安庆市2015—2018年0~14岁门诊儿童血铅水平及影响因素

叶玲飞; 王宁玲; 王士杰

doi:10.16835/j.cnki.1000-9817.2021.10.025

安庆市2015—2018年0~14岁门诊儿童血铅水平及影响因素

doi: 10.16835/j.cnki.1000-9817.2021.10.025

叶玲飞^{1, 2},
王宁玲^1, ,,
王士杰²

1.
安徽医科大学第二附属医院儿科，合肥 230601
2.
安徽医科大学附属安庆医院儿科

基金项目:

安庆市科技局科技计划项目 2018Z2008

详细信息

作者简介:
叶玲飞(1986-)，女，安徽岳西人，大学本科，主治医师，主要研究方向为儿童呼吸系统疾病

通讯作者:
王宁玲，E-mail：zwnltt@126.com

中图分类号: R446 R126
计量
- 文章访问数: 615
- HTML全文浏览量: 207
- PDF下载量: 35
- 被引次数: 0
出版历程
- 收稿日期: 2021-02-22
- 修回日期: 2021-05-18
- 网络出版日期: 2021-10-25
- 刊出日期: 2021-10-25

Blood lead level of outpatient children in Anqing from 2015 to 2018

YE Lingfei^{1, 2},
WANG Ningling^{1
, ,},
WANG Shijie²

1.
Department of Paediatrics, the Second Affiliated Hospital of Anhui Medical University, Hefei (230601), China

摘要

摘要: 目的分析安庆市2015—2018年0~14岁门诊儿童血铅水平的特点及影响因素，为防控儿童血铅水平升高提供依据。方法采用问卷调查、身体测量、实验室检测等方法，收集安徽医科大学附属安庆医院2015—2018年门诊儿童血铅水平、年龄、身高、体重、个人习惯、环境因素等相关信息，分析儿童血铅水平升高的影响因素。结果 2015—2018年安徽医科大学附属安庆医院儿科门诊检测血铅水平的儿童人数分别为4 406，4 177，3 833，3 381人，儿童血铅水平升高(elevated blood lead levels, EBLLs)检出者662，326，225，56例，检出率为15.02%，7.80%，5.87%，1.66%，其中男童EBLLs检出率为16.54%，7.31%，6.18%，1.88%，女童检出率为16.04%，8.51%，5.42%，1.33%，性别差异均无统计学意义(χ²值分别为2.47，2.00，0.99，1.53，P值均>0.05)。0~14岁儿童均可能有EBLLs，2015与2017年EBLLs检出率最高的年龄均为14岁。个人行为中，较少进食肉类及奶制品，经常接触土壤或灰尘的儿童更可能患EBLLs；餐前洗手、清洗玩具≥1次/周的儿童患EBLLs的可能性更低，差异均有统计学意义(χ²值分别为13.58，8.91，7.63，9.22，P值均 < 0.05)。环境因素中，住房距离主干道 < 50 m、家庭成员吸烟、父母从事铅相关职业的儿童更可能出现EBLLs，差异均有统计学意义(χ²值分别为4.92，10.63，22.95，P值均 < 0.05)。结论安庆市儿童2015—2018年EBLLs检出率逐年降低；餐前洗手、经常清洗玩具可降低EBLLs的风险。
- 铅 /
- 身体测量 /
- 儿童 /
- 患病率
Abstract: Objective To analyze blood lead levels of children aged 0-14 in Anqing City during 2015 to 2018, to provide basic data for child poisoning prevention and control. Methods Using questionnaire surveys, physical examination, and laboratory tests to assess blood lead, age, height, weight, personal habits, environmental factors and other relevant information, to analyze associated factors of elevated blood lead levels. Results From 2015 to 2018, among the 4 406, 4 177, 3 833 and 3 381 children aged 0-14 in the pediatric outpatient, 662, 326, 225, and 56 cases were found with elevated blood lead levels (EBLLs), with the detection rate of 15.02%, 7.80%, 5.87%, and 1.66%, respectively. Detection rate in boys (16.54%, 7.31%, 6.18% and 1.88%) was similar with that of girls (16.04%, 8.51%, 5.42% and 1.33%) (χ²=2.47, 2.00, 0.99, 1.53, P>0.05). Children in any age groups of 0-14 years might have EBLLs, highest in 14-year-old group in the year of 2015 and 2017. Personal behaviors associated with EBLLs included less meat and dairy products consumption, high frequent exposure to soil dust. In contrast, children who wash their hands before meals and wash toys ≥1 time/week were less likely to suffer from EBLLs (χ²=13.58, 8.91, 7.63, 9.22, P < 0.05). Environmental factors associated with EBLLs included were less than 50 m between the main road with residency, family members smoke, and parents engaged in construction, welding, automobile maintenance and other industries are more likely to have EBLLs, and the difference is statistically significant (χ²=4.92, 10.63, 22.95, P < 0.05). Conclusion The detection rate of EBLLs in Anqing City from 2015 to 2018 depressed by year. Washing hands before meals and cleaning toys frequently could reduce the risk of EBLLs.
- Lead /
- Body size /
- Child /
- Prevalence

HTML全文

图 1 各年龄儿童EBLLs检出率

Figure 1. EBLLs rates of child in different ages

下载: 全尺寸图片幻灯片

表 1 安庆市0~14岁儿童2015—2018年EBLLs的单因素分析

Table 1. Single factor analysis of EBLLs of aged 0-14 children in Anqing from 2015 to 2018

因素	选项	人数	EBLLs人数	χ²值	P值
居住地	城市	349	31(8.88)	0.63	0.43
	农村	162	18(11.11)
年龄段	学龄前	379	36(9.50)	0.17	0.96
	小学	103	10(9.71)
	中学	29	3(10.34)
消瘦	无	458	42(9.17)	0.89	0.35
	有	53	7(13.21)
体重不足	无	452	43(9.51)	0.03	0.87
	有	59	6(10.17)
功能性便秘	无	454	43(9.47)	0.07	0.80
	有	57	6(10.53)
过敏性疾病	无	446	41(9.19)	0.64	0.43
	有	65	8(12.31)
较少进食肉类及奶制品	无	374	25(6.68)	13.58	＜0.01
	有	137	24(17.52)
餐前洗手	无	280	36(12.86)	7.63	0.01
	有	231	13(5.63)
每周清洗玩具	无	292	38(13.01)	9.22	< 0.01
≥1次	有	219	11(5.02)
经常接触土壤或灰尘	无	382	28(7.33)	8.91	< 0.01
	有	129	21(16.28)
住房距离主干道 < 50 m	无	466	40(8.58)	4.92	0.03
	有	45	9(20.00)
家庭成员吸烟	无	456	37(8.11)	10.63	< 0.01
	有	55	12(21.82)
住在老旧或新	无	487	46(9.45)	0.25	0.62
装修住房	有	24	3(12.50)
父母从事铅相关职业	无	485	39(8.04)	22.95	＜0.01
	有	26	10(38.46)
注： ()内数字为检出率/%。

下载: 导出CSV

参考文献(27)

[1]	张红振, 董璟琦, 吴舜泽, 等. 铅污染损害评估研究[J]. 环境保护, 2016, 44(9): 51-55. https://www.cnki.com.cn/Article/CJFDTOTAL-HJBU201609015.htm ZHANG H Z, DONG J Q, WU S Z, et al. Study on damage assessment techniques of lead contamination[J]. Environ Protect, 2016, 44(9): 51-55. https://www.cnki.com.cn/Article/CJFDTOTAL-HJBU201609015.htm
[2]	DAPUL H, LARAQUE D. Lead poisoning in children[J]. Adv Pediatr, 2014, 61(1): 313-333. doi: 10.1016/j.yapd.2014.04.004
[3]	ZHANG Y F, XU J W, YANG Y, et al. The association between body lead levels and childhood rickets: a meta-analysis based on Chinese cohort[J]. Medicine, 2019, 98(8): e14680. doi: 10.1097/MD.0000000000014680
[4]	黄慧, 李国慧, 李贵霞, 等. 健康儿童血清中钙、镁、铁、锌、铜、铅、镉7种元素检测结果研究[J]. 中国实验诊断学, 2019, 23(3): 503-505. doi: 10.3969/j.issn.1007-4287.2019.03.050 HUANG H, LI G H, LI G X, et al. Study on the detection results of 7 elements of calcium, magnesium, iron, zinc, copper, lead and cadmium in the serum of healthy children[J]. Chin J Lab Diagn, 2019, 23(3): 503-505. doi: 10.3969/j.issn.1007-4287.2019.03.050
[5]	阳海林, 张国旺, 田超逸, 等. 电子废物铅和镉的暴露与小儿听力能力的相关性研究[J]. 中国妇幼保健, 2019, 34(15): 3504-3506. https://www.cnki.com.cn/Article/CJFDTOTAL-ZFYB201915038.htm YANG H L, ZHANG G W, TIAN C Y, et al. Correlation between exposure of lead and cadmium from electronic waste and hearing ability in children[J]. Matern Child Health Care Chin, 2019, 34(15): 3504-3506. https://www.cnki.com.cn/Article/CJFDTOTAL-ZFYB201915038.htm
[6]	HAUPTMAN M, STIERMAN B. Children children with autism spectrum disorder and lead poisoning: diagnostic challenges and management complexities[J]. Clinic Pediatr, 2019, 58(6): 605-612. doi: 10.1177/0009922819839237
[7]	赵莎, 钟燕, 赵兰. 儿童孤独症全血微量元素及血铅水平分析[J]. 实用预防医学, 2014, 21(1): 83-84. https://www.cnki.com.cn/Article/CJFDTOTAL-SYYY201401031.htm ZHAO S, ZHONG Y, ZHAO L. Analysis of trace elements and blood lead levels in whole blood of children with autism[J]. Pract Prev Med, 2014, 21(1): 83-84. https://www.cnki.com.cn/Article/CJFDTOTAL-SYYY201401031.htm
[8]	REUBEN A, CASPI A, BELSKY D W, et al. Association of childhood blood lead levels with cognitive function and socioeconomic status at age 38 years and with IQ change and socioeconomic mobility between childhood and adulthood[J]. JAMA, 2017, 317(12): 1244-1251. doi: 10.1001/jama.2017.1712
[9]	KELLER B, FACIANO A, TSEGA A. Epidemiologic characteristics of children with blood lead levels ≥45 μg/dL[J]. J Pediatr, 2017, 180(1): 229-234. http://www.sciencedirect.com/science/article/pii/S0022347616309271
[10]	邓美. 儿童血铅水平测定及其影响因素分析[J]. 实用检验医师杂志, 2018, 10(2): 85-87. https://www.cnki.com.cn/Article/CJFDTOTAL-CJCP201802007.htm DENG M. Determination of blood lead level and analysis of its influencing factors in childre[J]. Chin J Lab Pathol, 2018, 10(2): 85-87. https://www.cnki.com.cn/Article/CJFDTOTAL-CJCP201802007.htm
[11]	MOAWAD E M I, BADAWY N M, MANAWILL M. Environmental and occupational lead exposure among children in Cairo, Egypt: a community-based cross-sectional study[J]. Medicine (Baltimore), 2016, 95(9): e2976. doi: 10.1097/MD.0000000000002976
[12]	卫生部. 卫生部关于印发《血铅临床检验技术规范》的通知[J]. 中华人民共和国卫生部公报, 2006(2): 25-28. https://www.cnki.com.cn/Article/CJFDTOTAL-WSGB200602008.htm Ministry of Health of the People's Republic of China. Notice of the Ministry of Health on Printing and Distributing the "Technical Specifications for Clinical Testing of Blood Lead"[J]. Gazette Ministry Health PRC, 2006(2): 25-28. https://www.cnki.com.cn/Article/CJFDTOTAL-WSGB200602008.htm
[13]	赵露, 李霞, 罗钢. 《儿童高铅血症和铅中毒预防指南》及《儿童高铅血症和铅中毒分级和处理原则(试行)》解读[J]. 中国实用乡村医生杂志, 2007, 14(7): 52-53. https://www.cnki.com.cn/Article/CJFDTOTAL-FACT200707033.htm ZHAO L, LI X, LUO G. Interpretation of "Guidelines for the Prevention of Hyperleademia and Lead Poisoning in Children" and "Principles of Classification and Management of Hyperleademia and Lead Poisoning in Children (Trial)"[J]. Chin Pract J Rural Doct, 2007, 14(7): 52-53. https://www.cnki.com.cn/Article/CJFDTOTAL-FACT200707033.htm
[14]	GELTMAN P L, SMOCK L, COCHRAN J. Trends in elevated blood lead levels using 5 and 10 g/dl levels of concern among refugee children resettled in massachusetts, 1998-2015[J]. Public Health Rep, 2019, 134(6): 608-616.
[15]	康宇, 梁小华, 李廷玉, 等. 中国标准和WHO标准检出婴儿生长迟缓, 消瘦, 低体质量和超重率的差异分析[J]. 临床儿科杂志2014, 32(5): 442-445. https://www.cnki.com.cn/Article/CJFDTOTAL-LCAK201405014.htm KANG Y, LIANG X H, LI T Y, et al. The comparison of wasting, stunting, low weight, and overweight rate in infants by using the World Health Organi-zation Child Growth Standards and China Growth Standards[J]. J Clin Pediatr, 2014, 32(5): 442-445. https://www.cnki.com.cn/Article/CJFDTOTAL-LCAK201405014.htm
[16]	王卫平, 汪翼, 常立文. 儿科学[M]. 9版. 北京: 人民卫生出版社, 2018. WANG W P, WANG Y, CHANG L W. Pediatrics-Ninth Edition[M]. 9 ed. Beijing: People's Medical Publishing House, 2018.
[17]	王茂贵. 儿童功能性便秘: 罗马Ⅲ诊断标准临床评介[J]. 实用儿科临床杂志, 2007, 22(7): 559-560. https://www.cnki.com.cn/Article/CJFDTOTAL-SYQK200707048.htm WANG M G. Childhood functional constipation: clinical evaluation of diagnostic criteria Rome Ⅲ[J]. J Appl Clin Pediatr, 2007, 22(7): 559-560. https://www.cnki.com.cn/Article/CJFDTOTAL-SYQK200707048.htm
[18]	刘爱华, 李涛, 张帅明, 等. 中国18城市儿童血铅水平及影响因素现况调查[J]. 中国妇幼健康研究, 2018, 29(5): 539-542. https://www.cnki.com.cn/Article/CJFDTOTAL-SANE201805002.htm LIU A H, LI T, ZHANG S M, et al. Study on blood lead level and related risk factors among children in 18 cities of China[J]. Chin J Women Child Health Res, 2018, 29(5): 539-542. https://www.cnki.com.cn/Article/CJFDTOTAL-SANE201805002.htm
[19]	刘颖, 黄丽红, 林慧. 海口市2015—2018年学龄前儿童血铅水平及影响因素[J]. 中国学校卫生, 2019, 40(5): 742-744. doi: 10.16835/j.cnki.1000-9817.2019.05.026 LIU Y, HUANG L H, LIN H. Blood lead level and associated factors among preschool children in Haikou City from 2015 to 2018[J]. Chin J Sch Health, 2019, 40(5): 742-744. doi: 10.16835/j.cnki.1000-9817.2019.05.026
[20]	傅苏林, 张黎明, 李辉, 等. 合肥市2005—2011年儿童血铅水平及影响因素分析[J]. 中国学校卫生, 2013, 34(3): 320-323. http://www.cjsh.org.cn/article/id/zgxxws201303021 FU S L, ZHANG L M, LI H, et al. Analysis of blood lead levels and influencing factors of children in Hefei from 2005 to 2011[J]. Chin J Sch Health, 2013, 34(3): 320-323. http://www.cjsh.org.cn/article/id/zgxxws201303021
[21]	王珍, 欧洁雯, 肖伟. 湖南省衡阳市17858名儿童血铅水平分析[J]. 中国妇幼卫生杂志, 2018, 9(3): 54-56. https://www.cnki.com.cn/Article/CJFDTOTAL-YZWS201803016.htm WANG Z, OU J W, XIAO W. Analysis on blood lead level of 17 858 children in Hengyang City of Hunan Province[J]. Chin J Women Child Health, 2018, 9(3): 54-56. https://www.cnki.com.cn/Article/CJFDTOTAL-YZWS201803016.htm
[22]	吕玉桦, 石小飞, 刘珊渡, 等. 我国0~6岁儿童血铅水平及流行特征分析[J]. 实用预防医学, 2015, 22(2): 149-154. https://www.cnki.com.cn/Article/CJFDTOTAL-SYYY201502007.htm LYU Y H, SHI X F, LIU S D, et al. Analysis of blood lead level and its epidemiological characteristics in children aged 0-6 years in China[J]. Pract Prev Med, 2015, 22(2): 149-154. https://www.cnki.com.cn/Article/CJFDTOTAL-SYYY201502007.htm
[23]	MAYANS L. Lead poisoning in children[J]. Am Fam Phys, 2019, 100(1): 24-30.
[24]	张盟, 郜振彦, 徐健, 等. 上海新华医院铅中毒门诊194例儿童血铅资料的分析[J]. 中国妇幼健康研究, 2016, 27(2): 165-167. https://www.cnki.com.cn/Article/CJFDTOTAL-SANE201602007.htm ZHANG M, GAO Z Y, XU J, et al. Blood lead analysis of 194 outpatient cases of childhood lead poisoning in Shanghai Xinhua Hospital[J]. Chin J Women Child Health Res, 2016, 27(2): 165-167. https://www.cnki.com.cn/Article/CJFDTOTAL-SANE201602007.htm
[25]	戴耀华, 樊朝阳. 中国儿童铅中毒的影响因素[J]. 中国实用儿科杂志, 2006, 21(3): 165-167. https://www.cnki.com.cn/Article/CJFDTOTAL-ZSEK200603002.htm DAI Y H, FAN C Y. Influencing factors of lead poisoning in Chinese children[J]. Chin J Pract Pediatr, 2006, 21(3): 165-167. https://www.cnki.com.cn/Article/CJFDTOTAL-ZSEK200603002.htm
[26]	韩志轩, 闭向阳, 郭祥义, 等. 中国城市儿童血铅含量变化趋势及其影响因素[J]. 生态学杂志, 2017, 36(12): 3553-3557. https://www.cnki.com.cn/Article/CJFDTOTAL-STXZ201712030.htm HAN Z X, BI X Y, GUO X Y, et al. Children blood lead levels in urban and suburban areas of China and its influencing factors[J]. J Ecol, 2017, 36(12): 3553-3557. https://www.cnki.com.cn/Article/CJFDTOTAL-STXZ201712030.htm
[27]	LEAL M F, CATARINO R I, PIMENTA A M, et al. Lead migration from toys by anodic stripping voltammetry using a bismuth film electrode[J]. Arch Environ Occupat Health, 2016, 71(5): 300-306.