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卡亚俄和利马大都市区儿童血铅水平的决定因素。

Determinants of blood-lead levels in children in Callao and Lima metropolitan area.

作者信息

Espinoza Rocío, Hernández-Avila Mauricio, Narciso Juan, Castañaga Carmen, Moscoso Shirley, Ortiz Georgina, Carbajal Luz, Wegner Steve, Noonan Gary

机构信息

Dirección General de Salud Ambiental, Dirección de Salud Ocupacional, Lima, Perú.

出版信息

Salud Publica Mex. 2003;45 Suppl 2:S209-19. doi: 10.1590/s0036-36342003000800007.

DOI:10.1590/s0036-36342003000800007
PMID:14746006
Abstract

OBJECTIVES

To determine blood lead levels in urban populations of children (n = 2,510) and women (n = 874) in the early postpartum in certain districts of Lima and Callao, and to correlate those levels with particular exposures.

MATERIAL AND METHODS

Between July 1998 and January 1999 cross sectional study was conducted. The study population was selected using three sampling strategies in the government operated school system and from public pediatric and maternity hospitals at Lima and Callao, Peru. Study personnel were trained to collect finger stick blood samples with a protocol that minimizes external lead contamination. Lead determinations in blood and environmental samples were performed at the study site using portable anodic striping voltamenters. To determine the simultaneous effects of different predictors on blood lead levels, multivariate regression models were used to estimate adjusted mean differences.

RESULTS

The mean blood lead level in the children studied was 9.9 micrograms/dl ranging from 1 microgram/dl to 64 micrograms/dl with 29% of the children displaying values greater than 10 micrograms/dl and 9.4% at levels greater than 20 micrograms/dl. Among the women, the mean was 3.5 micrograms/dl (SD = 2.4 micrograms/dl), and 2.4% (n = 21) displayed levels greater than 10 micrograms/dl. Important differences were observed between the sample locations, and the highest levels were documented in the port region near Callao. The mean level of blood lead in this group was 25.6 micrograms/dl (SD = 4.6 micrograms/dl), while among the rest of the sample it was 7.1 micrograms/dl (SD = 5.1 micrograms/dl). The presence of a mineral storage area signified a difference in exposure in excess of 13 micrograms/dl for children living near the port area in contrast to the other children who were not as close to such fixed sources of lead exposure. For the participants in Lima, the risk of showing levels above 10 micrograms/dl was associated with exposure to high vehicular traffic.

CONCLUSIONS

In metropolitan Lima, we conclude that the mean blood lead levels of the populations studied were not alarming and that a positive health impact can be made by a reduction of lead in gasoline. With regard to the port area, the study demonstrates that the presence of mineral storage areas pose a detrimental risk factor for the health of the children living in this area. The English version of this paper is available too at: http://www.insp.mx/salud/index.html.

摘要

目的

测定利马和卡亚俄某些地区城市儿童(n = 2510)和产后早期妇女(n = 874)的血铅水平,并将这些水平与特定暴露因素相关联。

材料与方法

1998年7月至1999年1月进行了横断面研究。研究人群是通过秘鲁利马和卡亚俄政府运营的学校系统以及公立儿科和妇产医院的三种抽样策略选取的。研究人员接受培训,按照将外部铅污染降至最低的方案采集手指血样。在研究现场使用便携式阳极溶出伏安仪对血液和环境样本进行铅测定。为确定不同预测因素对血铅水平的同时影响,使用多元回归模型估计调整后的平均差异。

结果

所研究儿童的平均血铅水平为9.9微克/分升,范围为1微克/分升至64微克/分升,29%的儿童血铅值高于10微克/分升,9.4%高于20微克/分升。在妇女中,平均水平为3.5微克/分升(标准差 = 2.4微克/分升),2.4%(n = 21)血铅水平高于10微克/分升。在样本地点之间观察到重要差异,卡亚俄附近港口地区记录的血铅水平最高。该组的平均血铅水平为25.6微克/分升(标准差 = 4.6微克/分升),而其余样本的平均血铅水平为7.1微克/分升(标准差 = 5.1微克/分升)。与其他未靠近此类固定铅暴露源的儿童相比,有矿物储存区表明居住在港口地区附近的儿童暴露差异超过13微克/分升。对于利马的参与者,血铅水平高于10微克/分升的风险与高车辆流量暴露相关。

结论

在利马大都市,我们得出结论,所研究人群的平均血铅水平并不令人担忧,减少汽油中的铅含量可对健康产生积极影响。关于港口地区,研究表明矿物储存区的存在对居住在该地区的儿童健康构成有害风险因素。本文的英文版本也可在以下网址获取:http://www.insp.mx/salud/index.html 。

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