张乔柔, 曹云, 田英, 雷晓宁, 潘承谕, 吕铖, 施蓉. 学龄期儿童重金属暴露水平与其体格发育相关指标的关联性研究[J]. 环境与职业医学, 2022, 39(2): 127-132, 140. DOI: 10.11836/JEOM21280
引用本文: 张乔柔, 曹云, 田英, 雷晓宁, 潘承谕, 吕铖, 施蓉. 学龄期儿童重金属暴露水平与其体格发育相关指标的关联性研究[J]. 环境与职业医学, 2022, 39(2): 127-132, 140. DOI: 10.11836/JEOM21280
ZHANG Qiaorou, CAO Yun, TIAN Ying, LEI Xiaoning, PAN Chengyu, LYU Cheng, SHI Rong. Association between heavy metal exposure level and physical development indicators among school-age children[J]. Journal of Environmental and Occupational Medicine, 2022, 39(2): 127-132, 140. DOI: 10.11836/JEOM21280
Citation: ZHANG Qiaorou, CAO Yun, TIAN Ying, LEI Xiaoning, PAN Chengyu, LYU Cheng, SHI Rong. Association between heavy metal exposure level and physical development indicators among school-age children[J]. Journal of Environmental and Occupational Medicine, 2022, 39(2): 127-132, 140. DOI: 10.11836/JEOM21280

学龄期儿童重金属暴露水平与其体格发育相关指标的关联性研究

Association between heavy metal exposure level and physical development indicators among school-age children

  • 摘要: 背景 环境中重金属广泛存在,难以降解且存在生物富集。儿童体格发育尚不成熟,重金属暴露可能对其产生不可逆转的危害,然而目前研究结论尚不一致。因此,关注重金属污染物对体格发育的影响至关重要。

    目的 检测山东莱州湾地区学龄期儿童重金属暴露水平,并探讨重金属暴露水平与学龄期儿童体格发育指标的关联。

    方法 本研究对象来自山东莱州湾出生队列中2010年9月至2013年12月招募的孕妇所生育的子女,截至2019年7—9月随访时年满7周岁者,共318名。收集其尿液并采用电感耦合等离子体质谱法(ICP-MS)检测尿中砷(As)、镉(Cd)、铅(Pb)、汞(Hg)4种重金属的水平,同时对儿童身高、体重、腰围及体脂百分比进行测量,并计算体重指数(BMI),分析儿童尿中4种重金属水平与儿童体格发育相关指标的关联。

    结果 该318名学龄期儿童年龄( \bar x \pm s )为(7.77± 0.67)岁。其尿中As、Cd、Pb、Hg这4种重金属的中位数(M)及其第25、75百分位数(P25P75)水平分别为:73.98(44.81,124.61)、0.40(0.27,0.58)、1.20(0.71,1.72)、2.38(1.32,4.80)μg·g−1(以肌酐计)。儿童尿Cd水平(经自然对数转换)与其体重、BMI、腰围呈正向关联(P<0.05),其回归系数b及其95%可信区间(CI)分别为0.99(0.14~1.83)、0.43(0.06~0.81)和1.35(0.27~2.42);而其他金属元素未见与以上体格发育指标有关联(P>0.05)。性别分层后发现,男孩尿Cd水平与其身高、体重、BMI、腰围呈正向关联(P<0.05),b及其95%CI分别为1.73(0.53~2.93)、2.03(0.60~3.47)、0.75(0.11~1.38)、2.66(0.85~4.47);而女童中未见此关联。进一步对男童BMI按正常、超重及肥胖标准分层后发现,较高尿Cd水平与男性儿童肥胖的风险增加呈正向关联(P <0.05), b及其95%CI 为2.34(1.02~5.36)。

    结论 山东莱州湾地区男童尿Cd暴露水平与其身高、体重、BMI、腰围均呈正向关联,且可能与男童的肥胖有关。

     

    Abstract: Background Heavy metals are widely present in the environment, difficult to degrade, and bioaccumulative. Children's physical development are not mature, and exposure to heavy metals which may cause irreversible harm to them. However, the current research conclusions are still inconsistent. Therefore, it is very important to pay attention to the impact of heavy metal pollutants on physical development.

    Objective To detect the level of heavy metal exposure of school-age children in Laizhou Wan, Shandong Province, and to explore the relationship between heavy metal exposure level and physical development indexes of school-age children.

    Methods The subjects of this study were 318 children born to pregnant women recruited from Laizhou Wan Birth Cohort in Shandong Province from September 2010 to December 2013. The school-age children at age 7 were followed up from July to September 2019. Their urine samples were collected and the levels of arsenic (As), cadmium (Cd), lead (Pb), and mercury (Hg) in urine were detected by inductively coupled plasma mass spectrometry (ICP-MS). At the same time, the height, weight, body mass index (BMI), waist circumference, and body fat percentage of the children were evaluate to analyze the relationship between the four heavy metals in children's urine and the indicators related to children's physical development.

    Results Among the 318 school-age children with an age ( \bar x \pm s ) of (7.77±0.67) years, the median (P25, P75) levels of As, Cd, Pb, and Hg in urine were 73.98 (44.81, 124.61), 0.40 (0.27, 0.58), 1.20 (0.71, 1.72), and 2.38 (1.32, 4.80) µg·g−1 (of creatinine), respectively. The children’s urinary Cd level was positively correlated with their weight, BMI, and waist circumference (P<0.05), and corresponding regression coefficients (b) and its 95% confidence intervals (CI) were 0.99 (0.14-1.83), 0.43 (0.06-0.81), and 1.35 (0.27-2.42), respectively; while the other heavy metals were not related to the above physical development indicators (P>0.05). After sex stratification, it was found that boys’ urinary Cd level was positively correlated with their height, weight, BMI, and waist circumference (P <0.05) with associated b(95%CI) of 1.73 (0.53-2.93), 2.03 (0.60-3.47), 0.75 (0.11-1.38), and 2.66 (0.85-4.47), respectively; such associations were not found in girls. After further stratification of boys’ BMI according to normal, overweight, and obesity, it was found that a higher urinary Cd level was correlated with an increased risk of obesity in boys (P<0.05), and the associatedb(95%CI) was 2.34 (1.02-5.36).

    Conclusion The level of urinary Cd exposure of boys in Laizhou Wan, Shandong Province is positively correlated with their height, weight, BMI, and waist circumference, and may be related to obesity in boys.

     

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