Upadhyay Kuldip, Balachandar Rakesh, Bagepally Bhavani Shankara, Ravibabu Kalahasthi, Dhananjayan Venugopal, Raju Nagaraju, Yadav Geetika, Ravichandran Beerappa, Das Santasabuj
ICMR-National Institute of Occupational Health, Ahmedabad, India.
ICMR-National Institute of Epidemiology, Chennai, India.
Toxicol Rep. 2025 Feb 25;14:101975. doi: 10.1016/j.toxrep.2025.101975. eCollection 2025 Jun.
A recent systematic review reported very high pooled estimates of blood lead levels (BLLs) for Indian children. Current study aimed at systematically pooling the BLLs of Indian children (aged ≤ 14 years). Further, explore the time trend of BLLs with respect to implementing the ban on the use of Pb-petrol (i.e.2000) and a decade later (2010). Observational studies documenting the BLL in Indian children (aged ≤ 14 years) from PubMed-Medline, Scopus, and Embase digital databases from inception to August 2024 were systematically reviewed. Detailed protocol is available at PROSPERO (ID: CRD42022382835). Pooled mean BLL was estimated using the random-effects model and conventional- statistics to assess the heterogeneity, while the Newcastle Ottawa Scale for bias assessment. Sub-group, sensitivity, and meta-regression analyses were performed where data permitted. Observations from 65 reports (51 original studies) revealed pooled BLL of 10.4 (95 % CI: 9.55-11.2) µg/dL with a trend of gradual reduction during the last 3 decades. Subgroup analysis revealed the high risk (with known Pb exposure) children had BLL of 14.3 (12.3-16.2) µg/dL, while that of the low risk (no known Pb exposure) is 8.71 (7.71-9.71) µg/dL. Only the low risk group exhibited a time trend of a gradual reduction in BLL. Notably, the review observed high heterogeneity. A progressive decline in Pb burden with respect to the national ban on leaded petrol was observed. However, present observations emphasize remedial actions toward non-occupational Pb exposure particularly among high risk Pb group, such as periodic BLL surveys.
最近的一项系统评价报告称，印度儿童的血铅水平（BLL）汇总估计值非常高。当前的研究旨在系统地汇总印度儿童（年龄≤14岁）的BLL。此外，探讨在实施禁止使用含铅汽油（即2000年）及十年后（2010年）BLL的时间趋势。对从PubMed-Medline、Scopus和Embase数字数据库自建库至2024年8月记录印度儿童（年龄≤14岁）BLL的观察性研究进行了系统评价。详细方案可在PROSPERO（编号：CRD42022382835）获取。使用随机效应模型和传统统计方法估计汇总平均BLL以评估异质性，同时采用纽卡斯尔-渥太华量表进行偏倚评估。在数据允许的情况下进行亚组分析、敏感性分析和meta回归分析。来自65份报告（51项原始研究）的观察结果显示，汇总BLL为10.4（95%CI：9.55-11.2）μg/dL，在过去30年中有逐渐下降的趋势。亚组分析显示，高风险（已知有铅暴露）儿童的BLL为14.3（12.3-16.2）μg/dL，而低风险（无已知铅暴露）儿童的BLL为8.71（7.71-9.71）μg/dL。只有低风险组呈现出BLL逐渐下降的时间趋势。值得注意的是，该评价观察到高度异质性。观察到相对于国家禁止含铅汽油，铅负担呈逐步下降趋势。然而，目前的观察结果强调了针对非职业性铅暴露的补救措施，特别是在高风险铅暴露组中，如定期进行BLL调查。
