Morgan Brent W, Barnes Lauren, Parramore Constance S, Kaufmann Rachel B
Department of Emergency Medicine, Emory University; Atlanta, GA 30303, USA.
Ann Emerg Med. 2003 Sep;42(3):351-8. doi: 10.1016/s0196-0644(03)00491-8.
In February and March 2000, 4 adult emergency care patients were identified with potentially lethal lead toxicity at Grady Memorial Hospital, an urban Atlanta, GA, hospital. All were moonshine drinkers, prompting concern that lead exposure from moonshine was underrecognized in this setting.
We conducted a 2-phased, nested, cross-sectional study throughout a 14-day period in the emergency care center of Grady Memorial Hospital. The prevalence phase consisted of demographic data collection, eligibility screening, and a brief interview pertaining to alcohol and moonshine consumption. During the nested phase, a full interview and blood lead analyses were conducted on all consenting moonshine drinkers and a time-matched comparison group of non-moonshine drinkers.
In the prevalence phase, of 581 patients interviewed, 8.6% reported consuming moonshine in the past 5 years. Moonshine drinkers were predominantly men between the ages of 40 and 59 years. In the nested phase, the median blood lead levels among moonshine drinkers and nondrinkers were 11.0 microg/dL (0.531 micromol/L) and 2.5 microg/dL (0.121 micromol/L), respectively. Moonshine drinkers were significantly more likely to have blood lead levels of 10 microg/dL (0.483 micromol/L) or greater (odds ratio [OR] 10.94; 95% confidence interval 3.76 to 31.85). Patients who consumed moonshine in the previous week were significantly more likely to have a blood lead level of 10 microg/dL (0.483 micromol/L) or greater than were individuals who reported less recent consumption. Patients who consumed moonshine more than once a month were significantly more likely to have a blood lead level of 10 microg/dL (0.483 micromol/L) or greater than were those reporting less frequent use. Moonshine users were more likely to report heavy alcohol use.
Moonshine consumption was more prevalent than expected in our patient population and was strongly associated with elevated blood lead levels, particularly among recent moonshine drinkers.
2000年2月和3月，在佐治亚州亚特兰大市一家市区医院格雷迪纪念医院，4名成年急诊患者被确诊患有潜在致命性铅中毒。他们均为私酿酒饮用者，这引发了人们对在此环境下私酿酒导致铅暴露未得到充分认识的担忧。
我们在格雷迪纪念医院急诊中心进行了一项为期14天的两阶段嵌套横断面研究。患病率阶段包括收集人口统计学数据、进行资格筛查以及就饮酒和饮用私酿酒情况进行简短访谈。在嵌套阶段，对所有同意参与的私酿酒饮用者以及与之时间匹配的非私酿酒饮用者对照组进行全面访谈和血铅分析。
在患病率阶段，接受访谈的581名患者中，8.6%报告在过去5年中饮用过私酿酒。私酿酒饮用者主要是年龄在40至59岁之间的男性。在嵌套阶段，私酿酒饮用者和非饮用者的血铅水平中位数分别为11.0微克/分升（0.531微摩尔/升）和2.5微克/分升（0.121微摩尔/升）。私酿酒饮用者血铅水平达到或高于10微克/分升（0.483微摩尔/升）的可能性显著更高（比值比[OR]为10.94；95%置信区间为3.76至31.85）。前一周饮用过私酿酒的患者血铅水平达到或高于10微克/分升（0.483微摩尔/升）的可能性显著高于近期饮酒较少的个体。每月饮用私酿酒超过一次的患者血铅水平达到或高于10微克/分升（0.483微摩尔/升）的可能性显著高于饮用频率较低的患者。私酿酒饮用者更有可能报告大量饮酒。
在我们的患者群体中，私酿酒的消费比预期更为普遍，并且与血铅水平升高密切相关，尤其是在近期饮用私酿酒的人群中。
