Trends in Blood Lead Levels and Blood Lead Testing Among US Children Aged 1 to 5 Years, 1988-2004
Trends in Blood Lead Levels and Blood Lead Testing Among US Children Aged 1 to 5 Years, 1988-2004
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DOI：
10.1542/peds.2007-3608
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发表时间：
2009-03-01
期刊：
影响因子：
8
通讯作者：
Brown, Mary Jean
中科院分区：
文献类型：
--
作者：
Jones, Robert L.;Homa, David M.;Brown, Mary Jean
目标.评估儿童血铅水平的趋势和铅中毒风险儿童的血铅检测程度，从16年期间在美国进行的全国性调查。将1988-1991年和1991-1994年国家健康和营养调查III第一阶段和第二阶段的1 - 5岁儿童数据与1999- 2004年调查期间的数据进行比较。儿童血铅水平升高（>= 10微克/分升）的患病率从1988-1991年的8.6%下降到1999-2004年的1.4%，下降了84%。从1988-1991年和1999-2004年，非西班牙裔黑人（5.2-2.8 μ g/dL）、墨西哥裔美国人（3.9-1.9 μ g/dL）和非西班牙裔白色儿童（3.1 μ g/dL至1.7 μ g/dL）的儿童血铅几何平均水平下降。然而，与墨西哥裔美国人和非西班牙裔白色儿童相比，非西班牙裔黑人儿童的水平仍然最高。血铅水平分布如下：14.0%< 1.0 μ g/dL，55.0% 1.0至< 2.5 μ g/dL，23.6% 2.5至< 5 μ g/dL，4.5% 5至< 7.5 μ g/dL，1.5% 7.5至< 10 μ g/dL，1.4%>= 10 μ g/dL。多变量分析表明，居住在较旧的住房，贫困，年龄和非西班牙裔黑人仍然是铅含量较高的主要风险因素。参加医疗补助的儿童血铅检测从1988 - 1991年的19.2%上升到41.9%。只有43.0%的血铅水平升高的儿童以前进行过检测。在美国，儿童的血铅水平持续下降，即使在历史上铅中毒的高危人群中也是如此。为了保持已取得的进展并消除尚存的差距，必须继续努力对铅中毒高危儿童进行检测，并查明和控制铅的来源。国家、州和地方各级协调一致的预防战略将有助于实现消除血铅水平升高的目标。儿科2009;123：e376-e385
OBJECTIVES. To evaluate trends in children's blood lead levels and the extent of blood lead testing of children at risk for lead poisoning from national surveys conducted during a 16-year period in the United States.METHODS. Data for children aged 1 to 5 years from the National Health and Nutrition Examination Survey III Phase I, 1988-1991, and Phase II, 1991-1994 were compared to data from the survey period 1999-2004.RESULTS. The prevalence of elevated blood lead levels, >= 10 mu g/dL, among children decreased from 8.6% in 1988-1991 to 1.4% in 1999-2004, which is an 84% decline. From 1988-1991 and 1999-2004, children's geometric mean blood lead levels declined in non-Hispanic black (5.2-2.8 mu g/dL), Mexican American (3.9-1.9 mu g/dL), and non-Hispanic white children (3.1 mu g/dL to 1.7 mu g/dL). However, levels continue to be highest among non-Hispanic black children relative to Mexican American and non-Hispanic white children. Blood lead levels were distributed as follows: 14.0% were < 1.0 mu g/dL, 55.0% were 1.0 to < 2.5 mu g/dL, 23.6% were 2.5 to < 5 mu g/dL, 4.5% were 5 to < 7.5 mu g/dL, 1.5% were 7.5 to < 10 mu g/dL, and 1.4% were >= 10 mu g/dL. Multivariable analysis indicated that residence in older housing, poverty, age, and being non-Hispanic black are still major risk factors for higher lead levels. Blood lead testing of Medicaid-enrolled children increased to 41.9% from 19.2% in 1988 1991. Only 43.0% of children with elevated blood lead levels had previously been tested.CONCLUSIONS. Children's blood lead levels continue to decline in the United States, even in historically high-risk groups for lead poisoning. To maintain progress made and eliminate remaining disparities, efforts must continue to test children at high risk for lead poisoning, and identify and control sources of lead. Coordinated prevention strategies at national, state, and local levels will help achieve the goal of elimination of elevated blood lead levels. Pediatrics 2009;123:e376-e385