Staes C, Matte T, Copley C G, Flanders D, Binder S
Lead Poisoning Prevention Branch, National Center for Environmental Health, Centers for Disease Control and Prevention, Atlanta, GA 30341-3724.
Am J Epidemiol. 1994 May 15;139(10):1016-26. doi: 10.1093/oxfordjournals.aje.a116941.
A retrospective follow-up study was conducted to evaluate the effectiveness of lead-based paint hazard remediation in reducing children's blood lead levels. The authors reviewed existing St. Louis, Missouri, City Health Department records, identified 185 children younger than age 6 years who had blood lead levels > or = 25 micrograms/dl during 1989 or 1990, and compared changes in blood lead levels among children whose dwellings did and those whose dwellings did not undergo remediation. Among 54 children who had not moved or received chelation therapy and whose blood lead levels were measured 10-14 months after diagnosis, the geometric mean blood lead level decreased 23% among children living in remediated dwellings (n = 37) and 12% among children in nonremediated dwellings (n = 17) (p = 0.07, t test). The estimated size of the remediation effect was similar using multiple regression (-13%; 95% confidence interval (CI) -25 to 1; p = 0.06) and an approach based on generalized estimating equations (-16%, 95% CI -25 to -7; p = 0.002), when adjusted for covariates. The effect of remediation was greater among children whose blood lead levels at diagnosis were > or = 35 micrograms/dl (-22%) than among those whose blood lead levels at diagnosis were between 25 and 34 micrograms/dl (-1%). Among lead-poisoned children in St. Louis, children whose dwellings undergo lead-based paint hazard remediation have a greater decline in geometric mean blood lead level than do children whose dwellings do not, but the effect of remediation may be influenced by the blood lead level at diagnosis.
开展了一项回顾性随访研究，以评估消除含铅油漆危害措施在降低儿童血铅水平方面的有效性。作者查阅了密苏里州圣路易斯市卫生部门的现有记录，确定了185名6岁以下儿童，这些儿童在1989年或1990年期间血铅水平≥25微克/分升，并比较了居住环境接受了消除危害措施和未接受消除危害措施的儿童血铅水平的变化。在54名未搬家或未接受螯合疗法且在诊断后10 - 14个月测量了血铅水平的儿童中，居住在已采取消除危害措施住所的儿童（n = 37）几何平均血铅水平下降了23%，居住在未采取消除危害措施住所的儿童（n = 17）几何平均血铅水平下降了12%（p = 0.07，t检验）。在对协变量进行调整后，使用多元回归分析（-13%；95%置信区间（CI）-25至1；p = 0.06）和基于广义估计方程的方法（-16%，95%CI -25至-7；p = 0.002）得出的消除危害效果估计值相似。诊断时血铅水平≥35微克/分升的儿童（-22%）的消除危害效果大于诊断时血铅水平在25至34微克/分升之间的儿童（-1%）。在圣路易斯市的铅中毒儿童中，居住环境接受了含铅油漆危害消除措施的儿童几何平均血铅水平下降幅度大于居住环境未接受消除危害措施的儿童，但消除危害措施的效果可能受诊断时血铅水平的影响。
