CUMULATIVE EXPOSURE TO INORGANIC LEAD AND NEUROBEHAVIORAL TEST-PERFORMANCE IN ADULTS - AN EPIDEMIOLOGIC REVIEW
CUMULATIVE EXPOSURE TO INORGANIC LEAD AND NEUROBEHAVIORAL TEST-PERFORMANCE IN ADULTS - AN EPIDEMIOLOGIC REVIEW
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DOI：
10.1136/oem.52.1.2
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发表时间：
1995-01-01
影响因子：
4.9
通讯作者：
SCHWARTZ, BS
中科院分区：
文献类型：
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作者：
BALBUSKORNFELD, JM;STEWART, W;SCHWARTZ, BS
Objectives-To评估目前的证据表明，累积暴露于无机铅与降低性能在neurobiological tests.Methods-21独特的研究进行了审查，从28个已发表的手稿。根据暴露评估、混杂变量控制、受试者选择方法、测试条件和数据分析，开发了一种算法来确定每项研究的有用性。最高的重点放在使用的累积措施的暴露或absorption.Results-Only三项研究使用的措施的累积暴露或吸收的铅，和其他两个使用的暴露时间作为替代累积暴露。啊，其他研究使用的测量方法不能充分估计铅的累积暴露量，通常是当前的血铅浓度。其中20项研究将年龄作为混杂变量进行了控制，尽管在一些研究中，年龄的剩余混杂可能性仍然存在。16项研究控制了暴露前的智力;所有这些研究都使用了教育水平。在使用铅累积暴露或吸收的直接或替代措施的五项研究中，有两项被认为是低有用性的，因为暴露时间不足。剩下的三项研究发现，最近的暴露措施比那些累积exposed. Conclusion，目前的科学文献提供的证据不足，以得出结论，无论是累积暴露或吸收的铅对成人的神经行为测试的性能产生不利影响的neurobiological性能较强的关联。目前的证据是有缺陷的，因为对铅的累积暴露或吸收的估计不足，以及暴露前对年龄和智力的控制不足。
Objectives-To evaluate the current evidence that cumulative exposure to inorganic lead is associated with decreased performance in neurobehavioural tests in adults.Methods-21 unique studies were reviewed from 28 published manuscripts. An algorithm was developed to determine the usefulness of each study on the basis of exposure assessment, control of confounding variables, methods of subject selection, test conditions, and data analysis. Highest emphasis was placed on the use of cumulative measures of exposure or absorption.Results-Only three studies used a measure of cumulative exposure to or absorption of lead, and two others used duration of exposure as a surrogate for cumulative exposure. Ah other studies used a measure that did not adequately estimate cumulative exposure to lead, most often current blood lead concentration. 20 of the studies controlled for age as a confounding variable, although in several studies the possibility for residual confounding by age remained. 16 studies controlled for intellectual ability before exposure; all of them used educational level for this purpose. Of the five studies that used direct or surrogate measures of cumulative exposure to or absorption of lead, two were thought to be of low usefulness because of inadequate duration of exposure. The three remaining studies found stronger associations of neurobehavioural performance with recent exposure measures than with those of cumulative exposure.Conclusion-The current scientific literature provides inadequate evidence to conclude whether or not cumulative exposure to or absorption of lead adversely affects performance in neurobehavioural tests in adults. The current evidence is flawed because of inadequate estimation of cumulative exposure to or absorption of lead and inadequate control for age and intellectual ability before exposure.