| Objective: The purpose of these analyses was to assess the characteristics oflead-poisoned children in clinical,the blood lead levels of children, the risk factors innormal children,and evaluate the effectiveness of health education on reducing blood leadlevels on children. Thus,this paper helps offer recommendations for clinical diagnosis, thepopulation survey and intervention.Part oneMethods: According to the principle of informed consent, children’s information wascollected in lead poisoning outpatient; The "heavy metal outpatient questionnaire" was toevaluate the clinical features of lead-poisoned children; Children lead poisoning wasdiagnosed according to the children’s classification and principles of management of highblood lead and lead poisoning (try out). Blood samples were collected to measure bloodlead level by graphite furnace atomic absorption spectrometry.Results: As clinic symptoms was concerned, most of the Children have the symptomsof inattention,hyperactivity,aggressive behavior,and so on.As the fathers’ occupation wasconcerned, the lead poisoning incidence rate of children, whose father was worker, issignificantly higher than the other group of children(χ2=11.761, P <0.05); The leadpoisoning rates of children in multivitamin group is lower than the never supplement groupsignificantly (χ2=6.621, P <0.05); There is a significant difference in the lead poisoningincidence rate between the lead poisoning exposure group and non-exposure group (χ2=90.368, P <0.05); Children who used red powder had a significantly higher lead poisoningincidence rate than that unused groups (χ2=12.308, P <0.05).The lead poisoning incidencerate of children in burning foil group was significantly higher than that who was notburning foil (χ2=10.274, P <0.05); Logistic regression analysis showed that the influencefactors of children lead poisoning were lead pollution, especially industrial pollution andfather’s occupation. Conclusion: Sources of lead exposure were the major risk factors for elevated bloodlead levels in the hospital, there were no specificity of clinical manifestations inlead-poisoned childrenPart twoMethods: According to the principle of informed consent, in the two streets ofTaizhou, preschool children were randomly selected for epidemiological surveys.Children’s behavior and family environment was assessed with children healthquestionnaire.In the epidemiological investigation, Children lead poisoning was diagnosedaccording to the children’s classification and principles of management of high blood leadand lead poisoning (try out). Blood samples were collected to measure blood lead level bygraphite furnace atomic absorption spectrometry.Results: There were1849cases (91.2%) whoes blood lead level were in gradeⅠ,156cases (7.7%) in grade Ⅱ,9cases (0.4%) in grade Ⅲ,11cases (0.6%) in grade Ⅳ and3cases (0.2%) in Ⅴ level; In these2028children, including1090(53.8%) boys and938(46.2%) girls, the blood lead level is (11~468)μg/L and the mean is (57±39)μg/L. Allthe children with an average age of60months, during20months and96months; Asmother education level was concerned, the lead poisoning incidence rate in children ofprimary-school was significantly higher than that of secondary-school anduniversities(χ2=11.95, P=0.0025),which indicated that mother education level contributedto lead poisoning; Father and the main carer of the child education level was nosignificantly difference effect to lead poisoning (χ2=5.90and1.07,P>0.05); As themothers’ occupation was concerned, the mothers who were workers, the lead poisoningincidence rate of children is significantly higher than the other group of children (χ2=4.82,P=0.0282), while the lead poisoning incidence rate in children of father’s occupation wasno significantly difference (χ2=1.56, P=0.2117). As the family annual income wasconcerned, the lead poisoning incidence rate in children of high-income, middle-incomeand low-income was no significantly difference (χ2=0.09, P=0.9558); As the children’sbehavior was concerned,such as frequency of chew toys,chew the fingers and the key, pica,nails, the proportion of color or painted toys, wash hands thoroughly, contact mothercosmetics has no significantly difference in the lead poisoning(χ2=0.93,0.67,0.01,5.75,2.42,0.62,6.30,0.69and2.41, P>0.05); As the children’s nutrition was concerned,supplementing of calcium,iron and zinc was significantly influence the incidence of childhood lead poisoning (χ2=7.54, P=0.0231), which indicated that calcium,iron and zinccontributed to lead poisoning. While anemia, rickets, cod liver oil, popcorn, preserved egg,and potato chips has no significantly difference in the lead poisoning ((χ2=2.20,0.46,0.46,0.49,5.56,2.33,1.47and2.53, P>0.05); As the living environment was concerned, tin withdrinking water, patterned tableware and residential house floor had a significantlyinfluence on the incidence of childhood lead poisoning(χ2=11.74,15.55and11.74respectively, P<0.05); Small workshops and living around the factory hadsignificantly differences in incidence of childhood lead poisoning (χ2=7.37and6.64,P<0.05)； Passive smoking, smoking of the main carer, leftovers, tap water, foil, kitchenburning fuel, had no significantly differences in incidence of childhood lead poisoning(χ2=2.53,3.92,0.07,0.03,3.68,0.15,3.68,0.15and2.90, P>0.05); Logistic regressionanalysis showed that the influencing factors of children lead poisoning were mothereducation level, drinking tap water, patterned tableware, cutlery tin pot with drinking water,the residential house floor, living around the factory.Conclusion: Parents’ education, especially mother’s education is the most importantrisk factor of childhood lead poisoning, the higher education level their mother are of,thefewer children will develop as lead-poisoning. Father’s occupation can affect children’sblood lead levels, the father who is a worker, more children will develop aslead-poisoning.The higher the annual income is, fewer children will develop aslead-poisoning. Away from the polluted environment can reduce the blood lead level ofchildren; Reduce the lead pollution sources such as tin pot in family life can reduce thechildren’s blood lead levels.Part threeMethods: According to the principle of informed consent, in the epidemiologicalsurveys, children,whoes blood lead levels≤200μg/L,were randomly selected toparticipate in the health education interventions. Two kindergartens were randomlyselected from Fengjiang street and209qualified children were selected into the studygroup, Two kindergartens were randomly selected from Pengjie street and199qualifiedchildren were selected into the control group and the health education was given to thestudy group.All the children are required to fill out KABP (knowledge, attitude, belief,practice, KABP) questionnaire before and after the health education. After the healtheducation, all the children who participated in the health education interventions needed to detect blood lead again. Children lead poisoning was diagnosed according to the children’sclassification and principles of management of high blood lead and lead poisoning (tryout).Blood samples were collected to measure blood lead level by graphite furnace atomicabsorption spectrometry.Results: After health education, all the relevant knowledge of lead poisoning, leadsources and prevention of childhood lead poisoning of participating parents in study groupand control group were improved (study group χ2=27.78,17.19,33.82,35.63,23.61,16.62and17.78, P <0.0001,while control group χ2=3.19,2.32,3.31,2.69,3.63,0.32and3.73, P>0.05). After health education, children and parents′behavior in study group wasimproved,partial eclipse(study group χ2=0.45, p=0.5002, while control groupχ2=6.10,p=0.0136),washing hand (study group χ2=9.29, p=0.0023, while control group χ2=2.47,p=0.1161),biting pastels(study group χ2=6.91, p=0.0086, while control group χ2=0.71,p=0.3994); As parents attitude towards detection of blood lead level in children andlead poisoning intervention was concerned, there was a significantly difference betweenstudy group than control group (studygroupχ2=4.67, P=0.0308, control group χ2=0.03, P=0.8694).However, the decrease in blood lead levels was remarkable in the study groupand control group.There was average reduction of17μg/L in blood lead levels for studygroup (t=4.82, P <0.0001) and an almost13μg/Lfor control (t=4.24, P <0.0001).Thereduction in blood lead level was4μg/L greater in study group (t=1.11, P=0.2673).Conclusion: Health education can help reduce the blood lead level of children;Toimprove the effectiveness of health education on reducing blood lead levels, the longereducation, the effectively prevent of contamination in the process of study, the using ofblind method are needed. |
PDF Full Text Request