Carta Plinio, Aru Gabriella, Carta Laura, Carta Roberta, Ibba Antonio
Dipartimento di Sanità Pubblica - Sezione di Medicina del Lavoro, Universith di Cagliari.
G Ital Med Lav Ergon. 2013 Jan-Mar;35(1):32-5.
In several recent epidemiological studies blood lead levels (BLLs) even below the current CDC intervention level of 10 microg/dl have been associated with reduced neurocognitive capacities of children, with no clear evidence of a "safe" threshold. We analyzed the relationship between the BLLs and the neurocognitive capacities of 205 Sardinian students aged 11 to 15 years, using 2 tests of the Swedish Performance Evaluating System (SPES) and the full-scale Intelligence Quotient (IQ) derived from the Wechsler Intelligence Scale for Children (WISC). The studied population included 104 children (61 males and 43 females) living in Portoscuso, a town 2 Km far from a lead smelter (mean BLLs: 5.98 +/- 2.2; max 11.5 microg/dl), and 101 age-matched students (55 males and 46 females) living in Sant'Antioco, a town about 20 Km far from the same smelter (mean BLLs: 2.08 +/- 0.8; max 4.5 microg/dl). Subjects with BLLs above 4 microg/dl performed worse in the SPES tests and scored about 5.0 points less on the full-scale IQ compared to the students with lower BLLs. The adjusted regression coefficients derived from the multivariate analysis showed that higher BLLs were significantly associated with worse performances in the SPES tests and with reduced IQ (0.94 points for each microg/dl of BLL). This study confirms the potential neurotoxicity of low-levels of lead suggesting the need of lowering the actual CDC "limit of concern" for children to values lower than 4 microg/dl, improving at the same time the environmental primary prevention for limiting the lead exposure of subjects living near the lead smelter.
在最近的几项流行病学研究中,血铅水平(BLLs)即便低于美国疾病控制与预防中心(CDC)目前10微克/分升的干预水平,也与儿童神经认知能力下降有关,且没有明确证据表明存在“安全”阈值。我们使用瑞典性能评估系统(SPES)的两项测试以及韦氏儿童智力量表(WISC)得出的全量表智商(IQ),分析了205名11至15岁撒丁岛学生的血铅水平与神经认知能力之间的关系。研究人群包括104名儿童(61名男性和43名女性),他们生活在距离铅冶炼厂2公里的波特斯库索镇(平均血铅水平:5.98±2.2;最高11.5微克/分升),以及101名年龄匹配的学生(55名男性和46名女性),他们生活在距离同一冶炼厂约20公里的圣安蒂奥科镇(平均血铅水平:2.08±0.8;最高4.5微克/分升)。血铅水平高于4微克/分升的受试者在SPES测试中的表现较差,与血铅水平较低的学生相比,全量表智商得分约低5.0分。多变量分析得出的调整回归系数表明,较高的血铅水平与SPES测试中较差的表现以及较低的智商显著相关(血铅水平每增加1微克/分升,智商降低0.94分)。这项研究证实了低水平铅的潜在神经毒性,表明有必要将CDC目前针对儿童的“关注限值”降低至低于4微克/分升的值,同时加强环境一级预防,以限制生活在铅冶炼厂附近人群的铅暴露。