湖南省城镇学龄前儿童血铅水平流行病学调查

目的：调查湖南省城镇学龄前儿童血铅水平及影响因素，为儿童铅中毒的防治提供科学依据。方法：2008年9月至2009年6月整群随机抽取湖南省12个地区城镇学龄前儿童2 044名，男1 108名，女936名，年龄2～6岁，平均4.4±1.1岁。采用原子吸收光谱法测定末梢血血铅水平, 并采用《中国部分城市儿童铅中毒防治项目调查表》进行问卷调查。Logistic回归分析血铅水平的影响因素。结果：湖南省学龄前儿童平均血铅值为81.9±34.5 μg/L。血铅水平≥100 μg/L者482例，占23.58%。其中血铅水平100～199 μg/L(高铅血症)472例，占23.09%,血铅水平≥200 μg/L（铅中毒）10例，占0.49%。不同年龄组间血铅异常(血铅水平≥100 μg/L)率差异有统计学意义(P<0.01)。男童的血铅异常率为28.99%，高于女童的 21.98% （P<0.01）。不同地区儿童血铅异常率差异亦有统计学意义 (P<0.01)。回归分析显示，男性(OR=1.449, P<0.01)、父亲从事铅暴露职业(OR=1.314, P<0.01)及母亲常用染发剂（OR=1.678，P<0.05）为儿童血铅异常的危险因素。结论：湖南省城镇学龄前儿童血铅异常率较高。该省城镇学龄前儿童血铅异常率与儿童所在地区和年龄有关。男性、父亲从事铅暴露职业及母亲常用染发剂为儿童血铅异常的危险因素。［中国当代儿科杂志，2010，12（8）：645-649］

An epidemiologic survey on blood lead levels in preschool children living in towns of Hunan Province

Objective To investigate blood lead levels(BLLs)and influencing factors of BLLs among preschool children living in towns of Hunan Province.Methods A total of 2 044 preschool children(1 108 boys and 936 girls)from towns of 12 regions in Hunan Province were enrolled by a cluster sampling between September 2008 and June 2009.The average age of the children was 4.4±1.1 years(range 2 to 6 years).BLLs were determined using the atomic Absorption spectrographic method.The influencing factors of BLLs were investigated using a standard questionnaire and logistic regression analysis.Results The mean BLLs of the children were 81.9±34.5 μg/L.BLLs more than 100 μg/L were noted in 482 children(23.58%).Of the 482 children,472(23.09%)showed BLLs of 100-199 μg/L and 10(0.49%)showed BLLs ≥200 μg/L.There were significant differences in the prevalence of elevated BLLs(≥100 μg/L)among different age groups(P<0.01).The prevalence of elevated BLLs in boys(28.99%)was significantly higher than that in girls(21.98%)(P<0.01).There were significant differences in the prevalence of elevated BLLs in children from different regions(P<0.01).The logistic regression analysis showed that the male(OR=1.449,P<0.01),father's occupational lead exposure(OR=1.314,P<0.01)and maternal frequent use of hair dyes(OR=1.678,P<0.05)were risk factor for elevated BLLs.Conclusions The prevalence of elevated BLLs is higher in preschool children living in towns of Hunan Province and is associated with a child's region and age.The male,father's occupational lead exposure and maternal frequent use of hair dyes are risk factor for elevated BLLs.