Gundacker Claudia, Pietschnig Beate, Wittmann Karl J, Lischka Andreas, Salzer Hans, Hohenauer Leonhard, Schuster Ernst
Institut für Medizinische Biologie der Universität Wien, Labor Okophysiologie und Okotoxikologie, Vienna, Austria.
Pediatrics. 2002 Nov;110(5):873-8. doi: 10.1542/peds.110.5.873.
Heavy metals are potentially toxic substances, especially for the susceptible infant. Exposure to mercury (Hg) and lead (Pb) may result in neurotoxic and nephrotoxic impairment and in anemia. Previous data on breast milk Pb and Hg contents are sparse or missing for the Austrian population. No evaluations of the influence of mothers' lifestyles on Pb and Hg levels in breast milk are available.
Five- to 10-mL individual samples of breast milk were provided from healthy mothers in Vienna (urban; n = 59), Linz (industrial; n = 47), and Tulln (rural; n = 59). A questionnaire about area of residence, maternal nutrition, smoking habits, and dental fillings was filled out by the lactating mothers. Milk samples and infant formulas were lyophilized, wet-ashed with nitric acid (65%), and analyzed with atomic absorption spectrophotometry. Spiked skim milk powder was used as reference material. Statistical analysis included the Kruskal-Wallis test and multiple robust regression analysis.
Breast milk showed low Hg and Pb concentrations (Hg: 1.59 +/- 1.21 1g/l, n = 116; Pb: 1.63 +/- 1.66 6g/l, n = 138). Eight percent of the breast milk samples marginally exceeded the screening level of 3.5 micro g/L for Hg. Austrian Pb values declined strongly during the last 20 years. Bivariate comparison revealed that the factors significantly related to metal levels in breast milk were area of residence (Hg, Pb), prematurity (Hg), consumption of fish (Pb) and cereals (Hg), vitamin supplementation (Hg), and smoking (Pb). The Hg and Pb contents of cow milk and infant formulas were far below respective guideline values.
Neither Hg nor Pb concentrations exceeded critical levels. There are no reports on infants harmed by the intake of milk from unexposed mothers. We conclude that even theoretical risks from current Hg or Pb levels for the breastfed infant of a healthy mother can be ruled out.
重金属是潜在的有毒物质,对易受影响的婴儿尤其如此。接触汞(Hg)和铅(Pb)可能导致神经毒性和肾毒性损害以及贫血。奥地利人群中关于母乳中铅和汞含量的先前数据稀少或缺失。目前尚无关于母亲生活方式对母乳中铅和汞水平影响的评估。
从维也纳(城市;n = 59)、林茨(工业城市;n = 47)和图尔恩(农村;n = 59)的健康母亲处采集5至10毫升的母乳个体样本。哺乳期母亲填写了一份关于居住地区、母亲营养、吸烟习惯和补牙情况的问卷。母乳样本和婴儿配方奶粉经冻干后,用65%的硝酸进行湿灰化处理,并用原子吸收分光光度法进行分析。添加了标准物质的脱脂奶粉用作参考材料。统计分析包括Kruskal-Wallis检验和多重稳健回归分析。
母乳中汞和铅的浓度较低(汞:1.59±1.21μg/L,n = 116;铅:1.63±1.66μg/L,n = 138)。8%的母乳样本汞含量略超过3.5μg/L的筛查水平。奥地利的铅值在过去20年中大幅下降。双变量比较显示,与母乳中金属水平显著相关的因素包括居住地区(汞、铅)、早产(汞)、鱼类(铅)和谷物(汞)的摄入量、维生素补充情况(汞)以及吸烟(铅)。牛奶和婴儿配方奶粉中的汞和铅含量远低于各自的指导值。
汞和铅的浓度均未超过临界水平。目前尚无关于未接触有害物质的母亲所产母乳导致婴儿受到伤害的报告。我们得出结论,即使是健康母亲母乳喂养的婴儿,目前汞或铅水平带来的理论风险也可排除。