Prevalence of blood lead levels ≥5 μg/dL among US children 1 to 5 years of age and socioeconomic and demographic factors associated with blood of lead levels 5 to 10 μg/dL, Third National Health and Nutrition Examination Survey, 1988-1994
Prevalence of blood lead levels ≥5 μg/dL among US children 1 to 5 years of age and socioeconomic and demographic factors associated with blood of lead levels 5 to 10 μg/dL, Third National Health and Nutrition Examination Survey, 1988-1994
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DOI：
10.1542/peds.112.6.1308
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发表时间：
2003-12-01
期刊：
影响因子：
8
通讯作者：
McGeehin, MA
中科院分区：
文献类型：
--
作者：
Bernard, SM;McGeehin, MA
目标。作为对联邦儿童铅中毒预防政策可能修订的影响的调查的一部分，该政策将导致筛查儿童血铅水平大于或等于5mug/dl，而不是目前的10mug/dl，我们分析了最新的、具有全国代表性的数据，以确定大于或等于5mug/dl的血铅水平的患病率以及1至5岁患有血铅水平的儿童的社会经济和人口学特征。我们对第三次全国健康和营养检查调查(NHANES III)(1988-1994)的数据进行了统计分析，以描述总体和6岁儿童亚群中BLLS=5mug/dl的趋势，并比较3组儿童(BLLs大于或等于5但大于10mug/dl；且大于或等于20mug/dl；且大于或等于20mug/dl)的危险因素。以5微克/分升为参照物。在1至5岁儿童中，BLLS和Gt；=5µg/dl的总体患病率为25.6%，尽管这些儿童中大多数(76%)的BLLS和Lt；=10µg/dl。BLL值大于或等于5 MUG/dL的儿童包括46.8%的非西班牙裔黑人儿童、27.9%的墨西哥裔美国儿童和18.7%的非西班牙裔白人儿童；1946年之前建造的住房中有42.5%的儿童、1946年至1973年间建造的住房中有38.9%的儿童以及1973年后建造的住房中的儿童BLLS和GT；5大于或等于MUG/dL的儿童为14.1%。与非西班牙裔白人儿童相比，非西班牙裔黑人儿童的血淋巴细胞大于或等于5-10微克/dL的可能性是非西班牙裔儿童的3倍，10-20微克/dL的血细胞寿命是非西班牙裔儿童的7倍，血细胞白血病=20微克/dL的可能性是非西班牙裔儿童的13.5倍。在其他已知的危险因素包括住房年龄、国家地区和贫困方面，危险因素与BLL之间的关联性也有类似的增加。BLLS的高患病率将成为任何筛查和干预标准改变的重要变量。然而，大多数BLLS>；=5微克/分升的儿童低于目前10微克/分升的干预水平。在具有不确定危险因素的儿童中，BLLS>；=5µg/dL但<；10µg/dL的流行率表明，暴露于多种来源的铅。儿童铅中毒的一个或多个已知危险因素的可能存在随着血铅水平的增加而增加。
Objectives. As part of an investigation into the impact of a potential revision in federal childhood lead poisoning prevention policy that would result in screening children for blood lead levels (BLLs) greater than or equal to 5 mug/dL rather than the current 10 mug/dL, we analyzed the most recent available, nationally representative data to identify prevalence of BLLs greater than or equal to 5 mug/dL and socioeconomic and demographic characteristics of 1- to 5-year-old children with BLLs > 5 but < 10 mu g/dL.Methods. We performed statistical analyses on data from the Third National Health and Nutrition Examination Survey (NHANES III) (1988 - 1994) to describe trends in BLLs >= 5 mu g/dL overall and among subpopulations of children < 6 years old and to compare risk factors for falling within 1 of 3 groups of children ( those with BLLs greater than or equal to 5 but < 10 mu g/ dL; >= 10 but < 20 mug/ dL; and greater than or equal to 20 mug/dL) using the group reported as 0.7 to < 5 mu g/dL as the referent.Results. Overall prevalence of BLLs >= 5 mu g/dL among 1- to 5-year-old children was 25.6%, although most ( 76%) of these children had BLLs < 10 mug/ dL. Children with BLLs greater than or equal to 5 mug/ dL included 46.8% of non- Hispanic black children, 27.9% of Mexican American children, and 18.7% of non- Hispanic white children; 42.5% of children in housing built before 1946, 38.9% of children in housing built between 1946 and 1973, and 14.1% of children in housing built after 1973 had BLLs > 5 greater than or equal to mug/ dL. Compared with non- Hispanic white children, non- Hispanic black children were 3 times more likely to have a BLL greater than or equal to 5 but < 10 mu g/dL, 7 times more likely to have a BLL of 10 - 20 mu g/dL, and 13.5 times more likely to have a BLL >= 20 mu g/dL. Similar increases in the association between risk factor and BLL were seen with respect to other known risk factors including age of housing, region of the country, and poverty.Conclusions. The high prevalence of BLLs >= 5 mu g/dL overall and within US subpopulations will be an important variable in any change in screening and intervention criteria. However, most children with BLLs >= 5 mu g/dL are below the current intervention level of 10 mu g/dL. Exposure to lead from multiple sources is suggested by the prevalence of BLLs >= 5 mu g/ dL but < 10 mug/dL among children with uncertain risk factors. The probable presence of one or more known risk factors for childhood lead poisoning increases as BLL increases.