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美国 1-11 岁儿童血铅水平,1976-2016 年。

Blood Lead Levels in U.S. Children Ages 1-11 Years, 1976-2016.

机构信息

National Center for Environmental Health, Centers for Disease Control and Prevention (CDC), Atlanta, Georgia, USA.

Rutgers Biomedical and Health Sciences, Rutgers University, New Brunswick, New Jersey USA.

出版信息

Environ Health Perspect. 2021 Mar;129(3):37003. doi: 10.1289/EHP7932. Epub 2021 Mar 17.

Abstract

BACKGROUND

Lead can adversely affect child health across a wide range of exposure levels. We describe the distribution of blood lead levels (BLLs) in U.S. children ages 1-11 y by selected sociodemographic and housing characteristics over a 40-y period.

METHODS

Data from the National Health and Nutrition Examination Survey (NHANES) II (1976-1980), NHANES III (Phase 1: 1988-1991 and Phase II: 1991-1994), and Continuous NHANES (1999-2016) were used to describe the distribution of BLLs (in micrograms per deciliter; ) in U.S. children ages 1-11 y from 1976 to 2016. For all children with valid BLLs (), geometric mean (GM) BLLs [95% confidence intervals (CI)] and estimated prevalence (95% CI) were calculated overall and by selected characteristics, stratified by age group (1-5 y and 6-11 y).

RESULTS

The GM BLL in U.S. children ages 1-5 y declined from (95% CI: 14.3, 16.1) in 1976-1980 to (95% CI: 0.78, 0.88) in 2011-2016, representing a 94.5% decrease over time. For children ages 6-11 y, GM BLL declined from (95% CI: 11.9, 13.4) in 1976-1980 to (95% CI: 0.58, 0.63) in 2011-2016, representing a 95.3% decrease over time. Even so, for the most recent period (2011-2016), estimates indicate that approximately 385,775 children ages 1-11 y had BLLs greater than or equal to the CDC blood lead reference value of . Higher GM BLLs were associated with non-Hispanic Black race/ethnicity, lower family income-to-poverty-ratio, and older housing age.

DISCUSSION

Overall, BLLs in U.S. children ages 1-11 y have decreased substantially over the past 40 y. Despite these notable declines in population exposures to lead over time, higher GM BLLs are consistently associated with risk factors such as race/ethnicity, poverty, and housing age that can be used to target blood lead screening efforts. https://doi.org/10.1289/EHP7932.

摘要

背景

铅在广泛的暴露水平下会对儿童健康产生不良影响。我们描述了 40 年来美国 1-11 岁儿童的血铅水平(BLL)分布情况,按选定的社会人口统计学和住房特征进行分类。

方法

我们使用来自国家健康和营养检查调查(NHANES)II(1976-1980 年)、NHANES III(第 1 阶段:1988-1991 年和第 2 阶段:1991-1994 年)和连续 NHANES(1999-2016 年)的数据,描述了 1976 年至 2016 年间美国 1-11 岁儿童的 BLL(以每分升微克为单位;)分布情况。对于所有具有有效 BLL()的儿童,计算了总体和按选定特征(按年龄组(1-5 岁和 6-11 岁)分层)的几何平均 BLL([95%置信区间(CI)]和估计的流行率(95%CI)。

结果

美国 1-5 岁儿童的 GM BLL 从 1976-1980 年的 (95%CI:14.3,16.1)降至 2011-2016 年的 (95%CI:0.78,0.88),表明随着时间的推移,BLL 减少了 94.5%。对于 6-11 岁的儿童,GM BLL 从 1976-1980 年的 (95%CI:11.9,13.4)降至 2011-2016 年的 (95%CI:0.58,0.63),表明随着时间的推移,BLL 减少了 95.3%。即便如此,对于最近的时期(2011-2016 年),估计表明大约有 385,775 名 1-11 岁的儿童的 BLL 大于或等于疾病预防控制中心的血液铅参考值 。更高的 GM BLL 与非西班牙裔黑人种族/民族、家庭收入与贫困比率较低和较老的住房年龄有关。

讨论

总体而言,美国 1-11 岁儿童的 BLL 在过去 40 年中大幅下降。尽管随着时间的推移,人群接触铅的情况显著下降,但 GM BLL 始终与种族/民族、贫困和住房年龄等风险因素相关,这些因素可用于确定血液铅筛查的重点。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/1608/7969125/a017bdde631f/ehp7932_f1.jpg

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