NTP Monogr. 2012 Jun(1):xiii, xv-148.
Although reductions in lead (Pb) exposure for the U.S. population have resulted in lower blood Pb levels over time, epidemiological studies continue to provide evidence of health effects at lower and lower blood Pb levels. Low-level Pb was selected for evaluation by the National Toxicology Program (NTP) because of (1) the availability of a large number of epidemiological studies of Pb, (2) a nomination by the National Institute for Occupational Safety and Health for an assessment of Pb at lower levels of exposure, and (3) public concern for effects of Pb in children and adults. This evaluation summarizes the evidence in humans and presents conclusions on health effects in children and adults associated with low-level Pb exposure as indicated by less than 10 micrograms of Pb per deciliter of blood (< 10 microg/dL). The assessment focuses on epidemiological evidence at blood Pb levels < 10 microg/dL and < 5 microg/dL because health effects at higher blood Pb levels are well established. The NTP evaluation was conducted through the Office of Health Assessment and Translation (OHAT, formerly the Center for the Evaluation of Risks to Human Reproduction) and completed in April of 2012. The results of this evaluation are published in the NTP Monograph on Health Effects of Low-Level Lead. The document and appendices are available at http://ntp.niehs.nih.gov/go/evals. This document provides background on Pb exposure and includes a review of the primary epidemiological literature for evidence that low-level Pb is associated with neurological, immunological, cardiovascular, renal, and/or reproductive and developmental effects. The NTP Monograph presents specific conclusions for each health effect area. Overall, the NTP concludes that there is sufficient evidence that blood Pb levels < 10 microg/dL and < 5 microg/dL are associated with adverse health effects in children and adults. This conclusion was based on a review of the primary epidemiological literature, scientific input from technical advisors that reviewed pre-public release drafts of each chapter summarizing the evidence for specific health effects associated with low-level Pb, public comments received during the course of the evaluation, and comments from an expert panel of ad hoc reviewers during a public meeting to review the Draft NTP Monograph on November 17-18, 2011 (http://ntp.niehs.nih.gov/go/37090.
尽管随着时间推移，美国人群铅（Pb）暴露量的减少已使血铅水平降低，但流行病学研究仍不断证明，血铅水平越来越低时也会产生健康影响。美国国家毒理学计划（NTP）选择对低水平铅暴露进行评估，原因如下：（1）有大量关于铅的流行病学研究；（2）美国国家职业安全与健康研究所提名对较低暴露水平的铅进行评估；（3）公众对铅对儿童和成人的影响表示关注。本评估总结了人体研究证据，并就血铅水平低于每分升10微克（<10微克/分升）的低水平铅暴露对儿童和成人健康的影响给出结论。该评估重点关注血铅水平<10微克/分升和<5微克/分升时的流行病学证据，因为血铅水平较高时的健康影响已得到充分证实。NTP评估由健康评估与转化办公室（OHAT，前身为人类生殖风险评估中心）开展，并于2012年4月完成。本次评估结果发表在NTP《低水平铅暴露对健康影响的专论》中。该文件及附录可在http://ntp.niehs.nih.gov/go/evals获取。本文件提供了铅暴露的背景信息，并对主要流行病学文献进行了综述，以寻找低水平铅与神经、免疫、心血管、肾脏和/或生殖及发育影响相关的证据。NTP专论针对每个健康影响领域给出了具体结论。总体而言，NTP得出结论，有充分证据表明血铅水平<10微克/分升和<5微克/分升与儿童和成人的不良健康影响相关。这一结论基于对主要流行病学文献的综述、技术顾问的科学意见（这些顾问审查了各章在预发布版本中总结低水平铅相关特定健康影响证据的内容）、评估过程中收到的公众意见，以及2011年11月17 - 18日在一次公开会议上对NTP专论草案进行审查的特设评审专家小组的意见（http://ntp.niehs.nih.gov/go/37090）。
