THE DECLINE IN BLOOD LEAD LEVELS IN THE UNITED-STATES - THE NATIONAL-HEALTH AND NUTRITION EXAMINATION SURVEYS (NHANES)
THE DECLINE IN BLOOD LEAD LEVELS IN THE UNITED-STATES - THE NATIONAL-HEALTH AND NUTRITION EXAMINATION SURVEYS (NHANES)
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DOI：
10.1001/jama.272.4.284
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发表时间：
1994-07-27
影响因子：
120.7
通讯作者：
MATTE, TD
中科院分区：
文献类型：
--
作者：
PIRKLE, JL;BRODY, DJ;MATTE, TD
客观。-描述1976年至1991年期间美国人口和选定人口亚组的血铅水平趋势。两个全国代表性的横断面调查和一个横断面调查代表墨西哥裔美国人在美国西南部。设置/参与者。参与两项全国性调查，包括血铅测量：第二次全国健康和营养检查调查，1976年至1980年（n=9832），第三次全国健康和营养检查调查，1988年至1991年（n=12119）的第一阶段。此外，墨西哥裔美国人参加西班牙裔健康和营养检查调查，1982年至1984年（n=5682）。1至74岁人群的平均血铅水平下降了78%，从0.62 μ mol/L降至0.14 μ mol/L（12.8 μ g/dL降至2.8 μ g/dL）。非西班牙裔白色儿童1至5岁的平均血铅水平下降了77%（0.66至0.15 μ mol/L [13.7至3.2 μ g/dL]），非西班牙裔黑人儿童下降了72%（0.97至0.27 μ mol/L [20.2至5.6 μ g/dL]）。1至5岁儿童血铅水平0.48 μ mol/L（10 μ g/dL）或更高的患病率，非西班牙裔白色儿童从85.0%降至5.5%，非西班牙裔黑人儿童从97.7%降至20.6%。在按年龄、性别、种族/族裔、收入水平和城市地位界定的人口亚组中也发现了类似的下降。墨西哥裔美国人在较短的时间内也表现出类似的血铅水平下降幅度略小。结果表明，整个美国人口和选定的人口亚组的血铅水平大幅下降。观察到的血铅水平下降的主要原因很可能是从汽油中去除了99.8%的铅，以及从焊接罐中去除了铅。虽然这些数据表明在减少铅暴露方面取得了重大进展，但它们也表明，相同的社会人口因素继续与较高的血铅水平相关，包括年龄较小，男性，非西班牙裔黑人种族/民族和低收入水平。未来的努力，以消除其他铅源（如油漆，灰尘和土壤）是必要的，但将更困难，比消除铅从汽油和焊接罐。
Objective.-To describe trends in blood lead levels for the US population and selected population subgroups during the time period between 1976 and 1991.Design.-Two nationally representative cross-sectional surveys and one cross-sectional survey representing Mexican Americans in the southwestern United States.Setting/Participants.-Participants in two national surveys that included blood lead measurements: the second National Health and Nutrition Examination Survey, 1976 to 1980 (n=9832), and phase 1 of the third National Health and Nutrition Examination Survey, 1988 to 1991 (n=12119). Also, Mexican Americans participating in the Hispanic Health and Nutrition Examination Survey, 1982 to 1984 (n=5682).Results.-The mean blood lead level of persons aged 1 to 74 years dropped 78%, from 0.62 to 0.14 mu mol/L (12.8 to 2.8 mu g/dL). Mean blood lead levels of children aged 1 to 5 years declined 77% (0.66 to 0.15 mu mol/L [13.7 to 3.2 mu g/dL]) for non-Hispanic white children and 72% (0.97 to 0.27 mu mol/L [20.2 to 5.6 mu g/dL]) for non-Hispanic black children. The prevalence of blood lead levels 0.48 mu mol/L (10 mu g/dL) or greater for children aged 1 to 5 years declined from 85.0% to 5.5% for non-Hispanic white children and from 97.7% to 20.6% for non-Hispanic black children. Similar declines were found in population subgroups defined by age, sex, race/ethnicity, income level, and urban status. Mexican Americans also showed similar declines in blood lead levels of a slightly smaller magnitude over a shorter time.Conclusions.-The results demonstrate a substantial decline in blood lead levels of the entire US population and within selected subgroups of the population. The major cause of the observed decline in blood lead levels is most likely the removal of 99.8% of lead from gasoline and the removal of lead from soldered cans. Although these data indicate major progress in reducing lead exposure, they also show that the same sociodemographic factors continue to be associated with higher blood lead levels, including younger age, male sex, non-Hispanic black race/ethnicity, and low income level. Future efforts to remove other lead sources (eg, paint, dust, and soil) are needed but will be more difficult than removing lead from gasoline and soldered cans.