Alvarez Amaya M, Ackall G, Pingitore N, Quiroga M, Terrazas-Ponce B
College of Nursing and Health Sciences, University of Texas at El Paso 79902-4238, USA.
Public Health Nurs. 1997 Dec;14(6):353-60. doi: 10.1111/j.1525-1446.1997.tb00304.x.
Human exposure to environmental hazards is a major public health problem along the US-Mexico border due to socioeconomic, cultural and political factors. Childhood lead exposure is endemic in areas of extreme poverty and substandard housing. Hispanic children of indigent, poorly-educated, disenfranchised families are at disproportionate risk. Risk management is contingent upon consideration of the interrelationships between socioeconomics, politics, and culture. This case study explains childhood lead poisoning in a colonia family living at subsistence level from such a perspective. The purpose of the study was to identify, explain, and ameliorate lead exposure pathways. Case study methodology was used to support or refute the proposition that these children were exposed to occupational lead. The children were the study sampling unit and the family a subunit. An embedded single case explanatory design was appropriate. Data were collected from exposure surveys, environmental and blood specimens, and review of medical records. Pattern-matching and explanation-building techniques were used to analyze data. The study illustrated how extreme poverty, lack of access to health services, social isolation, language and legal barriers, and hazardous occupations may be singularly common risk factors for Hispanic children on the US-Mexico border. The study is pertinent to public health nurses who work with this population.
由于社会经济、文化和政治因素,美国与墨西哥边境地区的人群暴露于环境危害之中是一个重大的公共卫生问题。在极端贫困和住房条件不达标的地区,儿童铅暴露呈地方性流行。贫困、受教育程度低且被剥夺公民权的家庭中的西班牙裔儿童面临的风险尤其高。风险管理取决于对社会经济、政治和文化之间相互关系的考量。本案例研究从这一角度解释了一个生活在贫困线以下的边境定居点家庭中儿童铅中毒的情况。该研究的目的是识别、解释并改善铅暴露途径。采用案例研究方法来支持或反驳这些儿童接触职业性铅的观点。儿童是研究抽样单位,家庭是子单位。采用嵌入式单案例解释性设计是合适的。数据收集自暴露调查、环境和血液样本以及病历审查。运用模式匹配和构建解释的技术来分析数据。该研究表明,极端贫困、缺乏医疗服务、社会隔离、语言和法律障碍以及危险职业可能是美墨边境地区西班牙裔儿童共有的独特风险因素。该研究对与这一人群打交道的公共卫生护士具有参考价值。