Lanphear B P, Howard C, Eberly S, Auinger P, Kolassa J, Weitzman M, Schaffer S J, Alexander K
Children's Hospital Medical Center and the Department of Pediatrics, University of Cincinnati, Cincinnati, Ohio 45229-3039, USA.
Pediatrics. 1999 Apr;103(4 Pt 1):772-7. doi: 10.1542/peds.103.4.772.
Dust control is recommended as one of the primary strategies to prevent or control children's exposure to residential lead hazards, but the effect of dust control on children's blood lead levels is poorly understood.
To determine the effectiveness of dust control in preventing children's exposure to lead, as measured by blood lead levels, during their peak age of susceptibility.
A randomized, controlled trial.
Rochester, NY.
A total of 275 urban children were randomized at 6 months of age, of whom 246 (90%) were available for the 24-month-old follow-up visit.
Children and their families were randomly assigned to an intervention group (n = 140), which received cleaning equipment and up to eight visits by a dust control advisor, or a control group (n = 135).
Geometric mean blood lead levels and prevalence of elevated blood lead levels (ie, >10 microg/dL, 15 microg/dL, and 20 microg/dL).
At baseline, children's geometric mean blood lead levels were 2.9 microg/dL (95% confidence interval [CI] = 2.7, 3.1); there were no significant differences in characteristics or lead exposure by group assignment, with the exception of water lead levels. For children in the intervention group, the mean number of visits by a dust control advisor during the 18-month study period was 6.2; 51 (36%) had 4 to 7 visits, and 69 (49%) had 8 visits. At 24 months of age, the geometric mean blood lead was 7.3 microg/dL (95% CI = 6.6, 8.2) for the intervention group and 7.8 microg/dL (95% CI = 6.9, 8. 7) for the control group. The percentage of children with a 24-month blood lead >/=10 microg/dL, >/=15 microg/dL, and >/=20 microg/dL was 31% versus 36%, 12% versus 14%, and 5% versus 7% in the intervention and control groups, respectively.
We conclude that dust control, as performed by families and in the absence of lead hazard controls to reduce ongoing contamination from lead-based paint, is not effective in the primary prevention of childhood lead exposure.
建议将控制灰尘作为预防或控制儿童接触家庭铅危害的主要策略之一，但灰尘控制对儿童血铅水平的影响尚不清楚。
确定在儿童易感性最高的年龄段，通过血铅水平衡量，控制灰尘对预防儿童接触铅的有效性。
一项随机对照试验。
纽约州罗切斯特市。
共有275名城市儿童在6个月大时被随机分组，其中246名（90%）在24个月大时接受随访。
儿童及其家庭被随机分配到干预组（n = 140），该组接受清洁设备，并由灰尘控制顾问进行多达8次家访；或对照组（n = 135）。
几何平均血铅水平以及血铅水平升高（即>10微克/分升、>15微克/分升和>20微克/分升）的患病率。
在基线时，儿童的几何平均血铅水平为2.9微克/分升（95%置信区间[CI]=2.7，3.1）；除水铅水平外，按组分配的特征或铅暴露情况无显著差异。对于干预组的儿童，在18个月的研究期间，灰尘控制顾问的平均家访次数为6.2次；51名（36%）儿童接受了4至7次家访，69名（49%）儿童接受了8次家访。在24个月大时，干预组的几何平均血铅水平为7.3微克/分升（95%CI = 6.6，8.2），对照组为7.8微克/分升（95%CI = 6.9，8.7）。干预组和对照组中，24个月时血铅≥10微克/分升、≥15微克/分升和≥20微克/分升的儿童百分比分别为31%对36%、12%对14%和5%对7%。
我们得出结论，在没有铅危害控制措施以减少来自含铅油漆持续污染的情况下，由家庭进行的灰尘控制在预防儿童铅暴露方面无效。
