Lyle David M, Boreland Frances T, Quartermain Stephen J
Broken Hill University Department of Rural Health, Sydney Medical School, Faculty of Medicine and Health, University of Sydney, Broken Hill, NSW, Australia;
Broken Hill Environmental Lead Program, NSW Environment Protection Authority, Australia.
Public Health Res Pract. 2022 Mar 10;32(1):31122107. doi: 10.17061/phrp31122107.
To describe blood lead levels (BLLs) and their distribution among children in Broken Hill, New South Wales (NSW), at each of the scheduled testing points aligned with childhood immunisation and to determine how BLLs change over time for individual children. These data can inform action to prevent future lead exposure in Broken Hill children.
Retrospective longitudinal study.
Data were extracted from the Lead Management Program ACCESS database on children born between 2009 and 2015 and living in Broken Hill. BLLs were calculated using capillary blood collected via finger prick, classified according to specific blood lead thresholds and grouped according to the testing schedule. A subset of children tested at each of the first three annual testing points provided data to determine the blood lead trajectories for individual Broken Hill children. Data were analysed using SPSS and ArcGIS.
At the first test at 12 months, around half the children recorded a BLL of <5 µg/dL, one in three had a BLL of 5-9 µg/dL and one in five had a BLL of ≥10 µg/dL. A similar pattern was observed for subsequent test points at 18 months, 2 years, 3 years and 4 years. Of the 336 children who had results recorded at each of the 12-month, 2-year and 3-year test points, BLLs in around one-third remained below the recommended threshold of 5 µg/dL. Another one-third of these children had at least one test result ≥10 µg/dL, and the BLL in the remainder did not exceed 5-9 µg/dL at any of the test points. The geospatial distribution of children with very high BLLs shows clustering of these children in some localities, as well as their widespread distribution throughout Broken Hill.
It should be possible to keep BLLs below 5 µg/dL for the majority of young children in Broken Hill throughout their preschool years. This could be achieved by an integrated prevention strategy that includes population-level interventions such as targeted zonal remediation for high-risk areas and early intervention for individuals during the first 12 months and beyond, particularly for those who may not benefit directly from targeted zonal remediation. Routinely collected data could be used to guide the development, and monitor the effectiveness, of these interventions.
描述新南威尔士州（NSW）布罗肯希尔地区儿童在与儿童免疫接种对应的各预定检测点的血铅水平（BLLs）及其分布情况，并确定个体儿童的血铅水平随时间如何变化。这些数据可为预防布罗肯希尔儿童未来铅暴露的行动提供参考。
回顾性纵向研究。
从铅管理项目ACCESS数据库中提取2009年至2015年出生且居住在布罗肯希尔的儿童数据。使用通过手指针刺采集的毛细血管血计算血铅水平，根据特定血铅阈值进行分类，并按照检测时间表进行分组。在前三个年度检测点接受检测的儿童子集中，提供了用于确定布罗肯希尔个体儿童血铅轨迹的数据。使用SPSS和ArcGIS对数据进行分析。
在12个月时的首次检测中，约一半儿童的血铅水平<5μg/dL，三分之一儿童的血铅水平为5 - 9μg/dL，五分之一儿童的血铅水平≥10μg/dL。在18个月、2岁、3岁和4岁的后续检测点也观察到类似模式。在12个月、2岁和3岁检测点均有检测结果记录的336名儿童中，约三分之一儿童的血铅水平始终低于5μg/dL的推荐阈值。这些儿童中的另外三分之一至少有一次检测结果≥10μg/dL，其余儿童在任何检测点的血铅水平均未超过5 - 9μg/dL。血铅水平极高的儿童的地理空间分布显示，这些儿童在某些地区聚集，同时也广泛分布于布罗肯希尔各地。
在布罗肯希尔，应该有可能让大多数幼儿在整个学龄前阶段将血铅水平保持在5μg/dL以下。这可以通过综合预防策略来实现，该策略包括针对高危地区的有针对性的区域修复等人群层面的干预措施，以及在出生后12个月及以后对个体进行早期干预，特别是对于那些可能无法直接从有针对性的区域修复中受益的儿童。常规收集的数据可用于指导这些干预措施的制定并监测其有效性。
Zotero 插件