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格鲁吉亚克维莫-卡尔特里地区与铅暴露相关的健康风险因素

HEALTH RISK-FACTORS ASSOCIATED WITH LEAD EXPOSURE IN THE KVEMO KARTLI REGION OF GEORGIA.

作者信息

Tsiklauri R, Jankhoteli T, Chokheli M, Khachidze A, Kazarashvili L, Chkhaberidze N, Kavtaradze K, Chachua E, Vardoshvili M

机构信息

National Centre of Disease Control and Public Health, Tbilisi, Georgia.

出版信息

Georgian Med News. 2025 Jan(358):86-94.

Abstract

INTRODUCTION

In 2018, the first national study on blood lead levels (BLL) in children aged 2-7 years was conducted as a part of the Multiple Indicator Cluster Survey (MICS). The results revealed that a significant proportion of children (41%) had BLLs exceeding 5 μg/dL. The aim of this study is to evaluate the health risks associated with the potential environmental impacts of technogenic chemical agents in the Bolnisi-Dmanisi region. Additionally, the research seeks to develop recommendations for mitigating these risks through appropriate preventative and corrective measures.

METHODOLOGY

A cross-sectional method was used for this survey and biomonitoring to assess sources of lead exposure. Three target groups (TGs) were selected for the study based on potential exposure levels, randomly interviewed about their health status, and subjects were randomly selected to undergo venous blood testing for lead. For the correlation defining the Statistical analysis of crossover interference using the chi-square model was used. The results obtained determine the relative risks of various nosologies among the TGs, the correlations with various risk factors, and their potential cause-and-effect relationships.

RESULTS

Our results revealed a significant reduction in BLLs among residents of the study region when compared to the MICS results. In 2023, our findings indicated a decrease in BLLs among populations in potentially exposed areas of Kvemo Kartli. Specifically, the average BLL in the Kvemo Kartli region decreased by approximately 50%, from 4.2 μg/dL in 2018 to 1.8 μg/dL in 2023. Demographic risk factors did not exhibit significant variation across the TGs. Notably, statistically significant relative risks (RR) for diseases of the eye and adnexa were observed in the first and second TGs, while no such significant associations were found for other diseases.

CONCLUSION

Although the MICS study conducted in the country five years ago showed a significant reduction (by two times or more) in the high average biomonitoring results recorded in children, our study still revealed certain low, yet credible, health risks in populations living 'near production/mining' sites and 'potentially living on ore,' according to some nosological classes. The biomonitoring results also recorded isolated cases of relatively high BLLs, particularly in the exposed groups compared to the control group. Based on these findings, we conclude that the measures implemented over the past five years have yielded positive results, significantly reducing lead concentrations in humans. However, certain low but credible health risks persist in the presumably exposed areas. These results can serve as a baseline for future research, and periodic monitoring will help track the progress towards further improvement in the region.

摘要

引言

2018年,作为多指标类集调查(MICS)的一部分,开展了首次关于2至7岁儿童血铅水平(BLL)的全国性研究。结果显示,相当比例的儿童(41%)血铅水平超过5μg/dL。本研究的目的是评估博尔尼西-德马尼西地区技术源化学物质潜在环境影响所带来的健康风险。此外,该研究旨在通过适当的预防和纠正措施制定减轻这些风险的建议。

方法

本调查采用横断面方法并进行生物监测以评估铅暴露源。根据潜在暴露水平选择了三个目标组(TGs)进行研究,随机询问他们的健康状况,并随机选择受试者进行静脉血铅检测。对于交叉干扰的统计分析,使用卡方模型定义相关性。所获得的结果确定了各目标组中各种疾病的相对风险、与各种风险因素的相关性及其潜在的因果关系。

结果

与MICS结果相比,我们的结果显示研究区域居民的血铅水平显著降低。2023年,我们的研究结果表明克维莫-卡尔特里潜在暴露地区人群的血铅水平有所下降。具体而言,克维莫-卡尔特里地区的平均血铅水平下降了约50%,从2018年的4.2μg/dL降至2023年的1.8μg/dL。各目标组的人口统计学风险因素没有显著差异。值得注意的是,在第一和第二个目标组中观察到眼及附属器疾病具有统计学显著的相对风险(RR),而其他疾病未发现此类显著关联。

结论

尽管该国五年前进行的MICS研究显示儿童高平均生物监测结果显著降低(降低了两倍或更多),但我们的研究仍显示,根据某些疾病分类,生活在“靠近生产/采矿”地点和“可能生活在矿石上”的人群存在一定程度的低但可信的健康风险。生物监测结果还记录了个别血铅水平相对较高的案例,特别是与对照组相比,暴露组更为明显。基于这些发现,我们得出结论,过去五年实施的措施取得了积极成果,显著降低了人体中的铅浓度。然而,在推测的暴露地区仍存在某些低但可信的健康风险。这些结果可作为未来研究的基线,定期监测将有助于跟踪该地区进一步改善的进展情况。

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