Exposure to environmental tobacco smoke in pregnancy and lead level in maternal blood at delivery
Exposure to environmental tobacco smoke in pregnancy and lead level in maternal blood at delivery
复制标题
DOI：
10.2478/v10001-006-0034-5
复制
发表时间：
2006-01-01
影响因子：
2
通讯作者：
Perera, Frederica
中科院分区：
文献类型：
--
作者：
Jedrychowski, Wieslaw;Flak, Elzbieta;Perera, Frederica
目的：我们研究的特殊目的是评估环境烟草烟雾(ETS)对孕妇血铅水平个体变异性的影响，因为早期的研究表明吸烟者的血铅水平增加。材料和方法：材料由240名孕妇组成，她们参与了一项关于胎儿和婴儿对环境危害的易感性的前瞻性队列研究。登记的只包括18-35岁之间怀孕的不吸烟的单身妇女。采用电感耦合等离子体质谱检测全血铅浓度。结果：平均而言，孕妇分娩时的血铅水平较低(GM=1.7 mU g/dL；95%CI：1.6~1.8 mU g/dL)，无一例血铅水平高于4.0 mU g/dL，但有ETS暴露史的孕妇血铅水平(GM=1.9 mU g/dL；95%CI：1.8~2.1 mU g/dL)明显高于未接触ETS的孕妇(GM=1.6 mU g/dL；95%CI：1.5~1.7 mU g/dL)。为了从混杂变量中筛选出接触ETS的影响，我们以母亲血铅水平为因变量，以年龄、孕前体重、文化程度等一组自变量为因变量，进行逐步多元线性回归。分析结果显示，模型中包含的所有自变量解释了研究女性总血铅变异性的11%。差异最大的因素是ETS暴露(5%)、年龄(3%)、教育程度(2%)和体重(1%)。将居住面积和交通强度等其他变量纳入模型并不能改善可解释变异性的比例。结论：接触ETS的女性血铅水平较高的原因可能是烟草烟雾中含有铅。然而，吸入烟草烟雾也有可能增加对沉积在支气管树中的颗粒物中铅的吸收。
Objectives: The particular purpose of our study was to assess the impact of environmental tobacco smoke (ETS) on the individual variability of blood lead levels in pregnant women as earlier publications demonstrated the increased blood lead in smokers. Materials and Methods: The material consisted of 240 pregnant women who participated in a prospective cohort study on vulnerability of the fetus and infant to environmental hazards. The enrolment included only non-smoking women with singleton pregnancies between the ages of 18-35 years. Whole blood lead concentrations were determined using inductively coupled plasma mass spectrometry. Results: On average, blood-lead measured in pregnant women at delivery was low (GM = 1.7 mu g/dL; 95% CI:1.6-1.8 mu g/dL) and none of them showed levels above 4.0 mu g/dL, but persons reporting exposure to ETS had significantly higher blood lead level (GM = 1.9 mu g/dL; 95% CI:1.8-2.1 mu g/dL) than those free from this exposure (GM = 1.6 mu g/dL; 95%CI:1.5-1.7 mu g/dL). In order to single out the effect of the ETS exposure from the confounding variables, we used the stepwise multivariate linear regression for log blood-lead in maternal blood as dependent variable and a set of independent variables, such as age, weight of women before pregnancy and their education level. The results of the analysis showed that all the independent variables included in the model explained 11% of total blood-lead variability among the study women. The strongest component of variance was attributed to ETS exposure (5%), age (3%), education level (2%) and weight (1%). Inclusion into the model of other variables, e.g., residence area and traffic intensity did not improve the proportion of explained variability. Conclusions: The reason for higher levels of blood-lead in the ETS-exposed women may result from the fact that tobacco smoke contains lead. However, it is possible that inhaled tobacco smoke also increases the absorption of lead from particulate matter deposited in the bronchial tree.