Apostoli P
Cattedra di Medicina del Lavoro, Università degli Studi, Brescia.
Ann Ist Super Sanita. 1998;34(1):5-15.
In the past 10-15 years increasing attention has been paid to subclinical effects and to early or subtle health effects induced by lead (Pb) exposure. They form a continuum with classical clinical effects differing from them only for their degree. Accurate knowledge has been acquired on the effects of low level Pb exposure, especially concerning the effects on the nervous system, the cardiovascular system, the endocrine and immune system, on heme containing enzymes, and on reproductive function. The question of a possible mutagenic and carcinogenic action of Pb on humans is still open. Many of the above mentioned effects have been observed for blood lead (PbB) levels below the current limits proposed for workers and the general population. In addition, for certain effects, like those on heme, central nervous system, and blood pressure, it has not been possible to establish a clear threshold value. A critical evaluation of the current prevention models appears to be appropriate to eliminate the dose-dependent effects occurring in highly exposed groups and to reduce, as much as possible, the effects without threshold in the general population.
在过去10到15年里，人们越来越关注铅（Pb）暴露引起的亚临床效应以及早期或细微的健康影响。它们与经典临床效应形成一个连续体，只是在程度上与经典临床效应有所不同。关于低水平铅暴露的影响，尤其是对神经系统、心血管系统、内分泌和免疫系统、含血红素酶以及生殖功能的影响，已经有了准确的认识。铅对人类是否具有潜在的致突变和致癌作用这一问题仍然没有定论。上述许多影响在血铅（PbB）水平低于目前为工人和普通人群建议的限值时就已被观察到。此外，对于某些影响，如对血红素、中枢神经系统和血压的影响，尚未能够确定一个明确的阈值。对当前预防模式进行批判性评估，似乎有助于消除高暴露人群中出现的剂量依赖性效应，并尽可能减少普通人群中无阈值效应的影响。
