乡镇企业铅污染导致儿童铅中毒的流行病学调查

An epidemiological survey on saturnism among children due to lead pollution released from township enterprise

目的了解铅污染事件发生村及周边单位儿童铅中毒、血铅超标状况与范围，分析血铅水平与年龄、性别关系及对儿童健康的影响，为进一步采取预防控制措施提供依据。方法对污染源及周边环境进行调查；对事件发生村及周边单位14岁以下的221例儿童采集静脉血样、用原子吸收光谱法测定血铅；通过问卷调查了解儿童主要铅中毒症状，用SPSS13．0进行统计学分析。结果儿童高铅血症检出率66．06％（146／221），铅中毒检出率32．13％（71／221）。该村一、二、三组及玉石厂儿童血铅水平分别为（161．20±32．94）、（176．60±43．62）、（258．00±106．08）和（238．01±55．20）μg/L，经Kruskal-Wallis秩和检验差异有统计学意义（X^2=51．84，df=3，P〈0．01）；三组和玉石厂组显著高于一组和二组。未发现儿童年龄与血铅水平存在相关性（r=0．10，P=0．13），但男女性别间血铅水平差异有统计学意义（t’=3．83，P〈0．01）。随血铅水平升高，儿童铅中毒主要症状发生率明显上升。调查表明污染源为一粗铅冶炼厂。结论在粗铅冶炼厂周边居住的儿童血铅水平普遍增高，部分发生铅中毒，铅中毒对儿童健康造成了影响。

Objective To understand the current situations of saturnism and blood lead levels of children resided in village and circumjacent areas, and to know its relations with sex, age and other factors on children＇s health as to providing some evidences for prevention and control. Methods An epidemiological survey was conducted for finding out the pollution sources and for a better understanding of the surrounding environment. All 221 children under 14 years old, from the lead pollution villages and surrounding establishments were enrolled, and their blood lead levels were detected by graphite atomizer absorption spoctrophotometer method. Symptoms of the saturnism were investigated through a standardized questionnaire. SPSS13.0 software was administrated for data analysis. Results High blood lead level identification rate was 66.06% （146/221） ,and satumism rate 32. 13% （71/221）. The children＇s blood lead levels among group 1, group 2, group 3 in this village and jade factory were（161.20 ±32.94）, （ 176. 60 ± 43. 62 ）, （258.00± 106. 08 ） and （238.01 ± 55. 20 ） μg/L respectively and the significant differences were observed through Kruskal-WaUis test （x^2 =51.84, df=3 ,P 〈0. 01）. The blood lead levels of children from group 3 in this village and the jade factory were higher than those of other two groups. No correlation was found between children＇s age and blood lead level （r = 0. 10, P = 0. 13 ）. There was a significant difference in blood lead levels between boys and girls （t＇ = 3.83, P 〈 0. 01 ）. With the children＇s blood lead levels rising, the occurrence rate of main saturnism symptoms was significantly increased. This survey suggested that the pollution source was a coarse lead smelter. Conclusion The blood lead level should ke overwhelmingly increased among children who live nearby the higher level of lead blood, that living nearby the lead smeltery, might result in stautnism and negative effect on children＇s healthy.