Greene T, Ernhart C B, Boyd T A
Department of Psychiatry, Case Western Reserve University, Cleveland, OH.
Sci Total Environ. 1992 Apr 30;115(3):239-60. doi: 10.1016/0048-9697(92)90332-m.
The relationship between blood lead level (PbB) and an array of socio-demographic, behavioral, caregiving and environmental risk factors was investigated in a cohort of socioeconomically disadvantaged urban children at ages 2, 3 and 4 years and 10 months. The risk factors were also related to dentine lead level (PbD) from shed deciduous teeth. Strong persistent pairwise relationships with PbB and PbD were observed for maternal IQ, parental education, examiner ratings of the condition and cleanliness of the physical environment, and the HOME scale, which assesses the quality of the caretaking environment. The association between dirt pica and PbB was strong at 2 years (r = 0.30), but was less pronounced in subsequent assessments as the prevalence of pica decreased. Insignificant or weak relationships were found for maternal assessments of paint-and-plaster peeling in the home and non-dirt pica. The HOME scale and the ratings of the condition of the physical environment were significantly related to PbB and PbD even after adjustment for socio-demographic factors. These two measures were also strongly related to an array of developmental outcomes. The results indicate that statistical adjustment specifically for the quality of the caretaking environment can lead to substantial reductions in estimates of adverse lead effects.
在一组社会经济条件不利的城市儿童中，研究了血铅水平（PbB）与一系列社会人口统计学、行为、照料和环境风险因素之间的关系，这些儿童年龄分别为2岁、3岁、4岁和10个月。这些风险因素还与脱落乳牙的牙本质铅水平（PbD）有关。观察到母亲智商、父母教育程度、检查人员对身体环境状况和清洁程度的评分以及评估照料环境质量的HOME量表与PbB和PbD之间存在强烈的持续成对关系。在2岁时，异食癖与PbB之间的关联很强（r = 0.30），但随着异食癖患病率的降低，在随后的评估中这种关联不那么明显。在家中对油漆和灰泥剥落情况的母亲评估与非泥土异食癖之间的关系不显著或较弱。即使在对社会人口统计学因素进行调整后，HOME量表和身体环境状况评分仍与PbB和PbD显著相关。这两项指标还与一系列发育结果密切相关。结果表明，专门针对照料环境质量进行统计调整可大幅降低对铅不良影响的估计值。
