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A meta-analysis of blood lead levels in India and the attributable burden of disease
Environment International ( IF 10.3 ) Pub Date : 2018-09-29 , DOI: 10.1016/j.envint.2018.08.047
Bret Ericson , Russell Dowling , Subhojit Dey , Jack Caravanos , Navya Mishra , Samantha Fisher , Myla Ramirez , Promila Sharma , Andrew McCartor , Pradeep Guin , Mark Patrick Taylor , Richard Fuller

Multiple studies in India have found elevated blood lead levels (BLLs) in target populations. However the data have not yet been evaluated to understand population-wide exposure levels. We used arithmetic mean blood lead data published from 2010 to 2018 on Indian populations to calculate the average BLLs for multiple subgroups. We then calculated the attributable disease burden in IQ decrement and Disability Adjusted Life Years (DALYs). Our Pubmed search yielded 1066 articles. Of these, 31 studies representing the BLLs of 5472 people in 9 states met our study criteria. Evaluating these, we found a mean BLL of 6.86 μg/dL (95% CI: 4.38–9.35) in children and 7.52 μg/dL (95% CI: 5.28–9.76) in non-occupationally exposed adults. We calculated that these exposures resulted in 4.9 million DALYs (95% CI: 3.9–5.6) in the states we evaluated. Population-wide BLLs in India remain elevated despite regulatory action to eliminate leaded petrol, the most significant historical source. The estimated attributable disease burden is larger than previously calculated, particularly with regard to associated intellectual disability outcomes in children. Larger population-wide BLL studies are required to inform future calculations. Policy responses need to be developed to mitigate the worst exposures.



中文翻译:

对印度血铅水平和疾病可归因负担的荟萃分析

印度的多项研究发现目标人群的血铅水平(BLL)升高。但是,尚未对数据进行评估以了解整个人群的暴露水平。我们用算术2010年至2018年发布的印度人群的平均血铅数据,以计算多个亚组的平均BLL。然后,我们以智商下降和残障调整生命年(DALYs)计算可归因的疾病负担。我们的Pubmed搜索结果有1066篇文章。其中,代表9个州5472人的BLL的31项研究符合我们的研究标准。通过评估,我们发现儿童的平均BLL为6.86μg/ dL(95%CI:4.38–9.35),非职业暴露的成年人为7.52μg/ dL(95%CI:5.28–9.76)。我们计算出,这些暴露在我们评估的州导致了490万DALY(95%CI:3.9-5.6)。尽管采取了消除含铅汽油这一最重要的历史来源的监管行动,印度的全民BLL仍然较高。估计的可归因疾病负担大于先前计算的结果,尤其是与儿童相关的智力障碍相关的结果。需要进行更大范围的全民BLL研究,以为将来的计算提供依据。需要制定政策对策以减轻最严重的风险。

更新日期:2018-09-29
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