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首页> 外文期刊>Pediatrics: Official Publication of the American Academy of Pediatrics >A randomized, community-based trial of home visiting to reduce blood lead levels in children.
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A randomized, community-based trial of home visiting to reduce blood lead levels in children.

机译：一项基于社区的随机家庭试验，旨在降低儿童的血铅水平。

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OBJECTIVE: The objective of this study was to measure the effectiveness of intensive case management to reduce blood lead levels (BLLs) in children. Lead poisoning remains a common, preventable pediatric condition despite advances in reducing children's BLLs in the United States. Substantial evidence implicates lead paint-contaminated house dust as the most common high-dose source of lead in children's environments. Housekeeping and parental supervision also may contribute to risk for lead exposure. METHODS: We conducted a community-based, randomized trial of comprehensive education and home visiting for families of children with BLLs 15 to 19 microg/dL. BLLs after 1 year of follow-up were compared for intervention group children, whose families received individualized education that was designed to address specific risks factors in a child's environment, and comparison group children, whose families received customary care, usually 1 or 2 educational visits. Environmental samples were collected at baseline and after 1 year of follow-up for intervention group children and compared with those of comparison group children, collected only at the end of study. RESULTS: During the follow-up period, parents of intervention group children (n = 92) successfully decreased dust lead levels and significantly improved parent-child interaction and family housekeeping practices compared with comparison group children (n = 83). Overall geometric mean BLLs declined by 47%, and the difference in BLL by group was not significant (9 vs 8.3 microg/dL for intervention versus comparison group children, respectively.) After 1 year, nearly half of enrolled children had BLLs > or = 10 microg/dL. CONCLUSIONS: Until a reservoir of lead-safe housing is created, programs that educate families to reduce environmental exposure are needed. Although providing families with quantitative information regarding lead contamination may have a role in short-term efforts to prevent lead exposure, these null findings suggest that it has little benefit once BLLs are elevated.
机译：目的：本研究的目的是评估强化病例管理降低儿童血铅水平（BLL）的有效性。尽管在美国减少儿童的BLL方面取得了进展，但铅中毒仍然是一种常见的可预防的儿科疾病。大量证据表明，含铅涂料污染的房屋粉尘是儿童环境中最常见的高剂量铅源。家政和父母监督也可能导致铅暴露的风险。方法：我们对15至19 microg / dL的BLL儿童家庭进行了一项基于社区的随机综合教育和家访试验。比较干预组1年后的BLL，其中干预组儿童的家庭接受了旨在解决儿童环境中特定风险因素的个性化教育，而对比组儿童的家庭接受了常规护理，通常进行了1或2次教育访问。在基线时和干预后1年后收集干预组儿童的环境样本，并与对照组儿童进行比较，仅在研究结束时进行收集。结果：在随访期内，干预组儿童的父母（n = 92）与对照组儿童（n = 83）相比，成功地降低了粉尘铅含量，并显着改善了亲子互动和家庭管家行为。总体几何平均BLL下降了47％，按组别的BLL差异不显着（干预组和比较组儿童分别为9 vs 8.3 microg / dL。）1年后，将近一半的入组儿童的BLL>或= 10微克/分升。结论：在建立铅安全住房储备库之前，需要有一些计划来对家庭进行教育，以减少环境暴露。尽管向家庭提供有关铅污染的定量信息可能会在短期内预防铅暴露中发挥作用，但这些无效的研究结果表明，一旦BLL升高，它的益处就很小。

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