Intellectual impairment in children with blood lead concentrations below 10 μg per deciliter
Intellectual impairment in children with blood lead concentrations below 10 μg per deciliter
复制标题
DOI：
10.1056/nejmoa022848
复制
发表时间：
2003-04-17
影响因子：
158.5
通讯作者：
Lanphear, BP
中科院分区：
文献类型：
--
作者：
Canfield, RL;Henderson, CR;Lanphear, BP
背景：尽管儿童的血铅浓度急剧下降，疾病控制和预防中心的关注水平降低到10微克每分升（0.483微摩尔每升），很少有人知道儿童的神经行为功能在铅浓度低于此level.METHODS：我们测量了172名儿童的血铅浓度在6，12，18，24，36，48和60个月的年龄和管理斯坦福-比奈智力量表在3岁和5岁。智商和血铅浓度之间的关系估计与使用线性和非线性混合模型，调整母亲的智商，家庭环境的质量，和其他潜在的confuers.RESULTS：血铅浓度与智商呈负相关，显着。在线性模型中，终生平均血铅浓度每增加10微克/分升，智商就下降4.6个点（P = 0.004），而对于101名最大血铅浓度保持在10微克/分升以下的儿童的子样本，与铅浓度的给定变化相关的智商变化更大。当估计在一个非线性模型与全样本，智商下降了7.4点，终身平均血铅浓度增加1至10微克每deciliter.CONCLUSIONS：血铅浓度，即使是低于10微克每deciliter.CONCLUSIONS：与儿童的智商分数在三岁和五岁，和相关的智商下降是在这些浓度比在更高的浓度更大。这些发现表明，更多的美国儿童可能受到环境铅的不利影响，比以前估计的。
BACKGROUND:Despite dramatic declines in children's blood lead concentrations and a lowering of the Centers for Disease Control and Prevention's level of concern to 10 microg per deciliter (0.483 micromol per liter), little is known about children's neurobehavioral functioning at lead concentrations below this level.METHODS:We measured blood lead concentrations in 172 children at 6, 12, 18, 24, 36, 48, and 60 months of age and administered the Stanford-Binet Intelligence Scale at the ages of 3 and 5 years. The relation between IQ and blood lead concentration was estimated with the use of linear and nonlinear mixed models, with adjustment for maternal IQ, quality of the home environment, and other potential confounders.RESULTS:The blood lead concentration was inversely and significantly associated with IQ. In the linear model, each increase of 10 microg per deciliter in the lifetime average blood lead concentration was associated with a 4.6-point decrease in IQ (P=0.004), whereas for the subsample of 101 children whose maximal lead concentrations remained below 10 microg per deciliter, the change in IQ associated with a given change in lead concentration was greater. When estimated in a nonlinear model with the full sample, IQ declined by 7.4 points as lifetime average blood lead concentrations increased from 1 to 10 microg per deciliter.CONCLUSIONS:Blood lead concentrations, even those below 10 microg per deciliter, are inversely associated with children's IQ scores at three and five years of age, and associated declines in IQ are greater at these concentrations than at higher concentrations. These findings suggest that more U.S. children may be adversely affected by environmental lead than previously estimated.