Wasserman G A, Graziano J H, Factor-Litvak P, Popovac D, Morina N, Musabegovic A, Vrenezi N, Capuni-Paracka S, Lekic V, Preteni-Redjepi E
New York State Psychiatric Institute, Department of Child Psychiatry, New York, NY 10032.
Neurotoxicol Teratol. 1994 May-Jun;16(3):233-40. doi: 10.1016/0892-0362(94)90044-2.
For a prospective study of lead exposure and early development, we recruited pregnant women from a smelter town and a nonlead-exposed town in Yugoslavia and followed them and their children through age 4. For 332 children seen at age 4, mean scores on the McCarthy Scales General Cognitive Index (GCI) in the exposed and nonexposed towns were 81.3 and 86.6, respectively; geometric mean blood lead concentrations (BPb) were 39.9 and 9.6 micrograms/dl, respectively. Potential confounders included the quality of the HOME environment; maternal age, intelligence, education, and language; birthweight and gender. These showed predictable associations with 4-year intelligence, accounting for 42.7% of the variance in GCI. Following adjustment for these variables and for concurrent Hgb, we found significant independent adverse associations between GCI and BPb's, measured at 6-month intervals since birth. At age 4, BPb accounted for an incremental 3.5% of the variance in GCI, such that the estimated loss in GCI associated with an increase in BPb from 10-25 micrograms/dl was 3.8 points. The Perceptual-Performance subscale of the McCarthy was most sensitive to Pb exposure, a result consistent with findings from prospective studies in Boston and Port Pirie.
为了进行一项关于铅暴露与早期发育的前瞻性研究，我们从南斯拉夫的一个冶炼城镇和一个未受铅暴露的城镇招募了孕妇，并对她们及其子女进行追踪，直至孩子4岁。对于332名4岁儿童，在受铅暴露城镇和未受铅暴露城镇中，麦卡锡量表一般认知指数（GCI）的平均得分分别为81.3和86.6；几何平均血铅浓度（BPb）分别为39.9和9.6微克/分升。潜在的混杂因素包括家庭环境质量；母亲的年龄、智力、教育程度和语言能力；出生体重和性别。这些因素与4岁时的智力表现出可预测的关联，占GCI方差的42.7%。在对这些变量以及同时期的血红蛋白（Hgb）进行调整后，我们发现GCI与自出生起每隔6个月测量一次的BPb之间存在显著的独立不良关联。在4岁时，BPb占GCI方差的额外3.5%，因此，估计与BPb从10微克/分升增加到25微克/分升相关的GCI损失为3.8分。麦卡锡量表的感知 - 表现子量表对铅暴露最为敏感，这一结果与波士顿和皮里港的前瞻性研究结果一致。
