Cent Eur J Public Health 1998, 6(2):119-122
Clinical analysis of children living in a lead polluted environment
- 2nd Clinic of Paediatrisc and Gastroenterology, Clinic of Internal and Occupational Diseases, Medical Faculty, Wrocław, Poland
The aim of the study was to evaluate the blood lead levels (BLL) in children aged 3-9 years living in Wroclaw (619 children) and Olawa (153 children). Next we analysed the health status of all children with increased BLL exceeding 10 µg/dl. In all of those children detailed health and environmental date were collected, detailed physical examinations were made and analysed. All children were also examined psychologically and neurologically, a peripheral blood cell count and other tests such as erythrocyte count, protoporphyrin (FEP), δ-aminolaevulinic acid dehydratase activity (ALAD), δ-aminolaevulinic acid excretion (ALA) in urine were done. The BLL was estimated by atomic spectrophotometry. During screening examination increased BLL exceeding 10 µg/dl were observed in 34.5 % of children living in Olawa and in 4.4 % of children from Wroclaw. Most of children (82-91 %) with increased BLL lived near a street with heavy traffic. About 50 % of children were treated more than twice a year because of respiratory tract infections. Anaemia was observed in about 50 % of children. Abnormal values of ALAD were observed in 25-33 % children and increased FEP levels in 25-52.4 % of them. Electroencephalography (EEG) showed in every other child signs of increased cortex excitability. During neurological examination we observed a non-specific increase of neurovegetative excitability. The BLL checked in all of those children after 2-3 months from the first examination, showed generally lower values of BLL. As a result of analyses, a variability of BLL and the presence of laboratory signs of chronic lead poisoning were found in a group of children having no clinical symptoms. In 1991 the US Centers for Disease Control and Prevention redefined lead poisoning as a BLL of 10 µg/dl or higher, recommending counselling and environmental interventions when the child's BLL is persistently above 15 µg/dl and medical interventions when it is above 20 µg/dl. Subtle central nervous system (CNS) dysfunctioning appears to be one of the earlier signs of increased lead exposure. This was observed in the examined children. Many of them had classical pathological findings such as chronic nephropathy, neuronal injury or death.
Zveřejněno: 1. červen 1998 Zobrazit citaci