Majid Hafsa, Khan Aysha Habib, Khan Nadeem Ullah, Siddiqui Imran, Ghani Farooq, Jafri Lena
Department of Pathology and Laboratory Medicine, The Aga Khan University Hospital, Karachi.
Department of Emergency Medicine, The Aga Khan University Hospital, Karachi.
J Coll Physicians Surg Pak. 2017 Dec;27(12):767-770.
To evaluate the frequency of subclinical lead toxicity.
Cross-sectional study.
Department of Pathology and Laboratory Medicine, The Aga Khan University Hospital, Karachi, from January 2011 to December 2014.
Analysis of laboratory data for blood lead levels (BLL) was performed. Lead was tested by atomic absorption spectrometer. For all subjects, only initial test results were included while the results of repeated testing were excluded. Exemption was sought from institutional ethical review committee. BLL of 2-10 ug/dl and 10-70 ug/dl in children and adults, respectively were taken as subclinical lead toxicity.
Amongst the total number of subjects tested (n=524), 26.5% (n=139) were children (<16 years) while rest were adults. Overall median BLLs was 6.4 ug/dl (20.9-3.1). The median BLL was 4 ug/dl (6.7-2.6) in children and 8.3 ug/dl (27.9-3.4) in adults, respectively. The BLL increased with age; higher levels were observed in age range 21-30 years of subjects [median lead level 16.9 ug/dl (36.1-4)] and lower level [4.2 ug/dl (6.8-2.6)] in children with <10 years of age. Only 16% (n=22) children had desirable lead levels while most had either subclinical (76%, n=106) or toxic lead levels (8%, n=11). In adults, (55%, n=212) subjects had desired lead levels, and 40% (n=154) and 4.99% (n=19) had subclinical and toxic lead levels.
Presence of subclinical lead poisoning even after phasing out of lead petroleum in Pakistanis is alarming, especially in children. A national population-based study to determine the lead status and targeted intervention to identify potential sources is need of the time.
评估亚临床铅中毒的发生率。
横断面研究。
2011年1月至2014年12月，卡拉奇阿迦汗大学医院病理与检验医学科。
对血铅水平（BLL）的实验室数据进行分析。铅通过原子吸收光谱仪检测。所有受试者仅纳入初次检测结果，排除重复检测结果。已寻求机构伦理审查委员会的豁免。儿童血铅水平2 - 10微克/分升、成人血铅水平10 - 70微克/分升被视为亚临床铅中毒。
在总共检测的受试者（n = 524）中，26.5%（n = 139）为儿童（<16岁），其余为成人。总体血铅水平中位数为6.4微克/分升（20.9 - 3.1）。儿童血铅水平中位数为4微克/分升（6.7 - 2.6），成人血铅水平中位数为8.3微克/分升（27.9 - 3.4）。血铅水平随年龄增长而升高；在21 - 30岁的受试者中观察到较高水平[血铅水平中位数16.9微克/分升（36.1 - 4）]，而10岁以下儿童血铅水平较低[4.2微克/分升（6.8 - 2.6）]。仅16%（n = 22）的儿童血铅水平理想，而大多数儿童要么处于亚临床水平（76%，n = 106），要么处于中毒水平（8%，n = 11）。在成人中，55%（n = 212）的受试者血铅水平理想，40%（n = 154）和4.99%（n = 19）的受试者处于亚临床和中毒铅水平。
在巴基斯坦，即使在逐步淘汰含铅汽油后仍存在亚临床铅中毒情况，这令人担忧，尤其是在儿童中。当下需要开展一项基于全国人口的研究，以确定铅状况并进行有针对性的干预，以识别潜在来源。
