Lippmann M
New York University Medical Center, Institute of Environmental Medicine, Tuxedo 10987.
Environ Res. 1990 Feb;51(1):1-24. doi: 10.1016/s0013-9351(05)80179-3.
This paper, prepared in tribute to Dr. Alice Hamilton on her 120th birthday, reviews her pioneering studies of occupational lead poisoning and its control, her largely unheeded warnings about the possible consequences of widespread lead exposure to the general public through the use of leaded fuel, and the results of recent studies of human exposure to and health effects of lead in the general environment. Evidence is presented for dose-related non-threshold effects for children with blood lead concentrations below 25 micrograms/dl for a variety of effects including verbal IQ; mental development; physical size; and age at physical milestones such as first steps, hearing thresholds, and postural sway. For adults, various studies have produced associations between blood pressure and blood lead concentrations below 35 micrograms/dl, suggesting possible effects on cardiovascular health. While the biological mechanisms responsible for these effects remain poorly understood, recent and current efforts to reduce exposure to lead by the virtual elimination of lead in gasoline and food packaging show that we have learned one of Dr. Hamilton's important lessons, i.e., that the most effective means of reducing excessive exposures are through control of the environmental sources.
本文是为纪念爱丽丝·汉密尔顿博士诞辰120周年而作，回顾了她对职业性铅中毒及其控制的开创性研究，她关于通过使用含铅燃料向普通公众广泛接触铅可能产生的后果的 largely unheeded 警告，以及近期关于一般环境中人类接触铅及其健康影响的研究结果。有证据表明，对于血铅浓度低于25微克/分升的儿童，在包括语言智商、心理发育、身体大小以及诸如首次学步、听力阈值和姿势摇摆等身体发育里程碑的年龄等多种影响方面，存在与剂量相关的非阈值效应。对于成年人，各种研究表明，血压与血铅浓度低于35微克/分升之间存在关联，这表明可能对心血管健康产生影响。虽然导致这些影响的生物学机制仍知之甚少，但近期和当前通过在汽油和食品包装中几乎消除铅来减少铅接触的努力表明，我们已经吸取了汉密尔顿博士的重要教训之一，即减少过度接触的最有效方法是通过控制环境来源。
