School of Earth Sciences and Resources, China University of Geosciences (Beijing), Beijing 100083, China; UNESCO, International Center on Global-scale Geochemistry, Langfang, Hebei 065000, China; Key Laboratory of Geochemical Exploration, MLR, Institute of Geophysical and Geochemical Exploration, CAGS, Langfang, Hebei 065000, China.
School of Earth Sciences and Resources, China University of Geosciences (Beijing), Beijing 100083, China.
Sci Total Environ. 2018 Jun 1;625:1659-1666. doi: 10.1016/j.scitotenv.2017.12.315. Epub 2018 Jan 28.
Blood lead (Pb) poisoning is a worldwide heath problem, especially in developing countries. As the largest developing country in the world, China faces severe health challenges, in particular the threat of blood Pb poisoning. In this study, the temporal trend of Chinese children's blood lead levels (BLLs) and blood lead poisoning incidence (BLPI) (percentage of BLL>100μg/L) and its influencing factors were investigated. We collected articles on children's BLLs published from 1997 to 2017 with sampling time from 1997 to 2015 by searching the databases of VIP Medical Information System (VMIS), China National Knowledge Infrastructure (CNKI) and Wanfang Data. After a rigorous investigation, 259 articles with eligible inclusion criteria were reviewed. Meanwhile, the data of Pb concentrations in the soil of 23 cities and the annual mean PM10 (particulate matter<10μm) concentrations of 24 provincial cities were collected. The temporal trend of children's BLLs and BLPIs could be divided into three stages: upward trend from 1997 to 2000, downward trend from 2001 to 2013, and upward trend from 2014 to 2015. The decline of BLLs from 2001 was primarily due to the phasing out of leaded gasoline since 2000 in China, while the descending air quality could explain the upward trend of BLLs in the period from 2014 to 2015. The correlation and regression analysis indicated that soil and air were two major pathways of Pb exposure for children in China. Although a noticeable decrease has been shown, the Chinese children's BLLs were still significantly higher than the levels of developed countries. We highly recommended that the critical value of blood Pb poisoning should be lowered to 50μg/L in China. Guidelines on the prevention and management of blood Pb poisoning are needed in China.
血铅（Pb）中毒是一个全球性的健康问题，尤其是在发展中国家。作为世界上最大的发展中国家，中国面临着严峻的健康挑战，尤其是血铅中毒的威胁。本研究旨在调查中国儿童血铅水平（BLL）和血铅中毒发病率（BLPI）（BLL>100μg/L 的百分比）的时间趋势及其影响因素。我们通过检索维普医学信息系统（VMIS）、中国知网（CNKI）和万方数据，收集了 1997 年至 2017 年发表的关于儿童 BLL 的文章，采样时间为 1997 年至 2015 年。经过严格的调查，共审查了 259 篇符合纳入标准的文章。同时，收集了 23 个城市土壤中 Pb 浓度和 24 个省级城市年平均 PM10（<10μm 颗粒物）浓度的数据。儿童 BLL 和 BLPI 的时间趋势可分为三个阶段：1997 年至 2000 年呈上升趋势，2001 年至 2013 年呈下降趋势，2014 年至 2015 年呈上升趋势。2001 年 BLL 下降主要是由于中国自 2000 年起逐步淘汰含铅汽油，而 2014 年至 2015 年 BLL 上升可归因于空气质量下降。相关和回归分析表明，土壤和空气是中国儿童 Pb 暴露的两个主要途径。尽管已经有了显著的下降，但中国儿童的 BLL 仍明显高于发达国家的水平。我们强烈建议将中国血铅中毒的临界值降低到 50μg/L。中国需要制定血铅中毒的预防和管理指南。
