浙江某地农村学龄前儿童血铅水平

目的了解农村儿童铅中毒的流行情况.方法石墨炉原子吸收光谱法对217名学龄前儿童进行静脉血铅浓度测定.结果有63名儿童血铅水平≥目前国际上公认的儿童铅中毒诊断标准0.483μmol/L,铅中毒的流行率为29.03%.结论农村儿童存在环境铅中毒的危害.     

Status of children's blood lead levels in Pakistan: implications for research and policy

OBJECTIVES: Data on blood lead levels, sources of lead and health effects were reviewed among children in Pakistan. METHODS: A systematic review was conducted of published studies found through PubMed, an index of Pakistani medical journals PakMediNet and unpublished reports from governmental and non-governmental agencies in Pakistan. RESULTS: With the exception of a few studies that had adequate sample sizes and population-based samples, most studies were small and used convenience sampling methods to select study subjects. Overall, blood lead levels declined from 38 microg/dl in 1989 to 15 microg/dl in 2002. The major sources of lead that directly or indirectly resulted in lead exposure of children included: leaded petrol; father's occupation in lead-based industry; leaded paint; traditional cosmetics; and remedies. Apart from leaded petrol, there was no information regarding the level of lead in other sources such as paints and the household environment. Very little information was available regarding the adverse health effects of lead among children. CONCLUSION: The phasing out of leaded petrol was a commendable mitigation measure undertaken in July 2001 in Pakistan. A comprehensive assessment is now needed urgently to explore other sources of lead contributing to adverse health effects, and to plan intervention options with the ultimate goal of reducing the burden of disease due to lead exposure.     

Occurrence and determinants of increases in blood lead levels in children shortly after lead hazard control activities

This study is an examination of the effect of lead hazard control strategies on children's blood lead levels immediately after an intervention was conducted as part of the US Department of Housing and Urban Development's Lead-Based Paint Hazard Control Grant Program. Fourteen state and local government grantees participated in the evaluation. The findings indicated an overall average reduction in the blood lead levels of 869 children soon after the implementation of lead hazard controls. However, 9.3% of these children (n = 81) had blood lead increases of 5 microg/dL or more. Data routinely collected as part of the evaluation, as well as additional information supplied by the individual programs, were used to determine potential reasons for these observed increases in blood lead. A logistic regression analysis indicated that three principal factors were associated with the blood lead increases: the number of exterior deteriorations present in the child's home (prior to intervention), the educational level of the female parent or guardian of the child, and the child's age. The statistical analysis did not find evidence that children living in households that either did not relocate or relocated for less than the full work period were significantly more likely to have a blood lead increase equal to or greater than 5 microg/dL than children living in households that fully relocated. Statistical analyses also did not reveal any single interior strategy to be more or less likely than others to be associated with a blood lead increase of 5 microg/dL or more.     

Association between children's blood lead levels, lead service lines, and water disinfection, Washington, DC, 1998-2006

Objective

Evaluate the effect of changes in the water disinfection process, and presence of lead service lines (LSLs), on children’s blood lead levels (BLLs) in Washington, DC.

Methods

Three cross-sectional analyses examined the relationship of LSL and changes in water disinfectant with BLLs in children <6 years of age. The study population was derived from the DC Childhood Lead Poisoning Prevention Program blood lead surveillance system of children who were tested and whose blood lead test results were reported to the DC Health Department. The Washington, DC Water and Sewer Authority (WASA) provided information on LSLs. The final study population consisted of 63,854 children with validated addresses.

Results

Controlling for age of housing, LSL was an independent risk factor for BLLs ≥10 μg/dL, and ≥5 μg/dL even during time periods when water levels met the US Environmental Protection Agency (EPA) action level of 15 parts per billion (ppb). When chloramine alone was used to disinfect water, the risk for BLL in the highest quartile among children in homes with LSL was greater than when either chlorine or chloramine with orthophosphate was used. For children tested after LSLs in their houses were replaced, those with partially replaced LSL were >3 times as likely to have BLLs ≥10 μg/dL versus children who never had LSLs.

Conclusions

LSLs were a risk factor for elevated BLLs even when WASA met the EPA water action level. Changes in water disinfection can enhance the effect of LSLs and increase lead exposure. Partially replacing LSLs may not decrease the risk of elevated BLLs associated with LSL exposure.     

2007-2011年中国儿童血铅水平及铅中毒率的分析

摘要:目的　描述2007-2011年我国儿童整体血铅水平、铅中毒率及分布特征。方法　本研究通过计算机检索2007-2012年公开发表的关于儿童血铅水平和（或）铅中毒率研究的论文,依照时间挑选出2007-2011年的文献按年份分类整理。对27省（市）88万多人做了调查研究。结果　2007-2011年我国儿童血铅水平（μg/L）分别是:68.62、59.13、53.36、66.56和46.56,平均血铅水平58.88 μg/L;而相应的儿童铅中毒率（%）分别是:19.56、11.56、12.67、10.41和7.27,平均铅中毒率是12.29%。结果说明,2007-2011年我国0～5岁儿童的血铅水平和铅中毒率随着年龄的增加而升高,尽管6岁组与5岁组相比,血铅水平及铅中毒率有所降低,但仍高于其他年龄组;同样,除2010年的儿童血铅水平比2008和2009年有所增加外,2007-2011年儿童血铅水平和铅中毒率随着年份的增加呈降低趋势。此外,经Meta分析发现,2007-2011年儿童铅中毒率和血铅水平也呈现明显的性别分布特征和地区分布特征。结论　2007-2011年我国儿童血铅水平和铅中毒率仍然较高,预防儿童铅中毒仍然是我国今后应当重视的医学问题和社会问题。     

Blood lead levels in children, China

To evaluate Chinese children's blood lead levels (BLLs) and identify its distribution features, we collected articles on children's BLLs published from 1994 to March 2004 using the Chinese Biomedical Disc and reviewed 32 articles eligible for the following criteria: (1) BLLs measured by Graphite Furnace Atomic Absorption Spectroscopy or Inductively Coupled Plasma-Mass Spectrometry; (2) strict quality control; (3) no lead pollution sources in the areas where the screened subjects live; and (4) sample size bigger than 100. We found that mean BLLs of Chinese children was 92.9 microg/L (37.2-254.2 microg/L), and 33.8% (9.6-80.5%) of the subjects had BLLs higher than 100 microg/L. Nine of the 27 provinces or cities reported had average BLLs 100 microg/L. Boys' BLL was 96.4 microg/L, significantly higher than girls' 89.4 microg/L (P<0.001). BLLs of children 6 years increased with age. The mean BLLs of children living in industrial and urban areas were significantly higher than those of children in suburbs and rural areas. Our results suggested that children's BLLs in China are higher than those of their counterparts in other countries due to its heavy lead pollution. Therefore, this is of great public health importance.     

Effects of HUD-supported lead hazard control interventions in housing on children's blood lead

The Evaluation of the US Department of Housing and Urban Development Lead-Based Paint Hazard Control Grant Program studied the effectiveness of the housing intervention performed in reducing the blood lead of children at four post-intervention times (6-months, 1-year, 2-years, and 3-years). A repeat measures analysis showed that blood lead levels declined up to three-years post-intervention. The results at each successive collection time were significantly lower than at the previous post-intervention time except for the difference between the levels at two and three years. At two-years post-intervention, geometric mean blood lead levels were approximately 37% lower than at pre-intervention. Children with pre-intervention blood lead levels as low as 10 μg/dL experienced substantial declines in blood lead levels. Previous studies have found substantial improvements only if a child's pre-intervention blood lead level was above 20 μg/dL. Individual interior lead hazard control treatments as grouped by Interior Strategy were not a significant predictor of post-intervention blood lead levels. However, children living in dwellings where exterior lead hazard control interventions were done had lower blood lead levels at one-year post-intervention than those living in dwellings without the exterior interventions (all other factors being equal), but those differences were only significant when the mean exterior paint lead loading at pre-intervention was about the 90th percentile (7.0 mg/cm²). This observation suggests that exterior lead hazard control can be an important component of a lead hazard control plan. Children who were six to eleven months of age at pre-intervention had a significant increase in blood lead at one-year post-intervention, probably due to other exposures.     

杭州市3528例儿童血铅水平调查

目的:了解杭州市10岁以下儿童血铅水平及高血铅检出率。方法:用原子吸收光谱分析法对3 528例儿童进行血铅含量测定,比较不同性别和年龄组之间的差异。结果:3 528例儿童血铅平均值为24.91μg/L,其中>100μg/L有37例,占1.04%;不同性别儿童间血铅水平几何均值差异有统讲学意义,而高血铅检出率差异无统计学意义;不同年龄儿童的血铅水平几何均值差异无统计学意义,高血铅检出率有统计学差异。结论:杭州市儿童血铅水平较低,但铅中毒情况依然存在,应采取进一步措施减少儿童铅接触。     

幼儿园环境中铅含量对儿童血铅值的影响

目的探讨幼儿园环境是否对儿童铅暴露产生影响。方法采集、测定幼儿园环境样品中铅含量,同时采集、测定儿童的手尘铅和血铅浓度,分析环境铅和血铅的相关关系。铅测定方法为原子吸收法。结果19所幼儿园室内地面尘、脱落漆皮。室内降尘、室外地面尘、土壤和自来水铅含量的几何均数分别为86．5μg/m2、235.5μg/g、445．9μg/g、172．4μg/m2、70．1μg/g及12.5μg／L。儿童双手尘铅的平均值为3．4μg。相关分析结果提示血铅与室外地面尘铅、儿童手尘铅呈正相关。多因素分析显示手尘铅被引入血铅的回归方程,而且其标准化回归系数最大,达0.3842,其偏回归系数为0．2018。结论幼儿园的环境卫生状况直接影响着儿童铅的摄入水平。因此有必要对儿童进行健康教育,使其养成勤洗手的卫生习惯,克服吮吸手指的不良行为。     

十堰市2～6岁集居儿童血铅现状分析

目的 了解十堰市城区2～6岁集居儿童血铅水平现状并分析其影响因素.方法 血铅采用石墨炉原子吸收光谱法测定,并对儿童家长进行问卷调查.结果 2 431名集居儿童的血铅平均值为0.487 μmol/L,其中,1 092名儿童血铅≥0.48 μmol/L.结论 目前十堰市城区集居儿童平均血铅水平与铅中毒率较高,应采取措施控制诱发因素.     

The association between demolition activity and children's blood lead levels

Urban renewal efforts are a priority for many American cities. As efforts to reconstitute urban centers increase, the demolition of old, deteriorated structures has accelerated. Recent studies have identified demolitions as a potential source of environmental lead exposure. We conducted a study examining the relationship between demolition activity and blood lead levels of children residing in neighborhoods where demolition activity occurred. A retrospective cohort study was conducted in St. Louis City, Missouri. The study period was January 1, 2002 to December 31, 2002. Data were obtained from the Missouri Childhood Lead Poisoning Prevention Program's (CLPPP) lead surveillance system and St. Louis Demolition Permit Database. Children were considered exposed to a demolition if they had a blood lead test within 45 days of any demolition on a census block. Exposure was classified as both a dichotomous (yes/no) and a categorical (none/one/multiple) variable and was analyzed separately. Linear regression models were developed to determine effects of demolitions on blood lead levels. A total of 1196 children 6-72 months of age living in 395 census blocks were included. 314 (26.3%) were exposed and 882 (73.7%) were unexposed to a demolition. In an adjusted model, exposure to multiple demolitions was found to have significant effects on children blood lead levels (coefficient=0.281; 95% CI=0.069, 0.493; P-value=0.010). Age of the child, race, and age of housing where children's resided were also significant predictors. This study suggests that multiple demolitions within a census block may significantly increase children's blood lead levels. The findings may be useful to municipal planners in older cities where demolitions are being used as an urban renewal tool.     

The effect of lead-based paint hazard remediation on blood lead levels of lead poisoned children in New York City

Despite the widespread use of lead paint hazard control for children with lead poisoning, few controlled studies that estimate the effect of such control on children's blood lead levels have been published. This retrospective follow-up study examined the effects of lead hazard remediation and its timing on the blood lead levels of lead-poisoned children. From the New York City child blood lead registry, 221 children were selected who had an initial blood lead level of 20-44 micro g/dL between 1 July 1994 and 31 December 1996; were 6 months to 6 years of age; had a report of a follow-up blood lead test between 10 and 14 months after the initial test; had a lead-based paint hazard identified in the primary dwelling unit prior to the 10- to 14-month follow-up blood lead test; had resided or spent time at only one address with an identified lead-based paint hazard; and were not chelated. The decline in geometric mean blood lead levels from baseline to 10-14 months later was compared for children whose homes were remediated and whose homes were not remediated during the follow-up period. Regardless of remediation, geometric mean blood lead levels declined significantly from 24.3 micro g/dL at the initial diagnosis to 12.3 micro g/dL at the 10- to 14-month follow-up blood lead test (P<0.01). Among the 146 children whose homes were remediated the geometric mean blood lead levels declined 53% compared to 41% among the 75 children whose homes were not remediated by the follow-up blood lead test, a remediation effect of approximately 20% (P<0.01). After adjusting for potential confounders, the remediation effect was 11%, although it was no longer significant. Race was the only factor that appeared to confound the relationship: Black children had higher follow-up blood lead levels even after controlling for other factors, including the natural logarithm of the initial blood lead level. The effect of remediation appeared to be stronger for younger (10 to <36 months old) than for older (36 to 72 months old) children (P=0.06). While children in homes with earlier remediation (within less than 3 months) appeared to have greater declines in blood lead levels at the follow-up test than children in homes with later remediation (after 3 or more months), this trend was not significant when controlling for confounding factors. The findings of this study suggest that early identification of lead-poisoned children and timely investigation and abatement of hazards contribute to reducing blood lead levels. However, the apparent effect is modest and further research is needed to systematically test and improve the effectiveness of lead hazard controls.     

The continuing impact of lead dust on children's blood lead: Comparison of public and private properties in New Orleans

Background

Compared with a maximum collective lead (Pb) estimate of ∼1811 metric tons (MT) in exterior paint on 86,000 New Orleans houses, Pb additives in gasoline were estimated at ∼12,000 MT in New Orleans, yielding ∼9100 MT Pb exhausted as aerosols from vehicles; ∼4850 MT were particles >10 μm and ∼4200 MT were particles <0.25 μm.

Objectives

To evaluate pre-Hurricane Katrina soil Pb and children's blood Pb at public housing and private residential properties in the inner-city compared with the outer city of New Orleans.

Methods

This study includes 224 soil samples from 10 public housing properties and 363 soil samples from residential private properties within an 800 m radius of centroids of public housing census tracts. The Louisiana Childhood Lead Poisoning Prevention Program data from 2000 to 2005 (pre-Hurricane Katrina) was the source for 9807 children's blood Pb (μg/dL) results. Soil and blood Pb data were grouped by public housing census tracts and private residential properties. This study uses Multi-Response Permutation Procedures for statistical analysis.

Results

Brick public properties in the city core had significantly more soil Pb contamination and higher prevalence of elevated children's blood Pb than same-aged brick public properties in the outer areas of the city. The pre-Hurricane Katrina New Orleans concentration of Pb dust in the inner-city soil displayed a median of 438 mg/kg or 3.7 times larger than Pb dust in outlying areas where the median soil Pb was 117 mg/kg (p-value=2.9×10⁻¹⁵). Also, the pre-Hurricane Katrina prevalence of children's blood Pb ≥10 μg/dL was 22.9% within the inner-city compared with 9.1% in the outer areas of New Orleans (p-value=3.4×10⁻⁷⁴).

Conclusions

Comparing the quantities of Pb dust from paint and Pb additives to gasoline, this study supports the later source as a more plausible explanation for the differences in soil Pb and children's blood Pb within public and private housing in the higher traffic congested inner-city core compared with the lower traffic congested outer areas of New Orleans. Similar patterns of environmental Pb dust contamination and childhood Pb exposure are expected in all cities.     

南方某地16～60岁人群环境铅暴露现况调查

目的 了解南方某地16～60周岁人群环境铅暴露情况,分析影响血铅水平升高的危险因素以及铅暴露所致的健康损害.方法 随机选取居住于当地>5年,食用当地自产食物的人群,石墨炉原子吸收法检测血、尿、头发、趾/指甲样本中铅浓度.自制调查问卷面询.采用SPSS软件进行分析.结果 412名调查对象血铅水平为(64.1±1.8)μg/L,尿铅、发铅、指(趾)甲铅分别为(11.0±1.7),(11.7±3.4),(12.1±3.4)μg/g.对数变换的尿铅、发铅、甲铅与血铅呈正相关,对应Pearson相关系数分别为0.485,0.317,0.350;居住于D村、饮酒、男性是血铅升高的危险因素;发铅、指(趾)甲铅与失眠、记忆力减退、手脚麻木、视力模糊等自觉症状的发生有关.结论 A村铅暴露最严重,男性、饮酒是血铅增高的危险因素.     

上海市推广使用无铅汽油对儿童血铅水平影响的追踪调查

目的　研究推广使用无铅汽油前后儿童血铅水平的动态变化规律。方法　 1997年 8～9月间 ,在上海市 5个区县 30所托幼机构 196 9名 1～ 6岁儿童进行了血铅水平抽样调查 ,然后于1998年 4～ 6月及 1999年 8～ 9月对相应人群进行血铅水平两次追踪调查。调查采用末梢血纸片法血铅测定方法。结果　上海市儿童血铅水平几何均数在推广无铅汽油前为 83μg/L ,推广无铅汽油后的 1998年为 80 μg/L ,1999年为 76 μg/L ,与前一年相比血铅水平的变化均有显著意义 (t值分别为2 .2 190、4 .4 5 76 ,P值分别小于 0 .0 5和 0 .0 1) ;超过目前国际公认的儿童铅中毒诊断标准 (10 0 μg/L)的比例也由使用无铅汽油前的 37.8%下降到 1999年的 2 4 .8% ,差异有非常显著性 (u =8.82 4 7,P <0 .0 1)。儿童血铅水平几何均数下降幅度徐汇区为 10 μg/L、静安区 11μg/L、杨浦区 6 μg/L、嘉定区4 μg/L、崇明县 2 μg/L。 结论　推广使用无铅汽油可降低儿童的血铅水平。     

孕期低水平铅暴露对婴儿生长发育的影响

目的:探讨孕期低水平铅暴露对婴儿生长发育以及社会情感技能发展的影响,早期发现不利因素,开展健康教育,从社会、环境医学角度为培养全面发展的新一代探索更广的途径。方法:对110例母婴进行问卷调查,社会情感技能ASQ:SE婴幼儿社会情感问卷,新生儿神经行为评分,体检。采用原子吸收石墨炉法测定脐血铅水平。前瞻性观察足月新生儿脐血铅与体格发育、神经发育、父母职业、生活方式等指标的等级相关性,开展防铅健康教育。结果:110例新生儿脐血铅中位数(M):18·8μg/L,均数(x):23·84μg/L,标准差(s):20·43;血铅与出生体重、身长、头围相关系数分别为0·142、0·005、0·019,无显著相关性;与情商相关系数为0·827(P<0·01);与父母职业、交通情况相关系数分别为0·106(P<0·05)、0·228(P<0·05)、0·220(P<0·05)、0·228(P<0·05);与母亲被动吸烟、家庭装修相关系数分别为0·224(P<0·05)、0·203(P<0·05)。结论:提示孕期低水平铅暴露新生儿脐血铅水平与父母交通情况、母亲职业、母亲被动吸烟、家庭装修、婴儿日后情商有显著相关性。环境干预、健康教育是防治儿童铅中毒的有效途径。     

苏州2011某电子厂员工尿铅含量状况分析

目的:对某电子厂的工人进行尿铅含量的测定,了解企业职工健康状况,从而采取有效的防护措施。方法:利用MP-2溶出分析仪电极电位分析方法进行尿铅含量的测定并进行统计分析。结果:180份尿样检测中尿铅超标者共25人,超标率13.9%,女性超标率高于男性,但差异无显著性(P>0.05)。不同工龄间的尿铅水平超标率差异有明显不同。工作时间越长,超标率越明显。结论:统计结果表明该电子厂的员工尿铅超标率仍然处于较高水平,因此该单位应加强职工的职业健康监测工作,改善工作环境,同时提高工作人员的职业病防护意识,定期进行职业健康体检,保护职工自身健康。     

Elevated blood lead levels in a riverside population in the Brazilian Amazon

Lead (Pb) is recognized as one of the most toxic metals. Sources of Pb exposure have been widely documented in North America, and the removal of Pb additives from gasoline was reflected in a dramatic lowering of blood Pb concentration. In Latin America, the removal of Pb from gasoline resulted in decreased exposure, but Pb levels in many areas remain high due to occupational and environmental sources of exposure. While many of the Pb sources have been identified (mining, industries, battery recycling, lead-based paint, ceramics), new ones occasionally crop up. Here we report on blood Pb (B-Pb) levels in remote riverside communities of the Brazilian Amazon. Blood Pb (B-Pb) levels were determined in 448 persons from 12 villages of the Lower Tapajós River Basin, Pará, Brazil. Socio-demographic and dietary information, as well as occupational, residential and medical history was collected using an interview-administered questionnaire. B-Pb, measured by ICP-MS, showed elevated concentrations. Mean B-Pb was 13.1 μg/dL±8.5, median B-Pb was 11.2 μg/dL and ranged from 0.59 to 48.3 μg/dL. Men had higher B-Pb compared to women (median: 15.3 μg/dL vs 7.9 μg/dL respectively). B-Pb increased with age for women, while it decreased for men. For both genders, B-Pb decreased with education. There were significant differences between villages. Exploratory analyses, using linear partition models, showed that for men B-Pb was lower among those who were involved in cattle-raising, and higher among those who hunted, farmed and fished. The distribution profile of B-Pb directed us towards artisanal transformation of manioc to flour (farinha), which requires heating in a large metal pan, with stirring primarily done by young men. In the village with the highest B-Pb, analysis of Pb concentrations (dry weight) of manioc (prior to transformation) and farinha (following transformation) from 6 houses showed a tenfold increase in Pb concentration (mean: 0.017±0.016 to 0.19±0.10 μg/g). This was confirmed in one of these villages where we sampled manioc paste (just before roasting) and the roasted farinha (0.05 μg/g vs 0.20 μg/g). While there may be other sources (ammunition, sinkers for fishing nets), the high concentrations in farinha, a dietary staple, assuredly makes an important contribution. Further action needs to reduce Pb sources in this region.     

Take-home lead poisoning in a child from his father's occupational exposure

With the publication of revised CDC guidelines in 1991, concern about childhood lead poisoning has increased. Exposure to lead-based paint and paint dust is currently considered the major source of lead poisoning in the United States. We describe a child who had elevated BLL related to lead-contaminated clothing that the father brought home from his workplace. © 1996 Wiley-Liss, Inc.     

芜湖市市区561例学龄前儿童血铅水平调查分析

目的了解芜湖市市区学龄前儿童血铅水平,为提出针对性干预措施提供科学依据。方法对561名3~6岁儿童采左手无名指末梢血,采用电极溶出法进行血铅测定,并进行相关因素问卷调查。结果 561名儿童血铅值在0.15~194.44ug/l之间,平均54.43±39.82ug/l,儿童铅中毒检出率为14.08%,男女检出率差异无统计学意义（P〉0.05）,各年龄组儿童铅水平差异有统计学意义（P〈0.05）,检出率随年龄增长而升高。儿童铅中毒可引起儿童注意力不集中、攻击性、挑食、情绪不稳等。结论芜湖市市区学龄前儿童存在铅中毒,应加强血铅防控工作。