Prenatal Lead Exposures in Pakistan: A Prelude to Prevention

巴基斯坦产前铅暴露：预防的前奏

• 批准号: 7843632
• 负责人: NALINI SATHIAKUMAR
• 金额: $ 11.75万
• 依托单位: UNIVERSITY OF ALABAMA AT BIRMINGHAM
• 依托单位国家: 美国
• 财政年份: 2009
• 资助国家: 美国
• 起止时间: 2009-05-14 至 2014-03-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/7843632
• 关键词: AA Spectrophotometry; Address; Algorithms; Asia; Behavior; Birth; Blood; Calcium; Cellular Phone; Centers for Disease Control and Prevention (U.S.); Child; Child health care; Cities; Cosmetics; Country; Crime; Cross-Sectional Studies; Data; Deposition; Developed Countries; Developing Countries; Diet; Discipline of obstetrics; Environment; Environmental Health; Environmental Risk Factor; Equation; Extended Family; Ferritin; Fetus; Fluorescence; Follow-Up Studies; Future; Gasoline; Generations; Health Professional; Hemoglobin; Home environment; Hospitals; House Dust; Income; Infant; Intervention; Interview; Lead; Lead Poisoning; Life; Linear Regressions; Low income; Measurement; Measures; Methods; Modeling; Mothers; National Institute for Occupational Safety and Health; Natural graphite; Newborn Infant; Paint; Pakistan; Pathway interactions; Persons; Phase; Policy Maker; Prevention; Problem behavior; Procedures; Public Health; Questionnaires; Recording of previous events; Recruitment Activity; Regression Analysis; Relative (related person); Research; Research Personnel; Risk; Risk Reduction; Roentgen Rays; Role; Serum; Slum; Societies; Soil; Source; South Asian; Street Address; Structure; Study Subject; Telephone; Time; Toy; Traditional Medicine; Umbilical Cord Blood; Umbilical cord structure; United States; Violence; Woman; Work; World Health Organization; Youth; anti social; base; blood lead; bone; cognitive function; cohort; drinking water; environmental Pb exposure; fetal lead exposure; follow-up; lead control measure; lead exposure; member; migration; neonate; prenatal; programs; prospective; public health relevance; tertiary care; urban area; young adult

DESCRIPTION (provided by applicant): Lead toxicity remains a major environmental health risk throughout the world. Pakistan and South Asian countries consider phasing-out of leaded gasoline as an adequate measure for control of lead. However, lead deposited in environmental media and maternal bone continues to expose fetuses and children. Our preliminary study in Karachi has shown that approximately 50% of neonates in an urban area of Pakistan had cord blood lead levels (BLL) above10 <g/dL. We assessed sources of lead exposures using questionnaires; however, we were not able to measure lead levels in environmental media. The proposed study, a pioneer study on lead exposure in South Asia, will recruit women delivering infants at one of three tertiary care hospitals in Karachi, Pakistan and will measure lead in environmental media in their homes. The specific aims are: (1) to estimate the mean umbilical cord blood lead level and the proportion of newborns with high cord blood lead levels (>10</dl); (2) to determine sources and levels of environmental lead exposure in children's homes and surroundings; (3) and to identify the major determinants of umbilical cord blood lead level (BLL) including environmental sources and maternal determinants. We will recruit mothers presenting for delivery at the study hospitals, interview them, will collect their blood for BLLs, serum ferritin and hemoglobin, and will collect umbilical cord for lead levels. We will conduct environmental source measurements in homes and surrounding environment. The Centers for Disease Control and Prevention (CDC) will provide technical assistance to interpret and disseminate research findings for national policy makers and public health professionals. This study will contribute to understanding the sources of lead in environment that will provide a basis for which to inform issues of lead abatement and environmental risk reduction in Pakistan and serve as a model intervention for other countries in the region. PUBLIC HEALTH RELEVANCE: Narrative Lead toxicity continues to remain a major environmental health risk throughout the world. Previous research has shown that about 50% of Pakistani children have blood lead levels (BLL) >10 <g/dL. There is growing evidence of an association between children exposed to lead levels and lowered cognitive function, and delinquent behavior in young adulthood. These findings raise concerns about the health of children and of their future potential to be productive members of society in their country and in the world. This study, a pioneer study on lead exposure assessment in a developing country, will contribute to understanding the role of various sources of lead exposure in Pakistan. These data will provide a basis for intervention in Pakistan at the national level that will result in reduction of BLLs in children. The findings of this study also are directly relevant to lead prevention/control programs in other countries in South Asia.

描述（由申请人提供）：铅毒性仍然是全世界主要的环境健康风险。巴基斯坦和南亚国家认为逐步淘汰含铅汽油是控制铅的充分措施。然而，沉积在环境介质和母体骨骼中的铅继续使胎儿和儿童接触。我们在卡拉奇的初步研究表明，巴基斯坦市区约 50% 的新生儿脐带血铅水平 (BLL) 高于 10 <g/dL。我们使用问卷调查评估了铅暴露的来源；然而，我们无法测量环境介质中的铅含量。拟议的研究是关于南亚铅暴露的开创性研究，将招募在巴基斯坦卡拉奇三所三级护理医院之一分娩的妇女，并测量其家中环境介质中的铅。具体目标是：（1）估计平均脐带血铅水平和高脐带血铅水平（>10</dl）新生儿的比例； (2) 确定儿童家庭及周围环境铅暴露的来源和水平； （3）并确定脐带血铅水平（BLL）的主要决定因素，包括环境来源和母体决定因素。我们将招募在研究医院待产的母亲，对她们进行访谈，收集她们的血液以检测 BLL、血清铁蛋白和血红蛋白，并收集脐带以检测铅水平。我们将对家庭和周围环境进行环境源测量。疾病控制与预防中心 (CDC) 将提供技术援助，为国家政策制定者和公共卫生专业人员解释和传播研究结果。这项研究将有助于了解环境中铅的来源，为巴基斯坦的铅减排和环境风险降低问题提供基础，并为该地区其他国家提供干预示范。公众健康相关性：叙述 铅毒性仍然是全世界主要的环境健康风险。此前的研究表明，约 50% 的巴基斯坦儿童血铅水平 (BLL) >10 <g/dL。越来越多的证据表明，接触铅水平的儿童和认知功能下降与青少年时期的犯罪行为之间存在关联。这些发现引起了人们对儿童健康及其未来成为本国和世界社会富有成效的成员的潜力的担忧。这项研究是关于发展中国家铅暴露评估的开创性研究，将有助于了解巴基斯坦各种铅暴露来源的作用。这些数据将为巴基斯坦在国家层面进行干预提供基础，从而减少儿童的 BLL。这项研究的结果也与南亚其他国家的主要预防/控制计划直接相关。