株洲市2016—2018年门诊儿童血铅水平及影响因素分析

Blood lead levels and influencing factors among outpatient children from 2016 to 2018 in Zhuzhou

目的了解株洲市门诊儿童血铅水平及其影响因素,为防治铅暴露提供针对性建议。方法以2016年2月1日至2018年8月1日检测在湖南中医药高等专科学校附属第一医院儿科门诊进行常规体检的1 600名≤14岁儿童静脉血铅水平和血清钙、铁、锌、镁、铜含量,并对儿童家长进行儿童血铅水平影响因素问卷调查。结果儿童血铅水平为(95.2±46.5)μg/L。血铅水平≥100μg/L者检出率达25.7%,不同性别、年龄组儿童血铅水平差异均有统计学意义(Z值分别为1.85,2.85,P值均<0.05)。静脉血铅水平与血清钙、铁、锌、镁、铜含量呈负相关(F=16.80,P<0.01)。多因素Logistic回归分析显示,经常饮用罐装或瓶装饮料、进食前经常不洗手、常食爆米花、居室用煤、常吸吮手指/啃手指甲与血铅水平呈正性相关(OR值分别为2.12,1.57,1.46,1.78,3.24,P值均<0.01)。结论株洲市儿童血铅水平较高。应加强环境保护和行为干预,并定期检测血铅水平。

Objective To investigate the blood lead level of outpatient children and associated factors in Zhuzhou, and to offer targeted advice for the prevention and control of lead exposure. Methods The lead level in blood of 1 600 children aged ≤14 years old and the content of serum calcium, iron, zinc, magnesium, copper were tested, and the children and their parents were given a questionnaire regarding influencing factors of blood lead exposure. Results The average blood lead level of the children was(95.2±46.5)μg/L, The proportion of children with blood lead level ≥100 μg/L was 25.7%. The blood lead level between boys and girls had a statistical differences(Z=1.85, 2.85, P<0.05). The blood lead level was negatively correlated with serum calcium, iron, zinc, magnesium and copper(F=16.80,P<0.01). The risk factors for lead exposure included frequently drinking canned or bottled soft drinks, failing to wash one’s hands before meals, taking popcorn frequently, using coal for heat and for cooking, and constantly sucking fingers or biting fingernails(OR=2.12, 1.57, 1.46, 1.78, 3.24, P<0.01). Conclusion The blood lead levels of children in Zhuzhou is higher than national average level. We should strengthen environmental protection and behavioral interventions, and regularly monitor lead exposure among children.