Kirchner J T, Kelley B A
Department of Community and Family Medicine, Georgetown University School of Medicine, Washington, DC.
J Fam Pract. 1991 Apr;32(4):397-400.
The adverse effects of lead on behavioral and intellectual development have been recognized for many years. During the past 10 years several studies have shown that lead is toxic to children at levels previously thought to be harmless. Black children living in urban neighborhoods have been identified as being at greatest risk.
To determine whether children seen in a suburban family practice center were being exposed to lead, voluntary screening of 1-year-old patients was performed.
Over a 7-month period venous specimens for blood lead level were obtained from 40 children. Seventeen (43%) of the children had levels of 0.0 to 0.2 mumol/L (0 to 4 micrograms/dL). Fifteen (38%) had levels of 0.24 to 0.43 mumol/L (5 to 9 micrograms/dL). Eight (20%) children had levels of 0.48 mumol/L (10 micrograms/dL) or greater. The highest value obtained was 0.82 mumol/L (17 micrograms/dL). Seventy-five percent of the children with significantly elevated lead levels resided in suburban communities.
Children seen in a suburban family practice setting are at risk for lead exposure, and screening should be considered by primary care physicians who practice in nonurban settings.
铅对行为和智力发育的不良影响已被认识多年。在过去10年里，多项研究表明，铅在以前被认为无害的水平下对儿童也是有毒的。生活在城市社区的黑人儿童被认为风险最大。
为了确定在一家郊区家庭医疗中心就诊的儿童是否接触铅，对1岁的患者进行了自愿筛查。
在7个月的时间里，从40名儿童身上采集了血铅水平的静脉血标本。17名（43%）儿童的血铅水平为0.0至0.2微摩尔/升（0至4微克/分升）。15名（38%）儿童的血铅水平为0.24至0.43微摩尔/升（5至9微克/分升）。8名（20%）儿童的血铅水平为0.48微摩尔/升（10微克/分升）或更高。所获得的最高值为0.82微摩尔/升（17微克/分升）。血铅水平显著升高的儿童中有75%居住在郊区社区。
在郊区家庭医疗环境中就诊的儿童有铅暴露风险，在非城市地区执业的初级保健医生应考虑进行筛查。
