铅不良作用无阈值,并且铅尚未显示对人体有任何重要作用。[20]Jusko TA, Henderson CR, Lanphear BP, et al. Blood lead concentrations < 10 microg/dL and child intelligence at 6 years of age. Environ Health Perspect. 2008;116:243-248.http://www.pubmedcentral.nih.gov/articlerender.fcgi?tool=pubmed&pubmedid=18288325http://www.ncbi.nlm.nih.gov/pubmed/18288325?tool=bestpractice.com[25]Centers for Disease Control and Prevention (CDC) Advisory Committee on Childhood Lead Poisoning Prevention. Interpreting and managing blood lead levels < 10 microg/dL in children and reducing childhood exposures to lead. MMWR Recomm Rep. 2007;56:1-16.http://www.cdc.gov/mmwr/preview/mmwrhtml/rr5608a1.htmhttp://www.ncbi.nlm.nih.gov/pubmed/17975528?tool=bestpractice.com 所以预防暴露是防止铅中毒唯一有效的手段。可以通过公共卫生干预来实现。在美国,已经证明通过去除汽油中的铅可以降低人群的血铅水平,说明该干预手段有效。同样是在美国,去除涂料中的铅有效改善了儿童铅暴露的情况。[2]Centers for Disease Control and Prevention (CDC). Blood lead levels: United States, 1988-1991. MMWR Morb Mortal Wkly Rep. 1994;43:545-548.http://www.cdc.gov/mmwr/preview/mmwrhtml/00032080.htmhttp://www.ncbi.nlm.nih.gov/pubmed/8035771?tool=bestpractice.com 通过去除、替代和停止使用含铅水管道和铅焊接的供水系统等,改进罐头包装方法已经显著减少了食物中的铅暴露。[7]Levin R, Brown MJ, Kashtock ME, et al. Lead exposures in U.S. children, 2008: implications for prevention. Environ Health Perspect. 2008;116:1285-1293.http://www.pubmedcentral.nih.gov/articlerender.fcgi?tool=pubmed&pubmedid=18941567http://www.ncbi.nlm.nih.gov/pubmed/18941567?tool=bestpractice.com[8]Maas RP, Patch SC, Morgan DM, et al. Reducing lead exposure from drinking water: recent history and current status. Public Health Rep. 2005;120:316-321.http://www.pubmedcentral.nih.gov/picrender.fcgi?artid=1497727&blobtype=pdfhttp://www.ncbi.nlm.nih.gov/pubmed/16134575?tool=bestpractice.com
职业铅暴露可以通过改善通风、空气过滤、适当使用防护服以及限制在工作区饮食饮水等方法降低风险。 美国许多州都设立强制的血铅筛查项目,在所有儿童中进行铅中毒检查。