Epidemic Intelligence Service, Centers for Disease Control and Prevention, Atlanta, Georgia.
New York City Department of Health and Mental Hygiene, Long Island City, New York.
Pediatrics. 2024 Oct 1;154(Suppl 2). doi: 10.1542/peds.2024-067808G.
Previous analyses of New York City (NYC) health department's lead registry indicated that, among children with lead poisoning, an increased prevalence of sickle cell disease (SCD) exists. However, SCD is not considered a risk factor for lead poisoning. We assessed the association between SCD and childhood lead poisoning to determine if specific lead poisoning prevention efforts are needed for children with SCD.
We analyzed NYC's lead registry data for children with venous blood lead levels (BLLs) ≥15 mcg/dL during 2005 to 2019. t tests and χ2 tests were performed to compare demographic characteristics, BLLs, and lead exposure risks in non-Hispanic Black children with and without SCD. A t test was used to compare observed SCD prevalence among Black children with BLLs ≥15 mcg/dL with an estimated 0.43% SCD prevalence among Black NYC children.
Among 1728 Black children with BLLs ≥15 mcg/dL identified, 37 (2.14%) had SCD. When comparing children with and without SCD, both mean age at peak BLL (62.8 versus 42.7 months; P = .003) and peak BLL (42.59 versus 23.06 mcg/dL; P = .008) were higher for children with SCD. Among risk factors for lead exposure, children with SCD had higher prevalence of pica. Observed SCD prevalence was 1.71% higher than estimated SCD prevalence among Black NYC children (P < .001).
We found a potential association between SCD and childhood lead poisoning. Pica emerged as a potentially important risk factor. Our findings might have implications for lead poisoning prevention guidelines for children with SCD.
此前对纽约市（NYC）卫生部门铅登记处的分析表明，在患有铅中毒的儿童中，镰状细胞病（SCD）的患病率有所增加。然而，SCD 并不被认为是铅中毒的一个风险因素。我们评估了 SCD 与儿童铅中毒之间的关联，以确定是否需要针对患有 SCD 的儿童采取特定的铅中毒预防措施。
我们分析了 2005 年至 2019 年期间 NYC 铅登记处患有静脉血铅水平（BLL）≥15μg/dL 的儿童的数据。使用 t 检验和χ2检验比较了非裔美国儿童中患有和不患有 SCD 的儿童的人口统计学特征、BLL 和铅暴露风险。使用 t 检验比较了患有 BLL≥15μg/dL 的黑人儿童中观察到的 SCD 患病率与黑人 NYC 儿童中估计的 0.43%的 SCD 患病率。
在 1728 名 BLL≥15μg/dL 的黑人儿童中，有 37 名（2.14%）患有 SCD。在比较患有和不患有 SCD 的儿童时，患有 SCD 的儿童的峰值 BLL 年龄（62.8 个月对 42.7 个月；P=0.003）和峰值 BLL（42.59 对 23.06μg/dL；P=0.008）均较高。在铅暴露的危险因素中，患有 SCD 的儿童中嗜食异物的患病率较高。观察到的 SCD 患病率比黑人 NYC 儿童中估计的 SCD 患病率高 1.71%（P<0.001）。
我们发现 SCD 与儿童铅中毒之间存在潜在关联。嗜食异物成为一个潜在的重要危险因素。我们的发现可能对 SCD 儿童的铅中毒预防指南有影响。
