Departments of Emergency Medicine, University of Michigan, Ann Arbor, and Hurley Medical Center, Flint, the Department of Pediatrics, Michigan State University College of Human Medicine, Hurley Medical Center, Flint, and Oakland University, Rochester, Michigan; and the Departments of Pediatrics and Microbiology, Biochemistry, and Molecular Genetics, Rutgers New Jersey, Medical School, Newark, New Jersey.
Obstet Gynecol. 2019 Sep;134(3):628-635. doi: 10.1097/AOG.0000000000003416.
To compare blood lead levels in females of childbearing age, 12-50 years, living within and adjacent to Flint, Michigan, before, during, and after the Flint River water exposure and compare the levels to those that have been shown to cause fetal loss and preterm birth.
The switch in the community water source to the Flint River occurred on April 25, 2014, and was reverted to the original source on October 15, 2015. Using a retrospective cross-sectional study design using geocoded blood lead levels obtained from all females of childbearing age available from a single hospital database, we compared blood lead levels for the following 18-month time periods: April 25, 2012-October 15, 2013 (PRE), April 25, 2014-October 15, 2015 (DURING), and April 25, 2016-October 15, 2017 (POST).
Results are reported as geometric mean (95% CI). Within Flint, PRE blood lead levels in females of childbearing age were 0.69 micrograms/dL (95% CI 0.63-0.75), DURING blood lead levels were 0.65 micrograms/dL (95% CI 0.60-0.71), and POST blood lead levels were 0.55 micrograms/dL (95% CI 0.54-0.56). DURING Flint River water exposure blood lead levels were not significantly different than the PRE Flint River water time period. POST Flint River water exposure blood lead levels were significantly lower than both PRE and DURING levels. Overall, lower blood lead levels were found outside the Flint boundary in all cohorts.
Blood lead levels in Flint females of childbearing age did not increase during the Flint River water exposure and subsequent 18-month time period. Mean blood lead levels during the Flint River water exposure are not consistent with the markedly higher blood lead levels reported in the literature to be associated with fetal loss, low birth weight, or preterm birth.
比较密歇根州弗林特市及其周边地区年龄在 12-50 岁的育龄女性在弗林特河水源暴露前后的血铅水平，并将这些水平与已知导致胎儿流产和早产的水平进行比较。
社区水源于 2014 年 4 月 25 日切换至弗林特河，于 2015 年 10 月 15 日恢复为原始水源。采用回顾性交叉研究设计，利用单家医院数据库中所有育龄女性的地理编码血铅水平数据，我们比较了以下 18 个月时间段的血铅水平：2012 年 4 月 25 日至 2013 年 10 月 15 日（PRE）、2014 年 4 月 25 日至 2015 年 10 月 15 日（DURING）和 2016 年 4 月 25 日至 2017 年 10 月 15 日（POST）。
结果以几何均数（95%CI）报告。在弗林特市，育龄女性 PRE 血铅水平为 0.69 微克/分升（95%CI 0.63-0.75），DURING 血铅水平为 0.65 微克/分升（95%CI 0.60-0.71），POST 血铅水平为 0.55 微克/分升（95%CI 0.54-0.56）。DURING 弗林特河水源暴露期间，血铅水平与 PRE 弗林特河水源暴露期间无显著差异。POST 弗林特河水源暴露后的血铅水平明显低于 PRE 和 DURING 水平。总体而言，在弗林特市边界外的所有队列中，血铅水平均较低。
在弗林特河水源暴露及其随后的 18 个月期间，弗林特市育龄女性的血铅水平并未升高。弗林特河水源暴露期间的平均血铅水平与文献报道的明显更高的血铅水平不一致，后者与胎儿流产、低出生体重或早产有关。
