Department for Evidence-based Medicine and Evaluation, Danube University Krems, Krems a.d. Donau, Austria.
Department for Evidence-based Medicine and Evaluation, Danube University Krems, Krems a.d. Donau, Austria.
Sci Total Environ. 2022 Feb 1;806(Pt 1):150480. doi: 10.1016/j.scitotenv.2021.150480. Epub 2021 Sep 23.
To summarize the evidence on the effectiveness of soil remediation to prevent or reduce lead exposure.
We systematically searched MEDLINE, the Agricultural & Environmental Science Database, Web of Science, and Scopus from 1980 to February 15, 2021. We also performed reference list checking, hand-searched websites, and contacted experts. Eligible studies evaluated the effect of soil remediation to prevent or reduce lead exposure in humans of any age. We screened all records dually; one investigator performed the data extraction; a second checked for completeness and accuracy. Two investigators independently rated the risk of bias of included studies and graded the certainty of evidence. We synthesized findings narratively.
We identified 6614 potentially relevant publications, all focused on children, of which five studies (six records) fulfilled our prespecified inclusion criteria. The number of evaluated participants ranged from 31 to 1425, with follow-up periods of 11 months to one year. The primary soil remediation method was the replacement of the upper layer with clean soil. Outcomes were limited to blood lead levels (BLL), dust lead levels, and soil lead levels. The largest study, a controlled before- after study (n = 1425) reported favorable effects of soil remediation compared to no intervention. This finding was consistent with results from two cross-sectional studies and one uncontrolled before-after study. One year post-remediation, the mean reduction in BLL was 2.1 μg/dL (p < 0.0001) greater in the intervention group than in the control group. Two randomized controlled trials with a total of 511 participants showed no statistically significant incremental effect of soil remediation when combined with paint and/or dust abatement. The certainty of evidence for all outcomes was low.
Soil remediation appears to reduce BLL in children when used as a single intervention. The incremental benefit of soil remediation when part of other interventions is limited.
总结土壤修复预防或减少铅暴露的有效性证据。
我们系统地检索了 1980 年至 2021 年 2 月 15 日的 MEDLINE、农业与环境科学数据库、Web of Science 和 Scopus。我们还进行了参考文献检查、手动搜索网站，并联系了专家。合格的研究评估了土壤修复对预防或减少任何年龄段人群铅暴露的效果。我们对所有记录进行了双重筛选；一名调查员进行了数据提取；另一名调查员检查了完整性和准确性。两名调查员独立评估纳入研究的偏倚风险，并对证据的确定性进行分级。我们以叙述性方式综合了研究结果。
我们确定了 6614 篇潜在相关文献，均集中于儿童，其中五项研究（六篇记录）符合我们预先规定的纳入标准。评估参与者的数量从 31 到 1425 不等，随访时间为 11 个月至一年。主要的土壤修复方法是用干净的土壤替换表层土壤。结果仅限于血铅水平（BLL）、灰尘铅水平和土壤铅水平。最大的研究是一项对照前后研究（n=1425），与无干预相比，报告了土壤修复的有利效果。这一发现与两项横断面研究和一项无对照前后研究的结果一致。修复后一年，干预组的 BLL 平均降低 2.1μg/dL（p<0.0001），明显高于对照组。两项共有 511 名参与者的随机对照试验表明，土壤修复与油漆和/或灰尘减少联合使用时，没有统计学上显著的增量效果。所有结果的证据确定性均较低。
当作为单一干预措施使用时，土壤修复似乎可以降低儿童的 BLL。当作为其他干预措施的一部分时，土壤修复的增量效益有限。
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