顺义区3～7岁学龄前儿童血铅水平与行为问题关系的研究
- 刘雅静1,贾美香2,何亚萍1,王秀云1,项征1,崔文红1,李雪玲1,刘建华1,冀伟龙1
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Study on the relationship between the blood lead level and behavior problems in the preschool children aged 3～7 years old in Shunyi district
- LIU Ya-jing1, JIA Mei-xiang2, HE Ya-ping1, WANG Xiu-yun1, XIANG Zheng1, CUI Wen-hong1, LI Xue-ling1, LIU Jian-hua1, JI Wei-long1
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文章历史
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摘要
【目的】 了解北京市顺义区3～7岁学龄前儿童血铅水平,分析其分布规律,初探铅暴露对3～7岁学龄前儿童行为问题产生的影响。 【方法】 采用整群随机抽样的方法于2009年4-6月对顺义区5所幼儿园1 307名3～7岁在园儿童采集手指末梢血测定血铅水平,同时采用Achenbach量表(Child Behavior Checklist, CBCL)进行行为问题评估。按照检测的血铅值将研究对象分为高血铅组(≥100 μg/L)和低血铅组(<100 μg/L)。男童CBCL总粗分≥42分,女童≥45分即判定为有行为问题。 【结果】 北京市顺义区3～7岁学龄前儿童血铅对数均值为3.328±2.765,血铅值≥100 μg/L占总测查人数的1.22%,血铅值≥200 μg/L占0.15%。高血铅组行为问题检出率为76.47%,低血铅组CBCL行为问题检出率为10.85%。高血铅组CBCL粗分及行为问题检出率均显著高于低血铅组,差异有高度统计学意义(P<0.001)。男童高血铅组在攻击因子、多动因子、违纪因子检出率显著高于低血铅组(P<0.05),女童高血铅组违纪因子检出率显著高于低血铅组(P<0.001)。 【结论】 高血铅的学龄前儿童行为问题较血铅值<100 μg/L儿童多,今后应加大宣传力度,降低铅中毒对学龄前儿童的危害。
Abstract
【Objective】 To observe blood lead level and distributed characteristics among children of 3～7 years old in Shunyi district in Beijing and to explore the effects of lead poisoning on preschool children behaviors. 【Methods】 1 307 children of 3～7 years old were investigated from April to June 2009. All subjects were selected from 5 kindergartens through a clustered-random sampling in Shunyi district.Blood lead level was measured and behavior problems were made by CBCL.All children were divided into 2 group(high blood lead group and low blood lead group)by blood lead beyond or below 100 μg/L .The behavior problems were identified while the total crude scores of CBCL beyond 42 in boys and 45 in girls. 【Results】 The geometric mean of blood lead was (3.328±2.765) with 1.22% of those ≥100 μg/L,and 0.15%≥200 μg/L.The median of CBCL total crude scores in high blood lead group was significantly higher than those of low blood lead group(P<0.001).The ratio of behavior problems in high blood lead group(76.47%) was significantly higher than that of low blood lead group(10.85%)(P<0.001).The ratios of behavior of attack, hyperactivity and disobey were significantly higher in high blood lead group than those of low blood lead group in boys(P<0.05). The ratio of behavior of disobey was significantly higher in high blood lead group than that of low blood lead group in girls(P<0.001). 【Conclusions】 Preschool children lead poisoning is associated with their behavior problems. Promoting healthy information can alleviate danger of high blood lead.
关键词
Key words
high blood lead / preschool children&apos / s health / behavior problems
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参考文献
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[2] Zhang SM, Dai YH, Xie XH, et al. Surveillance of childhood blood lead levels in 14 cities of China in 2004-2006[J]. Biomed Environ Sci,2009,22(4):288-296.
[3] CDC. Laboratory standardization: lead. Atlanta, GA: centers for disease control and prevention[R/OL]. 2006,http:∥www.cdc.gov/nceh/dls/lead.html.
[4] Binns HJ, Campbell C, Brown MJ. Interpreting and managing blood lead levels of less than 10 μg/dL in children and reducing childhood exposure to lead: recommendations of the Centers for Disease Control and Prevention Advisory Committee on childhood lead poisoning prevention[J]. Pediatrics,2007,120(5):e1285-e1298.
[5] Brown MJ. Interpreting and managing blood lead levels <10 μg/dL in children and reducing childhood exposures to lead: recommendations of CDC's Advisory Committee on Childhood Lead Poisoning Prevention [J]. MMWR Recomm Rep,2007,56(RR-8):1-16.
[6] 梁晓红,朱兰芳,刘秋华,等.4～5岁学龄前儿童血铅与行为问题关系的研究[J].中国妇幼保健,2006,21(21):2955-2957.
[7] Bellinger DC. Very low lead exposures and children's neurodevelopment[J].Curr Opin Pediatr,2008,20(2):172-177.
[8] Lanphear BP, Hornung R, Khoury J, et al. Low-level environmental lead exposure and children's intellectual function: an international pooled analysis[J]. Environ Health Perspect,2005,113(7):894-899.
[9] Brubaker CJ, Schmithorst VJ, Haynes EN, et al. Altered myelination and axonal integrity in adults with childhood lead exposure: a diffusion tensor imaging study[J]. Neurotoxicology,2009,30(6):867-875.
[10] 余高妍,颜崇淮,余晓刚,等.慢性中度铅中毒对幼兔海马组织的影响[J].中华预防医学杂志,2008,42(3):160-164.
基金
首都医学发展科研基金(2007-3181)
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