2010 年尼日利亚西北部与手工采金有关的致命儿童铅中毒事件爆发。
Outbreak of fatal childhood lead poisoning related to artisanal gold mining in northwestern Nigeria, 2010.
机构信息
Healthy Homes and Lead Poisoning Prevention Branch, National Center for Environmental Health, Centers for Disease Control and Prevention, Atlanta, Georgia, USA.
出版信息
Environ Health Perspect. 2012 Apr;120(4):601-7. doi: 10.1289/ehp.1103965. Epub 2011 Dec 20.
BACKGROUND
In May 2010, a team of national and international organizations was assembled to investigate children's deaths due to lead poisoning in villages in northwestern Nigeria.
OBJECTIVES
Our goal was to determine the cause of the childhood lead poisoning outbreak, investigate risk factors for child mortality, and identify children < 5 years of age in need of emergency chelation therapy for lead poisoning.
METHODS
We administered a cross-sectional, door-to-door questionnaire in two affected villages, collected blood from children 2-59 months of age, and obtained soil samples from family compounds. Descriptive and bivariate analyses were performed with survey, blood lead, and environmental data. Multivariate logistic regression techniques were used to determine risk factors for childhood mortality.
RESULTS
We surveyed 119 family compounds. Of 463 children < 5 years of age, 118 (25%) had died in the previous year. We tested 59% (204/345) of children < 5 years of age, and all were lead poisoned (≥ 10 µg/dL); 97% (198/204) of children had blood lead levels (BLLs) ≥ 45 µg/dL, the threshold for initiating chelation therapy. Gold ore was processed inside two-thirds of the family compounds surveyed. In multivariate modeling, significant risk factors for death in the previous year from suspected lead poisoning included the age of the child, the mother's work at ore-processing activities, community well as primary water source, and the soil lead concentration in the compound.
CONCLUSION
The high levels of environmental contamination, percentage of children < 5 years of age with elevated BLLs (97%, > 45 µg/dL), and incidence of convulsions among children before death (82%) suggest that most of the recent childhood deaths in the two surveyed villages were caused by acute lead poisoning from gold ore-processing activities. Control measures included environmental remediation, chelation therapy, public health education, and control of mining activities.
背景
2010 年 5 月，一个由国家和国际组织组成的团队被召集起来，调查尼日利亚西北部村庄因铅中毒导致的儿童死亡事件。
目的
我们的目标是确定儿童铅中毒暴发的原因，调查儿童死亡的危险因素，并确定需要紧急螯合疗法治疗铅中毒的<5 岁儿童。
方法
我们在两个受影响的村庄进行了横断面、逐户问卷调查，采集 2-59 个月儿童的血液，并从家庭院落采集土壤样本。使用调查、血铅和环境数据进行描述性和双变量分析。使用多变量逻辑回归技术确定儿童死亡的危险因素。
结果
我们调查了 119 个家庭院落。在<5 岁的 463 名儿童中，有 118 名（25%）在过去一年中死亡。我们对 59%（204/345）<5 岁的儿童进行了检测，所有儿童都受到铅污染（≥10μg/dL）；97%（198/204）的儿童血铅水平（BLL）≥45μg/dL，这是开始螯合疗法的阈值。黄金矿石在三分之二以上的家庭院落内进行加工。在多变量模型中，前一年因疑似铅中毒死亡的显著危险因素包括儿童年龄、母亲在矿石加工活动中的工作、社区和主要水源以及院落内土壤铅浓度。
结论
环境污染物水平高、BLL 升高的<5 岁儿童比例（97%，>45μg/dL）以及死亡前儿童抽搐发生率（82%）表明，两个受调查村庄最近发生的大多数儿童死亡是由金矿加工活动导致的急性铅中毒引起的。控制措施包括环境修复、螯合疗法、公共卫生教育和采矿活动控制。
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