我国居民中药材砷暴露风险评估

摘要

目的 评估我国居民中药材的砷摄入水平及其潜在健康风险.方法 2008-2016年,在全国采集各类中药材正品2056份,检测其砷残留量.采用多阶段分层随机抽样方法,在黑龙江、辽宁、江西、贵州和甘肃5省采用问卷方式调查18岁及以上成年人中药材消费情况,共5739人.结合上述消费数据和砷残留量数据,采用确定性评估方法,对我国居民中药材砷暴露风险进行评估.同时,以目前我国中药材砷限量值进行理论评估.结果 中药材砷平均含量为0.81 mg/kg,动物类药材砷残留量水平(平均3.29 mg/kg)高于植物类药材(平均含量0.71 mg/kg).消费数据显示,中药材煎服使用量均值为207 g,P95为540 g;作为药膳的食用量均值为43 g,P95为500 g.以实际检测数据进行评估,结果显示常规服用中药材的人群砷暴露风险较低,但对长期服用的P95高暴露人群或作为药膳食用的P95高暴露人群,存在一定健康风险.动物类中药材砷残留量是植物类中药材近5倍,但根据其实际用量,整体风险并不高.以砷限量值2 mg/kg进行理论评估,结果显示当前中药材砷的限量标准足以保护一般用药人群,但对长期服用的人群或作为药膳食用的P95高暴露人群,仍存在健康风险.结论 当前执行的2 mg/kg限量标准总体是适宜的.在目前的中药材砷残留量水平下,我国大部分居民因中药材导致砷暴露的健康风险较低,但对于终生服用或作为药膳大量食用中药材者,砷暴露导致的健康风险需要关注.%Objective To analyze the intake of arsenic in Chinese materia medica by Chinese population; To assess its health risk. Methods Totally 2056 Chinese materia medica samples were collected from representative manufacturers and markets in China from 2008 to 2016 and their arsenic contents were detected. The consumption data of Chinese materia medica were collected among population aged 18 and above from 5739 individuals by face to face questionnaire surveys in 5 provinces (Heilongjiang, Liaoning, Jiangxi, Guizhou and Gansu) with the method of multistage stratified random sampling. A deterministic estimate was used to assess the exposure of arsenic by Chinese materia medica. At the same time, the Chinese standard limit of arsenic in Chinese materia medica was used to do the theory assessment. Results The average concentration of arsenic in Chinese materia medica was 0.81 mg/kg. The residue level of arsenic in animal Chinese materia medica (average concentration: 3.29 mg/kg) was higher than that in medicinal plants (average concentration: 0.71 mg/kg). The consumption data showed that average intake of Chinese materia medica as medicines was 207 g, and P95was 540 g; the average intake of Chinese herbals as medicinal food was 43 g, and P95was 500 g. The assessment using arsenic content data showed that common use of Chinese materia medica had low level of risk. However, the population with chronic and high consumption of Chinese materia medica as medicine or as food had certain level of health risk. Arsenic content in animal herbals was about 5 times higher than that of medicinal plants. But according to the consumption, the risk was not higher than that of medicinal plants. The assessment using the standard limit of arsenic (2 mg/kg) in herbals showed that recent standard could protect most people, but risk remained in those with chronic consumption of Chinese materia medica as medicineand high consumption of Chinese materia medica as medicinal food. Conclusion The current standard limit of arsenic (2 mg/kg) in Chinese materia medica is appropriate. The health risk of arsenic exposure from Chinese materia medica among Chinese population is at a low level, but those with chronic and high Chinese materia medica consumption need more attention.