Paulozzi L J, Shapp J, Drawbaugh R E, Carney J K
Vermont Department of Health, Burlington, USA.
Pediatrics. 1995 Jul;96(1 Pt 1):78-81.
The recent redefinition of childhood lead poisoning by the Centers for Disease Control and Prevention means that many more children are considered lead poisoned than previously. The primary purpose of this study was to determine how many 2-year-old children had lead levels of 10 micrograms/dL or more in a rural state.
Random samples of 334 children drawn from the birth certificate file and 350 children from Vermont Medicaid rosters submitted capillary blood specimens that were confirmed by venous tests if lead levels were 10 micrograms/dL or more.
Participation rates were 63.9% in the birth certificate group and 66.4% in the Medicaid group. In the birth certificate sample, the percentages of children with confirmed lead levels 10 micrograms/dL or more, 15 micrograms/dL or more, and 20 micrograms/dL or more were 9.0 (95% confidence interval [CI], 6.2-12.6), 2.7 (95% CI, 1.2-5.0), and 1.5 (95% CI, 0.5-3.4), respectively. In the Medicaid sample, the corresponding percentages were 14.9 (95% CI, 11.4-19.2), 5.1 (95% CI, 3.1-8.0), and 2.0 (95% CI, 0.8-4.1), respectively. The percentage of children in the state's most urban county with lead levels of 10 micrograms/dL or more was significantly less than that in the rest of the state in both samples.
The prevalence of elevated lead levels in 2-year-old children may be significant in rural states with old housing stock. Medicaid-enrolled children represent a readily identifiable high-risk group.
美国疾病控制与预防中心近期对儿童铅中毒的重新定义意味着,与之前相比,被认定为铅中毒的儿童数量更多。本研究的主要目的是确定在一个农村州有多少2岁儿童的血铅水平达到或超过10微克/分升。
从出生证明档案中随机抽取334名儿童样本,从佛蒙特医疗补助名单中随机抽取350名儿童样本,提交毛细血管血标本;如果血铅水平达到或超过10微克/分升,则通过静脉检测进行确认。
出生证明组的参与率为63.9%,医疗补助组为66.4%。在出生证明样本中,血铅水平经确认达到或超过10微克/分升、15微克/分升和20微克/分升的儿童比例分别为9.0%(95%置信区间[CI],6.2 - 12.6)、2.7%(95% CI,1.2 - 5.0)和1.5%(95% CI,0.5 - 3.4)。在医疗补助样本中,相应比例分别为14.9%(95% CI,11.4 - 19.2)、5.1%(95% CI,3.1 - 8.0)和2.0%(95% CI,0.8 - 4.1)。在两个样本中,该州城市化程度最高的县中血铅水平达到或超过10微克/分升的儿童比例均显著低于该州其他地区。
在有老旧住房存量的农村州,2岁儿童血铅水平升高的患病率可能很高。参加医疗补助的儿童是一个易于识别的高危群体。