2012年尼日利亚赞法拉州金矿加工社区儿童血铅升高的患病率及危险因素
Prevalence and Risk Factors of Elevated Blood Lead in Children in Gold Ore Processing Communities, Zamfara, Nigeria, 2012.
作者信息
Kaufman John A, Brown Mary Jean, Umar-Tsafe Nasir T, Adbullahi Muhammad Bashir, Getso Kabiru I, Kaita Ibrahim M, Sule Binta Bako, Ba'aba Ahmed, Davis Lora, Nguku Patrick M, Sani-Gwarzo Nasir
机构信息
National Center for Environmental Health, US Centers for Disease Control and Prevention, Atlanta, USA.
Nigeria Field Epidemiology and Laboratory Training Program, Abuja, Nigeria.
出版信息
J Health Pollut. 2016 Sep;6(11):2-8. doi: 10.5696/2156-9614-6-11.2.
BACKGROUND
In March 2010, Medecins Sans Frontieres/Doctors Without Borders detected an outbreak of acute lead poisoning in Zamfara State, northwestern Nigeria, linked to low-technology gold ore processing. The outbreak killed more than 400 children ≤5 years of age in the first half of 2010 and has left more than 2,000 children with permanent disabilities.
OBJECTIVES
The aims of this study were to estimate the statewide prevalence of children ≤5 years old with elevated blood lead levels (BLLs) in gold ore processing and non-ore-processing communities, and to identify factors associated with elevated blood lead levels in children.
METHODS
A representative, population-based study of ore processing and non-ore-processing villages was conducted throughout Zamfara in 2012. Blood samples from children, outdoor soil samples, indoor dust samples, and survey data on ore processing activities and other lead sources were collected from 383 children ≤5 years old in 383 family compounds across 56 villages.
RESULTS
17.2% of compounds reported that at least one member had processed ore in the preceding 12 months (95% confidence intervals (CI): 9.7, 24.7). The prevalence of BLLs ≥10 µg/dL in children ≤5 years old was 38.2% (95% CI: 26.5, 51.4) in compounds with members who processed ore and 22.3% (95% CI: 17.8, 27.7) in compounds where no one processed ore. Ore processing activities were associated with higher lead concentrations in soil, dust, and blood samples. Other factors associated with elevated BLL were a child's age and sex, breastfeeding, drinking water from a piped tap, and exposure to eye cosmetics.
CONCLUSIONS
Childhood lead poisoning is widespread in Zamfara State in both ore processing and non-ore-processing settings, although it is more prevalent in ore processing areas. Although most children's BLLs were below the recommended level for chelation therapy, environmental remediation and use of safer ore processing practices are needed to prevent further exposures.
PATIENT CONSENT
Obtained.
ETHICS APPROVAL
The study protocol was approved by the US Centers for Disease Control Institutional Review Board-A and the National Health Research Ethics Committee of Nigeria.
COMPETING INTERESTS
The authors declare no competing financial interests.
背景
2010年3月，无国界医生组织在尼日利亚西北部的赞法拉州发现了一起急性铅中毒疫情，该疫情与低技术含量的金矿加工有关。在2010年上半年，这起疫情导致400多名5岁及以下儿童死亡，并使2000多名儿童留下永久性残疾。
目的
本研究的目的是估计金矿加工社区和非金矿加工社区5岁及以下儿童血铅水平升高的全州患病率，并确定与儿童血铅水平升高相关的因素。
方法
2012年在赞法拉州对金矿加工村和非金矿加工村进行了一项具有代表性的基于人群的研究。从56个村庄的383个家庭院落中383名5岁及以下儿童采集血样、室外土壤样本、室内灰尘样本，以及关于金矿加工活动和其他铅源的调查数据。
结果
17.2%的家庭院落报告称，至少有一名成员在过去12个月内加工过矿石（95%置信区间（CI）：9.7，24.7）。在有成员加工矿石的家庭院落中，5岁及以下儿童血铅水平≥10μg/dL的患病率为38.2%（95%CI：26.5，51.4），在无人加工矿石的家庭院落中为22.3%（95%CI：17.8，27.7）。金矿加工活动与土壤、灰尘和血样中较高的铅浓度相关。与血铅水平升高相关的其他因素包括儿童的年龄和性别、母乳喂养、饮用管道自来水以及接触眼部化妆品。
结论
赞法拉州无论是在金矿加工地区还是非金矿加工地区，儿童铅中毒都很普遍，尽管在金矿加工地区更为流行。虽然大多数儿童的血铅水平低于螯合疗法的推荐水平，但仍需要进行环境整治并采用更安全的金矿加工方法以防止进一步接触铅。
患者同意
已获得。
伦理批准
该研究方案已获得美国疾病控制中心机构审查委员会A组以及尼日利亚国家卫生研究伦理委员会的批准。
利益冲突
作者声明无利益冲突。
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