hy cc hp cht c cha cc amino axit cha lu hunh v trong qu trnh kh trc tip sulphat. Vi khun proteus vulgaris l loi vi khun in hnh to ra H2S khi sng trong mi trng c protein. Qu trnh kh sulphat c tin hnh bi 2 loi vi khun k kh l Desulfovibro v Desulfotomaculum. Ngun hu c cho cc vi khun ny hot ng l cc axt hu c mch ngn sinh ra trong qu trnh ln men ca cc vi khun k kh khc hoc cc hp cht hu c phc tp hn. Do vy H2S Sinh ra trong cc mi trng thiu oxy, c cht hu c v c sulphat. 34

H2S l sn phm th cp ca cc qu trnh sn xut: - Qu trnh sn xut than cc t than cha lu hunh. - Qu trnh tinh ch du th cha lu hunh. - Qu trnh sn xut CS2 (hi cay). - Qu trnh sn xut si VISCO. - Qu trnh sn xut bt giy. Trong khng kh xung quanh, H2S thng c nng t 0,0015- 0,075 mg/m3. Trong mi trng cng nghip, H2S c th ln n 30- 75 mg/m3 hoc cao hn. H2S l kh kch thch v gy ngt. Cc phn ng kch thch trc tip vo m mt gy vim mng kt. Ht phi H2S s gy kch thch i vi ton b c quan h hp v c th mc cc bnh v phi. 1.500 - 3.000 mg/m3, H2S s hp th t phi vo mu gy th gp v km hm hot ng h hp. nng cao hn, H2S ngay lp tc lm t lit trung tm 'h hp. Thng thng nn nhn s cht do ngt th tr khi c h hp nhn to kp thi. y l nh hng c hi ng ch nht ca c tnh cp ca Hydrosulphur theo ng h hp cao, s kch thch mt xy ra nng 15-30 mg/m3. Mc d thiu nhiu d liu v c tnh theo ng ming nhng c th hiu rng ngi ta kh c th ung vo mt lng nc c cha mt liu Hyrosulphur gy c hi. V l do , khng c gi tr hng dn da trn l do sc kho cho Hydrosulphur. Tuy vy, khng nn c Hydrosulphur trong nc n mc c th pht hin c bng cm quan. Nng H2S tiu chun i vi mi trng lm vic c nhiu quc gia qui nh l 10- 15 mg/m3 trung bnh trong 8 gi trong iu kin lm vic bnh thng. Bng 3. Mt s ngh c th b nhim c H2S
X ly du v m ng vt. Vn chuyn phn ng vt Pha ch hng thm nhn to Nng dn cc tri chn nui Luyn kim Khai thc m

35

Ct gi Amian Sn xut Barium carbonate Sn xut mui Barium Sn xut Carbon disulfide Cng nhn, sinh vin, gio vin trong phng th nghim. Cng nhn luyn cc Tch sung t cc m ng Qu trnh ln men Sn xut phn bn Ch bin thy sn Khai phc nng lng a nhit Sn xut h Cng nhn cc m vng Kt ta kim loi iuch nc nng Tinh ch axit HCl Sn xut H2S Cng nhn bi rc Tch sulfit t qung ch Vn chuyn ch

Sn xut kh thin nhin Sn xut giy Sn xut v tinh ch xng du Tinh ch Photphat Nhn vin bo dng ng ng t qung Pyrite Sn xut si visco Sn xut cht lm lnh Ch bin nha, cao su Ra b cht Cng nhn nh my x l cc Cng nhn thng cng Sn xut t la Sn xut x phng Sn xut tng t c ci ng hoc ma Ch bin cc sn phm cha sulfur Sn xut si tng hp Cng nhn thuc da Cng nhn in vi o v dn ging...

2.1.20. Cc cht hu c bay hi (VOC) Ni chung, VOC l nhng cht ha tan trong m v d dng b hp th qua phi. Bng sau th hin cc ngun pht sinh VOC.

36

Bng 4. VOC v ngun pht sinh

Loi Th d Ngun pht sinh Nhin liu nu nc v si m, aerosol, cc cht ty qun o, du nhn, cht mu, cht thm. Aerosol, cht xng hi, cht lm lnh, cht ty du m, cht ty qun o. Sn, vecni, keo, cc cht ty ra gia dng, lm sch, cht ty ma toilet. Cht lau knh, ca s sn, dung mi, cht kt dnh. Sn, vecni, cht ty ra, cht kt dnh. Cht st trng gia dng, cc c bng g dn, m phm, cht to v

Propan, butan, he Hydrocacbon xan, limonen. Hydrocacbon Metyl cloroform, Halogen ha Metylen clorua Hydrocacbon Benzen, toluen, Thm xylen Ancol Xeton Andehit Etanol, metanol Axeton Formaldehit, nonanal

Hydrocarbon thng t gy nhim c mn tnh. m ch gy nhim c cp tnh. Cc triu chng nhim c cp tnh l: Suy nhc, chng mt, say, co git, ngt, vim phi, p xe phi. Khi ht th hi hydrocarbon nng 40.000 mg/m3 c th b nhim c cp tnh vi cc triu chng tc ngc, chng mt, ri lon gic quan, tm thn, nhc u, bun nn. Khi ht th hi hydrocarbon vi nng 60.000 mg/m3 s xut hin cc cn co git, ri lon tim v h hp, thm ch c th t vong. Dung mi Toluen v Xylen: y l cc hp cht hydrocarbon vng thm dn xut ca benzen, c c tnh cao i vi con ngi v ng vt mu nng. Khi tip xc vi toluen v xylen c th gy tc hi vi ngi: Gy vim nim 37

mc, kh th, nhc u) nn, cc triu chng v thn kinh, h thn nhit v c th gy lit. Tip xc lu di c th dn n cc bnh nhc u mn tnh, cc bnh ng mu nh ung th mu. Bng 5. Mt s v d v nh hng nhim khng kh
Nm a im Hu qu c ghi nhn Chuyn ng nhit lu gi SO2 38 ppm lm 60 ngi b cht, mt s sc vt cht Nhim n 40%, 20 ngi cht 2 ppm SO2 o ln nhit , sng m dy c 1,3 ppm SO2 khong 3.500 -4.000 ngi cht 0,4 ppm SO2 180 - 200 ngi cht S ngi cht ch yu (60%) la tui 70.

12.1930

Men se River Donora, Pennsylnania, USA London

10.1948

12.1952

01.1956 12.1957

London

Carbon tetrachloride (cacbon tetraclorua) Carbontetrachloride c dng ch yu sn xut chlorofluorocarbon, mt cht lm lnh. Cht ny thm nhim vo nc v khng kh trong qu trnh sn xut, s dng. Nng ca Carbontetrachloride trong nc ung thng thng t hn 5 g/l. IARC xp Carbontetrachloride vo nhm 2B. Carbontetrachlorie c th chuyn ha trong cc h thng vi th thnh gc trichloromethyl, gc ny lin kt vi nhng i phn t khi tho s oxy ha lipit v ph hy mng t bo. Ozon 38

O3 gy tc hi i vi mt v c quan h hp ca ngi. Ngi sng trong iu kin khng kh c 50 ppm O3 trong vi gi s b cht do trn dch phi (pulmonary edema) (ngha l s tch ly cht lng trong phi). Nhng ng vt non v nhng ngi tr c nhy cm hn i vi nhng tc ng gy c ny. Nhm Sulphyryl (-SH) enzym b tn hi o s tn cng ca cc tc nhn oxy ha. Cc enzym b t lit do cc tc nhn oxy ha quang ha gm izoxitrie dehydrogenaza, malicdehydrogenaza v glucosa-6-photphat. dehydrogenaza. Cc enzym ny b bao bc bi vng xc axit v km hm sn sinh nng lng t bo ca glucoza. Cc tc nhn oxy ha ny cn km hm hot tnh ca cc enzym tng hp trn celluloza v cht bo trong thc vt. Formaldehit Cc vt liu xy dng v c trong gia nh v cng s c dng Formaldehil: Vn sn, panel, g (bn gh, t, ging, gi n vch ngn t s si, cc tm cch nhit, cch tm xp t nha ur- formaldehit p tng. Tt c cc sn phm trn u dng nha cha formaldehit (Phenoplast hoc aminoplast) hoc lm cht kt dnh hoc sn ph b mt. Nha ur - formaldehit khng bn v mt ha hc. Chng c th gii phng lng formaldehit t do, cha phn ng ht cn lu li trong cc sn phm cng nh s phn hy thy phn ca chnh polyme. Tc ng ca formaldehit n sc kho ngi c th hin trong bng sau:

39

Bng 6. Formaldehit tc ng n sc kho

Tc ng Khng thy g Thy mi c trng Kch thch mt Kch thch ng h hp trn Tc ng ln phi Sung phi, vim phi T vong Nng (ppm) 00-0,05 0,05 - 1,0 0,1 - 2,0 0,1 - 25 5 - 30 50 - 100 >100

Theo EPA (Hi bo v Mi trng M) formaldehit l "c kh nng gy ung th ", c kh nng b gy mch AND gy t bin v lm thay i nhim sc th. Mt s nc (an Mch, H Lan. CHLB c v Italia) quy nh tiu chun cht lng khng kh: 0,01 ppm Formaldehit. Canada tm chp nhn tiu chun 0,10 ppm v mc tiu l 0,05 ppm. Fluoride (Florua, F+) S xm nhim florua xy ra trong cc qu trnh sn xut v s dng phn bn phosphat (phn phosphat c cha n 4% flo) sn xut nhm. Mc tip nhim ngha hng ngy ty thuc vng a l.Trong c v tr thng c ngha Cao hn so vi cc ngun thc phm khc... Mt ngun khc a flo vo c th l kem nh rng c flo. Nng florua trong nc th thng c 1,5 mg/l, nhng nc ngm nhng vng c nhiu cht khong cha flo c th c nng flo khong 10mg/l. i khi flo c cho thm vo nc ung phng chng su rng. Nm 1987, IARC xp florua v c vo nhm 3 (Tc nhn hoc hn hp cha th xp loi thuc nhm cht gy ung th 40

cho ngi). Theo cc nh chuyn mn th nu hm lng Flo cao hn l mn s lm tng nguy c b nhim no rng v nu cao hn na s b nhim no xng. Cianua Cianua pht hin c trong mt s loi thc phm. i khi pht hin thy cianua c trong nc ung do hu qu ca nhim cng nghip. Cianua gy c ch cc enzym oxy ha ng vai tr mt xch trung gian trong qu trnh s dng O2 sn xut ATP). thy c nhng nh hng i vi tuyn gip v c bit l i vi h thn kinh dn c n sn lu di v trong sn c cha cianua. 2.1.21. Ha cht bo v thc vt Aldicarb Aldicarb l cht bo v thc vt dng dit giun trong t, cn trng v ve c trn nhiu loi cy. Aldicarb tan tt trong nc v lu chuyn d dng trong t. Aldicarb b thoi bin ch yu do qu trnh thy phn v sinh hc. Thi gian tn lu Aldicarb trong mi trng c th t vi tun cho n vi thng. C nhiu bng chng cho thy Aldicarb khng c tnh gy nhim c trn hoc ung th. IARC cho rng Aldicarb xp vo nhm 3. xc nh c gi tr hng dn cho Aldicarb trong nc ung, ngi ta thc hin nghin cu trn chut cng trng cho ung nc c hn hp aldicarb sulfoxide v aldicarb sulfune vi t l l 1:1 trong 29 ngy. Gi tr NOAEL tm c l 0,4 mg/kg th trng/ngy do cn c trn s c ch men acetylcholinesterase. Ly h s bt nh l 100 (v s khc bit v loi v c th) ngi ta tnh c TDI = 4 g/kg th trng. Gi tr hng dn c ngh da trn t phn TDI cho nc ung bng 10% l 10 g/l. 41

Aldrin v Dieldrin Alrin v ieldrin l cht bo v thc vt nhm cha do dng dit su b trong t. bo qun g. Hai hp cht ny gn vi nhau v c tnh v khu gy c. Aldrin nhanh chng chuyn thnh dieldrin. Dieldrin l tht hp cht hu c do rt bn t linh ng trong t v c th bc hi vo khng kh. C hai cht ny c c tnh cao i vi ng vt v ngi. Aldrin v dieldrin c nhiu c ch gy c. C quan ch yu b nh hng khi c th nhim hai cht trn l h thn kinh trung ng v gan. T u thp nin 70, mt s quc gia hn ch nghim ngt hoc cm dng c hai cht ny, c bit l trong nng nghip IARC xp aldrin v dieldrin vo nhm 3. Nm 1997, JMPR ngh gi tr ADI l 0,1 g/kg th trng (tnh chung cho tng aldrin v dieldrin). gi tr ny da trn NOAEL bng 1 mg/kg thc n cho ch v 0,5 mg/kg thc n cho chut cng, tng ng 0,025 mg/kg th trng /ngy c hai loi. JMPR dng h s bt nh 250 cn c trn s lin quan gy ung th chut bch. Gi tr hng dn cho chng da trn t phn TDI phn b cho nc ung l 1% v c gi tr cho php trong nc ung l 0,03 tg/l). Atrazine Atrazine l cht dit c chn lc dng trc v sau khi cy mc. Do s di chuyn ca n trong t, ngi ta pht hin c trong nc b mt v nc ngm. Atrazine tng i bn trong t v trong nc, thi gian bn phn hy khong vi thng, b thoi bin do nh sng v vi sinh vt trong t. Da trn NOAEL bng 0,5 mg/kg th trng/ ngy thu c t mt nghin cu v tnh gy ung th cho chut cng trng v ly h s bt nh l 1.000 (100 cho s khc bit v loi v c th v 10 phn nh kh nng sinh khi u), ngi ta tnh 42

c TDI = 0,5 g/kg th trng. Vi t phn TDI dnh cho nc ung bng 10% gi tr cho php trong nc ung l 2 g/l. Bentazone Bentazone l cht dit c ph rng, dng ch nhiu loi hoa mu. N c th thoi bin quang hc trong t v nc nhng li rt linh ng trong t v tn lu mc trung bnh trong mi trng. JMPR nh gi c tnh ca bentazone vo nm 1991 v xc nh ADI = 0,1 g/kg th trng bng cch p dng h s bt nh 100 vo cng thc vi NOAEL = 10 mg/kg th trng/ngy. Carbofuran Carbofuran l cht dit ve, su b v giun, c tc ng ton thn. N c th thoi bin quang hc, ha hc v vi sinh. Cht ny c linh ng v thi gian tn ti lu c th ngm nhim t t vo nc ngm. Triu chng lm sng do nhim c Carbofuran tng t nhim c phospho hu c. Gi tr cho php trong nc ung l 5 g/l. DDT Ti nhiu quc gia, DDT b hn ch hoc b cm s dng nhng ti mt s nc khc th vn cn dng rng ri trong nng nghip. y l thuc tr su tn lu v n nh trong hu ht cc iu kin mi trng. DDT v cc cht chuyn ha ca n khng b phn hy bi vi khun trong t. Vi liu thp, DDT v cc cht chuyn ha hu nh c hp thu hon ton ngi qua ng tiu ha hoc h hp, sau tch t cc m m v sa. IARC xp DDT vo nhm 2B (khng bng chng gy ung th cho ngi nhng bng chng gy ung th trn ng vt th nghim) v n gy ung th gan cho chut bch v chut 43

cng trng. Heptachlor v heptachlorepoxide Heptachlor l ha cht tr su ph rng, cho n nay ti nhiu quc gia ngi ta hn ch hoc cm dng. Hin ti, ng dng chnh ca heptachlor l dit mi (bng cch phun vo t) S tip nhim heptachlor lu di c lin quan vi s nhim c h thn kinh v gan. Nm 1991, IARC nh gi li heptachlor v kt lun: bng chng v tnh gy ung th ca n ln ng vt th y , nhng trn ngi th cha, nn n c xp vo nhm 2B. JMPR trc y nhiu ln nh gi heptachlor, cho n nm 1991 thit lp gi tr ADI l 0,1 g/kg th trng da trn NOAEL = 0,025 mg/kg th trng/ngy, thu c t hai nghin cu trn ch vi h s bt nh l 200 (100 v s khc bit v loi v c th v 2 v c s d liu cha hon ton tho ng). Vi s phn b ADI trong nc ung l 1%, gi tr cho php trong nc ung l 0,03 g/l. Isoproturon Isoproturon l cht dit c chn lc dng dit c nht nin v c l ln khi trng ng cc. N c th b thoi bin quang hc, sinh hc v thy phn, tn lu t vi ngy n vi tun. N di chuyn trong t v c pht hin trong nc b mt v nc ngm. Isoproturon c vai tr l cht xc tin ung th hn l mt cht gy ung th. Gi tr cho php trong nc ung l 9 g/l. Lindane Lindane (tc hexachlorocyclohexane, HCH) l mt cht dit cn trng c s dng t lu. Ngoi vic s dng cho cy trng, vt nui, n cn c dng bo qun g. Lindane l mt cht tn lu c i lc vi nc thp v di ng trong t chm, pht hin c trong nc. Nhim 44

Lindane cho ngi xy ra ch yu do thc phm. Gi tr cho php trong nc ung l 2 g/l. Pentachlorophenol Pentachlorophenol (PCP) c dng ch yu bo qun g Ti nhng ni x l g ngi ta c th pht hin nhng nng PCP cao hn nhng ni khc. Ni chung, con ngi b nhim PCP thng qua thc phm v nc ung cng nh o tip xc vi nhng dng c c x l PCP (nh vi vc, da v cc sn phm t giy) v nhiu hn c l do ht th khng kh trong nhng cn phng nhim PCP. Permethrin Permethrin l cht dit cn trng gc pyrethroid tng hp, c dng rng ri bo v ma mng phc v cc hot ng trong y t cng cng. N cn c dng dit b gy trong cc b d tr nc v khng ch s pht trin ca cc ng vt khng xng sng trong cc ng dn nc chn Permethrin c i lc ng k vi t, cc cht lng v c i lc km vi nc. N c th b phn hy quang hc hoc sinh hc v tn lu trong khong thi gian t vi ngy n vi tun. Permethrin khng c tnh gy nhim c en. Gi tr cho php trong nc ung l 20 g/l. Pyridate Pyridate l cht dit c tip xc, c dng bo v ng cc, ng, la v cc hoa mu khc. N c tan trong nc rt thp v tng i t hot ng, khng tn lu m nhanh chng b phn hy, quang phn v phn hy sinh hc. Cc bng chng hin c cho thy pyridate khng c tnh gy nhim c en. Gi tr hng dn c ngh l 100 g/l. Simazine Simazine l cht dit c dng trc khi cy mc v dng c cho vng trng hoa mu ln vng khng c hoa mu. Da trn 45

nghin cu chut cng trng v tnh gy ung th v c tnh do tip xc di ngy ngi ta tm c NOAEL = 0,52 mg/kg th trng/ngy. Vi h s bt nh l 1.000 (100 cho s khc bit v loi v c th, 10 v tnh c l gy ung th), TDI tm c l 0,52g/kg th trng. Vi t phn TDI dnh cho nc ung l 10%, gi tr hng dn cho simazine l 2 g/l. 2.2. C CHT SINH HC Cc bnh truyn nhim gy ra do vi khun, vi rt, ng vt nguyn sinh hoc k sinh trng l nguy c rng khp gy hi i vi sc khe cng ng. Nguy c ny c lin quan nhiu n nc ung v khng kh b nhim. Cc vi khun c nguy c gy bnh khi c mt trong nc nh: Escherichia coli, Vibrio cholerae, Yersinia enterocolitica, Campylobacter jejuni, Campylobacter con, cc virus, cc Gardia k sinh, Cryptosporiium spp, Entamoeba histolytica v Dracunculus nedinensis. Ban u, cc bnh truyn nhim ly qu cht thi, c bit l phn ca ngi v ng vt, khi cng ng c ca bnh hoc ngi lnh mang trng, cc tc nhn gy bnh s c mt trong nc nu ngun nc b nhim phn. S lng ngun nc cho cc mc ch ung, ch bin thc n, tm ra v ngay c vic ht phi hi nc hay kh c nhim cc tc nhn trn s b nhim bnh. Bnh sn mng l mt bnh ch yu vng nhit i v cn nhit i khi pht do tip xc vi nc qua vic tm ra. Sau khi c gii phng khi loi c b nhim, u trng xm nhp vo da ngi. Phng thc ly truyn ca a s cc bnh thng l do trng xm nhp qua thc n b nhim phn hoc thc n nh t nhim phn vo c th (i vi bnh sn ln l do n phi tht sng cha u trng) v qua ng nc ung b nhim phn. 46

Sau khi ri khi c th vt ch, cc tc nhn gy bnh, k sinh trng n dn mt i kh nng sinh sn v gy bnh. T l b tiu hy ca tc nhn lun tng theo cp s nhn v sau mt thi gian nht nh s khng pht hin c chng. Cc tc nhn gy bnh no c kh nng tn ti ngoi mi trng thp phi nhanh chng tm ra vt ch mi tn ti v thng thng chng lan truyn qua ng tip xc, qua thc phm... S tn ti ca vi sinh vt b nh hng bi mt s yu t, trong nhit ng vai tr quan trng nht, nhit cng cao, chng b tiu dit cng nhanh. Chng c th b tiu dit do tc dng ca tia cc tm. Escherichia coli Escherichia coli thuc vi khun ng rut. E.coli c rt nhiu trong phn ngi v sc vt vi nng c th t ti 109g. C th tm thy E.coli trong nc, t v y l nhng ni c kh nng b nhim phn do ngi, sc vt, ng vt hoang i, chim v cht thi nng nghip. Tng s coliform Qua kt qu xt nghim coliform c th nh gi c hiu qu ca cc bin php x l cng nh kh nng r r ca h thng phn phi. Mc d khng phi coliform lun lin quan n nhim phn hoc s hin din ca tc nhn gy bnh trong nc song vn c th s dng kt qu xt nghim chng theo di cht lng nc v vi sinh vt hc. Nu c s nghi ng, c bit l trong trng hp tm thy coliform nhng khng thy cc coliform chu nhit, E. con th phi xc nh loi v xt nghim cc vi sinh vt ch th khc tm ra bn cht ca s nhim. PSP (Paralytic Shellfish Poisons) Trong h sinh thi bin, s chuyn ha PSP t thc vt ph du, qua ng vt ph du n cc loi c c theo di. C, chim bin cht hng lot c bit c lin quan n s n hoa 47

ca cc tc nhn cha PSP. Con ngi b nhim c c lin quan n vic n cc loi trai, s c PSP c theo di nhiu ni trn th gii. Khong 2.500 trng hp b lit do ng c s c xc nhn. C 24 trng hp t vong, 905 nhim PSP t 1969-1983. Du hiu v triu chng l nga v tai nh, t cng mi, t lit hon ton ri cht do kh th. Triu chng din ra rt nhanh trong nhiu pht n hng gi. Lit v kh th dn n t vong t 2-12 gi sau khi n. Tetrodoxin Tetrodoxin c tm thy trong loi c thuc h Tetraodentidae (pufferfish). Trong bung trng, gan, rut c hm lng tetrodoxin rt cao, da hm lng tetrodoxin l thp nht. Loi c cha nhiu c cht nht thy c dc b bin ca Nht Bn v Trung Quc. Cht ny cng c tm thy mt s loi s. Ngoi ra, trn da ca ch ngi ta cng tm thy cht tetrodoxin. Triu chng ca s nhim c bi cht tetrodoxin ng vt cng c th so snh vi triu chng ca s nhim c cht PSP. Tuy nhin cng mc t lit thn kinh c bp th tetrodoxin gy chng gim huyt p ng mch lu di hn v c chng gim thn nhit, cm gic bun nn, mt thng bng, t lit, i ngoi, au vng thng v. Qu trnh h hp b nh hng vi biu hin kh th, hi th nng, th nhanh v c bn b co git, tip da ti xanh v xy ra tim lon nhp. Qu trnh t lc nn nhn b nhim c cho n lc cht khong 6 gi. Nhim c thng gp khi n c (Pufferfish) loi c ny cha 0,5 - 30 g tetrodoxin/1 kg tht c ti). Nht Bn t nm 1974 -1979 c 60 trng hp b nhim c, trong c 20 trng hp b t vong. chu u c 10 trng hp b nhim c trong c 3 trng hp t vong do n c ng lnh nhp khu c cha tetrooxin. c cht gy a chy Trong nhng nm gn y nhiu c cht c tch ra t con 48

s c lin quan n cc cn au bng cho ngi. in hnh l hi chng t l, nn ma, au bng... 5 trong s cc c cht bit r v mt cu trc l cht Okadaic v cc dn xut ca chng. Rt nhiu loi thuc ngnh to, gip c cht Okadaic. c 3.000 trng hp bnh nhn Nht Bn v mt s trng hp khc c chu u v Nam M mc bnh ny. c cht gy tn thng h thn kinh Mt cn bnh ca ngi xut hin lin quan n thy triu do ca loi to gip Gymnodinium xut hin xung quanh vng b bin Florida ca M, gi l c cht gy tn thng h thn kinh (NSP). NSP c lin quan n vic s dng s huyt cha cc t bo c Gymnodinium breue. Nhng triu chng ni bt ca cht gy c thn kinh v bn cht ging vi PSP, tuy nhin khng xut hin chng t lit. c cht t vi khun Lam Lin quan n nhng c cht ny l mt loi vi khun Lam dng si Lynbya majuscula. Hai dng c cht bomoaplysiatoxin v lynbyatoxilz-A d c tch chit t loi Lynbya majuscula. Debomoaplysiatoxin l hp cht khng mu, im tan 100,5 - 107,00C, trng lng phn t 592. Lynbyatoxin - A l hp cht c mu nu, dng tinh th, trng lng phn t 437. Ngoi ra debomoaplysiatoxin cng c tch chit t hai loi to lam khc thuc h Oscilatoria. l Oscilatoria nigroviridis v Schizothrix calcicola Nhng nh hng cp tnh sau khi tip xc vi loi Lynbya majuscula c thng bo t Hawaii (Grauer & Arnold, 1961) v Nht Bn (Hashimoto,1979). Hawaii c hn 125 bnh nhn nm 1958. c im ca bnh ny l nga v nng dt vi pht n vi gi sau khi bi bin ni c mnh v ca to. Trn c th c nhng m , mn nga, sau 3-8 gi tip l mc vy Nhng tn thng ny l do c cht debomoaplysiatoxin gy tc ng trn da. c cht t Cyanobacteria 49

 Hepatotoxin (c cht gy tn thng gan) gy xut huyt gan trn din rng trong vng 24 gi sau khi n phi, dn n t vong. Neurotoxin (c cht gy tn thng h thn kinh).

50

Chng III S HP TH PHN B V O THI

3.1. GII THIU CHUNG C th ngi c ngn cch vi mi trng bn ngoi bi 3 loi mng chnh: Da. Biu m ca h tiu ha. Biu m ca h h hp. Nhn chung, c cht hp th vo c th qua ng tiu ha t hn so vi ng da v biu m ca h h hp. c ca cc cht s b gim bt khi qua ng tiu ha do tc ng ca dch tiu ha. Phi ngi c din tch tip xc vi khng kh l 90 m2 trong 70 m2 l din tch tip xc ca ph nang. Mng li mao mch ca phi c din tch ti 140 m2. Xm nhp vo mu, c cht phi vt qua c cc mng ny trc khi tn cng ln mt khu vc no ca c th. S xm nhp ca mt c cht qua bt k mt mng sinh hc no u c quyt nh bi cc tnh cht ha l ca n nh: - Mc ln ha thp. - H s phn b m/nc ca dng khng ion ha cao. - Cc bn knh nguyn t hoc phn t ca cc cht c kh nng tan t trong nc. Ngay khi mt c cht vt qua cc mng, n nhp vo vng tun hon mu v mang i khp c th vi mt s dng khc nhau: - Cc phn t c kh nng khuch tn t do c ha tan 51

trong nc nh tng. - Cc phn t lin kt thun nghch vi cc protein, chylomicron hoc cc cu t khc ca huyt thanh. - Cc phn t t do hoc lin kt nm trong hng cu v cc yu t to thnh khc. Phn ng sinh hc i vi mt ha cht nguy hi ph thuc trc tip vo liu lng ca ha cht hp th vo c quan ni tng. Tc ng ca bt k mt c cht no cng u ph thuc ch yu vo nng ca n ti khu vc tc ng. Tip xc S tip xc ca c cht vi c th sng c th c hiu l s c mt ca mt xenobiotic (ha cht l i vi c th) trong c th sinh vt. n v ca s tip xc thng c tnh bng ppm (n v mt phn triu) hay n v khi lng trn mt mt khi khng kh, mt lt nc hay mt kg thc phm. Liu lng tip xc qua da thng c tnh bng nng ca dung dch tip xc vi din tch b mt c th. Hp th Hp th l qu trnh cc cht thm qua mng t bo v xm nhp vo mu. S hp th cc c cht cn c th xy ra qua ng tiu ha, h hp, da,... S vn chuyn ca c cht t h tun hon vo trong m cng c gi l s hp th, n tng t nh qu trnh hp th ha cht t b mt c th vo h tun hon. Do vy, phi lun cn nhc hai kha cnh ca s hp th: 1. S vn chuyn t b mt c th vo mu hay huyt thanh. 2. T mu vo cc m. Lng hp th cc cht trong c th ng vt ph thuc vo lng cht a vo, thi gian c th b tip xc, kiu, loi xm nhp... 52

V d: c cht trong khng kh c th dng kh, cng c th dng ht bi. S hp th v thi gian lu tr cc c cht trong c th ng vt ph thuc nhiu vo kch thc ht ca chng. Nhng ht ny c th s kt lng b mt c quan h hp theo 1 trong 3 qu trnh sau: 1. Phn tn ht: xy ra i vi nhng ht c kch thc vi micron khi lung kh gp b mt dc. 2. Lng ng theo lc hp dn: Ph thuc vo khi lng v hnh dng ca ht. i vi ht c ng mt th qu trnh ny thng c ht c ng knh t 0,5 - 5 micro. 3. Khuch tn: Hin tng ny thng c ht c kch thc nh. Ngoi ra, s hp th cn ph thuc vo cc qu trnh phn b, chuyn ha v bi tit trong c th. Phn chuyn T h thng tun hon trong c th, c cht i qua mt, nhiu hay thm ch tt c cc c quan trong c th gi l qu trnh phn chuyn hay s phn chuyn. Phn chuyn l qu trnh vn chuyn c cht sau khi xm nhp vo mu n cc c quan trong c th. Sau mt s cht c th chuyn ha, mt s cht b tch ng trong c th. Tc phn chuyn cc c cht ti t bo ca mi c quan ph thuc vo dng mu lu chuyn qua c quan . Tuy nhin, s phn chuyn ca bt k mt cht no c th b nh hng bi s tch ly ti cc t bo khc nhau trong c th m c th c xem nh nhng khu vc lu gi. Cc khu vc ny l: - Cc protein ca huyt tng - M ca c th - Xng - Gan v thn 53

Do phn ng l ha ca c cht vi cc h thng c quan tng ng m c s phn b c bit cho tng cht: c cht c tnh in ly lu gi mt s t chc v c quan khc nhau nh ch, fluor tp trung trong xng, bc, vng da, hoc lng ng gan, thn di dng phc cht. Cc cht khng in ly loi dung mi hu c tan trong m tp trung trong cc t chc giu m nh thn kinh. Cc cht khng in ly v khng ha tan trong cc cht bo ni chung thm vo t chc km hn v ph thuc vo kch thc phn t v nng c cht. Bi tit Cc c cht o thi ra ngoi c th theo ng thn, tiu ha, da, tu thuc vo tnh cht l ha ca chng. Thn l c quan o thi chnh. Bn cnh , c cht cng c o thi qua cc ni c quan khc nh: Kim loi nng thng o thi ra khi c th qua ng rut..., gan mt s c cht c chuyn ha ri lin hp sulfo hoc glucuonic, sau c o thi. Qua hi th c th o thi mt s ln c cht di dng kh hi. Ngoi ra cc c cht cng cn c bi tit qua m hi v sa. Tn lu Kh nng tn lu ca cc cht trong c th ph thuc vo c im ha hc, cu trc phn t v tnh cht vt l ca chng. Mt s cht thng tp trung cc t chc m nh Chlordane, DDT, PCB (polyclorobiphenyl). Protein ca plasma c th lin kt vi Cu, Zn. Cn Pb tch ng trong xng. 3.2. MNG T BO c th hiu c qu trnh hp th ha cht t b mt ca c th vo mu v t mu vo n cc m cn phi nghin cu cu trc v bn cht ha hc ca mng t bo. Hu nh tt c 54

cc trng hp cc c cht phi i qua mng t bo ti nhng im nht nh c th gy nn phn ng sinh hc. Hnh 2 l s c trng ca mt mng t bo ng vt. Mt phn ca mng t bo ny c phng i hnh 3 biu din cc phospholipid v protein cu to nn mng t bo.

Hnh 3 cc phn t phosphohpid c biu th bng nhng hnh van sm mu vi hai ui v protein ca mng t bo 55

c biu din bng nhng ng xon mang theo hai in tch m v in tch dng.

Hnh 5 biu din mt phn t phospholipid, l thnh phn chnh to nn mng t bo. Trong minh ha ny phosphatidylchohne distearate c s ng lm v d (trong thc t c rt nhiu loi phn t tng t trong mng t bo) v tnh phn cc, u tan c trong nc v tnh khng phn cc, phn ui tan c trong m ca phn t.

Mng t bo ng vai tr nh mt lp du mng (cht lipid lng) trong mi trng lng (nc). Cc protein hnh cu trong 56

cc phn lng ca mng t bo di chuyn t do trn nhng phn bng phng ca mng (hnh 5). Mt s cc protein ny hon ton i qua mng t bo, to ra nhng rnh lng i xuyn qua lp mng lipid. Nhng phn t tan trong nc c kch thc nh v cc con c th thm thu qua nhng rnh lng ny, trong khi nhng phn t tan c. trong m c th thm thu t do qua cc thnh phn phospholipid ca mng t bo. Cc phn t tan trong nc c kch thc ln khng th ngay lp tc i qua mng t bo tr khi bng mt c ch vn chuyn c bit. Do thnh phn ch yu cu to nn mng t bo l phospholipid, nn nhng hp cht tan trong m i qua mng t bo nhanh hn rt nhiu so vi nhng hp cht tan trong nc. Nhng hp cht tan trong nc khng th no i qua c mng t bo mt khi rnh protein khng c to thnh. Do vy, trn c s cu trc ca mng t bo c th tm tt chung v qu trnh hp th nh sau: Cc hp cht tan trong m c hp th qua b mt c th nhanh hn (thng nhanh hn gp nhiu ln) so vi cc hp cht tan trong nc, cc hp cht tan trong nc ch c th i qua c mng t bo bng mt c ch vn chuyn c bit. Con ng chnh cc c cht trong mi trng i vo c th l thng qua da, qua phi v thnh rut. Mt s xenobiotic c th tc ng trc tip t b mt bn ngoi ca mng dch bo, chng c gn vo nhng protein c bit (c quan tip nhn) trn mng t bo. Phn ng m cc c quan tip nhn trn mng t bo lm cho cc hp cht sn c th chuyn ng t mng dch bo n nhng b phn khc ca t bo (nh l nhn t bo) s tc ng n phn ng. 3.3. HP TH C CHT QUA DA Rt nhiu hp cht c s dng cho cc mc ch nng nghip v cng nghip c kh nng tan trong m cao v gy c cho ngi s dng. Cc hp cht l cc thuc tr su photpht (DFP, parathion, malathion) v cc dung mi hu c 57

khc CCL4. v.v.. Mt cht y dnh trn da c th c 4 phn ng sau: Da v t chc m tc dng nh hng ro bo v chng li s xm nhp ca c cht gy tn thng c th. - c cht c th phn ng vi b mt da v gy vim da s pht. - c cht xm nhp qua da, kt hp vi t chc protein gy cm ng da. - c cht xm nhp qua da vo mu. C hai ng hp th qua da l qua t bo.da, qua tuyn b v cc tuyn khc. Qua t bo l ng c bn C nhiu yu t nh hng n hp th c cht qua da: Cu trc ha hc, tnh cht l ha, c cht, nhit mi trng, vng gii phu da khc nhau...

58

Hu ht cc c cht c hp th thng qua cc t bo biu b. Tuyn m hi v chn tc chim t hn 1% din tch b mt c th v ch mt s t cc c cht c hp th vo c th qua nhng im ny. Lp sng l lp ngoi cng ca biu b. Cc t bo biu b c gn vi nhau to nn mt lp mng chc kho, un c. Nhng si keratin cha trong nhng t bo ny c ph mt lp lipid mng. Lp biu b l lp mng khng ch tc hp th. Mt c cht mun c hp th qua da vo h tun hon phi i qua hng lot nhng lp t bo Tc di chuyn ca c cht t lp biu b vo h tun hon ph thuc vo dy ca da, tc dng mu, ca huyt thanh v cc yu t khc. Tc hp th cng nhanh, lng ca c cht c trong mu cng cao. Nhng vng da khc nhau trong c th c nhng tc hp th cc c cht khc nhau. 3.4. HP TH C CHT QUA PHI Cc c cht tip xc khi ht th s hp th qua phi. Cc c cht thuc nhm ny thng l cc kh nh CO, NO2, SO2 hi ca cc cht lng d bay hi nh benzen, CCl4 hi ch trong xng v cc Sol kh. Phi ngi c mt din tch tip xc vi khng kh l 90m2 trong 70m2 l din tch tip xc ca ph nang. Ngoi ra cn c mt mng li mao mch phong ph vi din tch l 140m2, dng mu qua phi nhanh v to iu kin thun li cho s hp thu cc cht c trong khng kh qua ph nang vo mao mch. Khong cch gia lp biu m mng phi v thnh mch mu khong 10 micron (hnh 7).

59

Ty theo bn cht ca c cht m gy phn ng trn ng h hp dn n tn thng nh kch thch, vim nhim, ph n, gin ph nang, x phi v.v... Cc cht kh c kh nng tan trong nc khi vo c th s tan trong nc nhy kh qun, tch ng v gy tn thng. Cc cht kh tan trong m thm thu qua mng phi vi tc ph thuc vo h s t s phn b m/nc v s ho tan ca kh trong mu. Cc ht bi c ng knh ln hn 10 m thng gy tc ng n dng h hp trn, c bit l phn mi v kh qun. Cc ht c ng knh t 1 n 5 m tc ng n phi v cc mao mch trong phi. Cc ht c ng knh nh hn 1 cm thng n ti mng phi. Cc ht lt vo phn trn ca h h hp thng b thi ra thng qua vic ho, ht hi hoc i khi nut vo theo ng tiu ha. Cc ht mc vo phn di. ca h h hp c th s c vn chuyn n tn mng phi. S vn chuyn ny ph thuc vo tc vn chuyn ca bch cu, cc hot ng ca cc mao mch v thnh mch mu ca mng phi v cc yu t khc. Trung 60

bnh khong 1/2 cc cht s thm nhp vo c th trong vng mt ngy, iu ny cng cn ph thuc vo bn cht ca c cht. Phn cn li s c thm nhp trong nhng ngy tip theo, thm ch hng nm sau. Cc ht tan thm qua mng phi i vo h tun hon mu. Cc ht khng tan c khuch tn chm hn v vo n c mch mu thng qua h tun hon ca bch cu. Bn cnh , qua hi th cng c th o thi mt s c cht di dng kh, hi. 3.5. HP TH C CHT QUA MNG RUT Nhiu c cht mi trng l cc cu t ca thc phm v do c hp th qua h tiu ha. Cc c cht thng rt ging cc cht dinh dng v cu trc v cc cht in ly thng vn chuyn chng vo mu. Nhn chung, c cht hp th qua ng tiu ha t hn so vi hai ng h hp v da. Ngoi ra, tnh c ca nhiu cht s b gim khi i qua ng tiu ha do tc ng ca dch d dy (axt) v dch ty (kim).

S hp th c th xy ra t ming cho n rut gi. Ni chung, cc hp cht c hp th qua rut ti nhng ni chng c mt vi nng cao nht v dng tan c trong m. Rt nhiu cc c cht mang tnh axt nh hay kim nh v tn ti di dng hn hp ca cc cht c ton ha v khng c ion ha. 61

Cc dng khng ton ha v c phn cc thp nht thng l c kh nng tan trong m v d khuch tn qua mng m. Nhng qu trnh chuyn ha sinh ha quan trng c th din ra trong rut v cc qu trnh ny c th s lm thay i hp th cc c cht hay thay i c tnh ca ha cht Nhng chuyn ha ny thc hin c l nh c cc vi khun ng rut. Phn c cht tn ti di dng khng ton ho ph thuc vo hng s in ly ca hp cht v vo pa ca dung dch m chng ha tan trong . Phng trnh Henderson-Hasselbach ch ra mi quan h trong mi trng axt yu. pH= pKa + log [(kim)/(axt)] Kim c th coi nh cht nhn ion H+ v axt nh l cht cho ion H+. Khi mt axt yu c ton ha mt na, nng kim tng ng vi nng axt, v gi tr Logarit biu din trong phng trnh ni trn s bng khng. Do vy ti im bn ln ha pha bng pH. pH thp khng ion ha ion ha pH CaO ion ha khng ion ha

axt yu kim yu

3.6. CHUYN HA C CHT c cht vo c th tham gia vo mi phn ng sinh ha hc hay l qu trnh bin i sinh hc. Qu trnh ny c th xy ra nhiu b phn v m. V tr chnh xy ra s trao i ha hc l gan, da v phi. Hot tnh enzym trao i cht c th c tm thy trong nguyn sinh cht, ty lp th, mng ni cht ca t bo gan (parenchymal). c tnh chung ca hu ht qu trnh chuyn ha cc sn phm ca s trao i cht l phn cc hn so vi cc cht ban 62

u. Qu trnh ny s thun li cho s o thi ca cc c cht vo nc tiu v mt. S trao i cht c th chia thnh 2 loi tu theo cc phn ng enzym: Cc phn ng ca giai on 1 - Oxy ha: L dng thng thng nht ca phn ng chuyn ha sinh hc gm oxy ha ru, aldehyt thnh cc axit tng ng, oxy ha cc nhm alkyl thnh cc alcol, nht thnh nitrat... - Kh oxy: t gp hn qu trnh oxy ha, v d aldehyt v xe ton thnh alcol, clorat thnh tricloretanol, cc nitro (- NO2) ca cacbua thm c kh thnh quan (- NH2) - Thy phn: i vi cc cht hu c, qu trnh thy phn nh enzym, cn i vi cht v c ch l phn ng thng thng. Thy phn cc hp cht ca carbon, sulfuanit rogen v photphat a n hnh thnh cc axit v ru. Cc ester thy phn thnh cc amide nh nhiu loi enzym tu thuc vo nhm alkyl. Cc phn ng ca giai on 1 chuyn ha cc ha cht thnh cc dn xut vi cc nht?i chc nng thch hp cho cc phn ng giai on 2. Cc h thng enzym chnh tham gia vo cc phn ng trong giai on 1 l cc oxydaza hoc monooxygenaza phi hp vi cytochrome. Cc phn ng ca giai on 2: Phn ng lin h Cc phn ng ca giai on 2 tham gia vo s tng hp dn xut ca cht l. Cc phn ng ny c xem nh phn ng lin hp. N ng mt vai tr quan trng trong qu trnh trao i cht loi b c tnh. C nhiu loi lin lp: - Lin hp vi lu hunh (S): axit cyanhydric v cc cyanua lin hp vi S to thnh thiocyanat khng c v thi vo nc tiu. 63

Lin hp vi nhm methyl (- CH3) - Lin hp vi H2SO4: Phn ln cacbua thm v dn xut ni tro v quan ca n b oxy ha (hoc kh), sau lin hp vi H2SO4 ri thi vo nc tiu di dng mui kim. Lin hp vi glucuronic: rt nhiu cht c o thi qua nc tiu di dng lin hp vi axit glucuronic nh phenol v dn xut, alcaloid, cc steroid. Cc phn ng lin hp glucuronic xy ra gan. - Lin hp vi glycin: Cc axit thm thng lin hp vi glycin. 3.7. CC C CHT KT HP VI PROTEIN S phn b v o thi cc c cht ph thuc vo: 1. Hm lng nc 2. Hm lng m 3. S kt hp ca cc phn t ln 4. Qu trnh di chuyn trong no 5. o thi qua phi 6. o thi qua thn 7. o thi qua mt 8. Qu trnh trao i cht 9. Sn xut sa, m hi, nc bt, nc mt. S kt hp ca c cht vi protein tng t nh lp lin kt enzym. S lin kt ny khng phi l lin kt ha tr m l lin kt tn, do vy qu trnh ny c th o ngc c. S kt hp vi protein din ra cc protein nm trong dch bo v m. Khng phi tt c cc protein u lin kt vi mt mc nh nhau m ph thuc vo kiu, s lng cc im lin kt, pa ca mi trng (tc nhn iu tit qu trnh ion ha). Albumin l protein quan trng nht (chng chim n 50% protein ca dch bo). 64

Ti pH= 7,4 albumin c nhiu in tch m hn in tch dng. Ti pH = 5 chng c khong 100 in tch m v 100 in tch dng trn mt phn t. Cc phn ng sinh hc ph thuc vo nng ca cc c cht khng c lin kt trong dch bo. Cc c cht lin kt n nh vi cc protein ca mu s tch t li trong c th v s tr nn nguy him. Cc hp cht lin kt trong dch bo c th bt ng c thi ra nu nhu xut hin mt hp cht mi cnh tranh lin kt cng a im lin kt ca c cht c. V d: Mt s tr s sinh thiu enzym glucuronyl transferase trong mu, cc enzym ny c chc nng kt hp vi bilirubin (sn phm phn hy ca hemoglobin). Kt qu l c mt lng ln bilirubin lin kt vi albumin ca mu (bnh hyperbilirubinemaia). Nu v mt l do no nhng tr s sinh ny c s dng mt liu sulphonamide hay vitamin K th cc hp cht ny s thay th v tr ca bilirubin trong albumin, khi lng bihrubin c gii phng va chng c th thm nhp vo no gy ra mt bnh gi l kernicterus (mt.loi bnh ph hy mt s lng ln cc t bo no). 3.8. O THI CC CHT C o thi cc c cht khi c th c th xy ra theo nhiu cch khc nhau. Thn l c quan chnh chu trch nhim thi loi cc c cht v cc cht l khi c th. Bn cnh , mt v phi cng c th o thi c cht ra khi c th. V nguyn tc, qu trnh o thi ging vi qu trnh hp th, vn chuyn cc ha cht i qua cc mng sinh hc da vo s chnh lch v nng ha cht. Ha cht di chuyn t im c nng cao n im c nng thp hn. Bi tit dch vng ca gan l mt v d ca s o thi cc 65

hp cht ha hc tan trong nc. Cc tc nhn gy c c th c o thi vo nc tiu qua con ng lc ca tiu cu, khuy ch tn v tit qua ng nc tiu. C ch o thi ca thn thng loi mt phn c cht khng b bin i trong mu qua thn. Bi tit cc c cht c th thng qua hai c ch bi tit ng: Mt c ch do cc anion hu c (axit) v mt c ch cho cc chun hu c (baz). Cc c cht lin kt protein khng b o thi bi s lc ca tiu cu thn hoc s khuch tn th ng, n b thi ra qua qu trnh bi tit ch ng. Cc cht s dng cng mt c ch vn chuyn ch ng s cnh tranh nhau ginh c h thng vn chuyn ch ng ca thn. Cc hp cht tan trong m o thi ra khi c th rt chm qua cc dng tun hon thi cht lng (nc) nh nc tiu hay ch vng ca gan. Do vy, cc hp cht tan trong m thng tch ng rt lu trong c th ngi, cho n tn khi chng b chuyn ha thnh nhng dn xut tan c trong nc. Cc hp cht tan trong m c thn lc ra khi mu thng li nhanh chng b hp th li vo mu li thn nu nh nc tiu khng c thi ngay ra ngoi c th. Mt c cht c th c o thi bi cc t bo gan vo trong mt, sau i vo rut. Nu cc tnh cht thch hp cho s hp th li, mt s hp cht c th c quay vng qua qu trnh hp th li t h tiu ha vo h tun hon (chu trnh gan rut) cho n khi c thi loi cui cng qua thn. S bi tit qua mt ng vai tr ch yu trong vic o thi ba loi hp cht vi trng lng phn t ln hn 300: Cc anion, cc chun v cc phn t khng b ton ha cha c cc nhm phn cc v cc nhm a m. Cc hp cht c khi lng phn t thp b bi tit ch yu trong mt, iu ny c l l o chng b hp th li khi i qua. Mt s c cht c chuyn ha ri lin hp sufo hoc glucuronic ri o thi qua mt. 66

Tc o thi S o thi ph thuc vo - Tc ca s kh hot tnh sinh ha - Tc bi tit Cng ca cc tc ng c hi ph thuc vo hm s nng ha cht ti khu vc b nhim. Trong hu ht cc trng hp, hp th l thm thu th ng. Do vy, chnh lch v nng ti khu vc hp. th v mu, nng hp th c biu th bng phng trnh m. log M = Log Mo - (Kat)/2,30 Trong : Mo: nng ca ha cht ti a im hp th thi im bt u. M: nng ca ha cht a im hp th ti thi im t. Ka: hng s hp th, tng ng vi 0,693: t1/2 t1/2: thi gian bn hp th (thi gian khi M/Mo=1/2) V d: Nng c cht tiu ha trong d dy xc nh tc c cht c hp th vo mu. Khi nng c cht trong d dy gim do c hp th bt vo mu, tc hp th sau cng gim dn. Phn ln, cc c cht vi nng thp b thi loi ra khi c th vi tc ph thuc vo nng trong mu v kh nng chuyn ha sang cc hp cht tan c trong nc. Nu c cht tan c trong m, o thi trc tip rt kh khn, lc ny tc o thi coi nh bng khng.

67

Chng IV CC YU T NH HNG N C TNH

4.1. BN CHT HA HC V BN CHT L HA CA CHNG Bn cht ha cht v cc c tnh l ha ca chng s xc nh mc cc hot tnh sinh hc. Cc kh rt d dng b hp th thng qua h thng h hp, c bit l thng qua phi i vo mu v cc phn ng ca c th i vi cc cht kh ny thng l phn ng cc b (nh i vi zn) hay h thng (nh t vi cc cht kh dng gy m). Hi nc v cc ht bi lng cng c th d dng c hp th t h thng kh qun. Chng c th kt hp vi nc trong h thng kh qun v to ra nhng nguyn vt liu cho phn ng v gy nn nhng tn thng cc b, nh hi formaldehyde, lu hunh i-xyt, xyt nit. Cc ht bi c th di chuyn n ph nang v hn ch s trao i kh y. Nhng ht ny bao gm c cacbon v silicat. Cc ha cht v ngay c cc vi sinh vt cng c th c hp th vo cc ht bi ri i vo c th v gy ra nhng phn ng mang tnh cc b hay mang tnh h thng. Cc protein b chuyn ha trong h thng tiu ha v thng thng chng mt ht hot tnh. C nhiu yu t quyt nh tc hi ca cc c cht i vi c th: Cu trc ha hc Theo Lazarev, cu trc ha hc quyt nh tnh cht l ha v hot tnh ha hc ca c cht. Nhng tnh cht trn li quyt nh hot tnh sinh vt hc ca c cht.

68

Visacscon a ra quy lut hot ng cc cht ha hc da vo cu trc ha hc: + Cc hp cht cacbonhydro c tnh c tng t l thun vi s nguyn t carbon c trong phn t, th d: pental (5C) c hn bu tan (4C) Butylic (4C) c hn etylic (2C) + Trong nhng hp cht c cng s nguyn t, nhng hp cht cha t nguyn t c hn cc hp cht cha nhiu nguyn t, th d: Nitrit (NO2) c hn nitrat (NO3) oxyt Carbon (CO) c hn carbonic (CO2) + Khi nguyn t halogen thay th cho hyro nhiu bao nhiu trong cc hp cht hu c th c tnh tng ln by nhiu, th d: Tetracloruacarbon (CCl4) c hn Chlorofoc (CHCl3) + Gc no (-NO2) v gc amino (-NH2) thay th cho H trong cc hp cht carbua vng nhiu bao nhiu th c tnh tng ln by nhiu, th d: nitrobenzen (C6H5NO2) c hn benzen (C6H6) Tnh cht l hc ca c cht c c trng bng nhit si bay hi, ho tan, kh nng hp ph... Nhit si xc nh cc hng s l hc khc nh tnh bay hi v tc bay hi. Cc cht bay hi cao to ra nng cao trong khng kh. 69

Cc cht c tnh bay hi ca c kh nng to ra trong khng kh ca ni lm vic mt nng cao. Mt khc cc cht c tnh bay hi cao s lm tng t trng khng kh ln. Tnh ha tan: Cc tnh cht l ha k c dng ca ha cht (cht bt, cht lng, cht kh) v ha tan trong m s xc nh tc v cng vn chuyn ha cht qua mng t bo cng nh nng ha cht ti c quan tip nhn. c cht cng d ha tan trong nc, trong dch th v m th cng c. Cc cht cng d tan trong m th c tnh cho h thn kinh cng cao. Cc ha cht tan c trong m c th d dng i qua mng t bo hn cc ha cht tan c trong nc. ha tan trong m c biu th bng h s Oerton Mayer l t s gia ha tan ca mt cht trong m so vi nc. V d: Benzen c h s l 300 c hn ru etylic c h sm 2,5. Mc ln ha cng lm nh hng n di chuyn ca ha cht. S lng ng sinh hc cng ph thuc vo nhng tnh cht ny. S lng ng sinh hc y bao gm c hp th, phn b, chuyn ha sinh hc, o thi v c cu tnh ng hc ca nhng qu trnh ny. Trong qu trnh chuyn ha sinh hc, c th thng chuyn ha cc hp cht tan trong m sang mt dng khc d o thi v t hot tnh hn di dng ha cht tan c trong nc. Kh nng hp ph l kh nng tp trung nhng cht dng kh, bi, hi trn b mt mt cht rn. Mc hp ph ty thuc vo kh nng hp ph ca vt liu xy dng, nhit khng kh, nng c cht v thi gian tip xc. Tc dng phi hp ca c cht

Trong thc t khi c nhiu c cht cng tn ti th tnh c s thay i, c th tng cng v cng c th tiu gim c. 4. 2. IU KIN TIP XC Ngoi bn cht ca ha cht v cc c tnh l ha ca 70

chng, phn ng i vi mt ha cht thng b nh hng bi iu kin tip xc bao gm liu lng hay nng , dng tip xc v thi gian tip xc. Liu lng c th tip nhn c v phng din sinh hc ca tc nhn, nng ti c quan tip nhn s xc nh cng phn ng. C th ni "liu lng lm cc cht tr thnh c cht". ng tip xc cng l mt yu t ng k nh hng n phn ng. V d ng vt tip xc vi methylene chloride qua ng h hp s b ung th, nhng cc ng vt cng tip xc vi ha cht ny qua con ng tiu ha th khng b. Tip xc trong mt thi gian ngn thng ch b nhng tc ng gy hi mang tnh c th phc hi c, nhng nu tip xc trong mt th gian di s b nhng tc hi khng th phc hi c. V d tip xc vi ru trong mt thi gian ngn c th lm cho gan khng th lc ni m trong mt thi gian nht nh, nhng nu tip xc trong mt thi gian di th s dn n bnh x gan. Phn ng i vi mt ha cht c th c xc nh bi ln ca mi lin kt vi c quan tip nhn, l s lng cc c quan tip nhn ring bit c ha cht chim gi v thi gian tng tc gia ha cht - c quan tip nhn. l hm s ca bn cht mi lin kt ha hc (hydrogen hay Van dt Waals) v nng ha cht ti c quan tip nhn. Liu lng hay nng cng ln th s c quan tip nhn tham gia cng nhiu, s lin kt lu hn, phn ng gy ra ln hn v trong mt thi gian di hn. V d, ngi ta tnh ton liu lng caffein trong 100 tch c ph c th gy cht ngi; lng solanine tm thy trong 180 kg khoai ty c th gy cht ngi. Liu lng ha cht c biu th nh mg/kg trng lng c th hoc mg/m2 din tch b mt c th. ng tip xc nh hng n phn ng ca ha cht do chng s xc nh mt lng ln nh th no c thm nhp vo c th. Con ng tip xc thng thng l qua ming vo n h tiu ha, qua da, qua h h hp. V d, khi ta tip xc vi 71

nc qua ming hay qua da, iu ny chng gy nn mt tc ng xu no, nhng nu ta tip xc vi nc qua phi th iu ny c th lm cht ngi. Cc vt cht c th c hp th qua ming. Mt s ha cht b phn hy do cc axt c sn trong d dy, trong khi cc ha cht khc li c th d dng b hp th trong d dy (v d nh ru). S c mt ca thc phm (loi v khi lng thc phm) trong h tiu ha, tn ti ca cc bnh v trng thi cc vi sinh vt cng gy nh hng n hp th. Cc vt cht, nht l cc cht tan trong m khi tip xc vi mt lp da nguyn lnh c th gy nn nhng phn ng c tnh cht h thng hoc ch gy ra nhng tc ng cc b. Nhng nu nh da b xy xc th cc cht rt d thm qua, vo c th v lc ny barie ngn cn khuch tn ca vt cht qua da b lm cho km hiu qu. Vic hp th qua h thng h hp ph thuc vo tnh cht l ha ca ha cht, k c kch c ht (chiu di v ng knh), tnh ho tan trong nc v ph thuc vo tc v su khi th. V d, nhng ngi v ngh nghip phi tip xc vi g v cc dung mi hu c, nikel, cc loi du bi trn, crom c th s b mc bnh l lot hay thm ch ung th mi, v mi phi lc cc cht ny hng ngy. Cc ht khng ha tan c th c th gy hi n h thng h hp. V d cc si aming, cc bi than silic c th gy ln bnh vim x phi v thm ch aming cn gy nn ung th phi. Cc dng ht cht trn c th b cc ha cht hay cc vi sinh vt bm vo b mt. Cc ht vi ng knh t hn vi micron khng hp th m c y ra theo hi th, cc ht vi ng knh nh hn 7 micron th tn ti trong kh qun v phi, cc ht c ng knh ln hn 7 micron cc lng mi chn li hay y li ln mi theo mt c ch c bit, qu trnh ny gi l qu trnh lm sch, sau c chuyn vo cung hng v b nut vo thc qun. Trong h tiu ha, cc ht ny c th tng tc vi thnh rut v 72

c th trc tip gy ra tn thng. Ha cht hay vi sinh vt bm trn ht cng c th tng tc vi thnh rut v gy tn thng, hoc lm ri lon hot ng bnh thng ca cc vi sinh vt ng rut, hu qu gy tn thng hay thay i chc nng ca chng. Phn nhiu nhng tip xc vi ha cht ngy ra ng thi do nhiu ng, nhng khng phi tt c cc ha cht u c hp th qua tt c mi ng. V d cc thuc tr su nhm ln hu c nhn chung hp th vo c th qua tt c cc ng v gy c nh nhau khng phn bit v con ng thm nhp. Ung vitamin D vi nng cao c th gy c, nhng nu tip xc vi vitamin D qua da th khng gy nn c tnh no. Thy ngn kim loi khng c nu b thm nhp qua tt c cc ng; nu thm nhp qua ng thc n n s c thi nguyn vn ra ngoi. Song nu hi ca thy ngn b ht vo qua. phi hay tip xc vi hi qua da th n s b hp th v gy nn c tnh rt ln. 4.3. LOI, GII TNH, TUI V CC YU T DI TRUYN TI THI IM TIP XC. Phn ng i vi mt ha cht mang tnh c th ring v loi. V d methanol rt c hi i vi con ngi v cc loi ng vt linh trng, n c th gy m cho nhng loi ny, nhng khng gy m cho cc loi khc. Cht triorthocresyl phosphate (TOCP) gy bnh demyelination cho ngi v cho g nhng khng gy cc bnh ny cho cc loi khc. Nitrobenzen gy nn bnh v mu gi l methemoglobineme v n rt c i vi con ngi nhng li khng c i vi kh, chut hay th. Alflatoxin B c th gy nn ung th cho c hi. 1,2dichloroethane gy ung th phi chut nht nhng khng gy ung th cho chut to. C quan ni tng m c cht tc ng vo cng khc nhau i vi nhng loi khc nhau. V d, dibutylnitrosamine gy ung th gan chut ln v cho ln nhng li gy ung th bng quang v ung th thc qun chut nht. 73

C s ca tnh c th i vi cc loi ph thuc nhiu v s chuyn ha sinh hc, khc nhau v sinh l (v d: Cc loi gm nhm khng bao gi nn, nhng ch v mo th li nn rt d dng hay qu trnh trao i cht, h hp ca cc loi gm nhm cao hn so vi ngi), khc nhau v h tiu ha gia cc sinh vt. khc nhau v hnh th (da ca ch khc vi da ngi nn ch khng b tot m hi), khc nhau v kch thc, khi lng hay din tch b mt c th. Tc ng ca cc ha cht trong c th ngi. ch c nh gi khi c cc s liu c cht hc thu c t cc th nghim da trn c s ng vt. Ni chung, cc. loi ng vt phn loi gn ngi c th c coi l loi ph hp hn nghin cu c cht hc. Trong mt s trng hp nghin cu c th s dng n cc loi ng vt mang tnh nhy cm cao. Phn ng i vi hoa cht c th b nh hng bi tui ca c th ti thi im tip xc. V d, DDT khng c tnh c hi tc thi i vi nhng con chut mi sinh nhng chng s tr nn c hi hn rt nhiu i vi nhng con chut c tui i lu hn; Parathion li c hi hn i vi nhng con chut mi sinh hn l nhng con chut c tui i lu hn; Boric axt c vi chut mi sinh hn l vi chut c tui i lu hn... C s ca nhng khc bit trong phn ng c th lin quan n kch thc c th, trng lng, b mt, thnh phn cu to c th, kh nng chuyn ha sinh hc, hay cc yu t khc cha c xc nh. Phn ng vi ha cht cn ph thuc nhiu n gii tnh. V d, chut c nhy cm hn chut ci gp 10 ln khi b tip xc lu vi DDT. Mt s cc hp cht photpho hu c c hn i vi chut Pht ci v chut ci to trong khi mt s hp cht khc li c hn i vi chut c. Do nhng s khc nhau v gii tnh thng b mt i khi b phn sinh dc b ct b v 74

nhng khc nhau ny cng ch c th hin nhng c th trng thnh, c ch hot ng y l c ch hot ng do hormon iu khin. 4.4. TNH TRNG CA SINH VT TI THI IM TIP XC Tnh trng sc kho ca sinh vt, trong tnh trng bnh tt c th gy nh hng trc tip n cc phn ng ca ha cht. Thng thng iu ny gy nn nhng nh hng xu n tn ng ca ha cht trong c th sinh vt. Thc n c y protein v cc cht vi lng (v d nh vitamin) c th bo v c th khi c tnh ca mt s tc nhn. Cc loi chut nht v chut to khi c n thc n dinh dng nhng t v khi lng, cho thy c nhng khi u pht trin trong c th chng. Thiu vitamin c th ko di thi gian hot ng ca ha cht (v d, bnh thiu vitamin C ko di thi gian hot ng ca pentobarbital). Khi gan b bnh (v d nh khi b tip xc vi cc hydrocarbon b halogen ha) th phn ng ca gan i vi ru c th b ko di hn do c ch chuyn ha sinh hc ca ru trong gan b thay i. S tn ti cc bnh v gan hay phi lm tng cc tc ng c hi ca cc tc nhn gy c i vi gan v phi. S tn ti ca cc bnh v thn gy nh hng n s o thi cc ha cht v ko di thi gian hot ng ca cc ha cht ny trong c th. 4.5. S C MT CA CC HA CHT TRONG C TH SINH VT,TRONG MI TRNG V TRONG THI GIAN TIP XC Cng vic nh gi c tnh ca hn hp cc loi ha cht s dng trong cuc sng l vic kh khn i vi cc nh nghin cu c cht hc. Nhn chung, mt s mi tng tc gia cc ha cht, nh gia cc dc phm vi nhau, gia dc phm vi thc phm 75

(vic hn ch s dng cc sn phm t sa khi ang s dng khng sinh tetracycline do s lin kt ca canxi vi tetracycline v to thnh nhng hp cht khng tan.) cng c khng nh. Nhng nghin cu cn thc hin thit lp ni quy, hng dn s dng ha cht mt cch an ton... v ang c thc hin. Cc v d v mi tng tc trong c cht hc nh: tng c tnh ca carbon tetrachlride do phenobarbital, tng cc phn ng ca phi i vi cc tc nhn gy ung th do vic ht thuc, ht cc kh tim nng gy ung th. Tng tc c th c phn ra: dng tng tc ho hc v tng tc sinh hc. Tng tc sinh hc gy nh hng n mt ha cht trong qu trnh tn ng sinh hc, hoc hot tnh c quan tip nhn mt ha cht khc. Tng tc ha hc lin quan n cc phn ng gia cc ha cht, gy nn hu qu trong vic hnh thnh cc cht c hot tnh v khng c hot tnh v phng din sinh hc. Mt khc tng tc ha hc c th xy ra bn ngoi hoc bn trong c th. Cc yu t nh hng n tng tc bao gm: a im tng tc, mi lin quan gia liu lng - p ng ca cc cht tham gia tng tc, mi lin h vi thi gian, nhng c tnh v phng din l ha hc v tnh trng ca i tng tip xc. Tng tc ha hc c th xy ra bn ngoi c th (exvivo), trong khng kh (v d: s to thnh axt sulphuric t kh xt lu hunh v nc), trong nc (nh to thnh trihalomethane t axt humic v chlorin), v trong thc phm (nh hp th cc cht vi lng). Tng tc sinh hc c th xut hin bn trong c th (exvivo) v thng lin quan n s lng ng sinh hc (bao gm hp th, phn b, chuyn ha sinh hc, o thi v.v...), hoc hot tnh ca c quan tip nhn. Tng tc xy ra trong c th c th lin quan n hp th cc cht tham gia tng tc v c th b nh hng bi cc tc nhn l ha (nh pH, pKa,tnh tan, c ht, kch thc phn t, s 76

lin kt), hp ph, cnh tranh c cc a im di chuyn qua mng t bo, ng nht ca b mt hp th. Vn chuyn ca cc cht tng tc thng lin quan n cc yu t l ha, cc protein lin kt (nh albumin), cc phn t c kch thc ln v s lu chuyn ca mu. Phn b v tch tr ca cc cht tham gia tng tc lin quan n cc yu t. l, ha, cc protein lin kt, cc phn t c kch thc ln v s lu chuyn ca mu. Chuyn ha sinh hc ca cc cht tng tc lin quan n ng nht ca cc m tham gia chuyn ha, cc enzym kch thch, hoc cc enzym c ch v s lu chuyn ca mu. S o thi cc cht tng tc lin quan n cc yu t. l ha, ng nht ca c quan tham gia o thi, cnh tranh c c a im lu chuyn mu. Mc hot ng ca c quan tip nhn cc cht tng tc lin quan n cc yu t. l ha, mi lin kt (tnh c th/ tnh chn lc/ i lc). S tng tc vi cc c quan tip nhn tch cc c th to thnh phn ng. S tng tc vi cc c quan tip nhn khng tch cc khng gy nn phn ng m i khi cc cht tng tc li tch tr li trong c th. Mc phn ng i vi ha cht trong h thng sinh hc l hm s lng ha cht c hot tnh sinh hc ti c quan tip nhn, ti m t bo c tip nhn, thi gian tng tc gia ha cht v c quan tip nhn; phn ng i vi mt ha cht l hm s ca liu lng v iu kin tip xc, k c thi gian tip xc Mc ca mi tng tc c cht hc ph thuc vo liu lng. Mc ca mi tng tc trong c cht hc ph thuc vo mi lin quan vi thi gian tip xc; c hi ca cc mi tng tc tng ln nhiu khi mt tip xc b tng. Nu nh cc tip xc xy ra ng thi, tc ng ln lng ng sinh hc l rt quan trng.. Cc yu t l ha gy nh hng n qu trnh ton ha, kch thc hay ha tan s gy nh hng.n vn chuyn qua mng t bo, phn ng i vi ha cht. 77

Tnh trng sc kho v dinh dng ca i tng tip xc s nh hng n phn ng i vi ha cht. Tc ng ca hai hay nhiu ha cht ng thi hot ng cng nhau c th l: tc ng tng ng, tc ng ln hn hay tc ng nh hn. Cng thm cc tc ng xut hin khi kt hp tc ng ca hai hay nhiu ha cht gy ra mt phn ng, chng bng tng cc tc ng ring bit cng li. C ch hot ng ca cc cht tng tc c th ging ht nhau, tng t hay khc hn nhau. V d A + B phn ng; 1 mc tc ng + 3 mc tc ng = 4 mc tc ng. Khi hai loi thuc tr su: ln hu c c a ng thi, th tc hi gy c ch enzym cholinesterase thng c tng theo php tnh cng. Gia tng vt bc xut hin khi kt hp tc ng hai hay nhiu ha cht gy ra mt phn ng ln hn nhiu ln ca tng phn ng tng ha cht kt hp li; c ngha l phn ng ln hn nhiu tng s hc cc tc ng n l. V d, A + B phn ng; 1 mc tc ng + 1 mc tc ng = 5 mc tc ng. Gia tng vt bc xy ra khi hai ha cht cng tc ng vo mt c quan ni tng. V d A + B phn ng; 1 mc tc ng + 3 mc tc ng = 10 mc tc ng; ethanol lm tng vt bc c tnh ca tetrachloride hoc chloroform. Gia tng vt bc cng xut hin khi mt ha cht khng gy tc ng no i vi mt c quan no , nhng s c mt ca n lm tng ln hot tnh ca mt ha cht khc trong c quan . V d, A + B phn ng; 0 mc tc ng + 3 mc tc ng =5 mc 'tc ng; ru isopropyl lm tng vt bc c tnh ca carbon tetrachloride. Suy gim xut hin khi c mt mt ha cht lm nh hng n hot ng ca mt ha cht khc. Khi tc ng c kt hp ca hai 78

hay nhiu ha cht th nh hn tc ng ca tng tng ha cht. iu c ngha l tc ng c kt hp nh hn tng s hc ca tng tc ng ring bit. V d, A +B phn ng; 1 mc tc ng + 3 mc tc ng= 2 mc tc ng; hay 1 mc tc ng + 3 mc tc ng = 0 mc tc ng. Suy gim c th lin quan n tnh chc nng, sinh l, ha hc, lng ng sinh hc, sinh ha hc. Suy gim chc nng hoc suy gim sinh l xut hin khi hai hay nhiu ha cht to ra mt tc ng ngc li trn cng mt c quan v lm trung ha cc tc ng (v d, thuc gim au c dng khng ch nhng cn co git), hoc trn cc c quan khc nhau to ra nhng tc ng tng tc v sinh l (v d, histamin gy nn hin tng gim p sut mu v norepinephrine gy tng p sut mu); cc ha cht thng c mt ng thi. Suy gim tnh cht ha hc xut hin khi hai hay nhiu ha cht tng tc v phn ng to thnh mt hp cht km hot tnh hn; v d: cht to thnh Ca vi tetracycline. suy gim lng ng sinh hc v tnh cht sinh ha xy ra khi mt ha cht thay i lng ng sinh hc ca ha cht khc v do vy lm gim nng cht ti c quan tip xc v suy gim hiu qu hay c tnh ca ha cht (v d, cc enzym kch thch lm thay i c cu chuyn ha sinh hc lm thay i c tnh hay hiu qu ca ha cht). Gim cc c quan tip nhn xut hin khi hai hay nhiu ha cht cng cnh tranh cho mt c quan tip nhn, kt qu l tc ng cui cng b suy gim hay ch cn to r mt khonh (lc). S suy gim cc c quan tip nhn thng c dng cp n nh cc mc (v d, O2 v CO. Cng cnh tranh trn cng mt c quan tip nhn Hb), cc ha cht thng c mt ng thi.. 79

Phng php xt duyt n gin xc nh nhng tng tc c th c bao gm vic xc nh ng cong liu lng - phn ng v xc nh LD20 cho mi ha cht. Sau kt hp s liu li vi nhau v nh gi kh nng gy t vong. Nu kh nng gy t vong vt qu 40%, c th gi thit l s tng trng vt bc; nu nh kh nng gy t vong t hn 40% th gi thit l suy gim; nu kh nng gy t vong bng 40% c th gi thit tng tc l cng thm. Nhng mi tng tc gia cc ha cht ca mi trng Cc ha cht ca mi trng bao gm nhng ha cht tm thy trong khng kh, nc v thc phm. Trong khng kh, chng bao gm cc loi kh (v d CO, SO2, NOx, O3, CO2, NH3) Cc dung mi hay cc hi dung mi (nh CCl4, CHCl3, 1,1,1- trichloroethane, tetrachloroethylene, cc hydrocarbon vng thm, thuc BVTV, cc kim loi v cc cht ht nh bi, khi). Cc ha cht tm thy trong nc bao gm cc cht tn ti mt cch t nhin (cc kim loi, cc khong cht), cc cht c ngun gc nhn to t nng nghip v cng nghip. Cc ha cht tm thy trong thc phm bao gm cc cht c t nhin v nhn to trong qu trnh chn nui, trng trt, x l, ch bin v lu kho. S tng tc gia cc tc nhn trong mi trng c tm tt trong bng 7. Vic phn tch nhng s liu ny ch ra rng kt qu ca cc tng tc thng khng th d on t cu trc ha hc hay t hot tnh dc hc hay c cht hc. Bng 7. Nhng mi tng tc gia cc tc nhn trong mi trng

80

Cc cht tng tc SO2/NO2 SO2/O3

Loi

im tc ng cui

Kt qu Khng tng tc Khng tng tc Tc ng ln hn Khng tng tc Tc ng nh hn Khng tng tc Khng tng tc Tc ng ln hn Tc ng Khng tng tc Cha xc nh Tc ng nh hn Khng tng tc Tc ng nh hn Khng tng tc Tc ng nh hn Kt qu Tc ng nh hn Tc ng nh hn Tc ng ln hn Tc ng ln hn Tc ng ln hn Tc ng ln hn Tc ng ln hn Tc ng ln hn Tc ng ln hn Tc ng ln hn

Con ngi Chc nng h hp Chut Biu m ph qun Con ngi Con ngi Con ngi Ln Con ngi Chut nht Chut to Con ngi Th Chut Con ngi Chut Chut Chut Loi Chut Chut Chut Th Con ngi Chut Con ngi Chut Chc nng h hp Chc nng h hp Chc nng h hp au rt, sng ty chc nng h hp Cc tc ng sinh ha Cc tc ng sinh ha Chc nng h hp Chc nng h hp Tc nhn gy qui thai Tc ng n thn Tc ng n thn Tng huyt p Tc nhn gy qui thai im tc ng cui Tc ng n gan Tc ng n gan Gy c ni chung Tc ng n tim Gy c tnh ni chung Gy c tnh ni chung Gy tc ng n tim Gy tc ng n tim Tc ng n gan Tc ng n gan

O3/NO2 O3/CO O3/H2SO4 Cd/Hg Cd/Pb

Cc cht tng tc Cd/CCl4 Cd/ Ethanol Pb/Cu Pb/Benzen Pb/Ethanol Co/Ethanol Ethanol

Ethanol/Alfl Chut atoxin Ethanol/Alfl Chut atoxin

81

Pb/Cu

Chut

Gy c ni chung Tc ng n mu

Tc ng ln hn Tc ng ln hn Tc ng ln hn Tc ng ln hn Tc ng ln hn Tc ng ln hn Tc ng ln hn Tc ng ln hn Tc ng ln hn

Ethanol/Benze Chut ne Ethanol/CS2

Con ngi Tc ng n gan Tc Chut ng n gan/h TK Chut Gy c tnh tc thi

Ethanol/CO Ethanol/CCl4

Con ngi Tc ng n gan Chut Tc ng n gan Tc ng n gan Tc ng n gan

Cc cht tng Con ngi Chut tc Thuc tr su L hu c/ Ln hu c Ethanol Con ngi Ethylenglycol Kh, chut

Gy c tnh ni chung Tc ng nh Gy c tnh ni chung hn Tc ng nh hn

4.6. CHP NHN HAY THCH NG Chp nhn hay thch ng l gim bt tnh phn hi (p ng) i vi mt ha cht khi c th tip tc phi tip xc vi ha cht. C s ca vic thch ng thng l kch thch enzy/n tham gia n qu trnh chuyn ha sinh hc. V d: Mt s ngi thch ng vi cht nicotine, caffeine v ru. 4.7. CC YU T MI TRNG C TH NH HNG N P NG I VI MT HA CHT Cc yu t mi trng c th gy nh hng n p ng ca 82

mt c th i vi mt ha cht bao gm nhit , m, p sut, cc thnh phn cu thnh mi trng xung quanh ti thi im tip xc, nh sng v cc loi tia phng x khc, tnh trng nh , ting n, cc yu t x hi.. . C ch cc yu t ny nh hng n phn ng bao gm bin i qu trnh tn ng sinh hc, thay i sinh l hc k c nhng thay i v hoc mn v nhng tng tc c th c v ha hc v vt l .

Chng V NH GI AN TON

5.1. GII THIU CHUNG Qu trnh nh gi s an ton l nh gi c tnh tim nng ca mt tc nhn ha hc hay l hc trn c th sinh vt (thng thng l ng vt) v sau l nh gi trn c th ngi; Vic lm mang y tnh khoa hc. Bi cc s liu sau s l cn c suy on mt cch khoa hc p ng cho con ngi. Tnh an ton khng phi l mt tnh cht sinh hc c nh ca tc nhn. S an ton l mt khi nim tng i v p dng trong trng hp c th tip xc vi tc nhn trong mt iu kin nht nh no m khng thy gy nn tc hi cho sc khe. An ton ch c nh gi y khi xem xt n iu kin tip xc bao gm c liu lng, nng , ng tip xc v thi gian tip xc. Chnh v vy, an ton y ch mang tnh tng i. An ton tuyt i xy ra khi hon ton khng xy ra mt tc ng bt li cho c th sinh vt trong bt k iu kin tip xc no. Thc t, n ton tuyt i ch l chuyn khng tng v khng bao gi xy ra. Cc nh nghin cu c cht hc trn th gii n lc rt 83

nhiu gim hoc thay th vic s dng ng vt trong cc nghin cu nh gi an ton. Cc nghin cu ny cng c th c tin hnh trn c th ngi khi c y s liu nghin cu trn c th ng vt. iu kin tip xc an ton cho con ngi c thit lp trn c s s liu y tng ng nghin cu trn ng vt hay s liu nghin cu trn c th ngi c c t cc ngun khc. Cc chng trnh nh gi an ton rt cn thit v nhng l do x hi, kinh t, php lut bo v sc kho con ngi. 5.2. THIT K TH NGHIM Chng trnh nh gi an ton l mt nghin cu khoa hc c thit k xc nh iu kin tip xc an ton cho con ngi. Nhng nguyn tc ca mt th nghim khoa hc phi c p dng cho tt c cc nghin cu nh gi an ton. Bc u tin trong chng trnh nh gi an ton l xc nh r rng, ngn gn mc tiu vn s gii quyt. V d, bao nhiu phm mu thc phm c th cho vo ung cho tr em v ngi ln, hoc tn d thuc t su cho php trn mt nng sn nht nh l bao nhiu. Bc tip theo, trc khi tin hnh th nghim trn c th ng vt cn phi thu thp tt c cc thng tin, s liu nn v tc nhn nghin cu c th thit k th nghim mt cch ph hp. Cc thng tin, s liu nn c th l cc tnh cht l, ha ca ha cht, cc phng php phn tch, bin i ca ha cht trong qu trnh ch bin, x l v.v... D kin s tip xc ca con ngi bao gm cc iu kin, liu lng, nng v thi gian phi c d kin trc khi tin hnh th nghim trn ng vt. Nhng s liu ny s c s dng trong qu trnh thit k th nghim xc nh liu lng, nng v iu kin tip xc. Vic phn chia r rng v la tui v phn trm tip xc s rt c ch trong vic nh gi s liu. 84

Yu t quan trng nht trong mt thit k ph hp ca cc nghin cu nh gi an ton l iu kin th nghi~ phi c thit k tht st vi iu kin tip xc ca con ngi. iu ny s lm cho cc nghin cu ph hp v tr gip cho vic suy on c tnh trong c th con.ngi. Nhng vn cn cn nhc khc bao gm: xc nh nhng vn mu cht, iu kin tip xc, cc ng vt ph hp phn tch thng k, nh gi ri ro v.v... C nhiu phng php nh gi an ton. Hai phng php chnh s dng y l: Phng php ma trn thc hin mt lot cc th nghim sau nh gi tt c s liu v thit lp iu kin tip xc an ton. Phng php dy tin hnh cc th nghim din ra k tip theo nhau; iu c ngha l thc hin cc th nghim sau da vo kt qu th nghim trc . Vi phng php ny, vic quyt nh c lm tip th nghim na khng s c xc nh. Chng trnh nh gi an ton theo phng php dy th nghim bao gm nhng th nghim sau: Nghin cu c tnh tc thi trn ng Tt, th nghim c tnh di truyn ngn hn bao gm cc th nghim in vi vo v in vi tro.

Nhc li liu lng hoc nghin cu cc nghin cu c tnh ngn hn trn c th ng vt, cc nghin cu so snh v tn ng sinh hc, hp th, phn b, chuyn ha sinh hc hay trao i cht, bi tit hay o thi v ng hc trong c th ng vt v c th ngi. S dng cc liu n v cc liu lp li nghin cu trn ngi v cc nghin cu trn ng vt. - Nhc li cc nghin cu liu lng trn c th ngi, cc nghin cu c tnh di hn hay mn tnh trn c th ng vt. 85

Nghin cu di hn hn trn c th ngi, cc nghin cu v c tnh ung th trn c th ng vt thch hp, nghin cu v sinh sn v sinh trng trn ng vt, cc nghin cu c bit cn tin hnh nh nghin cu min dch hc, c tnh ti c quan b tc ng, cc mi tng tc trn c th ng vt, cc nghin cu v dinh dng v cc nghin cu khc trn c th con ngi. Trc khi tin hnh tt c cc th nghim, cc thng tin, s liu nn phi c cc nh c hc chuyn nghip nh gi v cc s liu phi c a ra cn nhc cc iu kin tip xc an ton c th c thit lp hay khng. Nu nh s liu c c y , vic th nghim c th s tr nn khng cn thit. Nhng vn cn tn ti phi c gii quyt m bo c s liu cn thit cho vic nh gi an ton. Th nghim nh gi c tnh hc u tin l nghin cu v c tnh tc thi. Nhng nghin cu c tnh tc thi c thit k nh gi nhng c tnh c th c sau khi c th b tip xc vi mt ha cht hay vi mt tc nhn vt l. c th hnh dung ra c c tnh tc thi, thit lp c mi lin h liu lng - p ng, xc nh nhng c quan trong c th c th b tc ng v c ch tc dng ca c cht, a ra liu lng ph hp cho nhng nghin cu tip theo, phn bit nhng s khc nhau gia gii tnh v loi. Qua c th cung cp c nhng thng tin quan trng trong trng hp cn phi x l c tnh tc thi cho con ngi. C nhng quy nh v nghin cu c tnh tc thi c thng nht. l: Phi s dng s lng ng vt th nghim cn non, trng thnh, c, ci; ng tip xc phi m phng theo cch con ngi tip xc bao gm qua ng tiu ha, tip xc qua da hay qua ng h hp; Cc tc ng lin quan n ha cht, cc tc ng khng lin quan n liu lng phi c quan st k trn ng vt nghin cu sau mi liu tip xc, Cc ch tiu a ra nh gi l nhng s thay i v cc hot ng tiu ha, cc phn ng h hp, s tiu th thc phm, s tng 86

trng lng, tnh trng bnh tt, t l t vong; Cc ng vt thng thng phi c quan st 14 ngy sau khi tip xc. Nhng vn sau y cn phi c cn nhc: - Gii hn ca th nghim: lin quan n vic cho liu tip xc l 5g hoc 5 mi ca ha cht 1kg trng lng c th. - Cc th nghim gii hn trn di: cho mt ng vt tip xc vi mt liu lng trong mt thi gian nht nh, sau cho mt ng vt khc tip xc vi mt liu thp hn hoc cao hn. Th nghim p dng liu lng theo hnh thp: tng liu lng ln mi ngy hay tng thi gian tip xc cho n khi pht hin c c tnh. Th nghim ngn hn nghin cu e~nh di truyn xem xt n kh nng ca tc nhn ha hc gy nn nhng s thay i trong ADN hay trong chromosome. Nhng th nghim ny c tin hnh nh gi tim nng gy ung th ca ha cht khi n tng tc vi ADN cng nh xc nh xem ha cht c gy ra nhng thay i v mt di truyn hc hay khng. Cc th nghim ny khng i hi nhiu thi gian lm (khong vi tun). Nhng loi th nghim chnh s dng cho nghin cu c tnh di truyn ngn hn bao gm nhng th nghim xem xt n s t bin trn, s thay i ca chromosome, s hy hoi ADN v.v... Cc th nghim nhc li liu lng lin quan n cc ng vt tip xc vi ha cht hay vi mt tc nhn vt l di nhng iu kin th nghim nht nh trong vng 14 n 28 ngy lin tc. Nhng nghin cu ny c tin hnh c th hnh dung c c tnh xy ra vi cc liu lp li thit lp c mi quan h liu lng-phn ng, xc nh c cu quan no ca c th chu tc ng ca c cht v c cu tng i ca cc hot ng, cng nh cung cp s liu v liu lng cho nhng th nghim tip theo trn ng vt. 87

Quy chun cho cc nghin cu lp li v liu lng c ra, phi s dng mt s lng cc ng vt gm nhm c hai nhm c v ci (cng c th dng cc loi khng phi l loi gm nhm). Cc ch s c nh gi bao gm trng lng c th, lng thc n tiu th, hiu qu ca thc phm (t s trng lng c th gia tng c so vi trng lng thc n tiu th), tnh tranh bnh tt v t l t vong, cc kt qu phn tch nc tiu, trng lng cc c quan ni tng trong c th v nhng thay i khc. Cc nghin cu SO Snh tn ng sinh hc bao gm cc vn v s hp th, s phn b, s vn chuyn sinh hc, s o thi v cc nghin cu v c ch. Nhng nghin cu ny c tin hnh xc nh s phn b, s c mt ca ha cht trong c th nhng ng vt th nghim, xc nh xem loi ng vt no l ph hp cho nhng nghin cu tip theo v cung cp nhng s liu gip xc nh c liu lng ph hp cho nhng nghin cu su hn. Cui cng, mc ch tin hnh nhng th nghim ny l thit lp nn c s cho nhng chng trnh nh gi an ton. loi ng vt nghin cu ph hp l loi c s chuyn ha sinh hc tng t hoc ging ht vi s chuyn ha sinh hc ha cht trong c th ngi. Cc th nghim in vi.o c th cng c tin hnh. Cc nghin cu bn mn tnh c tin hnh trn cc ng vt th nghim tip xc vi ha cht hay vi tc nhn vt l di nhng iu kin th nghim nht nh. Thng thng nhng th nghim ny ko di 3 thng trong iu kin ng vt b tip xc lin tc; nhng th nghim cng c th c tin hnh trong thi gian 12 thng lin tc. Nhng th nghim ny c tin hnh nhm xc nh c bn mn tnh, thit lp mi quan h liu lng - phn ng; xc nh c quan ni tng b tc ng ca c cht v c ch ca cc phn ng; cung cp s liu v liu lng cho nhng nghin cu tip theo, cung cp nhng s liu cho nhng tc hi tim tng. v xc nh liu lng khng xc 88

nh c tc hi (NOAEL), c th suy din c cc hin tng s xy ra trong c th ngi. Cc nghin cu ny khc vi cc nghin cu lp li v liu lng ch chng c nghin cu trong mt khong thi gian di hn v s lng ch s nh gi cng nhiu hn. " Nhng nghin cu bn mn tnh thng l nhng nghin cu rt cn thit trong chng trnh nh gi an ton. Bi v nhng tc hi lu di ca tc nhn gy c tnh thng xut hin trong khong thi gian 3 thng sau khi tip xc, tr trng hp ung th hay nhng tn hi v thn kinh. Nu nh mt th nghim c tnh di truyn hc ph hp c tin hnh m khng pht hin c kh nng bin i n di truyn ca c cht, th nguy c b ung th do bin d n di truyn s t khi xy ra. Nguy c gy ung th khng phi do bin d n di truyn m nguyn nhn l cc t bo b ph v, hy hoi; nhng thay i ny c th c nhn thy trong vng 90 ngy sau khi tip xc. C nhng quy chun nht thit phi c thc hin trong nhng nghin cu bn mn tnh. Th nghim phi c tin hnh trn mt s lng cc loi ng vt gm nhm v khng gm nhm, c ging c v ging ci. iu kin tip xc phi c m phng da theo iu kin con ngi b tip xc. Cc ch s theo di nh gi bao gm: trng lng c th, thc n tiu th, hiu sut ca thc phm, tnh trng bnh tt, t l cht, cc du hiu gii c, nc tiu, trng lng cc c quan ni tng v nhng thay i khc trong cc m t bo. Cc ng vt th nghim phi c theo di t nht 2 ln mt ngy trong sut qu trnh trin khai th nghim. Nhng thit k cho nhng th nghim nh gi c tnh di hn c th khc nhau ty theo mi nc. Cc th nghim c hi di hn thng c tin hnh trong vng t 6 thng n 24 thng trn cc i tng ng vt gm nhm v khng gm nhm. Nhng th nghim ny c tin hnh c th hnh dung 89

mt cch khi qut c tnh di hn ca tc nhn trn c th ng vt th nghim; (thng ngi ta dng ch cho nhng th nghim ny), nhng th nghim ny cng c tin hnh tm hiu c quan no l c quan chu tc ng, thit lp mi quan h liu lng v phn ng, cung cp s liu v cc tc ng tch ly, xc nh nguy c gy ung.th v xc nh mc liu lng khng gy tc hi (NOAEL) c th suy din nhng s liu ph hp p dng trn c th ng li. Nhng nghin cu di hn, hay nghin cu tin hnh trong sut cuc i ca ng vt th nghim, trn ng vt gm nhm ko di t nht hai nm trong iu kin ng vt b tip xc lin tc vi tc nhn gy c. i vi ch hay vi kh, nhng nghin cu trong sut vng i ko di trong vng 7 nm hoc thm ch cn nhiu hn. C nhng quy chun nht thit phi tun th trong cc th nghim nghin cu c tnh i hn. Cc ch s theo di 11 gi bao gm trng lng c th, lng thc n tiu th, hiu du.t. ca thc n, tnh trng bnh tt, t l cht, du hiu ca vic giai c, nc tiu, trng lng cc c quan ni tng, nhng thay i khc trong cc m t bo. Nhng nghin cu mn tnh c thc hin nh gi nhng tc ng c th ca mt tc nhn ha hc hay vt l hc trong mt qu trnh tip xc rt i hn; c th hnh dung c nhng tc hi mn tnh ca c cht; thit lp mi quan h liu lng phn ng; xc nh c quan ni tng no chu tc ng ca tc nhn v c ch gy c trong c tht cung cp s liu v tc ng tch ly; nh gi kh nng phc hi ca c th sau khi b tc ng; nh gi mt cch chc chn v tnh gy ung th ca tc nhn v xc nh nng khng quan st c tc hi gip cho vic suy din s liu p dng i vi c th ngi. C nhng phi nht thit tun theo, l: Phi th nghim trn mt s lng ng vt gm nhm, ging c v ging ci. Cc ch tiu a ra xem xt nh gi bao gm trng lng 90

c th, lng thc phm tiu th, hiu sut ca thc n, tnh trng bnh tt v t l cht, du hiu gii c, nc tiu, trng lng cc c quan ni tng cng nh nhng thay i c th khc. Cc th nghim v kh nng gy ung th c tin hnh nh gi chc chn v kh nng gy ung th mt cch tim tng ca tc nhn trn c th ng vt th nghim. Thng thng nhng th nghim ny c tin hnh trn chut nht hay chut to ni chung. Nhng th nghim ny c coi nh dng khng nh kt qu v th nghim c tin hnh trong thi gian tng i di, thng l t 18 n 24 thng lin tc v vi mt liu lng tng i cao. Vi liu lng cao, con ng chuyn ha sinh hc ca tc nhn trong c th ng vt th nghim c th khc so vi liu lng thp hn; iu ny khin cho vic suy din p dng cho c th ngi khng c ph hp lm v con ngi thng b tip xc vi tc nhn mt nng thp hn nhiu. tit kim ngi ta thng kt hp nhng nghin cu th nghim mn tnh vi nhng th nghim v kh nng gy ung th. C nhng quy chun nht thit phi tun th cho nhng th nghim v kh nng gy ung th. Th nghim phi tin hnh trn mt s lng cc con c v con ci ca mt loi ng vt gm nhm. Cc ch s c theo di nh gi bao gm trng lng c th, lng thc phm tiu th, hiu sut ca thc n, tnh trng bnh tt v t l cht, du hiu gii c, nc tiu, trng lng cc c quan ni tng cng nh nhng thay i c th khc. Nhng nghin cu c bit khc c th l mt phn m rng ca chng trnh nh gi an ton k c nhng nghin cu chuyn su v nhng c quan chu tc ng ca c cht. Nhng c quan ny bao gm gan, thn, h thng ni tit. Nhng nghin cu ny c thit k v tin hnh e gii thch c ch 91

hot ng ca tc nhn i vi cc c quan trong c th chu tc ng ca c cht. C quan chu tc ng hay nhng phn ng gy ra do tc nhn c th c xc nh bi bt c nghin cu hay php th nghim no trong chng trnh nh gi an ton.

Chng VI NH GI NGUY C CA CHT C

6.1. XC NH MI NGUY C V CC HNH THC TC DNG CA C CHT Vic xc nh mi nguy hi bao gm vic thu thp, nh gi s liu v cc loi tn thng sc khe hay cc bnh tt c th gy ra do ha cht trong iu kin tip xc vi cc ha cht Vic xc nh mi nguy hi cng bao gm c vic c trng ha chu trnh chuyn bin ca cc ha cht trong c th v mi tng tc ca chng vi cc c quan, cc t bo v cc thnh phn to nn t bo (v d nh ADN). Cc s liu c cht hc c s dng xc nh dng c cht gy tc hi cho mt nhm qun th hay cho nhm ng vt th nghim c gy nh hng tng t cho con ngi hay khng? Cc tc ng c hi c th ch ko di trong mt thi gian ngn (nh bun nn, au u v.v...) hoc vnh vin (nh bnh kh th, au thn kinh ngoi vi v.v...) hoc thm ch e da c cuc sng (nh bnh ung th, c ch h thn kinh trung ng. v. v.. ) 92

Cc nghin cu v sc khe ca mt nhm ngi tip xc vi ha cht l ngun thng tin quan trng nht xc nh cc mi nguy hi. Nhng rt tic khng phi bao gi nhng nghin cu ny cng c thc hin sn cho phn ln cc ha cht. Hn na, cc nghin cu mi quan h gia vic tip xc vi ha cht v sc khe ngi thng kh tin hnh, rt t, kh a ra c kt lun v s liu thng t v cn c nhiu yu t khc, ng thi tc ng n ch th nghin cu, v d vic ht thuc, mi trng sng khc nhau v.v... Vic nghin cu c cht hc trn ng vt c tin hnh trong nhng iu kin mi trng phng th nghim c kim sot l ngun s liu quan trng nh gi mi nguy hi. Cc th nghim ny thng c kim sot cht ch do vy cc kt qu c th suy ra c r rng hn. Nhng kt qu nghin cu trn ng vt cng c nhng hn ch rt ln v ng vt thc cht cha phi l i tng quan tm. Cc thng tin h tr v c hc rt quan trng, c bit l cc thng tin v c ch ca c cht c suy ra t cc nghin cu trong phng th nghim trn cc t bo n l, cc thnh phn ca t bo v phn tch cu trc phn t. Tuy vy, ngi ta thng quan tm n cc th nghim tin hnh trn ng vt Vic s dng cc s liu c cht trn ng vt nh gi c cht gy ra cho ngi da trn gi nh rng tc ng gy ra cho con ngi c th suy ra t cc tc ng gy ra cho cc ng vt th nghim. Gi nh ny c chng minh ng v c bn cho cc c cht l ha cht v cc cht phng x (iu c ngha l tt c cc ha cht gy ung th cho ngi cng gy ung th cho t nht mt loi ng vt, mc c hi ca nhiu loi ha cht cng tng t ging nhau cho ngi v ng vt th nghim). Nguyn tc ny c p dng rng ri bi cc nh khoa hc. 93

Cc c cht th hin nhng nh hng ca n bng cc hnh thc vt l, ha hc, sinh l, sinh ha hc hoc bng s kt hp nhng phng thc ny. L hc Nhng c cht nh dung mi hoc nh tng c th gy kh da, vim da, bong vy sau mt thi gian tip xc ko di hoc lp li. nh hng ny do lm mt lp m da hoc lp keratin ngn nc di da b tn thng. Cc axit hoc kim dng hi kh v dng lng gy kch thch mt, ming v hng. Khi c cht xm nhp qua ng h hp, tiu ha c th gy kch thch. Kch thch c th dn ti vim hng gy vim teo ng h hp, gy bun nn, ri lon nhu ng rut v ri lon i tin. Cc kh tr gy ngt do chim ch oxy. Cc cht phng x c th lm thay i v tr v b gy cc lin kt ca nhim sc th. Ha hc S kt hp trc tip gia c cht v mt thnh phn ca c th, v d nhim oxyt carbon (CO), n s kt hp nhanh chng vi hemoglobin (Hb) to thnh carbonxy hemoglobin lm Hb khng cn kh nng vn chuyn oxy. Bin i sinh l Nhng nghin cu sinh ha ng vai tr quan trng trong nghin cu cc c ch tc ng ca nhiu c cht trong cng nghip. Tuy nhin, khi cc c cht ny tc ng c bit trn h thng thn kinh trung ng hoc ngoi vi, trong trng hp ny cn to ra nhng phng php thch hp pht hin v o mc bin i sinh l. V d: o ng chuyn ng ca con nhi trong t bo thn knh cng nh qua mng t bo thn kinh. 94

C ch enzym Hu ht cc c ch gy c l do tc ng ln hot ng bnh thng ca h thng enzym. Sau y l mt s phng thc th hin tc ng ca c cht thng qua h thng enzym. -Kt hp trc tip c cht c th thay i hot tnh ca enzym bng s kt hp trc tip gia c cht vi nhm hot ng hoc kim loi hot ng trong cu trc ca enzym lm c ch hot ng ca chng. V d: ch, thy ngn kt hp vi gc - SH ca enzym. Cc loi cyanua kt hp vi Fe ca enzym cytocromoxydase lm enzym mt hot tnh. -c ch cnh tranh: Cc c cht tranh ginh nhng sn phm chuyn ha bnh thng hay nhng coenzym cn thit cho s hot ng ca enzym. V d: Cht sulfanilamid c cu trc tng t nh vitamin nhm B. - S tng hp mt sn phm c mi t c cht xm nhp vo c th. Cht mi tng hp ny gy c bng cch tc ng vo qu trnh chuyn ha bnh thng. V d: cht Natnfluoroacetat sau khi c hp th vo c th, mt enzym chuyn ha fluor fluoroacetat to thnh nuorocitrat t axit chc, mt cht trung gian trong chu trnh Kin. Cht fluorocitrat ny khng cn kh nng m nhn vai tr trong chu trnh chuyn ha, kt qu l s h hp ca t bo ngng li. Enzym cm ng: Hu ht trong cc c ch trn, enzymu gim hot tnh. Nhng.trong mt s iu kin no s p ng c th l kch thch hot ng chuyn ha. Nhng enzym cm ng l nhng enzym lm s tng hp sinh l tng thm s lng enzym, do p ng vi mt tc nhn gy cm ng. V d: enzym to ra khi nhim thy ngn trong thc nghim trn ng vt. i vi loi ny thng gp vi khun v nm, ngi t gp. C ch min dch 95

C ch ny l kt qu ca vic to ra mt khng nguyn mi do s kt hp ca c cht vi nhng thnh phn ca c th, thng l protein C ch ny l c s ca mn cm da do tip xc vi mt s cht hu c nh chloroni-trobenzoic. 6.2. CC NGHIN CU C HC TRN C TH NG VT Ph thuc vo liu lng, thi gian tip xc vi ha cht, cc tc hi c cht s rt khc nhau, chng c th gy cht ngay lp tc, gy ung th, hoc gy ra nhng thay i v sinh ha, sinh l v.v... S liu cho ng vt Nhng thun li (d thit lp nguyn nhn) Nhng bt li Mi lin quan s liu cho ng vt i vi con ngi - Mi lin quan suy on gia liu lng cao, liu lng thp. ng nht gia cc ng vt th nghim v khng ng nht ca cng ng loi ngi. Cc ha cht gy c hi c gi l cc c cht ni hp nu n tc ng ln chc nng ca hng lot cc h thng c quan khc nhau. Khi nim c cht ni hp cp n cc tc ng sc khe xy ra ti nhng b phn xa im thm nhp ca ha cht vo c th. Cc nh hng c hi xy ra ti a im tip xc ca ha cht vi c th gi l c cht ti im. Mt loi ha cht c th gy ra mt hay nhiu tc ng nguy hi, ngay trn ch mm loi ng vt th nghim trong cng mt thi gian, hay trong nhng khong thi gian khc nhau, cc tc ng c th l: c tnh tc thi, c tnh bn mn tnh v mn tnh. Thng cc nh khoa hc tp trung ch vi cc tc ng nguy hi xut hin nng thp nht hay s tip xc t 96 Tip xc => Tc hi c xc nh r

nht. Nng thp nht ti xut hin c tnh khng hong gi l nng thp nht quan. st c tc ng c hi (LOAEL). Nng ngay st di nng LOAEL gi l nng khng quan st thy c tc ng c hi NOAEL. Nng NOAEL c dng thit lp gii hn tip xc an ton, chp nhn c ca con ngi i vi mt c cht thm nhp. Vic thit lp ny da trn mt gi nh c ng h bi cc kt qu th nghim: nu nh tip xc c quy nh mc thp hn ch s xut hin ca c tnh khng hong th tt c cc loi c tnh khc cng ng thi c hn ch (bi v cc c tnh khc xut hin vi tip xc cao hn). Cc s liu v ng vt Cc nghin cu c cht khng gy ung th - Tc thi: Ngn hn Bn mn tnh: Trung hn - Mn tnh: Di hn -Pht trin: Tip xc trong d con - Sinh sn Cc nghin cu c tnh c bit -c t hc min dch -C ch hot ng Cc nghin cu v ung th -Cc nghin cu v tip xc trong sut vng i -Cc nghin cu khi xng/ thc y - Cc nghin cu c bit v cc c quan ca c th 6.3. BNH HC, TRIU CHNG LM SNG V QU TRNH PHT TRIN NHIM C NGH NGHIP. 97

Bnh hc Nghin cu bnh hc s thu c kt qu v c tnh ca mt ha cht trong con ngi bng cch so snh tnh trng sc khe ca mt nhm ngi phi thng xuyn tip xc vi ha cht vi sc khe ca mt nhm ngi khc tng ng nhng khng phi tip xc vi ha cht nghin cu. Nghin cu v bnh hc c gng xc nh bt k mt hin tng gia tng v bnh no gy ra do vic tip xc vi loi ha cht nm trong nghi vn ca nhm ngi b tip xc vi ha cht. Nghin cu bnh hc thng c b tr trn nhm ngi phi tip xc nhiu vi nng ha cht cao ti ni lm vic. C hai cht benzen v vinyl clorua u c chng minh l nguyn nhn gy ung th cho con ngi trong nhng nghin cu nhm ngi tip xc vi hai loi ha cht ny. Khi nghin cu v bnh hc thu c kt qu thuyt phc th cc nghin cu ny s rt c ch bi chng cung cp thng tin v tc ng trc tip ca ha cht ln sc khe con ngi. Th nghim bnh hc c thit k, b tr thc hin tt c gi tr hn nhiu so vi nhng th nghim tin hnh trn c th ng vt. Tt nhin th nghim v bnh hc khng ph bao gi cng m bo l khng c nguy c ri ro. Mt kt qu nghin cu sai (hoc cha y ) v bnh hc c th dn n vic thit lp mc tip xc an ton khng chnh xc ca ha cht cho con ngi. Hu ht cc nghin cu v bnh hc mi trng thng c nhiu iu khng chc chn: Khng th c c hai nhm i tng nghin cu ging ht nhau: Ngh nghip, ch khc bit, phong cch sng, tnh hnh kinh t x hi khc nhau v.v... Rt kh c th kim sot c mt s ch s ri ro nh vic s dng thuc l v mt s loi dc phm.

98

Ch c mt s dng tc hi n sc khe c bit n cho con ngi. S liu chnh xc v mc tip xc vi ha cht khng phi bao gi cng c. Nht l khi con ngi tip xc vi ha cht trong qu kh. Mt s bnh, nht l bnh ung th, phi mt nhiu nm mi pht hin c (thi gian bnh thng rt di: trong trng hp ny nht thit phi ch nhiu nm sau khi tip xc vi ha cht trong thi gian i mi c th nghin cu bnh). Nhn lc trng dng tin hnh cc th nghim v bnh hc thng c hn. Ch khi no c c mt s lng ln ngi t nguyn tham gia th nghim hoc tc hi ca ha cht gy ra mt loi bnh rt him th nghin cu v bnh hc mi c th cho ra kt qu r rng.

Do nhng hn ch v nghin cu bnh hc nu trn nn cc kt qu m tnh phi c suy din mt cch rt thn trng. Mt nghin cu v bnh hc mun tng tin cy phi c thm mt hay nhiu yu t i km sau y: Thu c kt qu ging nhau sau nhiu th nghim. Tn ti mt mi lin kt cht ch gia tip xc v mc bnh. S liu v tip xc c tin cy v c h tr bi nhng si liu lin quan v sinh hc v mi trng. C mt mi lin quan r rng gia liu v phn ng. Nghin cu c tin hnh trn mt s ngi tng i ln. 99

Cc php tnh thng k ch ra khc bit r rng. C ti liu y v tin cy v cc hin tng ca bnh. Kt qu tng t c ng thi tm thy nhng th nghim trn ng vt. Cc trng hp c th ghi nhn c. Cc nghin cu v bnh dch hc.

S liu trn con ngi

Thun li Tin hnh ngay trn i tng c quan tm. Bt li -S liu v tip xc thng khng chnh xc. - Nhm ngi trong cc th nghim thng t. - Mt suyn t khng ng nht trong nhm ngi nghin cu. Triu chng lm sng v qu trnh pht trin nhim c ngh nghip Nhim c cp tnh Nhim c cp tnh xy ra trong mt thi gian ngn vi nng c cht ln. Nguyn nhn thng do cng nhn khng tn trng ni quy sn xut, thiu phng tin phng h... Qu trnh nhim c thng qua vi thi k: Thi k bnh: T khi hp th c cht n lc xut hin triu chng bnh u tin (Tr mt s axit, kim mnh c tc dng kch thch mnh, trc tip ngay, khng c bnh). Thi gian bnh tu s lng hoc nng c cht quyt nh. 100

Thi k tin bnh l: Xut hin triu chng khng r rt v khng in hnh, bnh nhn ch thy kh chu, mt mi v nhc u. Thi k pht bnh: Triu chng bnh r rt. Nhim c mn tnh Nhim c mn tnh xut hin do mt lng c cht tc ng trong mt thi gian di gy nn bnh cho c th. Triu chng khi pht bnh thng nh, khng r rt, khng nh hng nhiu n kh nng lao ng, bnh vn tin trin ngm ngm. Nhim c bn cp tnh Trong sn xut cn ch trng c 2 loi nhim c cp v mn tnh. Nhim c cp tnh nh hng ngay n lao ng, i khi c th cht. Nhim c mn tnh mang tnh cht rng ri v nghim trng. C nhng loi c cht biu hin khc nhau trong lm sng nh nhim c benzen gy nh hng cho h thn kinh trong nhim c cp tnh v cho c quan to mu trong nhim c mn tnh. Trng thi mang c cht c cht vo trong c th dn dn v pht hin thy c trong mu, nc tiu, tc... vi hm lng trn mc trung bnh, song cha c biu hin triu chng nhim c no khc. 6.4. KH NNG GY UNG TH Tt c cc cht gy ung th cho ngi c bit n cng ng thi gy ung th cho t nht mt loi ng vt. Hu ht cc ha cht c chng minh l gy ung th cho ng vt cha c tin hnh nghin cu bnh hc trn c th con ngi, do vy cha th bit c liu chng c ng thi l tc nhn gy ung th cho con ngi hay khng. Rt nhiu gi thit p dng trong qu trnh suy on kt qu 101

t s liu thu c trn nhng ng vt th nghim ln con ngi v cc tc nhn gy ung th: Nu nh mt loi ha cht gy ra ung th cho mt loi ng vt th nghim th n cng c th gy ung th cho con ngi. Cc m t bo trong c th con ngi gi inh s b nh hng bi ha cht khng nht thit phi ging ht nh trn m ng vt th nghim. Khng mt loi ng vt no c coi l loi ph hp nht c th da vo s liu c tnh trn loi ri suy ra cho con ngi. Ha cht c xc nh l tc nhn gy ung th cho ng vt liu lng cao th cng s gy ung th cho ng vt liu l lng thp. Cc qu trnh sinh l, sinh ha c bn bao gm hp th, phn b, trao i cht v o thi ha cht l ging nhau ng vt v con ngi. Nu nh nhng th nghim ngn ngy v c tnh di truyn v thay i hnh dng t bo c a ha cht nghi vn cho kt qu dng tnh th cng chc chn v gi thuyt ha cht ny c tim tng gy ra ung th ngi. Cc s liu thu c t cng tip xc chnh xc nh vic tip xc ca con ngi vi ha cht ngoi thc t th s liu ny d d on hn l nhng s liu thu c t nhng mc tip xc khc. Nu nh pht hin thy ung th ti c quan x vi im tip xc th mc tip xc by gi khng cn l yu t quan trng na. Mc ha cht c tim tng gy ung th tng dn khi: (l) Tng v s lng cc loi lng vt, gii tnh v s kt qu th nghim c hin tng ung th. (2) Tng v s lng m t bo b nh hng bi,ha cht. (3) Xut hin r rng v mi lin h 102

liu lng- phn ng cng nh cc php tnh ton thng k ch ra khc bit r rt trong vic tng hin tng xut hin u vi cc nhm ng vt i chng. (4) Suy gim lin quan n liu lng trong thi gian pht trin khi u. (5) C s tng lin quan n liu lng ca t l u c tnh trn t l u lnh tnh. (6) Tng cc loi u bt bnh thng hay u ti cc im bt bnh thng. Liu lng lm cc cht tr thnh cc c cht Tt c cc hp cht u l nhng c cht. Khng c mt cht no l cht khng c. Mt hm lng hp l s phn bit s khc nhau gia c cht v thuc cha bnh. 6.5. NH GI V LIU LNG - P NG 6.5.1. Gii thiu chung Ngay khi mt ha cht i n mc tiu, n s phn ng vi cc phn t chc nng trong t bo v tn cng vo gy ra tc ng hoc p ng. nh gi liu lng - p ng l cp n mi quan h nh lng gia lng tip xc ca con ngi vi mc tn thng hay mc bnh. Mt liu (dose) l mt n v tip xc vi mt ha cht v thng c biu din dng mt n v khi lng ca ha cht trn n v th trng (trn Kg th trng), hoc trn mt din tch b mt ca c th (trn m2 hoc cm2 ca din tch b mt c th). Mi lin quan gia liu lng v cc hiu ng sinh hc l mt trong nhng nguyn tc c bn trong lnh vc c cht hc. S liu nh gi liu lng - p ng c suy ra t cc nghin cu trn ng vt, trong mt s t trng hp suy ra t cc nghin cu bnh hc trn mt nhm ngi tip xc. C th c nhiu mi lin h khc nhau cho mt cht ha hc nu n gy ra nhiu tc hi khc nhau di nhng iu kin tip xc khc nhau. Nguy c ca mt cht ha hc khng th c chc chn vi bt k mt mc tin cy no nu nh mi lin h gia liu 103

lng - p ng cha c nh lng mc d cht ha hc vn c bit n l "c cht". Trong nh gi liu lng - p ng, mi lin quan nh lng gia lng tip xc (liu lng) v mc ca hin tng hay mc trm trng ca c tnh (phn ng) c xc nh. Trong nh gi liu lng - p ng mc tip xc cn thit gy nn nhng tc hi ca c cht c xc nh. S sinh ra ca mt p ng v mc ca p ng c lin quan vi nng ca tc nhn ti v tr phn ng. p ng v liu lng c lin h nhn qu vi nhau. Tuy nhin cc liu lng thp, ta s khng quan st c p ng. Liu lng thp nht m p ng cn c th o c gi l "Liu ngng". Nu cc s liu v liu lng - p ng c dy v c th biu th chng trn th v ng ni nhng im s liu gi l th liu lng - p ng. Trong thc t khng phi bao gi s liu cng c y v trong nhiu trng hp phi suy on phn ng t cc th nghim trn ng vt (hay s tip xc ti a im lm vic), nhng s liu ny thng sai s nhiu so vi mc tip xc thc. C rt nhiu dng ng cong liu lng -p ng, ng cong loi grade v ng cong dng quantal. i vi ung cong dng grade, tc ng c xc nh trong tng c th ca tng c nhn v cng c xp hng nh hm s ca loa liu lng ha cht. Cc c th trong qun th c th c nhng ng cong liu lng - p ng khc nhau do s khc bit v sinh hc. ng cong dng quantal lin quan n lp liu lng ha cht vi tn s ca phn ng trong qun th nghin cu. p ng c th xc nh trc c tc hi. Trong th liu lng p ng dng quantal ny tn s thay th cng trong ng cong dng grade. p ng khng bao gi c a ra bng gi nh. iu ny 104

c ngha l cc nghin cu thc nghim phi c tin hnh chng minh c rng cc phn ng ghi nhn c l kt qu ca s tip xc vi ha cht no . Nguyn nhn phi c chng minh.

c rt nhiu cch ng cong liu lng-p ng c th c dng so snh c tnh ca cc ha cht. Nu nh p ng c v nh hm s ca loa liu lng th dc ca ng thng s c dng so snh. dc cng ln th ha cht cng c hi. iu ny c ngha l khi liu lng tng mt cht, s gy ra s thay i ln trong phn ng. S dng loa liu lng, liu hiu qu 50 hoc ED 50 c th c xc nh. l nng to ra mt phn ng bng na phn ng mnh nht trn mt c th nht nh (ng cong liu lng-phn ng dng grade), hoc l liu lng to ra phn ng trong 50 % qun th tip xc (ng cong liu lng - phn ng dng quantal). Mt v d ca ED50 l LD50 hoc mt na liu gy cht c suy ra bng phng php thng k t mt liu lng ha cht. Liu lng LD50 s git cht 50 % qun th nghin cu di nhng iu kin th nghim c xc nh.

105

106

Liu LD50 c th c dng nh l c s ca vic nh gi c cht. V d Ottoboni xut mt vic nh gi nh sau: Liu lng gy cht nu c thm nhp qua ming Bng 8. Liu lng gy cht 107

LD 50 (mg/kg) T 0 - 5 5 -50 50 - 500 500 - 5 000 Trn 5 000

i vi tr em nng 10 kg i vi ngi ln nng DO kg 1 git 1 git n 1/8 tha c ph 1/8 - 1 tha c ph 1 tha n 4 tha c ph trn 4 tha 1/16 tha c ph 1/16 - 3/4 tha c ph 3/4 - 3 tha c ph 3 - 30 tha c ph trn 30 tha c ph

Mt s v d bao gm c cht botulium, 0,0001 mg/kg trng lng c th nicotin 0,5 mg/kg trng lng c th; DDT 100 mg/kg trng lng c th aspirin 1.500 mg/kg trng lng c th; mui 3.000 mg/kg trng lng c th ;ethyl alcohol 10 000 mg/kg trng lng c th; ng 30.000 mg/kg trng lng c th (cc gi tr c tnh mt cch tng i). Liu lng ca cc ha cht c biu din nh trng lng ca ha cht trn n v trng lng c th (mg/kg trng lng c th). Cc liu lng cng c th c biu din nh trng lng ca ha cht trn n v din tch b mt c th. V d, m ca ha cht trn 1 m2 hay cm2 ca b mt c th con ngi (mg/m2 b mt c th con ngi). Vn phc tp trong khi xc nh phn ng i vi ha cht l liu lng ha cht c kh nng tng tc c vi cc c quan tip nhn hay trit tiu ti cc c quan tip nhn. Nng ca ha cht ti c quan tip nhn ph thuc vo nng c trong mu. Nng trong mu ph thuc vo liu lng ha cht m c th tip xc v iu kin tip xc. S thng nht trong cch biu din liu lng l cn thit khi so snh phn ng ca c th i vi cng mt loi ha cht. Cch biu din liu lng thng nht l rt cn thit, v d: mt con chut nng 200 gam nhn mt liu lng l 100 mg/kg trng 108

lng c th ca mt loi ha cht no s nhn mt liu l 0,061 mg/cm2 din tch b mt c th; mt ngi nng 70 kg nhn mt liu ging ht ca cng loi ha cht s nhn 0,388 mg/cm2 din tch b mt c th. Khng c mt s liu thuyt phc no ni ln tnh u vit tuyt i ca mt phng php biu din liu lng, thng thng liu lng ng biu. din bng mg/kg trng lng c th. Hnh 16 th hin mi tng tc liu lng-p ng, c th l tc ng ca s tng nng ca mt cht i vi qu trnh sinh l ca mt c th sng.

Hnh 16. S v tc ng ca s tng nng ca mt cht i vi qu trnh sinh l ca mt c th sng i Vi mi mt c th sng cng nh i vi mt h sinh thi, con ngi c th gi thit rng tn ti mt nng ha cht nht nh, ti mi qu trnh sinh l hc din ra bnh thng nh khng h c mt mt ha cht no, v nng ny c th c xc nh bng th nghim. Tn s v mc ca cc tc ng n sc khe l hm s 109

ca liu lng (iu ny c ngha l mt v mc ca cc tc ng n sc khe tng khi con ngi tip xc nhiu vi mt hay nhiu ha cht). H qu ca nguyn tc ny l mc tip xc ca con ngi c th thit lp sao cho n thp mt ca cc tc hi n sc khe c th b qua. Trong hu ht cc trng hp mi lin quan liu lng - p ng phi c thit lp t cc nghin cu trn ng vt (s liu t cc nghin cu v bnh hc thng khng nh gi liu lng- p ng). C 3 vn xut hin do khng ph hp ca cc s liu th nghim t ng vt: ng vt thng b th nghim vi nng cao hn nhiu so vi nng tip xc ca con ngi cho nn cc tc hi ti nng thp, ph hp vi thc t phi c suy din nh cc m hnh ton hc v hiu ng sinh hc. Con ngi v ng vt c th khc nhau v nhy cm do nhng s khc nhau v sinh l, v trao i cht v.v... Con ngi c s ng nht v en nhiu hn cc ng vt th nghim. Do vy khong ca phn ng i vi mt ha cht nghi vn khng th hon ton c trnh by trn ng vt v mt s hiu chnh tng nhy cm c th c cho mt s ngi cn thit phi c thc hin. 6.5.2. nh gi liu lng - p ng cho cc c cht ni hp Vic nh gi liu lng - p ng cho c c cht ni hp ph thuc mt phn vo nhng tc ng quan st c ca mc tip xc nht nh c ng gp vo vic to thnh nhng tc ng c hi hay khng. Nhng quyt nh c da vo mc nng nh ca s tin trin cc tc ng: t vic thch nghi, thay i ph hp, n nhng thay i v tm l hay sinh ha, cc 110

bnh l khc nhau dn n vic mc bnh hay dn n ci cht. Php o c tnh c th c tin hnh bng cch s dng nhiu im cui hoc tiu chun khc nhau. im cui l tng s l im lin kt cht ch vi phn t c to thnh khi tip xc vi cc c cht. Do s chn la im cui gy c l rt kh khn. C hai loi quan h ca liu lng v p ng: - "p ng chia cp bc" miu t s ng p ca mt c th trn mt khong cc liu lng ca mt ha cht v c c trng bi s tng lin quan ti liu lng. - "p ng nh lng" miu t s phn phi ca cc p ng i vi cc liu lng khc nhau trong mt qun th ca cc c th. N l mt loi "tt c hoc khng" v nh vy l mt im cui c bit (nh s t vong hoc kh nng gy cht v.v...) phi c coi nh mt "p ng". S xc nh gi tr LD-50 (liu lng gy t vong 50% s lng ng vt th nghim) thng l th nghim u tin nh gi mc c hi ca c cht. Gi tr LD50 khng phi l mt hng s sinh hc. N c th c thay i bi nhiu yu t nh hng ti c tnh, v d: - Cc tnh cht ha l ca mt ha cht. - Cch thc tip xc, thi gian tip xc. - Cc yu t c lin quan ti vt ch l cc loi, ging, tui, gii tnh, tnh trng sc kho, bnh tt v ch n ung. Liu lng gy ra bnh hay gy ra t vong gi l nng trc tip gy hi (FEL). Cc khi nim v NOAEL, LOAEL v FEL thng rt hu ch cho nh gi liu lng - p ng ca nhng hin tng nhim c phc tp. Nhng nh hng khng gy hi l nhng thay i trong qu trnh sinh trng, pht trin, chc nng ca cc c quan, sinh ha hay hnh dng m khng lm nh hng ti nhng hot 111

ng bnh thng. Nhng nh hng nh thng khng c gi l nh hng c hi. V d vic gim trng lng c th thng khng c coi l nh hng c hi. i vi khi nim thay i chc nng: cc nh hng khng gy hi c coi nh l nhng thay i m khng dn n vic lm suy yu kh nng hot ng, khng lm tng nhy cm ca sinh vt i vi nhng nh hng gy hi ca cc nh hng ha hc, vt l hc hay mi trng. nh hng c hi c nh ngha nh nhng thay i sinh ha, suy yu chc nng, hay cc tn thng bnh l n phng, hay cng kt hp li tc hi xu n bn cht ca c sinh vt, hay suy gim kh nng ca sinh vt phn ng li vi nhng thch thc ca thay i mi trng. S khc bit r rt ca cc tc ng quan st c v mt thng k v v mt sinh hc khng phi bao gi cng c nh gi tng ng. V d, s suy gim r rt 8% trng lng c th ca cc c th trong nhm th nghim v nhm i chng trong qu trnh th nghim c cht mn tnh khng c coi l s khc bit r rt v mt sinh hc. Nhng thay i r rt v cng cc tc ng hay xut hin mt s loi bnh l gia nhm th nghim v nhm i chng, i khi khng c s khc bit r rng v phng din thng k, nhng li c s khc bit r rt v mt sinh hc. S nh gi mc ph hp v phng din sinh hc. v khc bit hay khng khc bit v phng din thng k ca cs.c tc ng l cn thit.. Cc tc ng c th phc hi tr li l cc phn ng thch ng i vi mt tc ng gy cng thng. Nhng thay i ny s c phc hi quay v trng thi bnh thng ban u trong qu trnh b tc ng hay trong nhng tip xc tip theo. Cc tc ng khng phc hi tr li c l nhng thay i vnh vin v n cn c th tip tc pht trin, thm ch trong khong thi gian rt lu sau khi tip xc. 112

Mt s cc tc ng c hi chc chn l khng phc hi tr li nh: d tt bm sinh, x gan v.v... Cc tc ng khc rt kh xp loi Liu lng nn (RfD - Reference Dose) l liu lng c tnh tip xc ca con ngi trong mt ngy m khng xy ra mt nguy c no i vi sc khe trong sut c i. Liu lng nn c dng nh im chun nh gi cc tc ng tim tng ca cc mc tip xc khc. Tip xc mc tng ng hay thp hn vi mc RfD s khng gy ra mt nguy c no cho sc khe. Nu nh liu lng v mt tip xc vt qu RfD th xc sut gy ra tc ng xu cho sc khe con ngi s tng. Mc tin cy v gi tr RfD ph thuc vo cht lng ca cc s liu c cht hc i vi ha cht nghin cu. S nghin cu khng hong (Critical study) v loi c chn nh c s ca vic xy dng gi tr RfD. Nhn chung, liu lng nghin cu khng hong i din cho nng th nghim cao nht m khng gy ra tc ng khng hong (NOAEL) th c chn lm gi tr RfD. Nu nh khng c sn cc s liu nghin cu trn c th ngi v NOAEL th dng gi tr nn ca cc s liu c hc trn ng vt thit lp gi tr RfD. khi cc S liu nghin cu trn c th ngi khng c th phi s dng cc s liu nghin cu c cht hc trn ng vt. Khi nh gi cc s liu ca ng vt, gi tr RfD s c suy ra t gi tr NOAEL ph hp nht t cc tc ng khng hong ca nhng nghin cu cn thn trn cc loi c bit c phn ng tng t nh ngi i vi ha cht chng ta quan tm. Nu nh khng c s liu v mn cm ca ngi trong mi tng quan vi ng vt th nghim th ni chung RfD c suy ra t gi tr NOAEL ca mt ng vt nhy cm nht c nghin cu. Do c nhng iu khng chc chn k trn nn trong thc t ngi ta phi chia gi tr NOAEL ca ha cht cho 113

mt gi ta gi l "ch s an ton" loi b nhng yu t khng chc chn . Gi tr thu c ca NOAEL chia cho ch s an ton gi l liu lng nn RfD hay lng tip xc chp nhn c trong mt ngy (ADI).

Ch s an ton s dng c thit k m bo rng mc tip xc chp nhn c (RfD, ADI) nm gi tr ngng hay di ngng ca mc tip xc nhy cm nht ca con ngi. ln ca ch s an ton s dng trong tng trng hp ph thuc vo: cht lng ca cc s liu c cht, bn cht ca cc tc ng c hi. Thi gian tip xc ca ng vt th nghim lin h vi thi gian nhm ngi l i tng c th phi tip xc vi ha cht quan tm. s hon ho ca vic thit t thc hin th nghim trong vic nh gi NOAEL, s liu lin quan n nhy, tnh ring bit ca tng loi v ca tng 114

nhm ng vt. Khi nim "ch s an ton" mc d vn c dng tng i thng dng nhng i khi chng vn c thay bng tn ch s khng chc chn hay ch s bin i". Ch s khng chc chn, UF (uncertaintly factor) thng l nhng bi s ca 10, vi mi ch s tng ng vi mt kha cnh ring bit khng chc chn ca s liu. C s p dng cc ch s khng chc chn khc nhau nh sau: 1. Ly gi tr UF bng 10 khi suy din s liu t ng vt cho con ngi. Ch s ny tnh n s khc bit gia cc loi ng vt c v dng th nghim vi con ngi. S dng gi tr UF bng 10 cho s khc bit tng qut gia mt cng ng ni chung v nhng c th nhy cm trong cng ng (v d nh ngi gi v tr nh). 2. Gi tr UF bng 10 c dng khi gi tr NOAEL- c suy ra t nghin cu bn mn tnh (thay th cho nghin cu mn tnh). 3. Gi tr UF c dng khi LOAEL c dng v NOAEL cn thiu nhiu s liu tin cy. S liu ny tnh n s khng chc chn trong khi suy din s liu t gi tr LOAEL sang s liu NOAEL. Tuy nhin trong mt s trng hp h s ny c th dng l 100 hoc 1000. V d: h s 10 thng xuyn c dng ngoi suy t mt lng ngi c hn ti mt s ng dn chng. H s 100 thng c p dng cho mt NOAEL t mt bnh kinh nin, kh nng ung th hoc mt nghin cu di hn. H s 1000 thng c p dng cho cc nghin cu ngn hn hn (v d: Mt nghin cu bn mn tnh 90 ngy) hoc cho cc nghin cu khc vi d liu c han nh: Nghincu NOEAL 115

(mg/kgth trng/ngy) Bn mn tnh (nghin cu 90 ngy) 1500 Mn tnh (nghin cu 2 nm) 1500 Nghin cu a th h 1000 Nghin cu pht trin 1250 NOAEL s c s dng l 1000 mg/kg th trng - ngy. Vic p dng h s an ton 100 (NOEAL/UF hoc SF: 1000/100) a n kt qu l liu lng con ngi hp th mi ngy c th chp nhn c (ADI) l 10 mg/kg th trng. ADI l lng ha cht hp th trong 1 ngy m trong sut cuc i dng nh khng gy nguy him ng k da trn tt c cc s kin bit trong thi gian . Ngoi nhng ch s khng chc chn k trn, ch s bin i (MF: modifying factor) i khi cng c s dng. Ch s bin i bin thin t 1 n 10. tnh gi tr RfD, ly gi tr NOAEL tng ng (hoc l gi tr LOAEL nu nh khng c mt gi tr NOAEL thch hp) chia cho tt c cc ch s khng chc chn v ch s bin i c th p dng c. RfD= NOAEL /(UF1 X UF2 X UF3.....X MF) RfD thng c biu din bng mt ch s c ngha vi n v miligam ha cht trn kilogam trng lng c th trong mt ngy (mg/kg-ngy). 6.5.3. Cch tnh gi tr hng dn t lng tip nhn c th chu c i vi nhiu loi c cht, c mt liu lng m di liu th s khng c tc ng xu xy ra. Vi nhng ha cht c nh hng c hi kiu nh th th "liu tip nhn hng ngy c th chu ng c" (TDI) c tnh nh sau:

116

Trong : NOAEL: mc c ghi nhn l khng gy nh hng bt li no LOAEL: mc thp nht c ghi nhn l c nh hng bt li UF: h s bt nh Gi tr hng dn (GV) s c tnh t TDI nh sau:

Trong : bw: Th trng (60 kg i vi ngi ln, 10 kg i vi tr em v 5 kg i vi tr s sinh). P: T phn TDI do nc ung mang li C: Lng tiu th nc trong hng ngy (2 lt i vi ngi ln, 1 lt i vi tr em, 0,75 lt i vi tr s sinh). nh ngha v TDI (tolerable ctaily intake) TDI l gi tr nh lng v khi lng ca mt cht c trong thc phm v nc ung tc ng trn mt n v th trng (mg/kg hoc mg/kg th trng) m con ngi c th tiu ha hng ngy trong sut i m khng c nguy c xu ti sc kho. Trong nhiu nm, JECFA v JMPR p dng nhng quy tc nht nh tnh "liu tip nhn hng ngy v c th chp nhn c" (ADI). Nhng quy tc ny c tun theo (nu thch hp) tnh TDI khi xy dng hng dn v cht lng nc ung. ADI c thit lp cho cc cht ph gia thc phm v d lng thuc tr su c mt trong thc phm do yu cu k thut hoc do bo v cy trng. i vi cc cht nhim ha hc l nhng cht m ngi ta khng ch nh a vo nc th thut 117

ng "liu tip nhn hng ngy c th chu ng c" c l l ph hp hn v n hm cho php hn l chp nhn. V TDI c xem l liu chu ng c trong sut cuc i cho nn khng cn qu nghim ngt ni rng khng th vt mc TDI trong mt thi gian ngn. S tip xc trong mt giai on ngn vi nhng cht vt mc TDI khng l iu phi lo lng bi v nu tnh trung bnh trong mt khong thi gian di hn th vi liu tip nhn ca c th nh vy s khng vt qu mc n nh ng k. Mt khc, khi xc nh TDI th thng dng h s bt nh (xem phn sau) c gi tr ln. bo m rng gn nh khng c nh hng c hi cho sc kho do s tip xc nhng lng vt mc TDI gy ra trong mt khong thi gian ngn. Gi tr TDI tm c s dng tnh gi tr hng dn, kt qu s c lm trn n mt ch s c ngha. Trong mt vi trng hp, gi tr ADI vi mt ch s c ngha do JECFA hoc JMPR ngh cng c dng. Ni chung, khi mt gi tr hng dn c lm trn cn mt ch s c ngha l mun phn nh tnh khng chc chn v s liu c tnh i vi ng vt v mc nhim do s tiu th nc. Cc con s c hn mt ch s c ngha ch c dng khi no c nhiu thng tin v c tnh v s tip xc vi chng cho thy c th khng nh chc chn hn. Mc c ghi nhn l khng gy nh hng bt li no (NOAEL) v mc thp nht c ghi nhn l c nh hng bt li (LOAEL). NOAEL biu th mt liu hoc nng cao nht ca mt cht ha hc trong mt nghin cu n, n c xc nh bng th nghim hoc quan st m mc khng gy ra mt nh hng bt li no cho sc kho n mc c th pht hin c. Khi c th, NOAEL s c cn c trn cc nghin cu di hn v nh hng ca mt cht c trong nc ung theo ng tiu ha. Tuy nhin, NOAEL thu c t nhng nghin cu ngn hn v nhng nghin cu v cc ng tip xc khc nh 118

thc n, khng kh cng c th c s dng. Nu khng c s liu thch hp v NOAEL th LOAEL s c dng. LOAEL l liu hoc nng thp nht ca mt cht c th gy nh hng bt li cho sc kho c th ghi nhn c Khi dng LOAEL thay cho NOAEL th h s bt nh c a vo cng thc tnh GV. H s bt nh H s bt nh c s dng rng ri trong cch tnh gi tr ADI cho thc phm, d lng thuc tr su v cc cht gy nhim mi trng. Vic xc nh h s ny cn c s lun gii chuyn mn v sng lc cn thn t thc t khoa hc. Trong tnh ton, cc gi tr hng dn v cht lng nc ung ca WHO, h s bt nh c p dng tnh TDI t gi tr NOAEL thp nht v LOAEL cho nhng p ng c xem l c ngha sinh hc. Nhng h s ny c cc chuyn gia thng nht vi nhau v da trn nguyn tc sau: Ngun bt nh H s S khc nhau v loi 1-10 S khc nhau trong mi loi 1-10 Mc hon ho, ca nghin cu v s liu 1 10 Bn cht v tnh nghim trng ca nh hng 1 10 Nhng c s d liu v nghin cu c coi l cha hon ho bao gm c nhng nghin cu dng ch s LOAEL thay v NOAEL v nhng nghin cu c thc hin 'trong mt khong thi gian ngn hn mc cn phi c. Nhng trng hp trong bn cht v s nghim trng ca nh hng cho thy cn c thm h s bt nh bao gm nhng nghin cu m cui cng dn n qui thai hoc dn n kt lun rng NOAEL lin quan trc tip n kh nng gy ung th. Trong trng hp sau, h s bt nh thm vo c p dng cho nhng hp cht gy ung 119

th tnh GV t TDI. V d, cc h s nh hn 10 s c dng cho s khc bit v loi khi ngi ta bit rng con ngi t nhy cm i vi cht hn so vi loi ng vt c dng nghin cu. Tng cc h s bt nh khng c vt qu 10.000. Nu mt nh gi nguy c no cn dng n h s bt nh ln hn th TDI rt ra khng c chnh xc lm v thiu ngha. i vi nhng cht m h s bt nh dnh cho n ln hn 1000 th gi tr hng dn s ghi tm thi nhn mnh rng trong gi tr bao gm h s bt nh cao. Vic la chn v s dng cc h s bt nh tnh ra gi tr hng dn rt quan trng i vi cc cht ha hc bi v n c th lm gi tr tnh c khc bit nhau nhiu. i vi nhng cht gy nhim c tnh bt nh thp th h s bt nh s c nhn gi tr thp. Tuy nhin, 'trong hu ht cc cht gy nhim u lin quan n tnh bt nh v v vy c h s bt nh cao. V l , ta s c mt bin rng v tnh cht an ton trn mi gi tr hng dn m bo khng gy nhng nh hng bt li cho sc kho. 6.6. MT S PHNG PHP NH GI TC NG GY HI N C TH SNG 6.6.1. Cch nh gi nhng tc ng c hi trong c hc Cc phng php thc nghim nh gi nhng tc ng c th c ca nhng ha cht nguy hi cn tin hnh nhiu mc vi nhng phc tp khc nhau ty thuc vo tng mc nghin cu cho tng i tng (mt loi ring bit, mt qun th, mt qun x hay mt h sinh thi), hoc ph thuc vo im cui cng (t l cht trong mt thi gian ngn hoc trong mt thi gian di, cc hiu ng mn tnh hay bn mn tnh, suy gim v kh nng sinh sn v.v...). Cn thit phi so snh gia mt h sinh thi thc s v n gin ca quy trnh th nghim cng nh suy din kt qu vn l 120

nhng vn tranh ci qua nhiu nm v vn to ra mt quy trnh th nghim chun vn cha bao gi thc s c gii quyt. Bng 9. Cc th nghim trong c hc v c hc sinh thi ti ba mc khc nhau theo ch dn ca EEC 79/831 Mc c Cp 1 Cp 2 bn chung Th nghin c cht hc c tnh tc thi - Ming - Qua h h hp - Nghin cu v kh nng sinh sn Nghin cu v kh nng gy qui thai ( Cc nghin cu Nghin cu v c tnh mn tnh Nghin cu v ung th - Nghin cu v kh nng sinh sn - Nghin cu v kh nng gy qui thai - Nghin cu v c tnh tc thi v bn tc thi trn mt loi khc

- Qua da Qua mt c tnh bn tc thi NOAEL sau 28 ngy Cc tc ng khc Bin d di truyn

bn mn tnh v mn tnh Nghin cu su hn v bin d di truyn

121

Th nghim c cht hc sinh thi

Tc ng n sinh vt c tnh tc thi i vi c S suy thoi cua: - Cc thnh phn hu c Cc thnh phn v c

- Th nghim v kh nng km hm s pht trin i vi ru, to Th nghim trn cc loi thc vt cp cao hn Th nghim trn giun t - Th nghim di hn trn c - Th nghim v kh nng tch ly trong mt s loi

- Th nghim m rng v kh nng tch ly sinh hc, s suy thoi v s di chuyn. Nghin cu su hn trn c (k c nghin cu v s sinh sn) - Nghin cu thm v c cht hc trn mt s loi chim Nghin cu thm v c cht hc trn tt s loi khc - Nghin cu v s hp ph v s gii hp

Bng 10: Cc th nghim v c cht hc v c hc sinh thi phi c tin hnh theo quy nh EEC 91/414 trc khi cho php mt loi thuc bo v thc vt c bn ra th trng Th nghim c hc Th nghim c hc sinh thi

122

c tnh tc thi Qua ming - Qua h h hp - Qua da - Qua mt c tnh bn tc thi - c tnh bn tc thi do tip xc qua ming sau 28 ngy -90 ngy sau khi th nghim trn thc n cho gia sc -Th nghim trn nhng ng tip xc khc c tnh hc mn tnh -c tnh i hn khi tip xc qua ming v kh nng gy ung th - Bin d di truyn Tc ng n s sinh sn - Nghin cu v kh nng gy qui thai - Nghin cu qua nhiu th h ng vt nghin cu v c ch trao i nht ca ng vt c v Cc nghin cu h tr khc Tc ng n c ch trao i cht - Nghin cu v c ch hot ng - Nghin cu trn cc gia sc v vt nui -Cc s liu v y hc v bnh dch hc

-Tc ng i vi cc loi chim -c tnh tc thi do tip xc qua ming - c tnh bn tc thi Tc ng n kh nng sinh sn -Tc ng n cc sinh vt ca h sinh thi thy sinh - c tnh tc thi i vi c -c tnh bn tc thi i vi c -Tc ng n s sinh sn v s pht trin ca c - S tch ly sinh hc trong c - Tc ng n s pht trin ca cc loi ru, to -Tc ng n cc sinh vt khc khng phi l i tng ca thuc BVTV -c tnh tc thi i vi ong mt v cc loi cn trng c li khc

- c tnh i vi giun t v cc loi ng vt khng xng sng khc sng trong t -Tc ng i vi vi sinh vt t

123

6.6.2. Cc loi th nghim trong c hc C nm loi th nghim c quy nh ty theo tng nhu cu khc nhau, nguyn gc chng c quy nh lm th nghim i vi c, nhng chng c th c p dng d dng i vi cc loi ng vt khc trong h sinh thi thy sinh hay h sinh thi cn. Nm loi th nghim c quy nh : 1 S b kim tra c tnh ca ha cht; 2. Quan trc c tnh s pht tn nhim ca cht thi hay ca cc ni chn cht thi; 3. Quan trc cht lng mi trng vi cc mc ch v lut php; 4. nh gi nhy ca mi trng t nhin i vi cc cht ha hc; 5. Nghin cu thit lp tiu chun mi trng; Dn chng minh ha trong phn tip theo ly vic th nghim trn c lm v d. a) S b kim tra c tnh ca ha cht V mt l thuyt, hu ht cc kim loi ti c h sinh thi thy sinh, c th do b thi ra mt cch ngu nhin, hay tnh c trong khi vn chuyn (trn khng, t lin, trn mt nc), hay b thi ra do mt hnh ng thiu trch nhim. Kiu th nghim ny c dng xc nh nguy c c hi ca nhm cc ha cht hay sn phm c kh nng thm nhp vo h sinh thi thy sinh khi con ngi s dng mt cch bnh thng. Do vy vic s dng cc hp cht t c nht c th c nghin cu su hn. Cc th nghim nh vy c chun ha. b) Quan trc c tnh ca s pht tn nhim cht thi hay cc ni chn cht thi 124

Thng thng tiu chun cht lng cho php thit lp cho cc dng cht thi c kim tra sau bng cch tin hnh phn tch ha hc. Tuy vy, nhng dng cht thi mang theo cc ha cht c hi thng kh phn tch v th nghim c tnh. hnh dung mc trm trng ca nguy c, mt th nghim n gin c dng quan trc tip dng cht thi. Php th nghim ny c gi l s quan trc dng cht thi. c) Quan trc cht lng mi trng vi cc mc ch v lut php Nu nh b tiu chun mi trng ni trn cn c a vo cc quy nh php lut, mt quy trnh th nghim chnh xc, hiu qu phi c thit lp v phi ph hp vi cc tiu chun v nghin cu c cht hc i vi c. Nhng php th nghim ny c gi l nhng php th nghim mang tnh php lut. d) nh gi nhy ca mi trng t nhin i vi cc cht ha hc Nh ni trn, cc dng sng c th b nhim mt cch rt ngu nhin t nhiu ngun khc nhau, gy nguy him cho nhng ngi s dng cui ngun. Nhng trng hp ny, h thng quan trc phi quan st c nhng du hiu l tc ng n nhng loi c sinh sng y. Quy a ra nhng kin ngh kp thi tip tc cho php hoc phi chm dt nhng hot ng gy ra nhng tc ng ni trn. Nhng th nghim ny gi l nhng th nghim quan trc cht lng nc chy trn sng. e) Nghin cu thit lp tiu chun mi trng C rt nhiu cc c cht xut hin trong mi trng nc, l do hu qu ca cc hot ng cng, nng nghip v nc thi sinh hot. Nhng ha cht ny lu li trong h sinh thi thy sinh vi nhng chu k rt di, thm ch i khi tn ti vnh cu. i vi nhng cht ny cn nhiu thng tin nh gi nguy hi, thit lp tiu chun cho php trong mi trng nc. Bn cht v quy m ca nhng th nghim km theo ph thuc vo bn cht ha hc ca tc nhn v mc gy ri ro 125

ca n. Quy trnh th nghim phi a ra nhng thng tin c th c din t nh l php th nghim thit lp tiu chun cht lng nc. Nhng th nghim ny thng phc tp, phai c tin hnh trong nhiu khong thi gian v trn hng lot cc loi khc nhau v.v... Bng 11. Kh nng p dng v ni dung thng tin ca cc kiu th nghim tin hnh trn cc mc khc nhau trong c hc

Trn mt loi a) S b kim tra c tnh ca ha cht; b Quan trc c tnh s pht tn nhim ca cht thi hay ca cc ni chn cht thi; c) Quan trc cht lng mi trng vi cc mc ch v lut php; di nh gi nhy ca mi trng t nhin i vi cc cht ha hc; +

Trn mt qun x

H sinh Nghi thi i n cu chng trn thc tn -

+ + -

126

e) Nghin cu + + thit lp tiu chun mi trng; K hiu + ngha l tnh tch cc. - ngha l tnh tiu cc; ngha l trung bnh hoc vn ang cn c tranh ci. Cc phng php v cch qun l d liu trong c hc sinh thi Cc quy trnh th nghim c cht hc vi c hay vi nhng loi ng vt thy sinh c thit lp rt r rng, i khi c chun ha, sau y l nhng iu hng dn chnh: - Lm mt dy cc th nghim vi nhng cht gy c khc nhau - Th nghim trn tng nhm sinh vt, thng vi mt si lng bng nhau trong mi b th nghim - Quan st t l cht hoc cc tc hi khc xy ra trong qu trnh tip xc vi c cht - Kt qu cui cng c biu din nh nng gy hi, gy cht i vi sinh vt Quy trnh tng t cng c p dng cho cc ng vt trn h sinh thi cn. th c tnh c trng c v hnh sau. dc ca th ch ra tc ca qu trnh gii c.

127

Hnh 18. c on nng gy cht cho mt thi gian tip xc nht nh; A. B. C l cc loi ha cht khc nhau Nu nh vic quan st cc hiu ng c da trn mi quan h vi thi gian, th kt qu c ch ra trn hnh 20 v cn c th x l bng cch ly thi gian c tc ng n 50% sinh vt th nghim tng quan vi loa ca nng .

Hnh 19. c tnh thi gian trung bnh gy cht ti 128

cc nng khc nhau i vi cc loi ha cht (l,2,3,4,5)

Cc ch s cht lng thng c s dng trong c hc bao gm: LD50 (Lethal dose 50%)- L liu lng ca ha cht gy cht 50% sinh vt th nghim. LC50 (Lethal concentration 50%)- gi tr dng khi tip xc vi ha cht ca sinh vt th nghim khng ra' ng ming v tiu ha m chng c tip xc qua cc ng khc nh nc v khng kh.. Nu nh im cui ca tc ng khng phi l cc cht m l cc tc ng sinh hc khc th ta s dng gi tr ED50 (effective dose) hay EC50 (effective concentration). Nu nh thi gian l mt thnh phn quan trng ca tip xc th n phi c ch ra rt r rng. V d nh LC50 24h l nng gy cht 50 % s sinh vt th nghim sau 24 gi. LT50 (lethal thc 50%) l mt cch o khong thi gian cn thit gy cht cho 50% sinh vt th nghim. 129

Chng VII NH HNG CA MT S CHT NGUY HI TI SC KHE CON NGI

7.1. MT S BNH DO NHIM MI TRNG 7.1.1. Bnh phi Bnh nhim bi phi silic Nhng cng vic c th gy bnh l tt c mi cng vic c tip xc vi bi silic t do nh: Cc hot ng khai thc khong sn hoc c cha silic t do. Sn xut v s dng cc loi mi, bt nh bng v cc sn phm khc c cha silic t do. Ch bin cht carborundun, ch to thy tinh, snh s, cc gm khc, gch chu la. Cng vic c c tip xc vi bi ct (khun mu, lm sch vt c ) Cc cng vic mi, nh bng, ra kh bng mi c cha silic t do. Bnh bi phi silic l bnh khng hi phc. Bnh bi phisilic lm gim tui th ngi bnh, t vong hay xy ra trong tui 40 - 50, sau cc bin chng nh ph qun - ph vim, suy tim phi - lao phi hp. Khi tip xc vi bi c nng v hm lng silic t do cao, thi gian tip xc lin tc ko di, bnh tin trin nhanh t vi thng n vi nm, nht l ngi tr, lm ngh phun ct, nghin khong sn (thch anh...). 130

Bnh bi phi cng nhn m than cc m than, ngi th phi ht th khng kh c bi than, bi st... dn n bnh bi phi ca cng nhn m than. Mt s lng ln bi than do cng nhn b bnh c th ht vo phi, lng ng xung quanh cc ph qun nh v cc ng mch phi nh i km to thnh nhng bi nh. Bnh bi phi nhim bi aming (abestos) Aming c trn vi nhiu sn phm nh xi mng, cao su, cht do... lm thay i tnh cht c l ca sn phm c li cho tiu dng. Aming cn dng dt vi, may o cch nhit, lm thm chng la cch nhit, lm thng cch nhit dng cho ni hi, l nung, lm vt liu cch m, lm ngi aming - xi mng, lm m phanh t... Atbet hay aming kp Ca v Mg, dng si trong thin nhin. C hai loi aming chnh l serpentin v amphibol. Loi ph bin nht l chrysoltil (90% sn lng trn th gii). Cn crocidolit l loi c bit hay gy ung th hn c Nhm amphibol 1 Crocidolit (aming xanh) 2. Amosit 3. Anthophylit 4. Tremolit 5. Actinolit Nhm serpentin Chrysoltil (aming trng) Cc th loi bnh -Th x ha phi - Th c tn thng mng phi lnh tnh 131

-U c tnh - Chai da Bnh bi phi - bng (Byssinosis) Cng vic c th gy bnh: L ao ng tip xc vi bi bng, trong vic x bng, chi th, lm si, bc si, qun si, dt vi, thu hoch bng, t ht ly bng Nhng ngi tip xc vi bi bng trong nhiu nm c nhng triu chng bnh c trng, s gim dung tch h hp khng hi phc c... Trong s cc cht gy co tht ph qun c trong bi bng hay nhng cht lm co tht cc ph qun nh bng s co c hay do ph n nim mc ng h hp... Mt s nc ngh ly tr s lmg/ma lm ngng ti a cho php ni vi bi bng. 7.1.2. Bnh xm da Nhng cng vic c th gy bnh: tip xc vi du ha, du mazut, du nhn, du xng, benzen, parafin, luyn cc, nha than, acridin, anthracen, nha ng, creosot, hi hydrocarbon, bc, ch, bc x ton ha hp cht lu hunh, phenol, than en, sa thch, sn xut cao su. Bnh thng gp trong cc ngnh cng' nghip nh ha du, luyn than, tm g, ra nha ng, li tu, luyn kim, phim nh, nha, bi thc vt, ha cht, cao su,... Bnh xm da tuy khng gy cht ngi cp tnh nhng lm sc kho suy gim, kit qu, nng sut lao ng gim st mt khc, bnh thng pht cc vng da h nh tay, c, mt lm nh hng n nhan sc thm m, nht l i vi nam n thanh nin. y khng ch l vn sc kho m cn l vn x hi cn c quan tm. Bin php khc phc 132

- Thay i nguyn liu hoc cng vic trnh tip xc vi cc yu t gy bnh. -Ci thin iu kin mi trng lm vic nh thng gi, ht bi, hi kh c, khp kn dy chuyn sn xut, trnh vi dy dnh, du m, bi than,. . . - Trang b y v s dng c hiu qu cc phng tin phng h lao ng. Hn ch, trnh tip xc vi nng nh thay i gi lm vic hp l, lm lu che chn nng cho ngi lao ng khi lm vic ngoi tri. 7.1.3. Bnh nhim c benzen v ng ng (Toluen, Xylen) Nhng cng vic c th gy bnh: tt c mi cng vic c lin quan ti benzen v ng ng ca benzen Khai thc, ch bin, tinh luyn cc hp cht benzen v ng ng ca benzen. iu ch dn sut t cc hp cht benzen v ng ng ca benzen. Ct cc cht bo, ty m xng, da, si, vi, len, d. ljau kh, ty m cc tm kim loi v tt c cc dng c c bm bn cht m. iu ch cc dung mi ha tan cao st thao tc v s dng cc dung mi , tt c mi vic s dng cc dn sut v cc cht thay th n lm cht ha tan cao su Pha ch v s dng vecni, sn, men, ma tt, mc in, cc cht bo qun c benzen; ch to da mm. H si bng sn phm cha benzen. S dng benzen lm cht ha tan nha thin nhin v tng hp. Dng benzen tch nc trong ru cn, trong 133

cc cht lng v cht c khc. Dng benzen lm cht bin dng. Pha ch v s dng nhng nhin liu c benzen v ng ng ca n... Nng ti a cho php mi trng lao ng, theo Vit Nam l 0,05 mg/l, theo Lin X c l 0,02 mg/l, theo Uruguay l 1 mg/l. y l mt bnh nguy him v d ngng tip xc, bnh vn khng loi tr c do c lng benzen tch ly cc t chc nhiu m, nht l ty xng. Ngoi ra, nhim c cn c th xut hin mun, ti 20 thng sau, cng do benzen tn lu lu di ty xng. Thi k ton pht, s lng hng cu di 1 triu, bch cu di 2000, bch cu trung tnh di 15% v c th dn ti t vong. Nu iu tr khi, thi gian hi phc ko di v bnh cng c th ti pht. Ph n c thai, d sy thai, non. i vi Vit Nam, theo vn bn 108 LB/Q ngy 30 thng 3 nm 1977, cm dng benzen lm dung mi pha ch sn. Nu do yu cu cng ngh i hi phi dng benzen th hm lng ca n cha trong dung mi khng c qu 10% cht lng (cht bay hi trong thnh phn ca sn). C bit cho php tng hm lng benzen ln 20% dng cho vic sn m nhng phi c s tha thun ca c quan qun cp trn. 7.1.4. Bnh nhim c ngh nghip da ch v cc hp cht ch Nhng cng vic c th gy bnh: tt c mi cng vic khai thc, ch bin, iu th, s dng ch, qung ch, hp km v hn hp ch, ch yu l: Khai thc, ch bin qung ch v cc ph liu c ch. Thu hi ch c. 134

Luyn, lc, c, dt mng ch v cc hp kim ch. Hn. m bng hp kim ch. Ch to, xn ct, nh bng cc vt liu bng ch v hp kim ch. c ch in bng hp km ch, vn hnh my c ch, sp ch in. Ti luyn ch v ko cc si dy thp c ti luyn bng ch. M bng phng php phun x. iu ch v s dng cc oxit ch v mui c... Pha ch v s dng sn, vc ni, mc in, ma tt c gc l cc hp cht ch. Ch to v s dng cc loi men c ch, thy tinh pha ch. Trng men v in hoa gm bng hp cht ch. Co, t, ct cc vt liu c ph lp sn ch. Pha ch v s dng tetraethyl ch, cc nhin liu c cha ch, c ra cc thng cha cc nhin liu ny. Nhim c ch v c c tnh ca ch Ch l kim loi mm, mu xm nht, c trong thin nhin di dng qung nh sulphur ch (ga len). Ch nng chy 3270c, Si 1,5150c nhng t khong 550 - 6000c Ch bay hi v khi tip xc vi khng kh, hi ch bin thnh oxyt ch rt c. Ch v cc hp cht ca ch u c. Cc hp cht ny cng d ho tan bao nhiu, ch cng c by nhiu. Mt gam ch tng ng vi 5% acetat ch hp th vo c th mt ln, thng l liu gy t vong. 135

- Mt liu hng ngy l 10 m c th dn n nhim c nng sau vi tun. - Hng ngy hp th 1mg ch, sau nhiu ngy c th xut hin nhim c mn tnh ngi bnh thng. Cc triu chng - Mu da ti: da mt c th ti xm thng do s co mch nhiu hn l do thiu mu. -ng vin ch Burton: mu xm sm, chn rng ni tip xc vi li, o ng sulphur ch li. ng vin ch thc ra ch l triu chng tip xc, do hp thu nhiu ch ch khng phi l triu chng nhim c. - Cn au bng ch: y l mt du hiu khi tnh trng nhim c nghim trng. Cc bnh Lit ch Lit ch l c trng trong s cc tn thng thn kinh ngoi bin, bao gm lit thn kinh quay, th hin lit cc c dui.Lc u, lit tp trung vo cc ngn gia v ngn eo nhn ri sau lan ra cc ngn tay. Lc ny, c th gp hnh nh bn tay ra. Chi di rt t khi gp lit ch, cc c c th b tn thng l c mc, c dui chung v c dui ring cc ngn. Lit ch l lit vn ng n thun do tn thng thn kinh v mt phn x gn. Tai bin no v mt biu hin c bit nghim trng, bnh nhn nhc u d di, co git, ng kinh, m sng, hn m, d t vong. Hin nay, tai bin no rt him thy. Vim thn 136

Vim thn pht trin chm, protein niu nh, m huyt tng nh, ln trn 0,5 g/l. Nc tiu c th c hng cu, bch cu. Huyt p cao Lc u c th huyt p cao n thun, sau tr thnh vnh vin v phi hp vi vim thn. Pb gy tc hi n mch v nhu m thn. Huyt p cao c th gy tai bin tim mch trong nhim c ch: xut huyt, tim to, suy tim. Thp khp do ch Xut hin tng cn, au cc khp lan to, nhng khng tp trung ct sng. Cn au ko di vi ngy. Cn c th au c, au xung quanh khp, nhng khng sng, khng . Nhim c ch hu c Ch hu c thng gp l te tra ethyl ch Pb(C2H5)4. Hp cht ny c s dng ngy cng nhiu pha vo xng - xng pha ch c nguy c gy nhim c cho cng nhn tip xc. Ti Vit Nam, s cng nhn tip xc vi xng pha ch ngy cng nhiu: th my, cng nhn kho xng du phi c ra cc b xng du, cc xitec,... nhng ngi vn chuyn, bo qun, phn ph v s dng xng du... Theo quy nh ca nhiu nc, lng tetraethyl ch ti a c php pha vo xng khng qu 0,5 phn nghn (hay o,5 g/l). Tetraethyl ch vo c th d dng qua da, v n ho tan c qua lp m bo v. Nhim c ch hu c cng rt d dng qua ng h hp. Do , nhim c hay gp nhng ngi lm vic c ra, sa cha cc b cha xng hay cc thng xitec v tetraethyl ch vo c th qua c ng da v ng h hp. i vi ngi, ch hu c gy nhim c kiu vim no. V c i lc vi t chc m, ch c nh t chc m ca no. Do tc dng chn lc ny, biu hin ca nhim c tetraethyl ch rt khc vi nhim c ch v c. Cc kt qu nghin cu v c cht hc 137

cho thy ch hu c tch ng nhiu no ri gan, thn. gan, tetratethyl ch c th chuyn thnh tri ethyl ch v ch v c, ch v c ny sau khi c gii phng, li tch ng vo xng. Triu chng nhim c ch hu c rt khc vi nhim c ch thng thng. Du hiu ni bt l thn kinh. Bin php khc phc Cho n nay, ngi ta thy cha c cht no pha vo xng tt hn ch hu c (tetratehtyl ch) vi tc dng chng n. Do kh c th thay th cht no khc s dng. V vy, quy trnh sn xut ch hu c phi tin hnh trong h thng tht kn. Khi pha ch hu c vo xng phi ngoi tri, hoc ni thng gi tt.. Cng nhn tip xc vi xng pha ch nh c ra, sa cha cc b cha... phi c qun o bo v c bit l khi no hm cha c nng ch hu c cao phi eo mt n. trnh s tip xc nguy him, i viemt s cng vic, cn phi trung ha c cht trc bng mt s cht oxy ha (nh KMnO4). Cc loi xng pha ch, trong bt k trng hp no cng khng c dng lm dung mi hoc ty sch du m dnh vo qun o hoc cc vic khc trong gia nh. trnh s nhm ln, ngi ta thng pha thm cht mu. Bin php ny cha y , m cn phi nhc nh nhng ngi s dng v hu qu nguy him ca xng pha tetraethyl ch. 7.1.5. Bnh lao phi Bnh lao phi vn l mt vn sc kho cng ng c quy m ton cu vi khong 8 - 10 triu ca mi v 3 triu ca t vong mi nm. Tnh trng trm trng n mc m WHO phi cng b lnh bo ng trn ton cu vo nm 1993. Lao phi cn l bnh mang tnh x hi hn l mt bnh truyn nhim v n thng xut hin nhng ngi ngho, sng 138

trong iu kin ng c cht cht v b suy dinh dng. Bnh lao phi li "bt tay" ng hnh vi dch HIV/AIDS. Virus HIV/AIDS ph hy h thng phng v ca c th - gi l h thng min dch - gp phn to iu kin cho qu trnh lao pht trin nhanh t giai on ly nhim n giai on trm trng. Lao phi l loi bnh c hi a phn git cht nhng ngi HIV dng tnh. C khong 1 triu ngi cht v AIDS nm 1995 th khong 1/3 b nhim lao. Trong khi c 90% nhng ngi cht v lao phi nm 1985 l lin quan ti AIDS. T l ny s t khong 17% vo khong nm 2000. 7.1.6. Bnh da ngh nghip do crome (lot da, lot vch ngn mi, vim da, chm tip xc) Nhng cng vic c th gy bnh Ch to c quy, luyn kim, sn xut nn, sp, thuc nhum, cht ty ra, thuc n, pho, dim, keo dn, xi mng, gm, mui crm, bt mu, men s, thy tinh, bn km, cao su, gch chu la, x phng, hp kim nhm, th xy dng, m in, m crome. Tt c nhng ngnh ngh trn m cc cng vic trong qu trnh ngi lao ng phi tip xc, ht th, dy dnh... vi crome hoc hp cht crome th cc loi bnh nh lot da, lot, thng vch ngn mi, vim da tip xc, chm tip xc... u c th xut hin. 7.1.7. Bnh nhim c ma ngan v cc hp cht ca ma ngan Nhng cng vic c th gy bnh: Khai thc, tn, nghin, sng, ng bao v trn kh bioxyt ma ngan (MnO2) nht l trong vic ch to cc phi in, que hn. Dng bioxyt ma ngan trong vic lm gi ngi, ch to thy tinh, thuc mu, k ngh luyn thp. Nghin v ng bao l luyn kim c bioxyt ma ngan. 139

Hi chng bnh

Thi T l mt gian bo kh nng m lao ng 3% 1 nm 60%-61% 80% 81-100%

Hi chng thn kinh kiu Parkinson Run nh cn lm c vic Run nng khng lm c vic - Bnh rt nng khng lao ng v t phc v c 7.1.8. Bnh nhim x ngh nghip

Phng x c s dng rng ri trong nhiu ngnh: m, a cht, thm d du kh, y t,... Ung th xng ngh nghip cng c bit r. Bnh xy ra do nhim x ni chiu radi () plutoni (), stronti (). Bin php khc phc Mt trong nhng bin php Phng chng nhim x l: s dng nhng tm che chn bng ch, bng b tng i vi tia X, tia gamma; bng cht do i vi tia bng Bo, Cadimi i vi cc ht notron. Nn thng xuyn o kim tra tnh hnh nhim x ti ni lm vic. Cng nhn vin khi lm vic c mang mt chic my o liu phng x, di hnh thc bt, phim... trnh n hoc th ht phi, ngi ta thng cc cht phng x cch bit mt ni, eo gng tay cao su pha ch khi thao tc, mc qun o khng thm nc v git gi c sau khi lao ng v tm ra trc khi v nh. V phng bnh, ngi ta ch cc bin php bo v, ngn nga tnh trng chiu x, bng khong cch, ngn chn bng mng che chn, thi gian v cch ly. 7.1.9. Bnh st do Leptospira ngh nghip 140

Bnh st do Leptospira hay gp Vit Nam, cc vng rng ni, cc khu vc khai hoang pht trin nng nghip, khu xy ng cng nghip. y cn l bnh gia sc truyn sang ngi. Ngi mc bnh do tip xc vi sc vt hoang di hay gia sc v cn do tip xc ngh nghip trong qu trnh chn nui hoc phi tip xc vi nc nhim. ng ly thng thng l do tip xc vi t hoc nc nhim nc tiu sc vt b bnh, trong khi lao ng phi ngm mnh i nc, bi hay li nc hoc bn ly. Cng c th ly trc tip kht tip xc vi vt, mm bnh vo c th qua a sy xt hoc qua nim mc. Bnh cn c th ly qua thc phm, nc ung nhim. Rt him gp trng hp ly bnh t ngi sang ngi. Cc triu chng sm xut hin l n khng ngon, au c, nhc u d di, lin tc, ngi l v au vng sau nhn cu, m hi v ra nhiu. Bnh nhn thng bun nn, c th a chy hoc to bn. Trong thi k u st, vm thn kinh mt v i khi lit nh thn kinh vn ng nhn cu. Vim mng mch nh mt (uveitis) l bin chng mun, xut hin t hai tun sau cn bnh pht cho n mt nm sau. Mng no b tn thng cng l ph bin nn c biu hin c cng, tng p lc dch no ty, bch cu n nhn tng ln 50/mm3 hay hn. Trong nhng ngy u, c tnh trng xut huyt. Gan v lch to, nhng khng thng xuyn. Thn thng tn thng dn n i ra m, ra mu. Bnh do Leptospira nng thng do Lipterohaemorrhagiae. Cc triu chng cng nh vy nhng nng hn, c bun nn, nn, c bit tiu chy nng. Rt hay c biu hin xut huyt, vim phi, vim c tim, try mch ngoi bin xut hin. Gan to vng a, chc nng gan b nh hng, cc triu chng nh hng v h thn kinh trung ng, bch cu tng, ch yu bch cu a nhn. Thn b suy, protein niu tng i t hoc v niu. 141

T vong thng do thn. bnh thng thng gp loi gm nhm, nn i hi phi dit loi ny, y l mt cng vic rt kh khn. Ngi ta dng thuc dit nh dicumarol hay cc mi c tng t. Gia sc nh ln, tru b, nga, ch cng l bnh nhng t hn so vi loi gm nhm. i vi vic dit Leptospira mi trng nhim c th tin hnh bng cch dng clo v khun nc. t b nhim c th x l bng mui ng sulphate, cyanamit canxi. 7.1.10. Bnh a chy Bnh a chy l bnh ly lan rt rng ti cc nc ang pht trin, n gy tnh trng m yu, bnh tt v cht ng k, c bit tr s sinh v tr em ni chung. Bnh ly nhim ch yu bi phn ngi nhim bn trong thc n v nc. 7.1.11. Ung th Ung th gan Men aflatoxin t nm Aspergillus c tron.g thc n thc vt (go, m, vng, u,...) b mc c tc dng gy ung th mnh. Nghin ru hoc thc n thiu methionin, cystin, m cng c th pht sinh bnh ung th gan. Ung th ph qun - phi -Cng nh cc ung th khc, ngi ta cha r nguyn nhn thc s ca ung th ph qun - phi m ch c th nu ln cc yu t thun li lm bnh pht sinh nh ngh nghip, mi trng sng, ht thuc. -Ung th ngh nghip xy ra sau mt thi gian lm vic khong 15 - 20 nm trong cc x nghip c nhiu c cht nng cao (cc cht phng x, niken, crmat, aming, hc n, cc ha cht...) nht l khi iu kin bo h khng tt. - Mi trng sng b nhim: cc thnh ph cng nghip khng kh b nhim do khi t cc nh my, kh thi t cc xe 142

c ng c, cc nh my t rc... - T nn ht thuc l: Cc nghin cu thng k M theo di trong 20 nm th thy nhng ngi nghin thuc l nng (trn 20 iu/ngy) b ung th phi nhiu hn cc ngi khc (hn 75%). Tc dng ung th ch xut hin khong 1 nm sau khi bt u ht. Ti sao ht thuc l li c hi? Khi 1 iu thuc l c khong 0,1 mg nicotin hay 1-metyl- 2 - (3-pyridyl) pyrolidin l mt ancaloit bay hi, c, khuch tn nhanh, v vy 90% nicotin c th thm nhp vo c th. u tin nicotin vi liu lng nh kch thch hch thn kinh t ng ca dy thn kinh ph giao cm ri n dy thn kinh giao cm, ty thng thn, gy mch nhanh, huyt p tng, kch thch s tit cc cht catecolamin, do lm tng s tiu th oxy c tim cng nh tng lu lng mu ng mch vnh, lm th nhanh, gin ng t, tng nhu ng rut. Vi liu lng cao n lm lit cc xinap thn kinh v ch giao tip c - thn kinh. Trong khi thuc l bao gi cng c cc hydrocacbua thm nhiu vng, trong c nht l 3,4 - benzopyren vi hm lng 0,5g/iu. Nghin thuc l lu nm s gy nhim c c th, lm gim tui th (trung bnh 4 nm), vim ph qun mn tnh, bnh tim mch, ung th ph qun phi. Trong kha hp thng 11 nm 1982 Ginev cc chuyn gia v ung th ph qun- phi u nht tr kt lun rng 80- 90% trng hp bnh u bt ngun t ht thuc l. Ung th vm hng Nguyn nhn ung th vm hng rt a dng, trong c th c: Vim mn tnh vng tai mi hng, cc ha cht dt c, ht thuc. Ung th vm hng c yu t di truyn. Ung th vm hng pht trin theo 3 th: Th lot, th tiu thy v th si. Ung th i tr 143

Y hc ngy nay thng k c 200 loi ung th, c nhng loi rt ph bin nh ni trn, song c nhng loi rt him thy. D sao th chng vn c nhng nt chung l: Mt t bo khng tun theo quy lut pht trin t nhin. N phn ra mt cch tri quy lut, qu trnh to ra khi u. Kho u xut pht t t bo pht trin khng bnh thng i khi cn c g l "t bo in". Tip chng dn dn lan ra khp c th. Mi t bo hng ngy phi t chnh 10.000 ch suy yu trong gen ca n. Nu ngng cuc chnh n y khng thc hin c th t bo c nguy c tr thnh ung th. Tuy nhin, nh c nhng enzym l cht chuyn tr ch suy yu y, nn thng thng n vn hon thnh c nhim v. Ch khi enzym yu i, mi t bo phm t 5 n 10 li th s cn bng gia gen sinh trng v gen n nh b ph v. Thng th h min dch ca c th pht hin ngay hin tng v tn cng tiu dit t bo c, nhng c trng hp bn thn h min dch c s c, gp trc trc, th l t bo ung th c dp honh hnh. Ngy nay ngi ta nhn thy mt lot yu t gy ung th xut pht t mi trng nh nhim khng kh, cc ha cht cng nng nghip phng x, tia t ngoi v li sng m quan trng nht l n ung, ru ch. thuc l, tim chch v c c yu t di truyu... trn cp n. 7.1.12. Bnh ic ngh nghip do ting n Ti Vit Nam, bnh ic ngh nghip c pht hin cc ngnh ng st, GTVT, nng lng, xy dng, cng nghip nng v nh... i vi cc gic quan khc, ting n qu gii hn cho php gy chng mt, bun nn, ngt. Ting n c th tc ng n tn cng thn kinh, duy tr thng bng tin nh.V sinh l, ting n gy mt mi ton thn, nhc u, chong vng, n mt ngon, gy yu, thiu mu. 144

Ti Vit Nam, gii hn ti a cho php i vi ting n mi trng lao ng l 90 dBA. Ngi ta nh ngha tn thng sc nghe l mc ngng nghe trung bnh vt qu 25 dBA tn s 500Hz, 1000Hz v 2000Hz. Tr s ny c s dng gim st s tip xc vi ting n. Gii hn ting n ti a cho php c th thay i theo thi gian: t ip xc hng ngy. Cng n cng cao, thi gian tip xc phi cng ngn.

145

Bng 12. S tip xc vi ting n Thi gian trong ngy, gi 8 6 4 3 2 1 + 1/2 1 3/4 1/2 1/4 n, dB 90 92 95 97 100 102 105 107 110 115 (+)

(+) Tr s ngng ti a (ceiling value), khng th tip xc ngh nghip qu 115 dBA.

7.1.13. Bnh rung chuyn ngh nghip 146

Rung chuyn l mt trong nhng yu t tip xc c hi trong lao ng hay gp mt s ngnh ngh v ngy cng pht trin theo nhp iu c gii ha trong cng nghip (nh khoan ng, khoan , khoan b tng, sng truyn,ca ct...) Nhng cng vic c th gy bnh: Thao tc vi cc loi dng c h nn cm tay nh ba di, ba tn riv, ph c khun, my khoan ... S dng cc my chy bng ng c n, loi cm tay, nh: my ca. mv ct c... Tip xc vi cc vt rung truyn theo ng tay khc nh ti khoan du kh, mi nhn cc vt kim loi (t vt mi ln mi quay trn...) Cc my mc gy rung ang hot ng nc ta c kh nhiu loi. Mi loi my gy rung vi cc kiu khc nhau, vi cc tn s cao thp khc nhau; mi loi tn s li c bin , vn tc hoc gia tc khng ging nhau. Mt khc, rung cn tc ng ti c th theo cch khc nhau: tc ng ton thn hay tc ng cc b. Rung chuyn tc ng ton thn hay rung ton thn thng tn s thp, cn gi l rung xc (tn s 2 - 20 Hz hoc rt thp, < 2 Hz). Thc t, phn ln rung tn s cao l rung chuyn cc b, truyn theo ng tay, gp cng nhn thao tc vi dng c rung cm tay. Bnh do rung chuyn cc b, truyn theo ng tay, c tn s cao, l bnh ngh nghip v nhiu nc trong c nc ta, c xp vo loi bnh ngh nghip c bo him. Cc tc gi Lin X c E.A. Drogicina v l.K. Razumov, 1974 chia rung chuyn tn scao ra ba 1oi: - Tn s di 40 Hz: bin ln hng xngtimt, gy tn thng xng v khp. 147

- Tn s t 40-300 Hz: bin hng milimt, gy ri lon vn mch, c bit gp bn tay, l hin tng Raynaud. Tn s trn 300 Hz: bin khong 0,01 mm, gy tn thng cn, c thn kinh, gp bn tay, cng tay, cnh tay v vai. Hu qu in hnh nht ca rung ton thn ny l ri lon thn kinh trung ng v c bit l ri lon chc nng vi cc triu chng v tim, no, ri lon trng lc mch, c th suy nhc. Ngi bnh c cm gic nng nhc u, km theo bun nn v nn. V rung ton thn c tc ng n chc nng tin nh, c ngha l thng xuyn b cc cn cho(ng vng, chng mt, tng t hi chng Menia. Ngt c th xut hin, khng c l do r rng, vi cm gic au vng tim v tim p mnh. Cn c th c ri lon th gic, ngi bnh nhn mi vt nh trong sng m, hoc nhn thy nhng imlp lnh hay rui bay trc mt. Ngoi ra, c triu chng yu ton thn, d mt mi, n km ngon, d cu gin, km ng v bt lc. 7.1.14. Bnh AIDS Tn gi Pht hin nm 1981 ti Hoa K (USA). AIDS - Ting Anh: Acquire Immuno-Deficiency Syndrom SIDA - Ting Php: Syndrom Immuno Deficence Acquise Bnh C - Ting Nga VitNam gi s dng tt c cc tn trn v cn gi l: GMD (Hi chng bnh Gim Min Dch) Bnh AIDS ly truyn qua 3 cch: 1 Quan h tnh dc vi ngi c bnh 2. Tip xc trc tip vi mu v sn phm ca mu, dng c y t c nhim HIV. 148

3. T m sang con thi k bo thai hoc khi sinh . Vy mun phng bnh phi trnh hoc chng li 3 cch ly lan trn y, c th: 1. trnh ly nhim qua ng sinh dc th phi. khng quan h tnh dc vi nhiu ngi - tt nht l "thy chung" mt v, mt chng. khng quan h vi ngi thuc nhm nguy c cao. Khng c quan h luyn i ng gii. S dng bao cao su (comdom). 2. trnh 1y nhim do tip xc trc tip v mu v sn phm ca mu b nhim HIV th phi: Ch tim v truyn mu khi tht cn thit. Kim tra mu v cc sn phm mu trc khi dng. Kim tra cn thn thng k mu ca ngi cho mu trc khi quyt nh ly mu. Kim tra mu v sn phm mu nhp ni. Bo m bm tim, kim tim, kim ly mu, kim xm chm, kim xu tai c tit trng ng quy cch v khng c mm bnh HIV. 3. trnh 1y t m sang con cn: Gio dc, khm nghim cc thai ph pht hin virus HIV. Thng bo trc cho cc sn ph v nguy c c th c ca thi k c thai v khi sinh n i vi chu b. 7.2. MT S V D V HU QU CA CHT GY NGUY HI XY RA TRN TH GII V VIT NAM 149

7.2.1. Cc v d v hv qu ca cht gy nguy hi xy ra trn th gii Bnh Minamatta Ri ro xy ra 1956 Nht do nhim thy ngn gy bnh Cho khong 14.000 ngi. Nguyn nhn do vng v thy ngn ca mt cng ty ti y khi dng thy ngn tng hp acetaldehyde. Hu qu lm cho nng th ngn c trong tht c cao hn mc an ton 10 ln, t gy bnh cho ngi qua chui thc n. Kinh ph chi ph khong 150 t yn x l lp i mt phn ca h trnh tip xc trm tl. Ngoi ra cn xy dng trm x l 40 triu yn. Cng ty Chisso (Cng ty gy ra s c) cn phi chi khong 90,8 triu yn n b thit hi v sc kho cho cng ng y. Aming Ti M 2,5 t USD c chi bi thng cho cc bnh nhn b bnh phi do aming gy ra. H2S Nm 1950 ti Poza Rica, thuc Mxico, mt thnh ph c 22000 ngi, cch thnh ph Mxico 210 km v pha ng Bc. Thi Poza Rica l trung tm sn xut du ln nht Mxico, l mt a im t mt s gin khai thc du m v c mt nh my sn xut sulphur. Vo mt bui sng sm, ct la t kh thi khng hot ng v dn ti vic mt s lng ln hydro sunphat cha c t chy thot ra ngoi khng kh. Kh ny c tr gip bi gi nh bui sng v nhit thp bay ti khu vc c dn gn nh my. Trong vng ba gi, 320 ngi phi vo bnh vin v 22 ngi cht. Triu chng ph bin nht l mt kh nng nhn bit mi. Hn mt na s bnh nhn c quan khu gic mt hiu lc, nu ngi khc mc chng kh th, au mt v 9 ngi b bnh ph phi, 4 trong s 320 nn nhn mc bnh ng kinh, hng thnh gic. 150

Thuc bo v thc vt Ti n , nm 1984 cng ty sn xut thuc bo v thc vt Union carbide phi bi thng do xy ra s c r r ha cht. Hu qu c khong 10.000 ngi b cht. Ti Thy S cng ty Sandoz tri 30 tn thuc tr su v sng Ranh, nguyn nhn do mt in. Hu qu lm khong 1 triu con c b cht. Cng ty phi bi thng 15 triu bng Anh x l. Hp cht Chlorothalonil c ch to M xut khu chng su bnh vi cc loi ph gia khc nhau chng su cy chui. C 150 ngi b nhim cht ny: Trng thi bn chn, au khp, ph n mt kh nng rng trng. Kinh ph u t x l rt ln (ngi ta phi to h b tng cha nc thi di lng t) Dioxin 7/1996 c v n my bay pha bc Phi lng. My bay ny ch triclophenol. Hu qu ko theo cc phn ng trung gian v to ra dioxin. Ngi dn y di chuyn sang vng khc. Ti vng b nhim, ngun kinh ph khng l phi chi ra x l t. Bin php x l y l o ho cch ly vi cc vt liu ct, t st, vi nha. Trn lp nha b tng, trn b tng t v trng c. Tng hp ha cht Trong nhng nm 1890, William Love o mt con knh cho mt phn d n thy in vng Niagara Fall thuc bang New York. Nm 1940 tp on nha v ha cht Hooker bt u cc cht thi ha hc t cc hot ng ch to ti nh my bng cch chn chng xung knh ny. Ha cht thng c chn xung trong nhng thng kim loi c k, g. i khi chng b v ra khi v thm ch cc ha cht c c trc 151

tip ra knh. Ngi ta nh gi khong 22.000 tn cc cht thi ha hc c chn xung knh. Khong 248 loi ha cht c xc nh trong cc cht thi ny. Vo nm 1952, hi ng trng hc mun mua mt phn knh Love xy dng mt ngi trng mi. Lc u hng Hoocker khng ng , v vi ny c lin quan ti vic rc thi. Nhng ch trong 1 thng vn ny c xem xt li v hng ng biu phn t ny ch vi gi l USD. iu kin hng Hoocker a ra l Hi ng nh trng s s hu ton b vng nhng phi p ng yu cu no ca h v phi cho php tip tc rc thi cho n khi ngi nh c xy dng xong. Vn mi v d lng ca ha cht c bo co u tin vo nhng nm 1960 v tng ln trong sut nhng nm 1970 khi mc nc dng ln mang theo nc ngm nhim ln b mt. Vo gia nm 1970, cc vng nhim di chuyn ti b mt ca knh, ti mt s tng hm ca cc knh v qua cc cng thi i vo cc dng sui. Cc cng trnh nghin cu ch ra rng mt lng ln cc c cht ha hc di chuyn ln b mt v trong cc khu vc xung quanh gn trc tip vi cc v tr cht thi. Nc thi c tho ra theo cc knh dn ra sng Niagara, xp x 3 dm v pha trn so vi cc ng nc vo ca nh my x l nc. Dioxin v cc cht nhim khc di chuyn t bi chn rc knh ti cc cng thi dn ra nhnh sng. Vo nm 1977 pht hin cc c cht ha hc thm vo cc ng dn nc, b mt t. 248 cht ha hc khc nhau tm thy, trong 30 loi rt c i vi bo thai hoc thai nhi, 18 1oi cht gy qui thai v khong trn 30 1oi b nghi ng l cht gy ung th, t l cc v xy thai trong cc gia nh c tr gn knh rt cao. Ngay sau 235 gia nh phi s tn. Vo nm sau di chuyn tip cc gia nh c ph n mang thai v cc gia nh c tr em di 2 tul. Nm 1980 ngi trng ti y b ng ca, v cc gia nh phi tip tc di chuyn, a s 152

h di chuyn ln ti 950 h. K hoch no vt knh c bt u t cu nm 1978. n nay ton b chi ph cho n ci to knh Love khong 250 triu USD. Rt nhiu c nhn v chnh quyn kin hng Hooker v cng ty ha cht u M (Cng ty m ca hng) lm con knh b nhim nng n bi vic ph thi. Thng 6/1994 chnh quyn bang m phin to xt x v pht cng ty ny 120 triu USD bng tin mt v ci to li mi trng. Ng c ln nht trong lch s nhn loi. Nm 1998 mi y, bo "Frankfurt ton cnh" CHLB c a tin v v ng c ln nht trong lch s nhn loi min ng n v Bnglat. Du hiu u tin l da chn, da tay b nt n, sau ni mn, u, mt s ngi b ho, mt , cui cng l ung th ng rut, d dy, gan v thn. c thi gian, nhng nn nhn ny b coi l mc bnh hi nn b x hi xa lnh. Hng triu ngi min ng n , min ty Bnggan v Bnglat b nhim cn bnh ny sut trong khong hn 10 nm qua. Nguyn nhn ca cn bnh lm hn mt triu ngi cht v s ngi nhim bnh ln ti 50 triu (theo nh gi ca Ngn hng Th gii) l do cht Arsen trong nc n. Hm lng Arsen trong nc n y theo cc nh chuyn mn cho bit: cao gp 20 n 300 ln nng cho php ca T chc Sc khe Th gii (WHO). Vng nhim c rng bng din tch ca Vng quc B v H Lan cng li. Nhng nm trc y, dn c nhng vng trn dng nc ao, chum, ging t... lm nc n, nn dch bnh nh: t, l, cc bnh ng rut honh hnh. Sau T chc UNICEF (Qy nhi ng ca LHQ) v WB (Ngn hng Th gii) u t nhiu tin ca, cng sc cho chng trnh nc sch vng ny. Kt qu trong hn 10 nm qua khoan c 3 triu ging khoan. 153

S dng qu nhiu nc ngm, nn mc nc ngm gim st nghim trng to iu kin cho cht Arsen trong pyrit trong nhng lp trm tch tan trong nc n vi liu lng gy cht ngi. Arsen li khng c mi, v, mu sc nn khng ai nghi ng n s hin din ca chng; sau khong 10 n 20 nm khi ngm vo c th v tch ng li dn trong c th, Arsen mi pht huy c tnh v tnh trng nh nu trn xy ra. Ngy nay ngi ta c bit Arsen khng ch c n , Bnglat m cn c nhiu lnnexia v Mng C. i vi nhng ngi nhim bnh ngoi vic phi cho ngi bnh n y hp v sinh v ung vitamin C ra, hin nay vn cha c thuc c tr. 7.2.2. Mt s v d v hu qu v s c mi trng do cht gy nguy hi gy ra Vit Nam Bnh ngh nghip Theo vin Y hc lao ng: -1984 trong s 174 trng hp cng nhn 1m vic trong iu kin rung chuyn c chp X quang xng v khp xng, 46 trng hp c tn thng, chim t l 26,7 % vi cc loi tn thng xng. Trong s 289 cng nhn tip xc rung chuyn c soi mao mch, 84 trng hp c bin mao mch, t l 29%. -1989 trn 408 cng nhn dt si bng v pht hin c 8,4% s ngi mc bnh bi phi - bng. S c mi trng -S c trn du ti thnh ph H Ch Minh. 13 gi 35 pht ngy 3 thng 10 nm 1994, tu ch du Neptune Aries ca Singapor ch 22.000 tn du DO trong lc cp cng nh my lc du Ct Li m vo cu cng. Tu thng nhiu l ln v gy ra s c trn du trn phm vi rng ln (trn 1.528 tn du DO v hn 100 tn xng du cc loi). 154

S c gy thit hi ln di vi nng nghip, ng nghip v lm bin dng h sinh thi thy khu vc sng Si gn - ng Nai, rng ngp mn, thm thc vt ven sng. Ch tu phi tr 4,2 triu USD bi thng thit hi. Ngoi ra ng i s Singapor cn thay mt chnh ph c th cam kt xem xt gip thnh ph H Ch Minh x l cc hu qu lu di v mi trng. Thng 1/1999 ti m than Mo Kh, Qung Ninh xy ra s c n kh metan (CH4) (trong hm m). Hu qu lm gn 20 ngi cht v hn 10 ngi b thng.

155

TI LIU THAM KHO [l] B Khoa hc, Cng ngh v Mi trng. Tiu chun Vit Nam v mi trng. [2] B mn Phn tch v c cht, trng i hc Dc Khoa. Bi ging kim nghim c cht. Nh xut bn Y hc, 1984. [3] o Ngc Phong. Bi ging c cht hc. Trng i hc Y H Ni, 1996 [4] inh Vn Sm, Trn Vn Nhn, 1997. nhim cc cht nguy hi m~ s ngnh cng nghip Vit Nam. HBKHN. [5] L Thc Cn, Trnh Th Thanh v nnk. Hin trng v b.o nhim cc cht nguy hi Cng nghip H Ni, 1997. [6] Mai nh Yn. Sinh thi c s. Bi ging. i hc Khoa hc T nhin, HQGHN, 1992. [7] Hong Nh T. c cht hc.Nh xut bnY hc vTDTT. [8] Phm Ngc ng, Trn Hiu Nhu. Hin trng nhim mi trng Vit Nam, 1998. B KHCN-MT, Cc MT, 1998. [9] T chc Y t Th gii. Hng dn v cht lng nc ung. Vin Pasteur Nha Trang,1998. [l0] Trnh Th Thanh. Qun l cht thi nguy hi. Bi ging i hc Tng hp H Ni, 1995. [ 1 l] L Trnh. Quan trc v kim sot nhm mi trng nc. NXB Khoa hc v k thut, 1997. [12] Chulabhorn Research lnstitute. Environment roxicology volume 1,2,3, 1996. [13] Hammer Mark.J. - water and wastewaer Technology 2nd edition, John Wiley & Sons, N.Y,1986. [14] Miljokonsulterna. Sebra Envotec. Hazardous wastes 156

management. Nykoping, Sweden, 1996. [15] Would Health Organisation (WHO). Principle of Toxicology, 1995. [16] Would Health Organisation (WHO). Assessment of sources of Air, Water and Land Pollution, 1997.

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MC LC Li ni u .................................................................................. 8 CHNG I:MT S KHI NIM, C BN V C HC, MI TRNG V SC KHE CON NGI...................... 10 1.1. NH NGHA C HC, C HC, MI TRNG V SC KHE CON NGI ............................................ 10 1.2. MT S KHI NIM V NGUYN TC C BN. 11 1.3. PHN LOI CHT THI NGUY HI ....................... 17 CHNG II:CC CHT C HI....................................... 23 2.1. C CHT L, HA .................................................. 23 2.1.1. Nhit ................................................................... 23 2.1.2. Asen ........................................................................ 23 2.1.3. Crom. ...................................................................... 24 2.1.4. Niken....................................................................... 24 2.1.5. Cadimi..................................................................... 25 2.1.6. Thy ngn ............................................................... 26 2.1.7. ng........................................................................ 27 2.1.8. Km......................................................................... 27 2.1.9. St ........................................................................... 28 2.1.10. Mangan ................................................................. 28 2.1.11. Ch......................................................................... 28 2.1.12. Cht ty ra b mt ............................................... 30 2.1.13. Aming.................................................................. 30 2.1.14. Ammonia (amoniac) ............................................. 31 2.1.15. Carbon monocide .................................................. 32 2.1.16. Kh cacbonic CO2................................................. 33 2.1.17. NOX ....................................................................... 33 2.1.18. Sulphur .................................................................. 34 2.1.19. Hidro Sulphur........................................................ 34 2.1.20. Cc cht hu c bay hi (VOC)............................ 36 2.1.21. Ha cht bo v thc vt....................................... 41 2.2. C CHT SINH HC .............................................. 46 CHNG III: S HP TH PHN B V O THI ..... 51 158

3.1. GII THIU CHUNG ................................................... 51 3.2. MNG T BO ............................................................ 54 3.3. HP TH C CHT QUA DA................................. 57 3.4. HP TH C CHT QUA PHI ............................. 59 3.5. HP TH C CHT QUA MNG RUT .............. 61 3.6. CHUYN HA C CHT ........................................ 62 3.7. CC C CHT KT HP VI PROTEIN .............. 64 3.8. O THI CC CHT C...................................... 65 CHNG IV: CC YU T NH HNG N C TNH ......................................................................................... 68 4.1. BN CHT HA HC V BN CHT L HA CA CHNG ....................................................................... 68 4. 2. IU KIN TIP XC................................................ 70 4.3. LOI, GII TNH, TUI V CC YU T DI TRUYN TI THI IM TIP XC. ............................. 73 4.4. TNH TRNG CA SINH VT TI THI IM TIP XC ...................................................................................... 75 4.5. S C MT CA CC HA CHT TRONG C TH SINH VT,TRONG MI TRNG V TRONG THI GIAN TIP XC ....................................................... 75 4.6. CHP NHN HAY THCH NG................................ 82 4.7. CC YU T MI TRNG C TH NH HNG N P NG I VI MT HA CHT.................... 82 CHNG V: NH GI AN TON ............................. 83 5.1. GII THIU CHUNG ................................................... 83 5.2. THIT K TH NGHIM ............................................. 84 CHNG VI: NH GI NGUY C CA CHT C... 92 6.1. XC NH MI NGUY C V CC HNH THC TC DNG CA C CHT ........................................... 92 6.2. CC NGHIN CU C HC TRN C TH NG VT ...................................................................................... 96 6.3. BNH HC, TRIU CHNG LM SNG V QU TRNH PHT TRIN NHIM C NGH NGHIP....... 97 6.4. KH NNG GY UNG TH.................................... 101 6.5. NH GI V LIU LNG - P NG ............. 103 159

6.5.1. Gii thiu chung.................................................... 103 6.5.2. nh gi liu lng - p ng cho cc c cht ni hp................................................................................... 110 6.5.3. Cch tnh gi tr hng dn t lng tip nhn c th chu c......................................................................... 116 6.6. MT S PHNG PHP NH GI TC NG GY HI N C TH SNG ....................................... 120 6.6.1. Cch nh gi nhng tc ng c hi trong c hc ......................................................................................... 120 6.6.2. Cc loi th nghim trong c hc ....................... 124 CHNG VII: NH HNG CA MT S CHT NGUY HI TI SC KHE CON NGI ..................................... 130 7.1. MT S BNH DO NHIM MI TRNG ....... 130 7.1.1. Bnh phi .................................................................. 130 7.1.2. Bnh xm da.......................................................... 132 7.1.4. Bnh nhim c ngh nghip da ch v cc hp cht ch.................................................................................... 134 7.1.5. Bnh lao phi ........................................................ 138 7.1.6. Bnh da ngh nghip do crome (lot da, lot vch ngn mi, vim da, chm tip xc) ................................. 139 7.1.7. Bnh nhim c ma ngan v cc hp cht ca ma ngan................................................................................. 139 7.1.8. Bnh nhim x ngh nghip.................................. 140 7.1.9. Bnh st do Leptospira ngh nghip ..................... 140 7.1.10. Bnh a chy........................................................ 142 7.1.11. Ung th ............................................................... 142 7.1.12. Bnh ic ngh nghip do ting n..................... 144 7.1.13. Bnh rung chuyn ngh nghip........................... 146 7.1.14. Bnh AIDS.......................................................... 148 7.2. MT S V D V HU QU CA CHT GY NGUY HI XY RA TRN TH GII V VIT NAM 149 7.2.1. Cc v d v hv qu ca cht gy nguy hi xy ra trn th gii 150 7.2.2. Mt s v d v hu qu v s c mi trng do cht gy nguy hi gy ra Vit Nam ..................................... 154 160

d v hu qu v s c mi trng do cht gy nguy hi gy ra Vit Nam ........................................................... 154

161