Çocuk Sağlığı ve Kurşun

Year 2007, Volume: 1 Issue: 1, 48 - 56, 01.06.2007

Aysu Duyan Çamurdan

Abstract

Kurşun toksisitesi önlenebilir bir halk sağlığı sorunudur. Çocuklarda kurşunla temasın neden olduğu rahatsızlıklar genellikle bulgu vermeyen kurşun toksisitesi şeklindedir. Erken tanı kan kurşun düzeyi taramaları ile konabilir. Çocuklarda toksik kabul edilen kan kurşun düzeyi yıllar içinde giderek azalmıştır. 1991' den başlayarak da nörolojik ve zihinsel işlevleri bozduğu saptanan düzey olan 10mg/dl toksik olarak kabul edilmiştir ancak son zamanlarda 10mg/dl' nin altındaki kan değerlerinde bile zeka puanlarında düşüklük ve nöropsikolojik işlevlerde bozukluk olduğu saptandığından eşik değerin 10mg/dl' nin altına çekilmesi önerilmektedir.

Keywords

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CHILD HEALTH AND LEAD

Abstract

Lead toxicity is a preventable public health problem. In children, the disorders caused by lead exposure are usually asymptomatic. Early diagnosis can be made by blood lead level screening. The level which is accepted as toxic is decreased in years. In 1991 10mg/dl was considered as the level which negatively affects neurological and cognitive functions, but recently even the levels below 10mg/dl were shown to decrease IQ scores and affect neuropsychological functions, therefore it is recommended that the threshold value should be below 10mg/dl

Keywords

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References

• Yapıcı G, Can G, Şahin Ü. Çocuklarda asemptomatik kurşun study of lead poisoning. Pediatrics 2003;112:259-264.
• Bellinger DC. Lead. Pediatrics 2004;113:1016-1022.
• Bellinger DC, Stiles KM, Needleman HL. Low-level lead exposure, intelligence and academic achievement: a long-term follow-up study. Pediatrics 1992;90:855-861.
• Lanphear BP, Dietrich K, Auinger P, Cox C. Cognitive deficits associated with blood lead concentrations <10mg/dL’ in US children and adolescents. Public Health Rep 2000;115:521-529.
• Canfield RL, Henderson CR Jr, Cory-Slechta DA, Cox C, Jusko TA, Lanphear BP. Intellectual impairment in children with blood lead concentrations below 10 microg per deciliter. N Engl J Med 2003;348: 1526.
• Chiodo LM, Jacobson SW, Jacobson JL. Neurodevelopmental effects of postnatal lead exposure at very low levels. Neurotoxicol Teratol ;26:359-371. döneminde yakalanması için KKD taramalarını ve gerektiğinde de şelasyon tedavilerini kapsar (2, 3, 49). Bellinger DC, Needleman HL. Intellectual impairment and blood lead levels. N Engl J Med 2003;349:500-502.
• Yüksel L. Kurşun ve çocuk. İst Çocuk Klin Derg 1996;31:218-227.
• Erickson L, Thompson T. A review of a preventable poison: pediatric uzaklaştırılması ve klinik bulguların tedavisini içerir. Kan kurşun düzeyi yüksek her çocuk toksik kabul edilip izleme alınmalı ve düzenli aralıkları KKD' leri kontrol edilmelidir. Kurşun toksisitesi saptanan çocuklar tedavi edildikten sonra kurşun etkilenim yolu ortadan kaldırılmadan taburcu edilmemelidir. lead poisoning, J Spec Pediatr Nurs 2005;10(4):171-182.
• İsmail Hamdi Kara. Toplum sağlığı yönünden kurşun zehirlenmesi. http://www.tr.net/saglik/genel_saglik_kursun.shtml World Health Organization/International Programme on Chemical Environmental Health Criteria 165. Inorganic Lead. Geneva, Switzerland: World Health Organization; 1995.
• Nordin JD, Rolnick SJ, Griffin JM. Prevalance of excess lead absorption and associated risk factors in children enrolled in a Midwestern Health Maintenance Organization. Pediatrics 1994; :172-176.
• E, Kösecik M, Koçyiğit A, Soran M, Baz MT, Ertaş T, Karazeybek AH. Şanlıurfa ilinde oto tamir atölyelerinde çalışan çıraklarda saç ve kan kurşun düzeyleri ve hematolojik değerler üzerine etkileri. Harran Tıp Fak Der 2004; 1(4):33-38.
• Balat A, Gül K, Özgen Ü Çekmen M, Küçükboy Z, Eğri M, Malatya ili şehir merkezi ve köylerinde yaşayan çocuklar ile çıraklarda kan kurşun düzeylerinin karşılaştırılması. Yeni Tıp Dergisi 1998;15:203-205.
• Department of Health and Human Services. Agency for Toxic Substance and Disease Registry. Http://www.atsdr.cdc.gov /HEC/CSEM/lead/whosat_risk.html zehirlenmesi. Cerrahpaşa J Med 2002; 33: 197-204.
• Sanborn MD, Abelsohn A, Campbell M, Weir E. Identifying and managing adverse environmental health effects: 3. Lead exposure. CMAJ 2002;166:1287 - 1292. :1072-1078.
• Bostancı İ, Beyazova U, Kılıç Y, Sezgin N, Sümbüloğlu K. Kord kanı Centers for Disease Control and Prevention. Preventing Lead Poisoning in Young Children. US Department of Health and Human Services, Public Health Service 1991. kurşun düzeyi ve prenatal kurşunla etkilenmenin erken çocuklukta zihinsel fonksiyonlara etkisi, XXXI. Türk Pediatri Kongresi İstanbul, Ekim 1995.
• Falk H. International environmental health for the pediatrician: case Öztürk M. Kurşunlu benzin tüketimi ve kurşunun etkileri. Çevre ve long-term effects of exposure to low doses of lead in childhood: an year follow-up report. N Engl J Med 1990;322:83-88.
• Orman Bakanlığı, 2004, Ankara .
• Işıklı B, Demir TA, Berber A, Kalyoncu C. Yol kenarı toprak ve bitkilerinde kurşun birikimi. VI.Ulusal Halk Sağlığı Kongresi Adana, Nisan 1998, s:414.
• Andrews PJ, Cisterio G. Intracranial pressure: Part one: Historical overview and basic concepts. Intensive Care Med 2004;30:1730-1733.
• Schlenker TL, Fritz CJ, Mark D, Layde M, Linke G, Murphy A, Matte T. Screening for pediatric lead poisoning. Comparability of simultaneously drawn capillary and venous blood samples. JAMA ;271:1346-1348.
• Koller K, Brown T, Spurgeon A, Levy L. Recent developments in low- level lead exposure and intellectual impairment in children. Environ Health Perspect 2004;112:987-994.
• Advisory Committee on Childhood Lead Poisoning Prevention. Recommendations for blood lead screening of young children enrolled in Medicaid: targeting a group at high risk. MMWR Recomm Rep 2000;49:1-13. how it affects exposure to environmental contaminants. Pediatrics ;113:996-1006.
• Centers for Disease Control and Prevention. Childhood Lead Poisoning Prevention Program (CLPPP). National Center for Environmental Health and U.S. Centers for Disease Control and Prevention. 2004a. http://www.cdc.gov/nceh/lead/lead.htm.
• Esteban E, Rubin CH, Jones RL, Noonan G. Hair and blood as substrates for screening children for lead poisoning. Arch Environ Health 1999;54:436-440.
• Guilarte TR. Glutamatergic system and developmental lead neurotoxicity. Neurotoxicology 1997;18:665-672.
• Todd AC, Buchanan R, Carroll S, Moshier EL, Popovac D, Slavkovich V, Graziano JH. Tibia lead levels and methodological uncertainty in year-old children. Environ Res 2001;86:60-65. brain to lead. Curr Opin Neurol 1998;11:689-693.
• Chisolm JJ, Kaplan E. Lead poisoning in childhood -comprehensive Dietrich KN, Ware JH, Salganik M, Radcliffe J, Rogan WJ, Rhoads GG, Fay ME, Davoli CT, Denckla MB, Bornschein RL, Schwarz D,
• Dockery DW, Adubato S, Jones RL; Treatment of Lead-Exposed Children Clinical Trial Group. Effect of chelation therapy on the neuropsychological and behavioral development of lead-exposed children after school entry. Pediatrics 2004;114:19-26. intelligence: a systematic review of the epidemiological evidence. BMJ ;309:1189-1197.
• Treatment guidelines for lead exposure in children. American Academy of Pediatrics, Committee on Drugs: Pediatrics 1995;96:155 160. and search for a threshold. Environ Res 1994;65:42-55.
• Liu X, Dietrich KN, Radcliffe J, Ragan NB, Rhoads GG, Rogan WJ. Do children with falling blood lead levels have improved cognition? Pediatrics 2002;110:787-791.
• Rogan WJ, Dietrich KN, Ware JH, Dockery DW, Salganik M, Radcliffe J, Jones RL, Ragan NB, Chisolm JJ Jr, Rhoads GG; Treatment of Lead-Exposed Children Trial Group. The effect of chelation therapy with succimer on neuropsychological development in children exposed to lead. N Engl J Med 2001;344:1421-1426. children. A meta-analysis of modern studies JAMA 1990;263:673
• Perlstein MA, Attala R. Neurologic sequelae of plumbism in children. Burns JM, Baghurst PA, Sawyer MG, McMichael AJ, Tong SL. Lifetime low-level exposure to environmental lead and children's emotional and behavioral development at ages 1113 years. The Port
• Pirie cohort study. Am J Epidemiol 1999;149:740-749. Clin Pediatr 1966;5:292-298.
• Centers for Disease Control and Prevention. Managing Elevated Blood Lead Levels Among Young Children: Recommendations From the Advisory Committee on Childhood Lead Poisoning Prevention. Atlanta, GA: Centers for Disease Control and Prevention; 2002. www.cdc.gov/nceh/lead/CaseManagement/caseManage_main.htm