苏州市学龄前儿童铅暴露现状及影响因素分析

目的分析苏州市学龄前儿童铅暴露现状及相关影响因素。方法采用分层整群随机抽样法选取苏州市2015年1月-2018年10月学龄前儿童2 486名,检测受试者血铅水平,以调查问卷了解受试者基本信息,分析受试者铅暴露特点。结果被调查儿童中129例血铅水平≥100μg/L,高血铅检出率为5.19%(高铅血症85例、轻度铅中毒41例、中度铅中毒3例)。男童的高血铅检出率略高于女童,差异无统计学意义(P>0.05),高血铅检出率为5.19%。血铅正常组与异常组儿童在父亲年龄、母亲年龄、家庭收入、吃爆米花、吃皮蛋、吮吸手指或咬指甲、使用彩色蜡笔方面比较,差异均无统计学意义(P>0.05);但两组在年龄、父母从事铅暴露工作、饭前洗手、使用奶制品、补充钙/铁/锌剂、是否清洗玩具方面比较,差异均有统计学意义(P<0.05)。多因素分析显示,清洗玩具、饭前洗手、使用奶制品、补充钙/铁/锌剂均是儿童铅中毒的保护因素(P<0.05);儿童年龄、父母从事铅暴露工作不是儿童铅中毒的保护因素(P>0.05)。结论苏州市学龄前儿童的血铅水平相对偏低,铅暴露情况相对较轻,日常生活、卫生及饮食习惯是儿童铅中毒的主要影响因素。

The current situation and influencing factors of lead exposure in preschool children in Suzhou City

Objective To analyze current situation of lead exposure of preschool children in Suzhou and its related influencing factors.Methods A stratified cluster random sampling method was used to select 2 486 preschoolers in Suzhou from January 2015 to October 2018.The blood lead level of the subjects was tested.The basic information of the subjects was obtained through the questionnaire,and the characteristics of lead exposure of the subjects were analyzed.Results The blood lead level of 129 children was higher than 100 microns/L,and the detection rate of high blood lead was 5.19%(85 cases of high blood lead poisoning,41 cases of mild lead poisoning,3 cases of moderate lead poisoning).The detection rate of high blood lead in boys was slightly higher than that in girls,with no statistically significant difference(P>0.05).There was no statistically significant difference between the normal group and the abnormal group in terms of father’s age,mother’s age,family income,eating popcorn,eating preserved eggs,sucking fingers or biting nails,and using colored crayons(P>0.05).However,there were statistically significant differences between the two groups in age,parental exposure to lead,hand washing before meals,use of dairy products,supplementation with calcium/iron/zinc,and cleaning of toys(P<0.05).Multivariate analysis showed that washing toys,washing hands before meals,using dairy products and supplementing calcium/iron/zinc were protective factors of lead poisoning in children(P<0.05).Age of children and parents’exposure to lead are risk factors of lead poisoning in children(P>0.05).Conclusions The blood lead level of preschoolers in Suzhou is relatively low,the lead exposure is relatively light,and the daily life,hygiene and dietary habits are the main influencing factors of lead poisoning in children.