Farias P, Borja-Aburto V H, Rios C, Hertz-Picciotto I, Rojas-Lopez M, Chavez-Ayala R
Instituto Nacional de Salud Pública, Cuernavaca, México.
Environ Health Perspect. 1996 Oct;104(10):1070-4. doi: 10.1289/ehp.961041070.
This study examined the determinants of blood lead (BPb) in 513 pregnant women in Mexico City: 311 from public hospital prenatal clinics, representing primarily women of low socioeconomic status (SES), and 202 from private hospitals, primarily women of high SES. Overall, BPb levels ranged from 1.38 to 29 micrograms/dl, with geometric means of 6.7 and 11.12 micrograms/dl for women from private and public hospitals, respectively. The crude geometric means difference obtained by t-test was 4.42 (p < 0.001). BPb was measured from January 1994 to August 1995 and showed higher levels during fall and winter and lower levels during spring and summer. The main BPb determinants were the use of lead-glazed ceramics in women from public hospitals and season of the year in women from private hospitals. Consumption of tortillas (corn bread rich in calcium) decreased BPb levels in the lower SES group, but the relationship was not statistically significant (p > 0.05). Consumption of milk products significantly (p < 0.05) reduced BPb levels in the higher SES group. In 112 women whose diets were deficient in calcium, taking calcium supplements lowered their blood lead levels about 7 micrograms/dl. A predictive model fitted to these data, using the strongest predictors plus gestational age, showed a difference of 14 micrograms/dl between the best and worst scenarios in women from public hospitals. Avoiding use of lead-glazed ceramics, consuming diets rich in calcium, and, if needed, taking calcium supplements, would be expected to result in substantial lowering of BPb, especially in pregnant women of low socioeconomic status.
本研究调查了墨西哥城513名孕妇血铅(BPb)的决定因素:311名来自公立医院产前诊所,主要为社会经济地位较低(SES)的女性;202名来自私立医院,主要为社会经济地位较高的女性。总体而言,血铅水平在1.38至29微克/分升之间,私立医院和公立医院女性的几何均值分别为6.7和11.12微克/分升。通过t检验得到的粗几何均值差异为4.42(p < 0.001)。血铅检测时间为1994年1月至1995年8月,结果显示秋冬季节血铅水平较高,春夏季节较低。主要的血铅决定因素是公立医院女性使用铅釉陶瓷以及私立医院女性所处的年份季节。食用玉米饼(富含钙的玉米面包)可降低社会经济地位较低组的血铅水平,但这种关系无统计学意义(p > 0.05)。食用奶制品可显著(p < 0.05)降低社会经济地位较高组的血铅水平。在112名钙摄入不足的女性中,补充钙剂可使她们的血铅水平降低约7微克/分升。根据这些数据拟合的预测模型,使用最强预测因素加上孕周,结果显示公立医院女性中最佳和最差情况之间的差异为14微克/分升。避免使用铅釉陶瓷、食用富含钙的饮食以及必要时补充钙剂,预计可大幅降低血铅水平,尤其是社会经济地位较低的孕妇。