Chomchai Chulathida, Padungtod Chantana, Chomchai Summon
Division of Ambulatory Pediatrics and Pediatric Toxicology, Department of Pediatrics, Faculty of Medicine, Siriraj Hospital, Bangkok, Thailand.
J Med Assoc Thai. 2005 Nov;88 Suppl 8:S53-9.
In the era post leaded-gasoline use, the risk of exposure to environmental lead in Thai children is not well described. This is a pilot study using a risk assessment questionnaire to identify children with elevated blood lead level.
Children from 4 communities, 2 in the Bangkok metropolitan area and 2 in Kanchanaburi province, were recruited during their well child visits. Blood lead levels were obtained in all children and parents are asked to fill out a 25-item risk assessment questionnaire.
The relationship between the blood lead level and dependent variables were tested using linear regression and one-way analysis of variance (ANOVA) as appropriate.
There were 296 children included in the study; 33 from Klong Toey and 114 from Siriraj community in Bangkok while 149 were from two different communities in Kanchanaburi province. The average blood lead level was 5.65 +/- 3.05 mcg/dL. The overall prevalence of children with blood lead level > 10 mcg/dL was 8.1%, while that of the Klong Toey community was 12.5%. The questionnaire identified 3 independent predictors of elevated blood lead levels; the presence of peeling paint in or outside the house, eating paints chips, and the geographic location of children.
Using a risk assessment questionnaire, together with obtaining blood lead level has proven effective in identifying key environmental features associated with elevated blood lead level in children from sampled Thai communities. The challenge now is to conduct a larger epidemiological study of a similar type in order to guide the screening and preventive efforts.
在无铅汽油使用的时代，泰国儿童接触环境铅的风险尚未得到充分描述。这是一项使用风险评估问卷来识别血铅水平升高儿童的试点研究。
在4个社区招募儿童，其中2个位于曼谷都会区，2个位于北碧府，招募时间为儿童健康体检期间。采集所有儿童的血铅水平，并要求家长填写一份包含25个条目的风险评估问卷。
根据情况，使用线性回归和单因素方差分析（ANOVA）检验血铅水平与相关变量之间的关系。
本研究共纳入296名儿童；其中33名来自曼谷的孔堤社区和诗里拉吉社区的114名儿童，而149名来自北碧府的两个不同社区。平均血铅水平为5.65 +/- 3.05 mcg/dL。血铅水平> 10 mcg/dL的儿童总体患病率为8.1%，而孔堤社区的患病率为12.5%。该问卷确定了血铅水平升高的3个独立预测因素；房屋内外是否存在油漆剥落、食用油漆碎片以及儿童的地理位置。
使用风险评估问卷并结合检测血铅水平，已被证明能有效识别泰国抽样社区儿童血铅水平升高相关的关键环境特征。现在的挑战是开展一项类似类型的更大规模的流行病学研究，以指导筛查和预防工作。
