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减少铅暴露和中毒的全球方法。

Global approach to reducing lead exposure and poisoning.

作者信息

Meyer Pamela A, Brown Mary Jean, Falk Henry

机构信息

Centers for Disease Control and Prevention, Coordinating Center for Environmental Health and Injury Prevention, 1600 Clifton Road, NE, Mailstop F-64, Atlanta, GA 30333, United States.

出版信息

Mutat Res. 2008 Jul-Aug;659(1-2):166-75. doi: 10.1016/j.mrrev.2008.03.003. Epub 2008 Mar 20.

Abstract

Lead poisoning is an important environmental disease that can have life-long adverse health effects. Most susceptible are children, and most commonly exposed are those who are poor and live in developing countries. Studies of children's blood-lead levels (BLLs) are showing cognitive impairment at increasingly lower BLLs. Lead is dangerous at all levels in children. The sources of lead exposure vary among and within countries depending on past and current uses. Sources of lead may be from historic contamination, recycling old lead products, or from manufacturing new products. In all countries that have banned leaded gasoline, average population BLLs have declined rapidly. In many developing countries where leaded gasoline is no longer used, many children and workers are exposed to fugitive emissions and mining wastes. Unexpected lead threats, such as improper disposal of electronics and children's toys contaminated with lead, continue to emerge. The only medical treatment available is chelation, which can save lives of persons with very high BLLs. However, chelating drugs are not always available in developing countries and have limited value in reducing the sequelae of chronic low dose lead exposure. Therefore, the best approach is to prevent exposure to lead. Because a key strategy for preventing lead poisoning is to identify and control or eliminate lead sources, this article highlights several major sources of lead poisoning worldwide. In addition, we recommend three primary prevention strategies for lead poisoning: identify sources, eliminate or control sources, and monitor environmental exposures and hazards.

摘要

铅中毒是一种重要的环境疾病,可对健康产生终身不良影响。儿童最为易感,而贫困且生活在发展中国家的人群最常接触铅。对儿童血铅水平(BLLs)的研究表明,血铅水平越来越低时就会出现认知障碍。铅对儿童的任何水平都是危险的。各国之间以及各国国内的铅暴露源因过去和当前的用途而异。铅源可能来自历史污染、回收旧铅产品或制造新产品。在所有已禁止使用含铅汽油的国家,平均人群血铅水平迅速下降。在许多不再使用含铅汽油的发展中国家,许多儿童和工人仍暴露于无组织排放物和采矿废物中。意想不到的铅威胁,如电子垃圾处理不当以及儿童玩具被铅污染等,不断出现。唯一可用的医学治疗方法是螯合疗法,它可以挽救血铅水平极高者的生命。然而,螯合药物在发展中国家并不总是可得,且在减少慢性低剂量铅暴露后遗症方面价值有限。因此,最佳方法是预防铅暴露。由于预防铅中毒的一项关键策略是识别并控制或消除铅源,本文重点介绍了全球范围内铅中毒的几个主要来源。此外,我们推荐预防铅中毒的三项主要策略:识别来源、消除或控制来源以及监测环境暴露和危害。

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