中国儿童血铅水平及变化趋势研究

Analysis of Blood Lead Levels and Changing Trend in Children in China

目的描述近年我国儿童血铅水平、分布特征及变化情况,为制定环境铅污染控制措施,保护儿童健康提供科学依据。方法通过计算机检索中国生物医学文献数据库和中国全文期刊数据库及相关文献追溯等途径,收集国内2004至2007年8月公开发表的2001年以后采样调查的关于儿童血铅水平研究的论文,选用原子吸收分光光度法(石墨炉及其它原子吸收分光光度法)或者电感耦合等离子体质谱法,有严格的质量控制且样本量大于100的文献进行综合分析,并与2004年研究结果(1995至2003年文献报道儿童血铅水平)进行比较。结果35篇文献纳入研究,血液样品采集时间为2001至2007年,总样本量为100 922人。分析结果显示,我国儿童血铅平均值为80.7μg/L(范围:45.5～165.3μg/L),23.9%(范围:3.2%～80.7%)的儿童血铅值≥100μg/L,明显低于1995至2003年儿童血铅研究结果。本次入选文献涉及全国24个省、市、自治区,其中4个省(甘肃、贵州、山西、广东)儿童血铅平均值≥100μg/L;与1995至2003年间的研究结果相比,4个省(湖南、广东、甘肃、江西)儿童血铅均值及铅中毒率相比以前均有升高,其他省市自治区则明显降低;居住于工业区的儿童血铅水平高于市区和郊区儿童,郊区儿童高于市区,且差异均具有统计学意义(P<0.001);男女儿童血铅平均值分别为79.3和76.9μg/L,铅中毒率分别为22.5%和19.6%,男女儿童间的差异具有统计学意义(P<0.001),男女儿童血铅值和铅中毒率较1995至2003年的结果均有明显降低;0～6岁儿童血铅均值和铅中毒率随年龄增加而升高。结论自2000年7月1日我国全面禁止使用含铅汽油后,我国儿童血铅水平随时间呈下降趋势,但仍显著高于发达国家水平,提示控制环境铅污染,降低我国儿童血铅水平将是一项长期任务。

Objective To evaluate Chinese children＇s blood lead levels （BLLs） and identify the distribution features with time and to provide the data for developing the policy to control environmental lead pollution. Methods The papers on children BLLs published from 2004 to Aug. 2007 with sampling time since 2001 were collected, by searching Chinese Biomedical Disk （CBMDisk）, Chinese Journal Full-test Database （CJFD） and other ways. Thirty-five articles eligible for inclusion criteria were reviewed. Also,the data were compared with our former study carried out in 2004 with articles studying time between 1995 and 2003. Results The mean BLL of Chinese children between 2001 and 2007 was 80.7 ug/L（45.5-165.3 ug/L）, and 23.9%（3.2%- 80.7%）were higher than 100 ug/L, both of which were lower than the levels in 1995 to 2003. Four of 24 provinces or cities reported had average BLLs ≥ 100 ug/L. Of the 24 provinces or cities, only four had higher BLL and prevalence rates of lead poisoning （BLL ≥ 100 ug/L） than that in 1995 to 2003. The mean BLL of children living in industrial areas was higher than that of children in urban and suburbs areas, and the mean BLL in suburbs was higher compared with urban areas. Boys BLL was 79.3 ug/L , significandy higher than girls （76.9ug/L）（P〈0.001 ）. The results also showed that children BLL increased with their ages, and the decreased BLL for all age were observed comparing with the results of our former study in 2004. Conclusion The BLL of children in China are getting lower with time but still higher than that in some developed countries, The prevention and control of children lead poisoning would be a long-term mission in China.