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终身暴露于环境铅与11至13岁儿童智力:皮里港队列研究

Lifetime exposure to environmental lead and children's intelligence at 11-13 years: the Port Pirie cohort study.

作者信息

Tong S, Baghurst P, McMichael A, Sawyer M, Mudge J

机构信息

Division of Human Nutrition, Commonwealth Scientific Industrial Research Organisation, Adelaide, Australia.

出版信息

BMJ. 1996 Jun 22;312(7046):1569-75. doi: 10.1136/bmj.312.7046.1569.

Abstract

OBJECTIVE

To examine the association between environmental exposure to lead and children's intelligence at age 11-13 years, and to assess the implications of exposure in the first seven years of life for later childhood development.

DESIGN

Prospective cohort study.

SUBJECTS

375 children born in or around the lead smelting town of Port Pirie, Australia, between 1979 and 1982.

MAIN OUTCOME MEASURE

Children's intelligence quotient (IQ) measured at 11-13 years of age.

RESULTS

IQ was inversely associated with both antenatal and postnatal blood lead concentrations. Verbal, performance, and full scale IQ were inversely related to blood lead concentration with no apparent threshold. Multivariate analyses indicated that after adjustment for a wide range of confounders, the postnatal blood lead concentrations (particularly within the age range 15 months to 7 years) exhibited inverse associations with IQ. Strong associations with IQ were observed for lifetime average blood lead concentrations at various ages. The expected mean full scale IQ declined by 3.0 points (95% confidence interval 0.07 to 5.93) for an increase in lifetime average blood lead concentration from 0.48 to 0.96 mumol/l (10 to 20 micrograms/dl).

CONCLUSION

Exposure to environmental lead during the first seven years of life is associated with cognitive deficits that seem to persist into later childhood.

摘要

目的

研究11至13岁儿童环境铅暴露与智力之间的关联,并评估生命最初七年的铅暴露对儿童后期发育的影响。

设计

前瞻性队列研究。

对象

1979年至1982年间出生于澳大利亚皮里港铅冶炼镇或其周边地区的375名儿童。

主要观察指标

11至13岁儿童的智商(IQ)。

结果

智商与产前及产后血铅浓度均呈负相关。言语、操作和全量表智商均与血铅浓度呈负相关,且无明显阈值。多变量分析表明,在对多种混杂因素进行校正后,产后血铅浓度(尤其是在15个月至7岁年龄段内)与智商呈负相关。在不同年龄阶段观察到终生平均血铅浓度与智商之间存在强关联。终生平均血铅浓度从0.48微摩尔/升(10微克/分升)增加至0.96微摩尔/升(20微克/分升)时,预期全量表平均智商下降3.0分(95%置信区间为0.07至5.93)。

结论

生命最初七年的环境铅暴露与认知缺陷有关,这些缺陷似乎会持续到儿童后期。

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