Ishitsuka Kazue, Yamamoto-Hanada Kiwako, Yang Limin, Mezawa Hidetoshi, Konishi Mizuho, Saito-Abe Mayako, Sasaki Hatoko, Nishizato Minaho, Sato Miori, Koeda Tatsuya, Ohya Yukihiro
Medical Support Center of JECS study, National Center for Child Health and Development, Tokyo, Japan; Department of Social and Preventive Epidemiology, Graduate School of Medicine, The University of Tokyo, 7-3-1 Hongo, Bunkyo-ku, Tokyo 113-8654, Japan.
Medical Support Center of JECS study, National Center for Child Health and Development, Tokyo, Japan.
Neurotoxicology. 2020 Jul;79:191-199. doi: 10.1016/j.neuro.2020.06.003. Epub 2020 Jun 8.
Although environmental lead exposure has decreased, several studies have shown that low-level lead exposure can result in adverse psychological symptoms. However, few studies have examined lead neurotoxicity in pregnant women. We investigated the association between lead exposure and psychological symptoms in pregnant women, and between socio-economic status and blood lead levels.
Blood lead levels were measured in 17,267 pregnant women in the Japan Environment and Children's Study. Odds ratios (ORs) for high blood lead levels were calculated using multinomial logistic regression. Psychological symptoms were assessed using the Kessler Psychological Distress Scale (K6). ORs for depression (K6 ≥ 13 or ≥5) were calculated using logistic regression with adjustment for potential confounders.
The geometric mean of whole blood lead levels was 0.58 μg/dl (range 0.14-6.75 μg/dl). Higher blood lead levels were associated with older age (OR 1.79, 9 5% confidence interval [CI] 1.46-2.19), unmarried status (OR 1.75, 95 % CI 1.31-2.33), lower household income (OR 1.76, 95 % CI 1.38-2.24), and lower educational attainment (OR 1.34, 95 % CI 1.20-1.48). The percentage of women with K6 scores ≥13 and ≥5 was 3 % and 28.2 %, respectively. There was no significant association between lead exposure and K6 score (K6 ≥ 13: OR 1.00, 95 % CI 0.76-1.32; K6 ≥ 5: OR 0.98, 95 % CI 0.88-1.09).
Our results indicate a small but significant association between higher blood lead levels and lower socio-economic status in a population with low blood lead levels, but no association between low-level lead exposure and psychological symptoms.
尽管环境铅暴露有所下降,但多项研究表明,低水平铅暴露会导致不良心理症状。然而,很少有研究调查孕妇的铅神经毒性。我们研究了孕妇铅暴露与心理症状之间的关联,以及社会经济地位与血铅水平之间的关联。
在日本环境与儿童研究中,对17267名孕妇测量了血铅水平。使用多项逻辑回归计算高血铅水平的比值比(OR)。使用凯斯勒心理困扰量表(K6)评估心理症状。使用逻辑回归并对潜在混杂因素进行调整,计算抑郁(K6≥13或≥5)的OR。
全血铅水平的几何平均值为0.58μg/dl(范围0.14 - 6.75μg/dl)。较高的血铅水平与年龄较大(OR 1.79,95%置信区间[CI] 1.46 - 2.19)、未婚状态(OR 1.75,95% CI 1.31 - 2.33)、家庭收入较低(OR 1.76,95% CI 1.38 - 2.24)以及教育程度较低(OR 1.34,95% CI 1.20 - 1.48)相关。K6评分≥13和≥5的女性比例分别为3%和28.2%。铅暴露与K6评分之间无显著关联(K6≥13:OR 1.00,95% CI 0.76 - 1.32;K6≥5:OR 0.98,95% CI 0.88 - 1.09)。
我们的结果表明,在血铅水平较低的人群中,较高的血铅水平与较低的社会经济地位之间存在虽小但显著的关联,但低水平铅暴露与心理症状之间无关联。