RESUMO
OBJECTIVES: To determine blood lead levels in urban populations of children (n = 2,510) and women (n = 874) in the early postpartum in certain districts of Lima and Callao, and to correlate those levels with particular exposures. MATERIAL AND METHODS: Between July 1998 and January 1999 cross sectional study was conducted. The study population was selected using three sampling strategies in the government operated school system and from public pediatric and maternity hospitals at Lima and Callao, Peru. Study personnel were trained to collect finger stick blood samples with a protocol that minimizes external lead contamination. Lead determinations in blood and environmental samples were performed at the study site using portable anodic striping voltamenters. To determine the simultaneous effects of different predictors on blood lead levels, multivariate regression models were used to estimate adjusted mean differences. RESULTS: The mean blood lead level in the children studied was 9.9 micrograms/dl ranging from 1 microgram/dl to 64 micrograms/dl with 29% of the children displaying values greater than 10 micrograms/dl and 9.4% at levels greater than 20 micrograms/dl. Among the women, the mean was 3.5 micrograms/dl (SD = 2.4 micrograms/dl), and 2.4% (n = 21) displayed levels greater than 10 micrograms/dl. Important differences were observed between the sample locations, and the highest levels were documented in the port region near Callao. The mean level of blood lead in this group was 25.6 micrograms/dl (SD = 4.6 micrograms/dl), while among the rest of the sample it was 7.1 micrograms/dl (SD = 5.1 micrograms/dl). The presence of a mineral storage area signified a difference in exposure in excess of 13 micrograms/dl for children living near the port area in contrast to the other children who were not as close to such fixed sources of lead exposure. For the participants in Lima, the risk of showing levels above 10 micrograms/dl was associated with exposure to high vehicular traffic. CONCLUSIONS: In metropolitan Lima, we conclude that the mean blood lead levels of the populations studied were not alarming and that a positive health impact can be made by a reduction of lead in gasoline. With regard to the port area, the study demonstrates that the presence of mineral storage areas pose a detrimental risk factor for the health of the children living in this area. The English version of this paper is available too at: http://www.insp.mx/salud/index.html.
Assuntos
Exposição Ambiental , Poluentes Ambientais/sangue , Intoxicação por Chumbo/epidemiologia , Chumbo/sangue , Criança , Pré-Escolar , Estudos Transversais , Feminino , Humanos , Lactente , Intoxicação por Chumbo/sangue , Masculino , Peru/epidemiologia , Período Pós-Parto , Fatores de Risco , População UrbanaRESUMO
In 1998, a school-based blood lead level (BLL) survey of 2,510 children, conducted in Lima and Callao, Peru, revealed elevated BLLs in children from 2 Callao schools (mean BLL = 25.6 microg/dl; n = 314) and in children from Callao overall (mean BLL = 15.2 microg/dl; n = 898), compared with children from Lima (mean BLL = 7.1 microg/dl; n = 1,612). Public health officials at Peru's Direccion General de Salud Ambiental (DIGESA) hypothesized that a possible source of the elevated pediatric BLLs observed in Callao was a large depository near the port where mineral concentrates are stored prior to shipment. The U.S. Centers for Disease Control and Prevention worked with DIGESA to identify source(s) that contributed to the pediatric lead poisonings by comparing isotopic profiles of lead in blood, mineral, gasoline, and air filter samples. The lead isotope ratio (IR) observed in mineral samples from the depository in Callao differed from those in gasoline samples from Lima and Callao. The blood lead IRs of children living near the depository were similar to the IRs of the mineral samples and different from the IRs of the gasoline samples, suggesting that lead from the depository-and not gasoline-was the primary source of lead in these children. Lead IR analysis of regional air filter samples supported these findings.
Assuntos
Poluentes Atmosféricos/análise , Exposição Ambiental/efeitos adversos , Intoxicação por Chumbo/sangue , Chumbo/análise , Metalurgia , Pré-Escolar , Humanos , Isótopos , Intoxicação por Chumbo/diagnóstico , Intoxicação por Chumbo/epidemiologia , Peru/epidemiologiaRESUMO
OBJETIVO: Determinar los niveles de plomo en sangre en una muestra compuesta por niños y mujeres en el posparto temprano, residentes en Lima y El Callao. Investigar los determinantes de estos niveles y algunas fuentes de exposición. MATERIAL Y MÉTODOS: Entre julio de 1998 y enero de 1999 se llevó a cabo una encuesta en el área metropolitana de Lima y en El Callao, Perú. La población de estudio fue identificada mediante tres estrategias de muestreo y con la cual se seleccionaron escuelas públicas y hospitales pediátricos y gineco-obstétricos. El personal que participó en el estudio recibió entrenamiento para la técnica de punción digital y puso especial énfasis en controlar la contaminación externa con plomo. Las determinaciones del metal en sangre y muestras ambientales se llevaron a cabo utilizando voltametría anódica. Para determinar los efectos simultáneos de diferentes predictores sobre los niveles de plomo en sangre se usaron modelos de regresión multivariada para estimar diferencias de media y ajustadas. RESULTADOS: Los niveles promedio de plomo en sangre fueron de 9.9 µg/dl de una variación entre 0 y 64 µg/dl. El 29 y 9.4% de los niños presentaron valores por encima de 10 µg/dl y 20 µg/dl,respectivamente. Para las mujeres el promedio de plomo en sangre fue de 3.5 µg/dl (DE=2.4) y 2.4% (n=2l) presentaron niveles superiores a 10 µg/dl. Se observaron diferencias importantes en relación con el sitio de residencia; los niveles más altos se documentaron en la zona de El Callao. Para este grupo la media de plomo en sangre fue de 25.6 µg/dl (DE=4.6) mientras que para el resto de la muestra el promedio de plomo en sangre fue de 7.1 µg/dl (DE=5.l). En esta zona se detectó un área de almacenamiento de minerales como una fuente importante de exposición. Los niños que viven cerca de esta área tenían en promedio un exceso de 13 µg/dl en sangre. Para los participantes de la zona de Lima el riesgo de presentar niveles por encima de 10 µg/dl se asoció con la exposición a tráfico vehicular. CONCLUSIONES: Para Lima Metropolitana se puede concluir que los niveles de plomo en sangre no representan un problema urgente, sin embargo, el reducir el plomo de la gasolina se acompaña de un beneficio importante. En contraste, para el área cercana al puerto de El Callao, nuestro estudio demuestra la presencia de sitios de almacenamiento de minerales que representan un riesgo importante para la salud de los niños que viven en esta zona.