Effects of early childhood lead exposure on academic performance and behaviour of school age children
Effects of early childhood lead exposure on academic performance and behaviour of school age children
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DOI：
10.1136/adc.2008.149955
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发表时间：
2009-11-01
影响因子：
5.2
通讯作者：
Emond, A. M.
中科院分区：
文献类型：
--
作者：
Chandramouli, K.;Steer, C. D.;Emond, A. M.
目的：要确定是否早期铅暴露在低于10微克/分升的水平有影响的教育和行为outcomes at school.Methods：静脉样本取自亚组的雅芳纵向研究的父母和儿童（ALSPAC）参加一个研究诊所在30个月的年龄（n=582），铅水平进行了测量原子吸收光谱法。在7-8岁时收集这些儿童的发育、行为和标准化教育结果（标准评估测试，SAT）。结果：488例（84%）有完整的混杂因素和结果数据。在调整混杂因素和使用铅浓度的对数剂量反应模型后，血铅水平显示出与SAT的阅读、写作和拼写成绩以及反社会行为显著相关。铅浓度加倍与SAT等级下降0.3分（95% CI-0.5至-0.1）相关。分类处理铅水平，参考组0-2 μ g/dl，2-5 μ g/dl对结局无明显影响，但5-10 μ g/dl水平与阅读（OR 0.51，p=0.006）和书写（OR 0.49，p=0.003）评分降低相关。铅水平>10 μ g/dl也与反社会行为（OR 2.9，p=0.040）和多动（OR 2.82，p=0.034）的得分增加有关。结论：儿童早期铅暴露对随后的教育程度有影响，即使血液水平低于10 μ g/dl。这些数据表明，临床关注的阈值应降至5 μ g/dl。
Aim: To determine whether early lead exposure at levels below 10 mu g/dl has an impact on educational and behavioural outcomes at school.Methods: Venous samples were taken from a subgroup of the Avon Longitudinal Study of Parents and Children (ALSPAC) attending a research clinic at 30 months of age (n=582), and lead levels were measured by atomic absorption spectrometry. Developmental, behavioural and standardised educational outcomes (Standard Assessment Tests, SATs) were collected on these children at age 7-8 years. In the analysis, blood lead concentration was investigated both as a continuous covariate and as a categorical variable.Results: 488 cases (84%) had complete data on confounders and outcomes. After adjustment for confounders and using a log dose-response model for lead concentration, blood lead levels showed significant associations with reading, writing and spelling grades on SATs, and antisocial behaviour. A doubling in lead concentration was associated with a 0.3 point (95% Cl -0.5 to -0.1) decline in SATs grades. Treating lead levels categorically, with the reference group 0-2 mu g/dl, no effects on outcomes were apparent at 2-5 mu g/dl, but levels of 5-10 mu g/dl were associated with a reduction in scores for reading (OR 0.51, p=0.006) and writing (OR 0.49, p=0.003). Lead levels >10 mu g/dl were also associated with increased scores for antisocial behaviour (OR 2.9, p=0.040) and hyperactivity (OR 2.82, p=0.034).Conclusions: Exposure to lead early in childhood has effects on subsequent educational attainment, even at blood levels below 10 mu g/dl. These data suggest that the threshold for clinical concern should be reduced to 5 mu g/dl.