Recommendations for medical management of adult lead exposure.
Recommendations for medical management of adult lead exposure.
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DOI：
10.1289/ehp.9784
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发表时间：
2007-03
影响因子：
10.4
通讯作者：
Woolf A
中科院分区：
文献类型：
--
作者：
Kosnett MJ;Wedeen RP;Rothenberg SJ;Hipkins KL;Materna BL;Schwartz BS;Hu H;Woolf A
近年来进行的研究增加了公众对低剂量铅的毒性的关注，并支持重新评估工作场所可能安全容忍的铅暴露水平。这篇文章是关于成人铅暴露的迷你专著的一部分，在这篇文章中，我们总结了一系列已发表的文献，这些文献确立了全血铅浓度为40μg/dL的成年人患高血压的可能性、对肾功能的影响、认知障碍和不利的女性生殖结局。根据这些文献和我们评估成人铅暴露的集体经验，我们建议，如果单个血铅浓度超过30μg/dL，或者如果在4周间隔内连续测量的两个血铅浓度为≥20μg/dL，则应将个人从职业性铅暴露中移除。如果长期的铅暴露控制措施没有将血铅浓度降低到10μg/dL，或者如果存在可能增加持续暴露风险的选定医疗条件，则应考虑将个人从铅暴露中移除，以避免对健康的长期风险。对所有铅暴露工人的建议医学监测应包括对血铅浓度在10至19μg/dL之间的个人进行季度血铅测量，并在持续血铅浓度为<；10μg/dL时每半年进行一次血铅测量。对于孕妇来说，避免职业性或业余性铅暴露会导致血铅浓度&5μg/dL是明智的。对于患有有症状的铅中毒的高暴露成人，螯合疗法可能具有辅助作用，但不建议对血铅浓度较低的无症状个人使用。
Research conducted in recent years has increased public health concern about the toxicity of lead at low dose and has supported a reappraisal of the levels of lead exposure that may be safely tolerated in the workplace. In this article, which appears as part of a mini-monograph on adult lead exposure, we summarize a body of published literature that establishes the potential for hypertension, effects on renal function, cognitive dysfunction, and adverse female reproductive outcome in adults with whole-blood lead concentrations < 40 μg/dL. Based on this literature, and our collective experience in evaluating lead-exposed adults, we recommend that individuals be removed from occupational lead exposure if a single blood lead concentration exceeds 30 μg/dL or if two successive blood lead concentrations measured over a 4-week interval are ≥ 20 μg/dL. Removal of individuals from lead exposure should be considered to avoid long-term risk to health if exposure control measures over an extended period do not decrease blood lead concentrations to < 10 μg/dL or if selected medical conditions exist that would increase the risk of continued exposure. Recommended medical surveillance for all lead-exposed workers should include quarterly blood lead measurements for individuals with blood lead concentrations between 10 and 19 μg/dL, and semiannual blood lead measurements when sustained blood lead concentrations are < 10 μg/dL. It is advisable for pregnant women to avoid occupational or avocational lead exposure that would result in blood lead concentrations > 5 μg/dL. Chelation may have an adjunctive role in the medical management of highly exposed adults with symptomatic lead intoxication but is not recommended for asymptomatic individuals with low blood lead concentrations.
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成人铅毒性的流行病学：测量剂量和考虑其他方法论问题。
影响因子：
10.4
作者：
Hu, Howard;Shih, Regina;Rothenberg, Stephen;Schwartz, Brian S.
通讯作者：
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影响因子：
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作者：
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通讯作者：
Taylor, AJ