Blood Lead Levels in Mexico and Pediatric Burden of Disease Implications
Blood Lead Levels in Mexico and Pediatric Burden of Disease Implications
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DOI：
10.1016/j.aogh.2014.08.002
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发表时间：
2014-07-01
影响因子：
2.9
通讯作者：
Fuller, Richard
中科院分区：
文献类型：
--
作者：
Caravanos, Jack;Dowling, Russell;Fuller, Richard
背景资料：尽管随着含铅汽油的逐步淘汰，在减少铅暴露方面取得了成功，但墨西哥的铅暴露继续威胁着数百万人的健康，其中大部分来自陶器中使用的铅基釉，这些釉会渗入食物。目标：对墨西哥人口血铅水平的现有数据进行了广泛的历史回顾和分析。我们使用了计算的几何平均值来评估铅对儿科疾病负担的影响。方法：广泛的文献检索确定了83篇发表的文章，从1978年至2010年的血铅水平（BLL）数据在墨西哥人口代表150个数据点，从超过50,000名研究参与者。这些出版物中的数值被分为不同的组别。然后，我们计算的发病率和残疾调整的生命年，这些BLL使用世界卫生组织的疾病负担的电子表格轻度mental retardation.Results：回顾所有相关的研究，几何平均数的墨西哥BLL在城市和农村地区，分别为8.85和22.24微克/分升。自逐步淘汰含铅汽油以来，城市地区的平均值为5.36微克/分升，预计农村地区的平均值会高得多。美国疾病控制和预防中心（CDC）6岁以下儿童血铅的上限为5 ug/dL，目前美国的平均值为1.2 ug/dL。我们的研究结果表明，超过15%的人口将经历铅暴露的智商下降超过5点。分析还使我们相信，铅是负责820，000残疾调整生命年铅引起的轻度精神发育迟滞的儿童0至4 years.Conclusion：铅继续威胁数百万人的健康，仍然是一个重要的原因，在墨西哥残疾。为了保护公众健康，有必要采取额外的干预措施，减少或管理含铅陶瓷釉料。
Background: Although there has been success in reducing lead exposure with the phase-out of leaded gasoline, exposure to lead in Mexico continues to threaten the health of millions, much of which is from lead-based glazes used in pottery that leaches into food.Objectives: An extensive historical review and analysis of available data on blood lead levels in Mexican populations was conducted. We used a calculated geometric mean to evaluate the effect of lead on the pediatric burden of disease.Methods: An extensive bibliographic search identified 83 published articles from 1978 to 2010 with blood lead level (BLL) data in Mexican populations representing 150 data points from more than 50,000 study participants. Values from these publications were categorized into various groupings. We then calculated the incidence of disease and disability-adjusted life-years resulting from these BLLs using the World Health Organization's burden of disease spreadsheets for mild mental retardation.Results: Reviewing all relevant studies, the geometric means of Mexican BLLs in urban and rural areas were found to be 8.85 and 22.24 ug/dL, respectively. Since the phase-out of leaded gasoline, the mean in urban areas was found to be 5.36 ug/dL and the average in rural areas is expected to be much higher. The U.S. Centers for Disease Control and Prevention's (CDC) upper limit of blood lead in children under the age of 6 years is 5 ug/dL and the current U.S. average is 1.2 ug/dL. Our results indicate that more than 15% of the population will experience a decrement of more than 5 IQ points from lead exposure. The analysis also leads us to believe that lead is responsible for 820,000 disability-adjusted life-years for lead-induced mild mental retardation for children aged 0 to 4 years.Conclusion: Lead continues to threaten the health of millions and remains a significant cause of disability in Mexico. Additional interventions in reducing or managing lead-based ceramic glazes are necessary to protect the public health.