广州市荔湾区0～6岁儿童血铅水平及影响因素分析

Blood Lead Level and Influencing Factors among Children of 0-6 Years in Liwan District of Guangzhou

目的了解广州市荔湾区0～6岁儿童血铅水平及铅中毒的流行情况,分析儿童铅中毒的影响因素,为临床防治提供理论依据。方法采用单纯随机抽样和整群随机抽样的方法抽取荔湾区0～6岁儿童2464例,采用原子吸收光谱法进行末梢血铅测定。同时进行问卷调查,采用病例对照研究的方法进行铅中毒危险因素分析,通过非条件Logistic回归分析筛选出儿童铅中毒的影响因素。结果荔湾区儿童血铅分布在3～356μg/L之间,血铅浓度的中位数为62.47μg/L,儿童铅中毒检出率为13.35%,其中男童的铅中毒率为15.14%,女童的铅中毒率为10.79%,差异有统计学意义(χ2=14.28,P<0.05)。多因素Logistic回归分析筛选出荔湾区儿童铅中毒的危险因素为餐前未洗手(OR=1.806)和家庭成员吸烟(OR=1.635),其保护因素为每周1～2次服用钙、锌、铁制剂(OR=0.722),食用母乳、动物奶及其制品(OR=0.841),每天服用钙、铁、锌制剂(OR=0.891)。结论儿童血铅的影响因素较多,应采取综合干预措施,预防铅中毒的发生。

Objective To investigate the blood lead level of children aged 0-6 years living in Liwan District of Guangzhou, analyze the influencing factors of child lead poisoning, and provide theoretical basis for clinical controlling of lead poisoning. Methods The simple random sampling and multistage stratified ran- dom sampling were used. A total of 2464 children aged 0-6 years in Liwan district of Guangzhou. Blood lead level was tested by graphite atomizer absorption spectrophotometer, the risk factors of lead poisoning were an alyzed by case-control study, non-conditional logistic regression was performed to analyze the influencing factors of lead poisoning. Results Liwan district children＇s blood lead distribution in 3-356μg/L, the blood lead concentrations in the median of 62.47 μg/L, the prevalence of lead poisoning was 13.35 %. The preva- lence rates of lead poisoning were 15.14% in male and 10.79% in female, and the difference was significant （x^22 = 14.28 ,P 〈 0.05 ）. The Logistic regression analysis showed that never or rarely washing hands before meals（ OR = 1. 806 ）, second hand smoking（ OR = 1. 635 ） were the risk factors of lead poisoning. Supplemen- ting of calcium, zinc and iron once or twice a week （ OR = 0. 722）, drinking breast milk or milk-products （ OR =0. 841 ）and supplementing of calcium,zinc and iron everyday（ OR =0. 891 ） were the protective factors of lead poisoning. Conclusion Blood lead level of children are influenced by multiple factors, so comprehensive intervention measures should be carried out to prevent lead poisoning.