Prenatal Lead Exposures in Pakistan: A Prelude to Prevention

巴基斯坦产前铅暴露：预防的前奏

• 批准号: 7624941
• 负责人: NALINI SATHIAKUMAR
• 金额: $ 12.56万
• 依托单位: UNIVERSITY OF ALABAMA AT BIRMINGHAM
• 依托单位国家: 美国
• 财政年份: 2009
• 资助国家: 美国
• 起止时间: 2009-05-14 至 2011-03-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/7624941
• 关键词: AA Spectrophotometry; Address; Algorithms; Asia; Behavior; Birth; Blood; Calcium; Cellular Phone; Centers for Disease Control and Prevention (U.S.); Child; Child health care; Cities; Cosmetics; Country; Crime; Cross-Sectional Studies; Data; Deposition; Developed Countries; Developing Countries; Diet; Discipline of obstetrics; Environment; Environmental Health; Environmental Risk Factor; Equation; Extended Family; Ferritin; Fetus; Fluorescence; Follow-Up Studies; Future; Gasoline; Generations; Health Professional; Hemoglobin; Home environment; Hospitals; House Dust; Income; Infant; Intervention; Interview; Lead; Lead Poisoning; Life; Linear Regressions; Low income; Measurement; Measures; Methods; Modeling; Mothers; National Institute for Occupational Safety and Health; Natural graphite; Newborn Infant; Paint; Pakistan; Pathway interactions; Persons; Phase; Policy Maker; Prevention; Problem behavior; Procedures; Public Health; Questionnaires; Recording of previous events; Recruitment Activity; Regression Analysis; Relative (related person); Research; Research Personnel; Risk; Risk Reduction; Roentgen Rays; Role; Serum; Slum; Societies; Soil; Source; South Asian; Street Address; Structure; Study Subject; Telephone; Time; Toy; Traditional Medicine; Umbilical Cord Blood; Umbilical cord structure; United States; Violence; Woman; Work; World Health Organization; Youth; anti social; base; blood lead; bone; cognitive function; cohort; drinking water; environmental Pb exposure; fetal lead exposure; follow-up; lead control measure; lead exposure; member; migration; neonate; prenatal; programs; prospective; public health relevance; tertiary care; urban area

DESCRIPTION (provided by applicant): Lead toxicity remains a major environmental health risk throughout the world. Pakistan and South Asian countries consider phasing-out of leaded gasoline as an adequate measure for control of lead. However, lead deposited in environmental media and maternal bone continues to expose fetuses and children. Our preliminary study in Karachi has shown that approximately 50% of neonates in an urban area of Pakistan had cord blood lead levels (BLL) above10 <g/dL. We assessed sources of lead exposures using questionnaires; however, we were not able to measure lead levels in environmental media. The proposed study, a pioneer study on lead exposure in South Asia, will recruit women delivering infants at one of three tertiary care hospitals in Karachi, Pakistan and will measure lead in environmental media in their homes. The specific aims are: (1) to estimate the mean umbilical cord blood lead level and the proportion of newborns with high cord blood lead levels (>10</dl); (2) to determine sources and levels of environmental lead exposure in children's homes and surroundings; (3) and to identify the major determinants of umbilical cord blood lead level (BLL) including environmental sources and maternal determinants. We will recruit mothers presenting for delivery at the study hospitals, interview them, will collect their blood for BLLs, serum ferritin and hemoglobin, and will collect umbilical cord for lead levels. We will conduct environmental source measurements in homes and surrounding environment. The Centers for Disease Control and Prevention (CDC) will provide technical assistance to interpret and disseminate research findings for national policy makers and public health professionals. This study will contribute to understanding the sources of lead in environment that will provide a basis for which to inform issues of lead abatement and environmental risk reduction in Pakistan and serve as a model intervention for other countries in the region. PUBLIC HEALTH RELEVANCE: Narrative Lead toxicity continues to remain a major environmental health risk throughout the world. Previous research has shown that about 50% of Pakistani children have blood lead levels (BLL) >10 <g/dL. There is growing evidence of an association between children exposed to lead levels and lowered cognitive function, and delinquent behavior in young adulthood. These findings raise concerns about the health of children and of their future potential to be productive members of society in their country and in the world. This study, a pioneer study on lead exposure assessment in a developing country, will contribute to understanding the role of various sources of lead exposure in Pakistan. These data will provide a basis for intervention in Pakistan at the national level that will result in reduction of BLLs in children. The findings of this study also are directly relevant to lead prevention/control programs in other countries in South Asia.

描述（由申请人提供）：铅毒性仍然是全球主要的环境健康风险。巴基斯坦和南亚国家认为，淘汰铅汽油是控制铅的适当衡量标准。但是，在环境媒体和母体骨骼中沉积的铅继续暴露胎儿和儿童。我们在卡拉奇的初步研究表明，巴基斯坦市区的新生儿中约有50％的新生儿在10 <g/dl上方的脐带血铅水平（BLL）。我们使用问卷调查了铅暴露的来源；但是，我们无法衡量环境媒体中的潜在客户水平。拟议的研究是一项关于南亚铅暴露的先驱研究，将招募妇女在巴基斯坦卡拉奇的三家三级护理医院之一分娩，并将衡量其家中环境媒体的铅。具体目的是：（1）估计平均脐带血铅水平和高索绳铅水平的新生儿的比例（> 10 </dl）； （2）确定儿童家庭和周围环境中环境铅暴露的来源和水平； （3）并确定脐带血铅水平（BLL）的主要决定因素，包括环境来源和孕产妇决定因素。我们将招募在学习医院分娩的母亲，采访他们，将为BLL，血清铁蛋白和血红蛋白收集血液，并将收集脐带以达到铅水平。我们将在房屋和周围环境中进行环境源测量。疾病控制与预防中心（CDC）将为国家政策制定者和公共卫生专业人员解释和传播研究结果。这项研究将有助于理解环境中的铅来源，这将提供一个基础，以告知巴基斯坦铅和环境风险降低的问题，并作为该地区其他国家的模型干预。公共卫生相关性：叙事铅毒性继续仍然是全球主要的环境健康风险。先前的研究表明，大约50％的巴基斯坦儿童的血铅水平（BLL）> 10 <g/dl。越来越多的证据表明，暴露于潜在客户水平的儿童与认知功能降低的儿童与成年年轻人的行为降低。这些发现引起了人们对儿童健康及其未来潜力成为其国家和世界上社会成员的潜力的关注。这项研究是一项关于发展中国家铅暴露评估的先驱研究，将有助于了解巴基斯坦铅暴露的各种来源的作用。这些数据将为巴基斯坦在国家一级的干预提供基础，这将导致儿童BLL减少。这项研究的发现也与南亚其他国家的领导预防/控制计划直接相关。