Shy C M
Department of Epidemiology, School of Public Health, University of North Carolina, Chapel Hill.
World Health Stat Q. 1990;43(3):168-76.
The health aspects of the use of lead in petrol were evaluated in the 1920s in the United States of America and, in spite of warnings from certain lead-toxicity experts, lead addition to petrol became standard international practice. Available data now show that lead in petrol at the scale of use in the 1970s produced significant environmental lead contamination and increased average blood-lead levels in the general population. National sample surveys of blood-lead levels in the United States carried out annually from 1976 show a decreasing trend closely correlated with the use of lead in petrol. Recent longitudinal epidemiological studies have concluded that the exposure levels associated with lead in petrol can cause a reduced average mental ability in children. These studies accounted for the potential confounding from socioeconomic and other factors. The practical conclusion from the studies reviewed is that there should be as little human lead exposure as possible, because there may be no threshold for the effects occurring and many thousand children have already been affected in the United States and other countries. The environmental health calamity caused by lead in petrol could have been avoided if the initial warnings had been heeded and better preliminary research of the health issues had been carried out. Nevertheless, incontrovertible proof of causality should not be required before regulations are made to protect public health.
20世纪20年代，美国对汽油中铅的使用对健康的影响进行了评估。尽管有某些铅中毒专家发出警告，但向汽油中添加铅还是成为了国际通行做法。现有数据表明，20世纪70年代使用规模的含铅汽油造成了严重的环境铅污染，并使普通人群的平均血铅水平上升。美国自1976年起每年开展的全国血铅水平抽样调查显示，血铅水平呈下降趋势，且与汽油中铅的使用密切相关。近期的纵向流行病学研究得出结论，与汽油中的铅相关的接触水平会导致儿童平均智力下降。这些研究考虑到了社会经济和其他因素可能造成的混杂影响。所审查研究得出的实际结论是，应尽可能减少人类接触铅的机会，因为影响的发生可能不存在阈值，而且美国和其他国家已有数千名儿童受到影响。如果当初听从了最初的警告并对健康问题进行更好的初步研究，汽油中的铅所造成的环境卫生灾难本可避免。然而，在制定保护公众健康的法规之前，不应要求有确凿的因果关系证据。
