Heron Jon, Golding Jean
Unit of Paediatric and Perinatal Epidemiology, Department of Community-Based Medical Sciences, University of Bristol, Bristol, United Kingdom.
Pediatrics. 2004 Sep;114(3):577-83. doi: 10.1542/peds.2003-1176-L.
There is an established link between exposure to mercury and impaired childhood cognitive development and early motor skills. Thimerosal (also known as thiomersal), a preservative used in a number of children's vaccines, contains ethylmercury (an organic compound of mercury), and there has been concern that this exposure to mercury may be of some detriment to young children. The aim of this research was to test in a large United Kingdom population-based cohort whether there is any evidence to justify such concerns.
We used population data from a longitudinal study on childhood health and development. The study has been monitoring >14,000 children who are from the geographic area formerly known as Avon, United Kingdom, and were delivered in 1991-1992. The age at which doses of thimerosal-containing vaccines were administered was recorded, and measures of mercury exposure by 3, 4, and 6 months of age were calculated and compared with a number of measures of childhood cognitive and behavioral development covering the period from 6 to 91 months of age.
Contrary to expectation, it was common for the unadjusted results to suggest a beneficial effect of thimerosal exposure. For example, exposure at 3 months was inversely associated with hyperactivity and conduct problems at 47 months; motor development at 6 months and at 30 months; difficulties with sounds at 81 months; and speech therapy, special needs, and "statementing" at 91 months. After adjustment for birth weight, gestation, gender, maternal education, parity, housing tenure, maternal smoking, breastfeeding, and ethnic origins, we found 1 result of 69 to be in the direction hypothesized-poor prosocial behavior at 47 months was associated with exposure by 3 months of age (odds ratio: 1.12; 95% confidence interval: 1.01-1.23) compared with 8 results that still supported a beneficial effect.
We could find no convincing evidence that early exposure to thimerosal had any deleterious effect on neurologic or psychological outcome.
接触汞与儿童认知发育受损及早期运动技能受损之间存在既定联系。硫柳汞(也称为硫代汞)是多种儿童疫苗中使用的一种防腐剂,含有乙基汞(汞的一种有机化合物),人们一直担心这种汞接触可能对幼儿有一定危害。本研究的目的是在英国一个基于人群的大型队列中进行测试,看是否有证据支持这种担忧。
我们使用了一项关于儿童健康与发育的纵向研究中的人群数据。该研究一直在监测来自英国原埃文地区、于1991 - 1992年出生的14000多名儿童。记录了接种含硫柳汞疫苗的年龄,并计算了3、4和6个月大时的汞接触量,并与6至91个月大期间的多项儿童认知和行为发育指标进行比较。
与预期相反,未经调整的结果通常表明硫柳汞接触有有益影响。例如,3个月时的接触与47个月时的多动和行为问题呈负相关;与6个月和30个月时的运动发育呈负相关;与81个月时的发音困难呈负相关;与91个月时的言语治疗、特殊需求及“特殊教育需求认定声明”呈负相关。在对出生体重、孕周、性别、母亲教育程度、产次、住房 tenure、母亲吸烟、母乳喂养和种族进行调整后,我们发现69项结果中有1项符合假设方向——47个月时亲社会行为差与3个月大时的接触有关(优势比:1.12;95%置信区间:1.01 - 1.23),而仍有8项结果支持有益影响。
我们找不到令人信服的证据表明早期接触硫柳汞对神经或心理结果有任何有害影响。