Jarosinska D, Rogan W J
Department of Environmental Medicine, Institute of Occupational Medicine and Environmental Health, Sosnowiec, Poland.
Cent Eur J Public Health. 2003 Dec;11(4):192-7.
Exposure to excess lead during childhood is preventable, but nowhere has that goal been achieved. In the US, recommendations for prevention of childhood lead poisoning are issued by the Centres for Disease Control and Prevention, based on periodically updated population-based data on the prevalence of lead poisoning by age and blood lead level. A well developed public health infrastructure is to provide case management to the lead exposed children. In Poland, the social and economic transitions of the last decade changed the potential for childhood lead exposure, and there has been a profound restructuring of the health care system. Blood lead testing in children is performed outside the primary care. Data on blood lead levels are not collected and analysed centrally. The range of follow-up services may differ among the regions, depending on the local expertise. An updated approach to prevention of childhood lead poisoning, making better use of the existing expertise and involving primary care providers, needs consideration. Complex public health programs like this of lead poisoning prevention cannot be transplanted whole to other countries. However, experiences gained by the US might provide valuable suggestions for others, even though the US policy has flaws and is not fully implemented. Discussing proposal for Poland in light of the current US practice highlights the necessity of reliable estimates of the exposed population for rational policy. It also helps to define research questions relevant to public health practice in Poland, and confirms that prevention of lead poisoning in children requires the coordinated work of different professionals.
儿童时期接触过量铅是可以预防的，但这一目标在任何地方都尚未实现。在美国，疾病控制与预防中心根据按年龄和血铅水平定期更新的、基于人群的铅中毒患病率数据，发布预防儿童铅中毒的建议。完善的公共卫生基础设施应为铅暴露儿童提供病例管理。在波兰，过去十年的社会和经济转型改变了儿童铅暴露的可能性，医疗保健系统也进行了深刻的重组。儿童血铅检测在初级保健之外进行。血铅水平数据未集中收集和分析。后续服务的范围可能因地区而异，这取决于当地的专业知识。需要考虑一种更新的预防儿童铅中毒的方法，更好地利用现有专业知识并让初级保健提供者参与进来。像这样复杂的预防铅中毒公共卫生项目不能完全移植到其他国家。然而，美国获得的经验可能会为其他国家提供有价值的建议，尽管美国的政策存在缺陷且未得到充分实施。根据美国目前的做法讨论波兰的提议，凸显了对暴露人群进行可靠估计以制定合理政策的必要性。这也有助于确定与波兰公共卫生实践相关的研究问题，并证实预防儿童铅中毒需要不同专业人员的协同工作。
