Blumenthal H T, Mayfield R
St Louis Comprehensive Neighborhood Health Center, Missouri.
J Natl Med Assoc. 1995 Feb;87(2):99-104.
This article continues the report of a study at the St Louis Comprehensive Neighborhood Health Center in which definitive blood lead levels were routinely determined in pediatric patients younger than 5 years of age. Data on changes during the 1980s in population, housing, and soil lead levels also are provided for possible correlation with changes in blood lead levels. From 1976 through 1993, there has been a progressive decline in annual mean blood lead levels and in the percentage of patients at several ranges indicative of different degrees of risk for brain damage. Comparisons of blood lead levels in residents of other neighborhoods in the city of St Louis show that most predominantly black neighborhoods and a single predominantly poor white neighborhood are particularly high-risk areas. In the study catchment area, the total population has decreased but the number of children younger than 5 years of age has increased. The latter has resulted in about a doubling of admissions to our health center in 1993. There also has been a decline in occupied housing units, an increase in unoccupied units (probably unfit for habitation), and the demolition of more than 6700 units. There also has been a remarkable citywide reduction in soil lead levels, somewhat more marked in the study catchment area than in some other areas of the city. The reduction in the lead burden in children in the study catchment area appears to be associated with the decline in housing units and the decline in soil lead levels.
本文继续报道了在圣路易斯综合社区健康中心开展的一项研究，该研究对5岁以下儿科患者的确诊血铅水平进行了常规测定。文中还提供了20世纪80年代人口、住房和土壤铅水平的变化数据，以便与血铅水平的变化进行可能的关联分析。从1976年到1993年，年平均血铅水平以及处于几个表明不同程度脑损伤风险范围的患者百分比都在逐渐下降。对圣路易斯市其他社区居民血铅水平的比较显示，大多数主要为黑人的社区以及一个主要为贫困白人的社区是特别高风险区域。在研究集水区，总人口有所减少，但5岁以下儿童的数量有所增加。后者导致1993年我们健康中心的入院人数大约翻了一番。已占用住房单元数量也有所下降，未占用单元数量增加（可能不适于居住），超过6700个单元被拆除。全市土壤铅水平也有显著下降，在研究集水区比该市其他一些地区更为明显。研究集水区儿童铅负荷的降低似乎与住房单元数量的减少和土壤铅水平的下降有关。
