株洲市门诊儿童血铅水平及其影响因素的流行病学研究

Epidemiological studies on blood lead levels and influencing factors among children attended outpatient clinic in Zhuzhou

目的了解株洲市门诊儿童血铅水平及其影响因素,为防治铅中毒提供针对性建议。方法对株洲地区儿科门诊的1 200例1月~14岁儿童进行问卷调查,并测定其静脉血铅水平和血清铁、钙、铜、镁、锌含量。结果 1）门诊儿童血铅水平平均为（96.1±64.4）μg/L,≥100.0μg/L者检出率达28.7%。2）逐步回归分析：血铅水平与全血铁、钙、铜含量呈负相关,而不认为血铅水平与全血镁、锌含量存在显著关系。3）Logistic回归分析：母亲年龄较大、常补充钙/铁/锌制剂、常食用乳类和乳制品、散居是儿童血铅含量≥100μg/L的保护因素。母亲文化程度低、父亲吸烟、男童、常在交通繁忙地带散步/玩耍、进食前几乎不洗手、常咬文具/玩具、常食爆米花、常吸吮手指/啃手指甲、常玩橡皮泥、常服中草药、经常饮用罐装饮料、住所距离主干道较近、居室有墙皮脱落、住所楼层较低、大年龄儿童是儿童血铅含量≥100μg/L的危险因素。结论株洲市门诊儿童血铅水平≥100.0μg/L检出率较高,当地政府和社会应以改善生态环境、加强营养干预、普及健康教育、落实行为指导为切入点,减轻儿童铅暴露及其危害。

Objective To investigate the blood lead levels and its influencing factors among children attended outpatient clinic in Zhuzhou,in order to offer advice on how to prevent and treat lead poisoning. Methods A questionnaire survey was conducted on 1 200 children who attended outpatient clinic aged 1month to 14 years old in Zhuzhou.The contents of plumbum,iron,calcium,copper,magnesium and zinc in blood were determined. Results The mean level of blood lead was（96.1±64.4）μg/L.The proportion of children with blood lead level≥100μg/L was 28.7%in Zhuzhou.By stepwise regression analysis,the blood lead level was insignificantly correlated with iron,calcium,and cuprum in whole blood,positively correlated with magnesium and zinc.Using multiple logistic regression analysis,the protective factors against lead poisoning in children with blood lead level≥100μg/L mainly included older mother,the nutritional status of calcium,iron,zinc,regular consumption of dairy products,scattered living.The risk factors which influenced blood lead status of children with blood lead level≥100μg/L were education status of mother,fathers smoking,boy,frequently staying or walking in the heavy traffic areas,without wash their hands before eating,behavior and dietary habit of children,regular eating popcorn,fingernail biting,constantly playing with playdough,taking Chinese herbal medicine,taking regularly canned drinks,houses around the main road,the peeling wall,lower floors,older children. Conclusions In Zhuzhou,the proportion of children with blood lead level≥100μg/L is higher.The local governments and the society should have to work together to reduce the environmental lead exposure on children and lead-induced damage,thought that to improve the environment,strengthen nutrition intervention,popularize the health education and execute behavior guidance.