Assessment of Child Lead Exposure in a Philadelphia Community, 2014
Assessment of Child Lead Exposure in a Philadelphia Community, 2014
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DOI：
10.1097/phh.0000000000000711
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发表时间：
2019-01-01
影响因子：
3.3
通讯作者：
Brown, Mary Jean
中科院分区：
文献类型：
--
作者：
Dignam, Timothy;Pomales, Ana;Brown, Mary Jean
简介：宾夕法尼亚州费城的几个城市社区有土壤、家用含铅油漆和潜在的铅排放工业污染的历史。目的：(1)描述目标社区的血铅水平（bll），(2)确定铅暴露的危险因素和来源，(3)描述家庭环境铅水平，(4)将结果与现有数据进行比较。方法：采用简单、随机、横断面抽样策略，于2014年7月在费城选定的有铅排放工业历史的社区中招募8岁及以下儿童。计算儿童bll的几何平均值和bll≥5 μ g/dL的患病率。线性和逻辑回归分析用于确定bll升高的危险因素。结果：在104名接受血铅检测的儿童中，13名（12.4%；95%可信区间[CI]， 7.5-20.2）的血铅浓度为5 μ g/dL或更高。几何平均BLL为2.0 μ g/dL （95% CI为1.7 ~ 2.3 μ g/dL）。较高的几何平均bll与前门入口通道灰尘铅含量、1900年以前建造的住宅以及目前或曾经接受医疗补助的儿童显著相关。71%的家庭土壤含量超标，25%的家庭前门地板灰尘铅含量超标，28%的家庭儿童游乐区地板灰尘铅含量超标，14%的家庭室内窗户灰尘铅含量超标。有2至3个环境铅样本升高的家庭中，儿童的血铅浓度更有可能达到或超过5 μ g/dL。家庭与历史上的铅排放设施的接近程度与儿童BLL之间的空间关系尚未确定。结论：入口通道地板灰尘铅水平与参与者的血铅水平密切相关。结果强调了通过解决家庭内部和周围的所有铅危害来确保住房铅安全的重要性。减少儿童铅暴露是至关重要的，建议继续进行血铅监测、测试和检查血铅浓度为5 μ g/dL或更高的儿童的家庭，以确定和控制铅源。儿科医疗保健提供者可以特别警惕筛选符合医疗补助资格/登记的儿童和生活在非常旧的住房中的儿童。
Introduction: Several urban neighborhoods in Philadelphia, Pennsylvania, have a history of soil, household lead paint, and potential lead-emitting industry contamination.Objectives: To (1) describe blood lead levels (BLLs) in target neighborhoods, (2) identify risk factors and sources of lead exposure, (3) describe household environmental lead levels, and (4) compare results with existing data.Methods: A simple, random, cross-sectional sampling strategy was used to enroll children 8 years or younger living in selected Philadelphia neighborhoods with a history of lead-emitting industry during July 2014. Geometric mean of child BLLs and prevalence of BLLs of 5 mu g/dL or more were calculated. Linear and logistic regression analyses were used to ascertain risk factors for elevated BLLs.Results: Among 104 children tested for blood lead, 13 (12.4%; 95% confidence interval [CI], 7.5-20.2) had BLLs of 5 mu g/dL or more. The geometric mean BLL was 2.0 mu g/dL (95% CI, 1.7-2.3 mu g/dL). Higher geometric mean BLLs were significantly associated with front door entryway dust lead content, residence built prior to 1900, and a child currently or ever receiving Medicaid. Seventy-one percent of households exceeded the screening level for soil, 25% had an elevated front door floor dust lead level, 28% had an elevated child play area floor dust lead level, and 14% had an elevated interior window dust lead level. Children in households with 2 to 3 elevated environmental lead samples were more likely to have BLLs of 5 mu g/dL or more. A spatial relationship between household proximity to historic lead-emitting facilities and child BLL was not identified.Conclusion: Entryway floor dust lead levels were strongly associated with blood lead levels in participants. Results underscore the importance to make housing lead safe by addressing all lead hazards in and around the home. Reduction of child lead exposure is crucial, and continued blood lead surveillance, testing, and inspection of homes of children with BLLs of 5 mu g/dL or more to identify and control lead sources are recommended. Pediatric health care providers can be especially vigilant screening Medicaid-eligible/enrolled children and children living in very old housing.