Cleveland Lisa M, Minter Monica L, Cobb Kathleen A, Scott Anthony A, German Victor F
University of Texas Health Science Center, San Antonio, USA.
Am J Nurs. 2008 Nov;108(11):40-7; quiz 47-8. doi: 10.1097/01.NAJ.0000339156.09233.de.
In the United States the risk of lead exposure is far higher among poor, urban, and immigrant populations than among other groups. And even slightly elevated blood lead levels increase children's risk of significant neurobehavioral problems extending through adolescence. Research has shown that blood lead levels in pregnant women well below the Centers for Disease Control and Prevention's "level of concern" of 10 micrograms per deciliter can cause miscarriage, premature birth, low birth weight, and subsequent developmental delays in their children. Despite these well-established dangers of lead exposure, routine prenatal lead screening and education is not a standard of care in the United States. Part 1 of this two-part article (October) presented the case of a pregnant woman with lead poisoning and described the epidemiology of lead exposure in the United States, the main sources of it, and its effects on a pregnant woman and her developing fetus and child. Part 2 describes recommendations for prenatal screening and strategies for dealing with lead exposure when it occurs: education, reduction in environmental exposure, treatment options, and developmental surveillance.
在美国，贫困、城市和移民群体接触铅的风险远高于其他群体。即使血铅水平稍有升高，也会增加儿童在整个青春期出现严重神经行为问题的风险。研究表明，孕妇的血铅水平远低于疾病控制与预防中心每分升10微克的“关注水平”，仍可能导致流产、早产、低体重出生以及孩子随后出现发育迟缓。尽管铅暴露存在这些已被充分证实的危险，但在美国，常规的产前铅筛查和教育并非医疗标准。这篇分两部分的文章（10月刊）的第一部分介绍了一名铅中毒孕妇的病例，并描述了美国铅暴露的流行病学、主要来源及其对孕妇及其发育中的胎儿和儿童的影响。第二部分介绍了产前筛查的建议以及铅暴露发生时的应对策略：教育、减少环境暴露、治疗选择和发育监测。
