Needleman H L, Riess J A, Tobin M J, Biesecker G E, Greenhouse J B
Department of Psychiatry, University of Pittsburgh (Pa) School of Medicine, USA.
JAMA. 1996 Feb 7;275(5):363-9.
To evaluate the association between body lead burden and social adjustment.
Retrospective cohort study.
Public school community.
From a population of 850 boys in the first grade at public schools, 503 were selected on the basis of a risk scale for antisocial behavior. All of the 850 boys who scored in the upper 30th percentile of the distribution on a self-reported antisocial behavior scale were matched with an equal number drawn by lot from the lower 70% of the distribution. From this sample, 301 students accepted the invitation to participate. EXPOSURE MEASURE: K x-ray fluorescence spectroscopy of tibia at subjects' age of 12 years.
Child Behavior Checklist (CBCL), teachers' and parents' reports, and subjects' self-report of antisocial behavior and delinquency at 7 and 11 years of age.
Subjects, teachers, and parents were blind to the bone lead measurements. At 7 years of age, borderline associations between teachers' aggression, delinquency, and externalizing scores and lead levels were observed after adjustment for covariates. At 11 years of age, parents reported a significant lead-related association with the following CBCL cluster scores: somatic complaints and delinquent, aggressive, internalizing, and externalizing behavior. Teachers reported significant associations of lead with somatic complaints, anxious/depressed behavior, social problems, attention problems, and delinquent, aggressive, internalizing, and externalizing behavior. High-lead subjects reported higher scores in subjects' self-reports of delinquency at 11 years. High-lead subjects were more likely to obtain worse scores on all items of the CBCL during the 4-year period of observation. High bone lead levels were associated with an increased risk of exceeding the clinical score (T > 70) for attention, aggression, and delinquency.
Lead exposure is associated with increased risk for antisocial and delinquent behavior, and the effect follows a developmental course.
评估体内铅负荷与社会适应之间的关联。
回顾性队列研究。
公立学校社区。
从公立学校一年级的850名男孩中,根据反社会行为风险量表选取了503名。在自我报告的反社会行为量表上得分处于分布前30%的所有850名男孩,与从分布后70%中随机抽取的同等数量的男孩进行匹配。从这个样本中,301名学生接受邀请参与研究。暴露测量:在受试者12岁时对胫骨进行KX射线荧光光谱分析。
儿童行为检查表(CBCL)、教师和家长报告,以及受试者7岁和11岁时反社会行为和犯罪的自我报告。
受试者、教师和家长对骨铅测量结果不知情。在7岁时,调整协变量后,观察到教师的攻击、犯罪和外化得分与铅水平之间存在临界关联。在11岁时,家长报告铅与以下CBCL聚类得分存在显著关联:躯体主诉、犯罪、攻击、内化和外化行为。教师报告铅与躯体主诉、焦虑/抑郁行为、社交问题、注意力问题以及犯罪、攻击、内化和外化行为存在显著关联。高铅受试者在11岁时犯罪的自我报告得分更高。在4年观察期内,高铅受试者在CBCL所有项目上更有可能获得较差得分。高骨铅水平与注意力、攻击和犯罪的临床评分(T>70)超标风险增加相关。
铅暴露与反社会和犯罪行为风险增加相关,且这种影响遵循发育过程。