High prevalence of elevated blood lead levels in both rural and urban Iowa newborns: Spatial patterns and area-level covariates.
High prevalence of elevated blood lead levels in both rural and urban Iowa newborns: Spatial patterns and area-level covariates.
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DOI：
10.1371/journal.pone.0177930
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发表时间：
2017
期刊：
影响因子：
3.7
通讯作者：
Saftlas A
中科院分区：
文献类型：
--
作者：
Carrel M;Zahrieh D;Young SG;Oleson J;Ryckman KK;Wels B;Simmons DL;Saftlas A
母体血液中的铅可以穿过胎盘，导致新生儿血铅水平升高，可能对神经认知功能产生负面影响，特别是如果与儿童期铅暴露相结合。然而，关于新生儿血铅水平升高的负担，或新生儿铅水平升高的地区和人群，特别是农村地区的研究很少。使用爱荷华州新生儿出生后1-3天内收集的约2300个干血斑，与出生时母亲居住的地区相联系，我们研究了血铅水平升高（>5 μg/dL）的空间模式和血铅水平升高的生态水平预测因子。我们发现，五分之一的新生儿超过了美国疾病控制和预防中心（CDC）设定的5 μg/dL行动水平。贝叶斯空间零膨胀回归表明，新生儿血铅升高与20世纪40年代前农村和城市环境中受教育程度低的育龄妇女和住房面积增加有关。城乡孕产妇居住地血铅水平和儿童血铅超过5 μg/dL的比例无差异，但在农村县存在血铅升高的空间聚集性。这些特征可以指导在存在风险因素的地方进行婴儿健康预约时对婴儿进行检测的建议，可能导致更早地启动病例管理。研究结果还表明，农村人口的血铅水平升高的风险与城市人口一样大。新生儿干血斑分析是监测新生儿铅中毒的一个重要工具，可以将公共卫生工作导向铅检测和病例管理将产生最大影响的特定地方和人群。
Lead in maternal blood can cross the placenta and result in elevated blood lead levels in newborns, potentially producing negative effects on neurocognitive function, particularly if combined with childhood lead exposure. Little research exists, however, into the burden of elevated blood lead levels in newborns, or the places and populations in which elevated lead levels are observed in newborns, particularly in rural settings. Using ~2300 dried bloods spots collected within 1–3 days of birth among Iowa newborns, linked with the area of mother’s residence at the time of birth, we examine the spatial patterns of elevated (>5 μg/dL) blood lead levels and the ecological-level predictors of elevated blood lead levels. We find that one in five newborns exceed the 5 μg/dL action level set by the US Centers for Disease Control & Prevention (CDC). Bayesian spatial zero inflated regression indicates that elevated blood lead in newborns is associated with areas of increased pre-1940s housing and childbearing-age women with low educational status in both rural and urban settings. No differences in blood lead levels or the proportion of children exceeding 5 μg/dL are observed between urban and rural maternal residence, though a spatial cluster of elevated blood lead is observed in rural counties. These characteristics can guide the recommendation for testing of infants at well-baby appointments in places where risk factors are present, potentially leading to earlier initiation of case management. The findings also suggest that rural populations are at as great of risk of elevated blood lead levels as are urban populations. Analysis of newborn dried blood spots is an important tool for lead poisoning surveillance in newborns and can direct public health efforts towards specific places and populations where lead testing and case management will have the greatest impact.