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乌克兰3岁儿童血铅水平升高的预测因素:一项巢式病例对照研究。

Predictors of elevated blood lead levels among 3-year-old Ukrainian children: a nested case-control study.

作者信息

Friedman L S, Lukyanova O M, Kundiev Y I, Shkiryak-Nizhnyk Z A, Chislovska N V, Mucha A, Zvinchuk A V, Oliynyk I, Hryhorczuk D

机构信息

University of Illinois, School of Public Health, Division of Environmental and Occupational Health Sciences, Chicago, IL 60612, USA.

出版信息

Environ Res. 2005 Oct;99(2):235-42. doi: 10.1016/j.envres.2004.12.006. Epub 2005 Jan 21.

Abstract

OBJECTIVES

Lead is common in the general population. However, data are lacking for the Ukraine and many other countries from the former Soviet Union (FSU). In this study we evaluate the level of blood lead among 212 Ukrainian children and determine predictors of elevated lead levels. We also describe the health effects associated with elevated blood lead.

METHODS

A nested case-control study from a prospective cohort of Ukrainian 3-year-old children was conducted in March 1998. Blood assays were analyzed for lead by labs at the Centers for Disease Control and using portable examination kits. We evaluated predictors of elevated blood lead (blood levels in the upper quartile >4.65 microg/dL) using a multivariable logistic regression model. The model included socioeconomic status, parent occupation, environmental tobacco smoke, hygiene, diet, and health status.

RESULTS

The geometric mean lead level was 3.15 microg/dL (range, 0.7--22.7). In our adjusted model, we observed a strong association between lead levels in the upper quartile and children whose fathers worked manual labor jobs in industries associated with lead exposures [adjusted odds ratio (OR)=2.25; P=0.025] and mothers who smoke indoors (adjusted OR=2.87; P=0.047). Daily hygiene and dietary habits were not associated with elevated lead levels. No increased risks of overall morbidity or lead-associated illness were observed (anemia, dental caries, renal disease, cardiovascular diseases, and musculoskeletal complaints).

CONCLUSION

This is the first study to describe lead levels and associated variables among Ukrainian children in the peer-reviewed literature. Elevated lead levels in these children were associated with paternal occupation and mothers smoking indoors. At age 3 no adverse health effects were observed. More data are needed to determine the level of heavy metal contamination in children from the Ukraine and many other former Soviet nation-states.

摘要

目的

铅在普通人群中很常见。然而,乌克兰以及许多其他前苏联国家缺乏相关数据。在本研究中,我们评估了212名乌克兰儿童的血铅水平,并确定血铅水平升高的预测因素。我们还描述了与血铅水平升高相关的健康影响。

方法

1998年3月,对乌克兰3岁儿童的前瞻性队列进行了一项巢式病例对照研究。血样由疾病控制中心的实验室使用便携式检测试剂盒分析铅含量。我们使用多变量逻辑回归模型评估血铅水平升高(血铅水平处于上四分位数>4.65微克/分升)的预测因素。该模型包括社会经济地位、父母职业、环境烟草烟雾、卫生习惯、饮食和健康状况。

结果

几何平均铅水平为3.15微克/分升(范围为0.7 - 22.7)。在我们的校正模型中,我们观察到血铅水平处于上四分位数的儿童与父亲在与铅暴露相关行业从事体力劳动工作的儿童之间存在强烈关联[校正比值比(OR)=2.25;P = 0.025],以及与在室内吸烟的母亲之间存在关联(校正OR = 2.87;P = 0.047)。日常卫生习惯和饮食习惯与血铅水平升高无关。未观察到总体发病率或铅相关疾病(贫血、龋齿、肾病、心血管疾病和肌肉骨骼疾病)的风险增加。

结论

这是同行评审文献中首次描述乌克兰儿童铅水平及相关变量的研究。这些儿童血铅水平升高与父亲职业和母亲在室内吸烟有关。在3岁时未观察到不良健康影响。需要更多数据来确定乌克兰和许多其他前苏联国家儿童的重金属污染水平。

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