防治儿童铅中毒刻不容缓

近年来随着我国的工业化、城市化进程的加快 ,公路的快速发展、汽车的显著增加、工业铅污染的排放、乡镇企业的不合理分布等因素造成我国儿童铅中毒的问题逐渐受到政府和公众的关注。我国儿童铅中毒的防治工作起步较晚 ,任务十分艰巨。近 2 0多年来 ,国内外专家围绕儿童铅中毒的问题进行了大规模的流行病学调查和临床研究 ,证实了婴幼儿正处在大脑发育的关键时期 ,铅的过量接触导致的脑功能损伤往往是不可逆的 ,有害健康效应将是长期甚至是终身的。儿童血铅水平在 10 0μｇ/Ｌ左右时已能对儿童的智能发育、体格生长、学习记忆能力和感觉功能…     

哈尔滨市儿童铅中毒防治项目调查

目的:了解、掌握哈尔滨市0～6岁儿童铅中毒率、血铅水平分布及其危险因素。方法:统一培训的调查员进行问卷调查和经培训合格的检验员操作血样检测,使用2100钨舟原子吸收光谱仪。对象:哈尔滨市2个城区1276例0～6岁儿童。结果:①0～6岁儿童铅中毒率9.56%;②血铅水平分布在1～419μg/L之间;③危险因素有住房楼层低、住房附近有铅作业相关工厂、常玩玩具、常吃爆米花、常咬铅笔、有异食癖。     

中国儿童铅中毒及其研究的现状

儿童铅中毒作为一种独立的儿科疾病已有100多年的历史，直到20世纪70年代由美国联邦政府资助下的大规模儿童血铅筛查之后，儿童铅中毒的普遍性和严重性才受到广泛关注。近年来随着我国经济快速发展，工业化进程加快、城市汽车数量急剧增加，而相关的法律、法规及环境保护措施滞后，铅中毒已是影响儿童健康的重大公共卫生问题，正在引起政府、卫生行政部门和妇幼医疗保健机构及社会各界、尤其是儿童家长的广泛关注。80年代以后，各地陆续开展了儿童铅中毒的研究，获得了有价值的资料。     

2435名学龄前儿童血铅水平及铅中毒调查分析

目的：了解丽水市区学龄前儿童血铅水平和铅中毒情况，以便采取干预措施。方法：用BH2100型原子吸收光谱仪对丽水市区2435名学龄前儿童进行了血铅测定。结果：丽水市区学龄前儿童血铅水平为62．895=37．30μg／L，铅中毒（血铅值≥100μg／L）检出率为13．8％，男女童之间无显著性差异；各年龄组儿童血铅水平、铅中毒检出率，均有显著性差异（P〈0．05）。结论：丽水市区学龄前儿童铅中毒流行状况不容忽视，应对重点人群采取行之有效的措施，同时应引起儿童家长乃至全体市民的高度重视。     

广州市某医疗机构体检儿童血铅水平调查

[目的]调查广州市0～14岁儿童血铅水平,为防治儿童铅中毒提供科学依据。[方法]收集2010年1月至2011年6月在广东省中医院就诊的0～14岁儿童1517名血铅资料,按照年龄划分为3组：〈3岁、3～7岁及〉7岁儿童组。采用原子吸收光谱法测定血铅含量。[结果]0～14岁儿童血铅均值为57.05μg/L;血铅≥100μg/L者39例,占调查人数的2.57%。不同年龄组间儿童血铅水平差异有统计学意义（P〈0.05）;3～14岁年龄段男童血铅水平明显高于女童（P〈0.05）。[结论]本次调查儿童血铅水平及铅中毒率较低。但铅对儿童健康的潜在风险不能忽视,应加强儿童铅中毒防治健康教育。     

某蓄电池厂周边儿童铅蓄积状况调查

目的了解某蓄电池厂周边儿童血铅水平,为制定铅中毒防治策略提供科学依据。方法抽取蓄电池厂周边6月龄～14岁儿童240名为调查对象,按拟定的调查表调查儿童的基本情况;采集儿童静脉血,用石墨炉原子吸收光谱法测定血铅,分析儿童血铅水平及血铅异常检出率,比较不同性别、年龄、住址、饮食习惯和行为习惯的儿童血铅水平。结果儿童血铅水平为(98.89±27.28)μg/L,血铅异常检出率为41.67%。男童血铅水平高于女童血铅水平;学龄前儿童的血铅水平高于学龄儿童血铅水平;住址在公路边或街边、且靠近工厂的儿童血铅水平高于住址不在公路边或街边、且远离工厂的儿童血铅水平,差异均有统计学意义(均P0.05)。有不良饮食、行为习惯的儿童血铅水平高于无不良习惯的儿童血铅水平,但差异无统计学意义(均P0.05)。结论蓄电池厂周边儿童铅蓄积状况严重,环境干预和健康教育是预防儿童高铅血症和铅中毒发生的有效措施。     

轻、中度铅中毒儿童外周血象的检测

近年来,儿童铅中毒问题越来越受到重视。我们于2003年检测了2682名儿童的血铅水平(BPb)及外周血象,观察轻、中度铅中毒时儿童外周血象的变化,探讨铅对儿童血液系统的影响。现报道如下。     

浅谈儿童铅中毒的危害与预防

铅是一种用途广泛，但对人体具有神经毒性的重金属元素。铅在人体内无任何生理作用，人体内理想的血铅浓度应该是零。但是绝大多数人体中都或多或少含有一定量的铅，血铅超过100μg／L时引起铅中毒。对儿童来说，铅中毒最大的危害是影响孩子的智力发育，儿童血铅水平上升100μg其智商就下降6～8分。     

隆昌县铅中毒儿童血铅水平检测结果分析

[目的]了解隆昌县铅中毒儿童含量,探讨其综合防治措施以及血铅污染的来源。[方法]以隆昌县鱼建镇金属铅回收厂周围800m以内的1～12岁的424名儿童作为检测对象,以2009年7月～2010年2月泸州医学院附属医院儿科体检的3548名儿童作为参考对象,用原子吸收光谱仪测量其铅含量,计算机统计分析。[结果]隆昌县鱼建镇金属铅回收厂周围800m以内的4岁以下的儿童铅元素含量与对照组比较差异有统计学意义(P﹤0.01),4岁以上的儿童铅元素含量与对照组比较差异具有统计学意义(P﹤0.05),且年龄越小铅中毒阳性率越高。[结论]隆昌县鱼建镇金属铅回收厂周围800m以内的儿童铅元素含量明显高于对照组,且随年龄减少而上升,年龄越小,捡出率越高。应予以足够重视,寻找污染来源,注意环境污染的治理及个人和家庭卫生,保持饮食合理,营养平衡,防治铅重毒给儿童带来的伤害。     

北京市房山区儿童血铅现状调查及干预效果分析

目的了解北京市房山区儿童血铅水平现状以及干预效果的评价。方法采用随机抽样的方法对房山区3 209名儿童父母进行问卷调查,了解其生活环境和饮食行为习惯等信息,并采用微分电位溶出法测定儿童血铅浓度,对出现铅中毒症状儿童进行健康教育,6个月后测定儿童血铅浓度。结果共对3 209名儿童进行了调查,血铅的平均值为40.99±12.91μg/L,出现铅中毒症状的儿童血铅浓度明显高于对照儿童,经过干预后,儿童血铅浓度从59.50±8.10μg/L降低到36.36±8.98μg/L。结论北京市房山区儿童血铅浓度处于较低的水平,针对出现铅中毒症状的儿童干预措施能够明显降低其血铅的浓度。     

我国儿童血铅水平分析研究

目的描述我国儿童血铅整体水平及分布特征。方法通过计算机检索《中国生物医学文献数据库》及相关文献追溯等途径熏收集国内1994-2004年3月公开发表的关于儿童血铅研究的论文熏从中选择用石墨炉原子吸收分光光度法(GFAAS)和电感耦合等离子体质谱法(ICP鄄MS)检测血铅,并有严格质量控制报告且研究样本量大于100的文献进行综合分析。结果32篇文献被纳入研究,分析结果表明,我国儿童血铅平均值为92.9μg/L(37.2～254.2μg/L),有33.8%(9.6%～80.5%)的儿童血铅平均水平超过100μg/L;在所报道的27个省、自治区或直辖市中,有9个省、自治区或直辖市儿童血铅平均水平超过100μg/L;山西、河南、四川等地区儿童血铅平均水平及铅中毒率较高,其中山西省儿童血铅平均水平及铅中毒率最高,分别为172.5μg/L和70.6%;湖南省最低,儿童血铅平均值及铅中毒率分别为42.4μg/L和10.1%;男、女儿童的血铅平均值分别为96.4μg/L和89.4μg/L,差异有显著性意义(P<0.001);0～6岁儿童血铅水平随年龄增大而增加;居住在工业区和市区儿童的血铅水平高于郊区和农村儿童。结论我国儿童血铅水平较高,铅污染可能是影响我国儿童的生长发育的潜在环境因素之一。     

Association Between Aminolevulinate Dehydrase Genotypes and Blood Lead Levels in Children from a Lead-Contaminated Area in Antofagasta,Chile

Childhood environmental lead exposure in the city of Antofagasta, Chile, was generated by the accumulation of recently removed lead stores derived from mining activities for a long period of time. Susceptibility to harmful lead effects may be associated with polymorphisms of delta-aminolevulinic acid dehydratase (ALAD) because of the differential binding of lead to the codified proteins. We assessed the associations and possible interactions among the following variables: blood lead levels, ALAD genotypes, and distance to the source of lead contamination in Chilean children exposed to lead contamination in Antofagasta, Chile. Ninety-three children were recruited from schools located near a lead- contaminated area. Lead blood levels were measured by atomic absorption spectrophotometry. ALAD genotypes were determined by polymerase chain reaction and restriction fragment-length polymorphism analysis. The frequency of the ALAD-2 allele was estimated at 0.054. Children with the ALAD-2 genotype had higher blood lead levels than noncarriers (p = 0.06). As expected, blood lead levels were inversely correlated with the distance from lead stores. Interestingly, ALAD-2 carriers were more frequent within the area defined by a distance of 200 m from lead deposits (27%) than in areas >200 m (5%) away. Children living within a maximum distance of 200 m from the lead stores showed higher blood lead levels in ALAD-2 carriers (geometric mean = 16.4 g/dl, range 6 to 27) than in noncarriers (geometric mean = 12.1 g/dl, range 0 to 26) without achieving statistical significance (p = 0.13). A trend for higher blood lead levels in ALAD-2 carriers compared with ALAD-1 homozygous children has been observed. Because ALAD-2 frequency was higher in subjects living within 200 m from the lead deposits, we hypothesized that a long-term selective pressure against the presence of the ALAD-1 allele is the cause of the overrepresentation of the ALAD-2 allele in children living in proximity to the recently removed lead stores.     

中国农村地区儿童血铅水平分析

目的 描述中国农村儿童血铅总体水平及分布特征,为改善农村铅污染状况提供依据.方法 通过计算机检索中国期刊全文数据库及相关文献追溯等途径,依照严格的入选标准收集并筛选国内1994-2008年10月公开发表的关于农村儿童血铅水平研究的文献进行分析.结果 我国农村儿童血铅均值为74.93μg/L(范围:41.14～193.54μg/L),铅中毒率为19.32%(范围:2.2%～43%).禁止含铅汽油使用后儿童血铅从87.53μg/L降至71.16μg/L(u=7.13,P<0.01),禁止含铅汽油使用前后农村儿童血铅水平均低于同时期全国儿童血铅水平.调整无铅汽油使用的影响后,北京、山东农村儿童血铅均值较高.分别为99.16和92.13μg/L;吉林、河北较低,分别为41.14和56.14μg/L;18篇文献的综合分析显示,农村儿童和城市儿童的血铅均值分别为77.90和87.24 μg/L(u=3.73,P<0.01);8篇文献的综合分析显示,农村儿童和工业区儿童血铅均值分别为70.25和80.86μg/L(u=10.00.P<0.01).结论 农村地区儿童血铅水平低于全国总体水平,低于城市和工业区儿童血铅水平,推广无铅汽油后农村儿童血铅水平有了明显改善.

Abstract：

Objective To evaluate Chinese rural children's blood lead levels (BLLs) and identify its distribution features and to provide data for policy development to the prevention of rural environmental lead pollution. Methods The papers on rural children's BLLs published from 1994 to Oct. 2008 were collected by using CNKI's (China National Knowledge Infrastructure) Chinese Journal Full-test Database and other ways. The papers which were eligible for the following criteria were reviewed:(l) BLLs measured by atomic absorption spectroscopy (graphite or others) or inductively coupled plasma-mass spectrometry; (2) strict quality control; (3) no local lead pollution sources in the areas where the screened subjects live in; (4) children aged from 0 to 14 years old; (5)sample size more than 40. Results Analysis on the included 32 papers indicated that, the mean BLLs of Chinese rural children between 1994 and 2008 was 74.93μg/L (range:41.14-193.54 μg/L)and 19.32%(range:2.2%-43%) of the subjects had BLLs higher than 100 μg/L. The rural children's BLLs changed from 87.53 μg/Lto 71.16 μg/L after the use of lead free gasoline in 2000 in China, which were both lower than the general children's BBLs before 2000 and after 2001. The children in Beijing city and Shandong province showed the highest mean BLLs , with 99.16 μg/L and 92.13 μg/L respectively; while the children in Jilin province and Hebei province showed the lowest levels, with 41.14 μg/L and 56.14 μg/L respectively. The comprehensive analysis of 18 papers indicated that the mean BLLs in rural areas and urban areas were 77.90 μg/L and 87.24μg/L respectively (u=3.73, P<0.01 ). The comprehensive analysis of 8 papers indicated that the mean BLLs in rural areas and industrial areas were 70.25 μg/Land 80.86 μg/L respectively(u=10.00,P<0.01). Conclusion The BLLs of rural children in China are lower than the general levels of children in China, and also lower than urban areas and industrial areas. Promoting lead free gasoline can make a considerable decrease in the blood lead levels of rural children.     

太原市幼儿血铅水平与环境铅污染状况研究

目的：了解太原市幼儿血铅水平及环境铅污染状况。方法：用原子吸收法在质控条件下测定末梢血铅、空气、土壤及学习用品中铅的含量。结果：幼儿血铅均值为（0．637－1．388）μmol/L(几何均值0．498－0．982μmol/L),63%-92%的幼儿血铅≥0.4830644mol/L,两项皆以电池厂与煤气公司第一幼儿园为最高。3所幼儿园空气铅超标。土壤铅全部超标,也以上述两园为最高。学习用品中浅绿色桌面漆层含铅量为4094．5μg/g,超标15．4倍。结论：太原市幼儿血铅水平高、超标人数众多,应予以重视。土壤已被铅污染,可能是幼儿血铅高的主要原因。     

合肥市儿童血铅水平现况研究

目的了解合肥市儿童血铅水平现状,为防治铅危害提供依据。方法选择合肥市4个城区,采用随机整群原则对抽取的4个幼儿园1 018名2~7岁儿童进行了毛细血管血铅测定,对所有儿童的个人情况及家庭生活环境均进行了问卷调查。结果合肥市儿童铅中毒率为9.1%;男童血铅平均水平高于女童(t=3.011,P=0.003);男、女童铅中毒率无显著性差异;随年龄增长儿童血铅水平增高(F=7.738,P<0.001);不同年龄儿童铅中毒率差异有显著性(2χ=11.945,P=0.036)。结论合肥市儿童铅中毒发生率较低。但仍需要加强铅防护工作的宣传教育,提高群众的自我保护意识。     

Blood Lead Levels in Children in South Central Los Angeles

We retrospectively reviewed 3 679 pediatric records from King/Drew Medical Center, south central Los Angeles, between 1991 and 1994. Blood lead levels of children were followed to age 18 y. Patients were not referred specifically for lead poisoning. The sample was primarily Latino. Geometric mean blood lead peaked at 6.7 μg/dl (0.32 μmol/l) between 2 and 3 y of age. There was a downward secular trend and a seasonal trend. Males had higher lead levels than females. Children who lived in several zipcode areas, in which the lowest family incomes were reported, had higher lead levels. More Latino children had higher lead levels than African American children. Latino children (i.e., 20.2%) who were 1–5 y of age had blood lead levels that were ≤ 10 μg/dl. Young Latino children in this zone of Los Angeles may be at increased risk for lead exposure.     

Regular Breakfast and Blood Lead Levels among Preschool Children

Background  

Previous studies have shown that fasting increases lead absorption in the gastrointestinal tract of adults. Regular meals/snacks are recommended as a nutritional intervention for lead poisoning in children, but epidemiological evidence of links between fasting and blood lead levels (B-Pb) is rare. The purpose of this study was to examine the association between eating a regular breakfast and B-Pb among children using data from the China Jintan Child Cohort Study.