a MOE-Shanghai Key Laboratory of Children's Environmental Health , Xinhua Hospital Affiliated to Shanghai Jiaotong University School of Medicine , Shanghai , China.
b Division of Environmental Sciences , Children's Hospital at Montefiore, Albert Einstein College of Medicine , Bronx , NY , USA.
Clin Toxicol (Phila). 2018 Jun;56(6):397-403. doi: 10.1080/15563650.2017.1391392. Epub 2017 Oct 27.
This study explored the sources of lead exposure, identified patients' geographic distribution and evaluated the symptoms of children with elevated blood lead levels (BLLs) referred to a pediatric lead specialty clinic in China.
Data were collected from 515 consecutive outpatients attending the Pediatric Lead Poisoning Clinic in Xinhua Hospital, Shanghai, China, between 2011 and 2016, referred for BLLs ≥5 μg/dL. Atomic absorption spectrometry was used to measure venous BLLs.
The mean ± standard deviation age of the patients was 4.1 ± 3.2 years. Their BLLs ranged from 5 to 126 μg/dL. The geometric mean and median BLLs were 24 and 26 μg/dL, respectively. Two hundred and twenty-two children (43.1%) were exposed to industrial lead pollution-mainly from Zhejiang, Jiangsu, Hunan, Henan and Anhui provinces; whereas, 41.4% (213 cases) were induced by folk medicines used widely throughout China. Other nonindustrial sources of lead exposure included lead-containing tinfoil and tin pots. Household lead paint was a rare source. Most patients exhibited nonspecific symptoms, such as hyperactivity, attention difficulty, aggressiveness, constipation and anorexia.
Industrial pollution and folk medicines are important sources of lead exposure in China. Childhood lead poisoning may be difficult to diagnose clinically as symptoms are nonspecific. Thus, blood lead screening may be necessary to identify children at high risk of exposure. Education to raise the awareness of potential sources of exposure resulting in their elimination would be expected to decrease the incidence of children with elevated BLLs.
本研究旨在探讨中国某儿科铅中毒专科门诊就诊的血铅水平（BLL）升高患儿的铅暴露源，确定患儿的地域分布，并评估其症状。
2011 年至 2016 年期间，连续收集 515 例因 BLL≥5μg/dL 就诊于上海新华医院儿科铅中毒专科门诊的门诊患者的数据。采用原子吸收光谱法测量静脉血 BLL。
患儿的平均年龄为 4.1±3.2 岁，BLL 范围为 5-126μg/dL，几何均数和中位数分别为 24μg/dL 和 26μg/dL。222 例（43.1%）患儿暴露于工业铅污染，主要来自浙江、江苏、湖南、河南和安徽；41.4%（213 例）患儿因广泛使用的民间药物而受到影响。其他非工业铅暴露源包括含铅锡箔和锡锅。家庭含铅涂料是一种罕见的来源。大多数患儿表现出非特异性症状，如多动、注意力困难、攻击性、便秘和食欲不振。
工业污染和民间药物是中国儿童铅暴露的重要来源。儿童铅中毒的临床诊断可能较为困难，因为症状不具特异性。因此，可能需要进行血液铅筛查以识别处于高暴露风险的儿童。提高对潜在暴露源的认识并加以消除，有望降低血铅水平升高的儿童发病率。
