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首页> 美国卫生研究院文献>International Journal of Environmental Research and Public Health >Evolving from Reactive to Proactive Medicine: Community Lead (Pb) and Clinical Disparities in Pre- and Post-Katrina New Orleans
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Evolving from Reactive to Proactive Medicine: Community Lead (Pb) and Clinical Disparities in Pre- and Post-Katrina New Orleans

机译：从反应医学到积极医学的发展：卡特里娜飓风前后的社区铅（Pb）和临床差异

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In 2012 the U.S. Centers for Disease Control (CDC) set the blood Pb reference value at ≥5 µg/dL. Clinical analysis of children’s blood Pb levels is the common way to diagnose environmental Pb contamination, and intervention ensues with education and household dust cleanup. Recent review indicates that education and household dust cleanup are not effective at reducing children’s Pb exposure. Here we review mapping environmental Pb and children’s blood Pb response as an alternative approach for proactive Pb dust intervention. New Orleans was divided into a high (≥100 mg/kg) and low (<100 mg/kg) soil Pb communities. The children’s blood Pb prevalence ≥5 µg/dL for the high and low Pb domains were 58.5% and 24.8% respectively pre-Katrina vs. 29.6% and 7.5% post-Katrina. Elevated soil Pb (mg/kg) and consequently Pb loading (µg/square area) permeates the high Pb domain and outdoor locations lack Pb dust safe play areas. The U.S. EPA 400 mg/kg soil Pb standard poses an outside Pb dust loading burden >37 times larger than allowed on interior residential floor environments. Environmental Pb dust is decreasing because of the transfer of large quantities of low Pb soil into selected communities. City-scale soil Pb mapping is an alternative diagnostic tool that provides information for planning proactive medicine to prevent clinical Pb exposure in the first place.
机译：2012年，美国疾病控制中心（CDC）将血液中Pb的参考值设置为≥5µg / dL。对儿童血液中Pb水平的临床分析是诊断环境Pb污染的常用方法，随后需要进行教育和家庭除尘以进行干预。最近的审查表明，教育和家庭除尘并不能有效减少儿童的铅暴露。在这里，我们回顾了对环境铅和儿童血液铅反应的绘图，作为主动进行铅粉尘干预的替代方法。新奥尔良分为高（≥100mg / kg）和低（<100 mg / kg）土壤铅社区。高和低Pb域的儿童血液Pb患病率≥5µg / dL，卡特里娜飓风之前分别为58.5％和24.8％，卡特里娜飓风之后分别为29.6％和7.5％。高的土壤铅含量（mg / kg），因此铅含量（微克/平方面积）渗透到高铅域中，并且室外场所缺乏铅尘安全游玩区。美国EPA 400 mg / kg的土壤Pb标准造成室外Pb粉尘负荷负担大于室内住宅地板环境所允许的Pb负担37倍以上。由于大量的低铅土壤转移到选定的社区，环境铅尘正在减少。城市规模的土壤铅测绘是一种替代性的诊断工具，可为规划预防性药物提供信息，从而从一开始就防止临床铅暴露。

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