使用无铅汽油后广州市儿童血铅水平的影响因素

Children Blood Lead Levels and Influencing Factors after Unleaded Gasoline Used in Guangzhou

目的了解使用无铅汽油后影响儿童血铅水平的可能因素,为采取新的儿童铅中毒控制措施提供依据。方法于2006年10月—2007年8月按分层随机抽样方法抽取广州市市中心区、城郊区和郊县各1个有代表性的区(县)级市,共选择12所幼儿园和12所小学,选取2373名2至12岁自愿抽血检测的儿童为调查对象,每名儿童抽取静脉血3～5ml,用0.1%TritonX-100和0.1%HNO3对血样稀释20倍后直接以电感耦合等离子-质谱法(ICP-MS)测定血铅。用包括儿童基本情况、家居情况、家庭烹调及儿童饮食情况、儿童生活及卫生习惯情况四大内容34个可能导致儿童血铅水平增高的危险因素的调查问卷进行调查,并对高血铅儿童进行家访。结果2373名儿童血铅几何均值为58.28μg/L,男童血铅均值(61.11μg/L)高于女童(55.37μg/L)差异有统计学意义(t=8.671,P=0.000)。高血铅60人,占2.53%,其中男童36人,占2.90%;女童24人,占2.09%,差异无统计学意义(χ2=1.594,P=0.207)。城乡结合部的白云区血铅均值为60.33μg/L,明显高于市中心的荔湾区(58.09μg/L)和农村的增城(56.72μg/L),差异有统计学意义(F=9.273,P=0.000)。进行多元线性回归分析显示,父亲文化程度低、家居住房面积小、家居较敞开、儿童少洗手和常吸吮手指等是儿童血铅高的危险因素。结论使用无铅汽油后,城郊儿童血铅水平较高,家庭环境和个人卫生是影响儿童血铅水平主要因素。

Objective To understand the blood lead levels(BLLs) and their influencing factors of Guangzhou children after the unleaded gasoline was used. Methods 12 kindergartens and 12 elementary schools were chosed from one downtown district(Yuexiu),one suburb(Baiyun) and one county(Zengcheng) of Guangzhou by stratified random sampling. 2 373 children recruited to this survey and 3-5 ml vein blood was collected. The blood lead was determined by inductively coupled plasma mass spectrometry (ICP-MS) after the blood sample was diluted with 0.1% Triton X-100 and 0.1% HNO3 by 1∶20. A questionnaire with 34 items which included house situation, favorite meal and cooking, habits and hygiene behavior of the children was asked to fill in by the child parent or guardian. Results Among 2373 children, geometric mean (G) of BLL was 58.28μg/L, that in male (61.11 μg/L) was higher than that in female (55.37 μg/L). Sixty (2.53%) children were identified with elevated BLLs(>100 μg/L), 36(2.90%)male and twenty four (2.09%)female. BLLs(G) in Baiyuen (suburb) children(60.33 μg/L) was the highest among three districts, Yuxiu (downtown) was 58.09 μg/L and Zengcheng (countryside)was 56.72 μg/L. Linear regressions (stepwise) were taken with geometric BLLs as dependent, 34 items as independents in SPSS 11.5. Fathers with lower diploma, narrower houses, better aired houses, fewer hand washings and sucking fingers were the risk factors for children high BLLs. Conclusion BLLs in suburb children become the highest after unleaded gasoline used in Guangzhou. The housing circumstance and hygienic behavior of children may effect the blood lead level.