Screening housing to prevent lead toxicity in children
Screening housing to prevent lead toxicity in children
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DOI：
10.1177/003335490512000315
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发表时间：
2005-05-01
影响因子：
3.3
通讯作者：
Ho, M
中科院分区：
文献类型：
--
作者：
Lanphear, BP;Hornung, R;Ho, M
客观的。对儿童进行筛查以确定血铅水平 >= 10 μg/dl 的儿童并不能保护儿童免受与铅相关的认知缺陷和行为问题的影响。为了扩大我们在初级预防方面的努力，需要制定筛查标准，以便在儿童过度暴露之前识别铅污染的住房。本研究的目的是确定并验证与血铅水平升高（>= 10 mu g/dl）儿童相关的住房特征。方法。现有的两项研究被用来检验与过度铅暴露相关的住房特征：一项对 205 名 12 至 31 个月大的儿童进行的横断面研究，以及对 276 名 6 至 24 个月大的儿童进行的纵向研究中的随机样本。进行Logistic回归分析以检查儿童血铅水平≥10μg/dl的关联。结果。 481 名儿童的平均年龄为 17.8 个月； 99人（20.6%）的血铅浓度为10μg/dl或更高。以下特征与血铅浓度 >= 10 μg/dl 相关：地板铅负荷 > 15 μg/ft(2)（优势比 [OR]=2.2；95% 置信区间 [Q] 1.3, 3.8）；出租住房（OR=3.2；95% CI 1.3, 7.6）；住房条件差（OR 2.1；CI 1.2、3.6）；非裔美国人 (OR=3.3; CI 1.9, 6.1)；油漆碎片摄入（OR=5.8；CI 1.3, 26.5）；和土壤摄入（OR=2.2；CI 1.1，4.2）。住房特征，包括租赁状况、铅污染地板灰尘和住房条件，敏感度范围为 47% 至 92%；特异性从 28% 到 76%；阳性预测值从 25% 到 34%；阴性预测值为 85% 至 93%。结论。住房特征和地板灰尘铅含量可用于筛查住房，以便在入住前、购买房屋前或装修后识别铅危害，以防止儿童接触铅危害。
Objective. Screening children to identify those with blood lead levels >= 10 mu g/dl fails to protect children from lead-associated cognitive deficits and behavioral problems. To broaden our efforts at primary prevention, screening criteria are needed to identify lead-contaminated housing before children are unduly exposed. The purpose of this study was to identify and validate housing characteristics associated with children having elevated blood lead levels (>= 10 mu g/dl).Methods. Two existing studies were used to examine housing characteristics linked with undue lead exposure: a cross-sectional study of 205 children aged 12 to 31 months, and a random sample from a longitudinal study of 276 children followed from 6 to 24 months of age. Logistic regression analysis was conducted to examine the association of children's blood lead levels >= 10 mu g/dl.Results. The mean age of the 481 children was 17.8 months; 99 (20.6%) had a blood lead concentration of 10 mu g/dl or higher. The following characteristics were associated with blood lead concentration >= 10 mu g/dl: floor lead loading > 15 mu g/ft(2) (odds ratio [OR]=2.2; 95% confidence interval [Q] 1.3, 3.8); rental housing (OR=3.2; 95% CI 1.3, 7.6); poor housing condition (OR 2.1; CI 1.2, 3.6); African American race (OR=3.3; CI 1.9, 6.1); paint chip ingestion (OR=5.8; CI 1.3, 26.5); and soil ingestion (OR=2.2; CI 1.1, 4.2). Housing characteristics including rental status, lead-contaminated floor dust, and housing condition had a range of sensitivity from 47% to 92%; specificity from 28% to 76%; a positive predictive value from 25% to 34%; and a negative predictive value of 85% to 93%.Conclusions. Housing characteristics and floor dust lead levels can be used to screen housing to identify lead hazards prior to occupancy, before purchasing a home, or after renovation to prevent children's exposure to lead hazards.