Lanphear B P, Winter N L, Apetz L, Eberly S, Weitzman M
Department of Pediatrics, University of Rochester School of Medicine and Dentistry, New York, USA.
Pediatrics. 1996 Jul;98(1):35-40.
Dust control is recommended as one of the cornerstones of controlling childhood lead exposure; however, the effectiveness of dust control has not been demonstrated for children who have low to mild elevations in blood lead (ie, less than 25 micrograms/dL). The objective of this study was to determine whether dust control, as performed by families, had an effect on children's blood lead levels and dust lead levels in children's homes.
Randomized, controlled trial.
Community-based trial in Rochester, NY.
One hundred four children, 12 to 31 months of age at baseline.
Families and children were randomized to one of two groups. Families of children in the intervention group received cleaning supplies, information about cleaning areas that are often contaminated with lead, and a cleaning demonstration. Families in the control group received only a brochure about lead poisoning prevention.
Baseline measurements of lead in blood, house dust, soil, water, and paint were taken from both groups. Seven months after enrollment, a second blood lead assay was obtained, and lead levels in household dust were measured. The main outcome measures were change in blood lead levels and dust lead levels by treatment group.
The median blood lead level of children enrolled in the study was 6.7 micrograms/dL (range, 1.7 to 30.6 micrograms/dL). There was no significant difference in the change of children's blood lead levels or dust lead levels by treatment group. The median change in blood lead levels among children in the intervention group was -0.05 micrograms/dL compared with -0.60 micrograms/dL among those in the control group. There also was no significant difference in the change of dust lead by group assignment, although there was a trend toward a significant difference in the percentage of change in dust lead levels on noncarpeted floors, which was greater among houses in the intervention group.
These data suggest that an intervention that consists only of providing cleaning supplies and a brief description of dust control is not effective at reducing blood lead levels among urban children with low to mild elevations in blood lead levels at a 7-month follow-up.
建议将控制灰尘作为控制儿童铅暴露的基石之一；然而，对于血铅水平轻度至中度升高（即低于25微克/分升）的儿童，控制灰尘的有效性尚未得到证实。本研究的目的是确定家庭进行的灰尘控制是否会对儿童的血铅水平及儿童家中灰尘的铅含量产生影响。
随机对照试验。
纽约罗切斯特的社区试验。
104名儿童，基线时年龄为12至31个月。
家庭和儿童被随机分为两组。干预组儿童的家庭收到清洁用品、关于清洁常被铅污染区域的信息以及一次清洁示范。对照组家庭仅收到一份关于预防铅中毒的手册。
两组均进行血铅、室内灰尘、土壤、水和油漆中铅的基线测量。入组7个月后，进行第二次血铅检测，并测量家庭灰尘中的铅含量。主要观察指标为治疗组血铅水平和灰尘铅含量的变化。
纳入研究的儿童血铅水平中位数为6.7微克/分升（范围为1.7至30.6微克/分升）。治疗组儿童血铅水平和灰尘铅含量的变化无显著差异。干预组儿童血铅水平的中位数变化为-0.05微克/分升，而对照组为-0.60微克/分升。按组分配，灰尘铅含量的变化也无显著差异，不过在未铺地毯的地板上，灰尘铅含量变化百分比存在显著差异的趋势，干预组房屋中的差异更大。
这些数据表明，仅提供清洁用品和简短的灰尘控制说明的干预措施，在7个月的随访中，对于血铅水平轻度至中度升高的城市儿童，在降低血铅水平方面无效。
