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儿童铅中毒:一个持续存在的公共卫生问题。

Lead Toxicity in Children: An Unremitting Public Health Problem.

机构信息

Resident Physician, Child Neurology, Department of Neurology, University of Kentucky, Lexington, Kentucky.

Medical graduate, College of Medicine, University of Kentucky, Lexington, Kentucky.

出版信息

Pediatr Neurol. 2020 Dec;113:51-55. doi: 10.1016/j.pediatrneurol.2020.08.005. Epub 2020 Aug 11.

Abstract

BACKGROUND

Lead is a pervasive environmental contaminant. Lead accumulates in the body, impairing a molecular level various cellular processes. Lead exposure during childhood causes adverse and permanent neurodevelopmental consequences, sometimes even with "low" blood lead levels. Symptoms are frequently silent, making lead exposure an often unrecognized and underestimated threat for pervasive neurocognitive disorders.

METHODS

We identified articles focusing on childhood exposure to lead and neurodevelopment via a search of the electronic database PubMed (National Library of Medicine), including journal articles published from 2007 to 2019. These articles were used to evaluate the effect of environmental lead exposure and analyze whether control efforts over the past decades have altered the prevalence of exposed children.

CONCLUSIONS

Children are still being exposed to lead despite evidence of the adverse impact of exposure, even for children with blood lead levels below the currently recognized threshold for intervention. Legislative and educational efforts have reduced lead exposure but are not being followed universally. Primary prevention and identification of high-risk populations are the best cost-benefit interventions to fight this public health problem.

摘要

背景

铅是一种普遍存在的环境污染物。铅在体内蓄积,损害各种细胞过程的分子水平。儿童时期接触铅会导致不良和永久性的神经发育后果,即使血铅水平“低”也是如此。症状常常不明显,这使得铅暴露成为广泛存在的神经认知障碍的一个经常未被认识和低估的威胁。

方法

我们通过检索国家医学图书馆的电子数据库 PubMed 来确定了关注儿童时期铅暴露和神经发育的文章,包括 2007 年至 2019 年发表的期刊文章。这些文章用于评估环境铅暴露的影响,并分析过去几十年的控制工作是否改变了暴露儿童的流行率。

结论

尽管有证据表明接触铅会产生不良影响,但儿童仍在接触铅,即使是血铅水平低于目前公认的干预阈值的儿童也是如此。立法和教育努力已经减少了铅暴露,但并没有得到普遍遵循。初级预防和确定高危人群是解决这一公共卫生问题的最佳成本效益干预措施。

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