Chiodo Lisa M, Covington Chandice, Sokol Robert J, Hannigan John H, Jannise James, Ager Joel, Greenwald Mark, Delaney-Black Virginia
Carman and Ann Adams Department of Pediatrics, Wayne State University School of Medicine, University Health Center, Schoo-Be Research Study, Detroit, MI 48201, USA.
Neurotoxicol Teratol. 2007 Sep-Oct;29(5):538-46. doi: 10.1016/j.ntt.2007.04.001. Epub 2007 Apr 21.
The detrimental effects of early exposure to lead are credible and persistent, but there is presently no agreement on a safe threshold for circulating lead levels. Although several research groups have found significantly poorer cognitive performance in children who have whole blood levels as low as 5 microg/dL, most government agencies, including the EPA and the CDC, continue to use 10 microg/dL as the criterion for concern in public health advisories. Prior research has consistently indicated a negative relation between lead levels and attention. Similarly, the results of the present study show a relation between blood lead level and neurobehavioral outcome in 7-year-old children (N=506). Higher lead levels were associated significantly with decreased scores on measures of intelligence (i.e., overall, performance and verbal IQ), lengthened reaction time, hyperactivity, and social and delinquent behavior problems. Importantly, the present study documents a significant negative impact of blood lead levels on attention, but not impulsivity, in early elementary age children, further delineating the specific aspects of attention related to blood lead concentrations. Analyses were also conducted to identify a "safe" blood lead level threshold. Visual inspection of non-parametric regression plots suggested a gradual linear dose-response relationship for each endpoint. None of the neurobehavioral outcomes assessed showed evidence of a threshold under which lead levels appear to "safe". In light of the consistency of these findings with those of several other groups, it is advisable to consider whether the threshold for an acceptable blood lead level should be reduced.
早期接触铅的有害影响是可信且持久的,但目前对于血液中铅含量的安全阈值尚无定论。尽管有几个研究小组发现,全血铅水平低至5微克/分升的儿童认知能力明显较差,但包括美国环境保护局(EPA)和疾病控制与预防中心(CDC)在内的大多数政府机构在公共卫生建议中仍继续将10微克/分升作为关注标准。先前的研究一直表明铅水平与注意力之间存在负相关关系。同样,本研究结果显示了7岁儿童(N = 506)的血铅水平与神经行为结果之间的关系。较高的铅水平与智力测试得分降低(即总体智商、操作智商和言语智商)、反应时间延长、多动以及社交和犯罪行为问题显著相关。重要的是,本研究记录了血铅水平对小学低年级儿童注意力而非冲动性有显著负面影响,进一步明确了与血铅浓度相关的注意力的具体方面。还进行了分析以确定“安全”的血铅水平阈值。对非参数回归图的直观检查表明,每个终点都存在逐渐的线性剂量反应关系。所评估的神经行为结果均未显示出铅水平似乎“安全”的阈值证据。鉴于这些发现与其他几个研究小组的结果一致,建议考虑是否应降低可接受的血铅水平阈值。