Bates Michael N, Selevan Sherry G, Ellerbee Susan M, Gartner Lawrence M
School of Public Health, University of California, Berkeley, 94720, USA.
J Toxicol Environ Health A. 2002 Nov 22;65(22):1867-79. doi: 10.1080/00984100290071766.
Studies of environmental chemicals in human milk have been carried out in many countries, but few have been conducted in the United States. These studies are useful for monitoring population trends in exposure to chemicals, for research into the determinants of environmental chemicals in milk and relationships between the levels found and the health status of the women and their infants, and for risk assessment. This article provides practical advice on data and information reporting for such studies. Participation in these studies comes at a difficult time for the breast-feeding mothers, so it is important that the mothers support the study and its goals. A key goal of any study of environmental chemicals in human milk must be to ensure that the breast-feeding process is not disrupted by unwarranted concerns about harm to the infant from chemicals in human milk. Therefore, it is essential that reporting of information be a two-way process. Information needs to be supplied to participating mothers before, during, and after their participation in the study. Information supplied before participation is necessary to satisfy the ethical requirement for informed consent; information supplied during participation includes advice on expressing, collecting, and storing milk samples, and how to avoid sample contamination; and information supplied to each participant at the end of the study includes a report of their individual results and a summary of study results and outcomes generally. The key instrument for obtaining data from the participants is the study questionnaire. This needs to be prepared in accordance with principles of good questionnaire development, and preferably should be interviewer administered. The questionnaire content will vary according to the objectives of the study. Although studies of environmental chemicals in human milk are logistically complex and demanding, they are practicable and, with careful planning and execution, yield important data.
许多国家都开展了关于人乳中环境化学物质的研究，但在美国进行的此类研究较少。这些研究有助于监测人群接触化学物质的趋势，研究乳汁中环境化学物质的决定因素以及所发现的化学物质水平与母亲及其婴儿健康状况之间的关系，还可用于风险评估。本文就此类研究的数据和信息报告提供实用建议。对于母乳喂养的母亲来说，参与这些研究面临着困难时期，因此母亲支持该研究及其目标非常重要。任何关于人乳中环境化学物质的研究的一个关键目标必须是确保母乳喂养过程不会因对人乳中化学物质对婴儿造成伤害的无端担忧而受到干扰。因此，信息报告必须是一个双向过程。在参与研究之前、期间和之后都需要向参与的母亲提供信息。参与前提供的信息对于满足知情同意的伦理要求是必要的；参与期间提供的信息包括关于挤奶、收集和储存乳汁样本的建议，以及如何避免样本污染；研究结束时向每位参与者提供的信息包括其个人结果报告以及一般研究结果和成果的总结。从参与者那里获取数据的关键工具是研究问卷。这需要按照良好问卷设计的原则来准备，最好由访谈员进行询问。问卷内容将根据研究目标而有所不同。尽管关于人乳中环境化学物质的研究在后勤方面复杂且要求高，但它们是可行的，并且经过精心规划和执行，可以产生重要数据。
