Epidemiology Branch, National Institute of Environmental Health Sciences, National Institutes of Health, Research Triangle Park, NC 27709, USA.
Neurotoxicology. 2010 Jan;31(1):1-9. doi: 10.1016/j.neuro.2009.10.017. Epub 2009 Dec 5.
Because the toxicological effects of mercury (Hg) are more serious in the developing central nervous system of children than adults, there are growing concerns about prenatal and early childhood Hg exposure. This study examined postnatal methylmercury (MeHg) exposure and cognition and behavior in 780 children enrolled in the Treatment of Lead (Pb)-exposed Children clinical trial (TLC) with 396 children allocated to the succimer and 384 to the placebo groups. Mercury exposure was determined from analyses of blood drawn 1 week before randomization and 1 week after treatment began when succimer had its maximal effect on blood Pb (PbB). The baseline MeHg concentrations were 0.54 microg/L and 0.52 microg/L and post-treatment concentrations were 0.51 microg/L and 0.48 microg/L for placebo and succimer groups, respectively. Because the baseline characteristics in the two groups were balanced and because succimer had little effect on MeHg concentration and no effect on the cognitive or behavioral test scores, the groups were combined in the analysis of MeHg and neurodevelopment. The children's IQ and neurobehavioral performance were tested at age 2, 5 and 7 years. We saw weak, non-significant but consistently positive associations between blood MeHg and IQ test scores in stratified, spline regression and generalized linear model data analyses. The behavioral problem scores were constant or decreased slightly with increasing MeHg concentration. Additional adjustment for PbB levels in multivariable models did not alter the conclusion for MeHg and IQ scores, but did confirm that concurrent PbB was strongly associated with IQ and behavior in TLC children. The effects of MeHg on neurodevelopmental indices did not substantially differ by PbB strata. We conclude that at the present background postnatal MeHg exposure levels of US children, adverse effects on children's IQ and behavior are not detectable.
由于汞(Hg)对儿童发育中中枢神经系统的毒性作用比成人更严重,因此人们越来越关注产前和幼儿期的汞暴露问题。本研究在参加“治疗铅暴露儿童”临床试验(TLC)的 780 名儿童中,检测了产后甲基汞(MeHg)暴露与认知和行为,其中 396 名儿童被分配到依地酸钙钠组,384 名儿童被分配到安慰剂组。汞暴露是通过在随机分组前一周和治疗开始后一周(依地酸钙钠对血铅的影响达到最大时)采集的血样分析确定的。安慰剂组和依地酸钙钠组的基线 MeHg 浓度分别为 0.54μg/L 和 0.52μg/L,治疗后浓度分别为 0.51μg/L 和 0.48μg/L。由于两组的基线特征均衡,并且依地酸钙钠对 MeHg 浓度几乎没有影响,对认知或行为测试评分也没有影响,因此将两组合并进行 MeHg 与神经发育的分析。在 2、5 和 7 岁时对儿童的智商和神经行为表现进行了测试。我们在分层样条回归和广义线性模型数据分析中观察到,血 MeHg 与智商测试评分之间存在微弱的、无统计学意义但一致的正相关。随着 MeHg 浓度的增加,行为问题评分保持不变或略有下降。多变量模型中对血铅浓度的进一步调整并未改变 MeHg 与智商评分的结论,但确实证实了同期血铅与 TLC 儿童的智商和行为有很强的关联。MeHg 对神经发育指数的影响在血铅浓度分层中没有显著差异。我们的结论是,在美国儿童目前的产后 MeHg 暴露水平下,其对儿童智商和行为的不良影响无法检测到。