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首页> 外文期刊>Journal of public health management and practice: JPHMP >Control of Lead Sources in the United States, 1970-2017: Public Health Progress and Current Challenges to Eliminating Lead Exposure
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Control of Lead Sources in the United States, 1970-2017: Public Health Progress and Current Challenges to Eliminating Lead Exposure

机译：控制美国的铅来源，1970 - 2017年：公共卫生进步和目前对消除铅曝光的挑战

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Context: During the past 45 years, exposure to lead has declined dramatically in the United States. This sustained decline is measured by blood and environmental lead levels and achieved through control of lead sources, emission reductions, federal regulations, and applied public health efforts. Objective: Explore regulatory factors that contributed to the decrease in exposure to lead among the US population since 1970. Design/Setting: We present historical information about the control of lead sources and the reduction of emissions through regulatory and selected applied public health efforts, which have contributed to decreases in lead exposure in the United States. Sources of lead exposure, exposure pathways, blood lead measurements, and special populations at risk are described. Results: From 1976-1980 to 2015-2016, the geometric mean blood lead level (BLL) of the US population aged 1 to 74 years dropped from 12.8 to 0.82 mu g/dL, a decline of 93.6%. Yet, an estimated 500 000 children aged 1 to 5 years have BLLs at or above the blood lead reference value of 5 mu g/dL established by the Centers for Disease Control and Prevention. Low levels of exposure can lead to adverse health effects. There is no safe level of lead exposure, and child BLLs less than 10 mu g/dL are known to adversely affect IQ and behavior. When the exposure source is known, approximately 95% of BLLs of 25 mu g/dL or higher are work-related among US adults. Despite much progress in reducing exposure to lead in the United States, there are challenges to eliminating exposure. Conclusions: There are future challenges, particularly from the inequitable distribution of lead hazards among some communities. Maintaining federal, state, and local capacity to identify and respond to populations at high risk can help eliminate lead exposure as a public health problem. The results of this review show that the use of strong evidence-based programs and practices, as well as regulatory authority, can help control or eliminate lead hazards before children and adults are exposed.
机译：背景：在过去的45年中，美国暴露在美国急剧下降。这种持续下降是通过血液和环境铅水平来衡量的，并通过控制铅来源，排放减排，联邦法规和应用公共卫生努力实现。目的：探讨自1970年以来，促进对美国人口铅下降的降低的监管因素。设计/环境：我们通过监管和选定的应用公共卫生努力提出有关控制权来控制的历史信息和减少排放的历史信息有助于减少美国的铅暴露。描述了铅暴露的来源，暴露途径，血铅测量和风险的特殊群体。结果：从1976-1980到2015-2016，美国人口的几何平均血铅水平（BLL）为1至74岁以下从12.8升至0.82亩，下降93.6％。然而，估计的500 000名1〜5年的儿童在疾病控制和预防中心建立的5亩G / DL的血铅参考价值或高于血铅参考价值。低水平的暴露会导致健康效应不良。没有安全水平的铅曝光，并且已知小于10μg/ dl的子BLL对IQ和行为产生不利影响。当曝光源是已知的，大约95％的25μg/ dl或更高的BLL是美国成年人的工作相关。尽管减少了在美国的领先风险方面取得了很大进展，但消除了暴露存在挑战。结论：有未来的挑战，特别是某些社区中铅危害的不公平分配。维持联邦，州和地方能力识别和响应高风险的人口可以帮助消除作为公共卫生问题的铅暴露。该评论结果表明，使用强有力的基于证据的计划和实践以及监管机构，可以帮助控制或消除儿童和成人暴露之前的铅危险。

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