Brown Mary Jean, Margolis Stephen
Division of Emergency and Environmental Health Services, National Center for Environmental Health, Centers for Disease Control and Prevention, 4770 Buford Highway NE, Atlanta, GA 30084, USA.
MMWR Suppl. 2012 Aug 10;61(4):1-9.
Lead is a pervasive environmental contaminant. The adverse health effects of lead exposure in children and adults are well documented, and no safe blood lead threshold in children has been identified. Lead can be ingested from various sources, including lead paint and house dust contaminated by lead paint, as well as soil, drinking water, and food. The concentration of lead, total amount of lead consumed, and duration of lead exposure influence the severity of health effects. Because lead accumulates in the body, all sources of lead should be controlled or eliminated to prevent childhood lead poisoning. Beginning in the 1970s, lead concentrations in air, tap water, food, dust, and soil began to be substantially reduced, resulting in significantly reduced blood lead levels (BLLs) in children throughout the United States. However, children are still being exposed to lead, and many of these children live in housing built before the 1978 ban on lead-based residential paint. These homes might contain lead paint hazards, as well as drinking water service lines made from lead, lead solder, or plumbing materials that contain lead. Adequate corrosion control reduces the leaching of lead plumbing components or solder into drinking water. The majority of public water utilities are in compliance with the Safe Drinking Water Act Lead and Copper Rule (LCR) of 1991. However, some children are still exposed to lead in drinking water. EPA is reviewing LCR, and additional changes to the rule are expected that will further protect public health. Childhood lead poisoning prevention programs should be made aware of the results of local public water system lead monitoring measurement under LCR and consider drinking water as a potential cause of increased BLLs, especially when other sources of lead exposure are not identified.
铅是一种普遍存在的环境污染物。儿童和成人铅暴露对健康的不良影响已有充分记录，且尚未确定儿童安全的血铅阈值。铅可通过多种途径摄入，包括含铅油漆和被含铅油漆污染的室内灰尘，以及土壤、饮用水和食物。铅的浓度、摄入的铅总量以及铅暴露的持续时间会影响健康影响的严重程度。由于铅会在体内蓄积，应控制或消除所有铅源以预防儿童铅中毒。从20世纪70年代开始，空气、自来水、食物、灰尘和土壤中的铅浓度开始大幅下降，导致美国儿童的血铅水平（BLLs）显著降低。然而，儿童仍在接触铅，其中许多儿童居住在1978年禁止使用含铅住宅油漆之前建造的房屋中。这些房屋可能存在含铅油漆危害，以及由铅、铅焊料或含铅管道材料制成的饮用水管道。充分的腐蚀控制可减少铅管道部件或焊料向饮用水中的浸出。大多数公共供水企业符合1991年的《安全饮用水法铅和铜规则》（LCR）。然而，一些儿童仍在饮用水中接触到铅。美国环境保护局（EPA）正在审查LCR，预计该规则将有进一步变化，以进一步保护公众健康。儿童铅中毒预防项目应了解当地公共供水系统根据LCR进行的铅监测测量结果，并将饮用水视为血铅水平升高的潜在原因，尤其是在未确定其他铅暴露源时。
