住在老旧房屋中的儿童,应该在 9 至 12 个月时常规进行一次筛查,在 24 个月时进行再次筛查。 所有社会经济地位低下的儿童也需要进行筛查。[4]Harvey B, ed. Managing elevated blood lead levels among young children: recommendations from the Advisory Committee on Childhood Lead Poisoning Prevention. Atlanta, GA: CDC; 2002.http://www.cdc.gov/nceh/lead/casemanagement/managingEBLLs.pdf[35]Wengrovitz AM, Brown MJ; Advisory Committee on Childhood Lead Poisoning, Division of Environmental and Emergency Health Services, National Center for Environmental Health; Centers for Disease Control and Prevention. Recommendations for blood lead screening of Medicaid-eligible children aged 1-5 years: an updated approach to targeting a group at high risk. MMWR Recomm Rep. 2009;58:1-11.http://www.cdc.gov/mmwr/preview/mmwrhtml/rr5809a1.htmhttp://www.ncbi.nlm.nih.gov/pubmed/19661858?tool=bestpractice.com[36]Boreland F, Lyle D. Screening children for elevated blood lead: learnings from the literature. Sci Total Environ. 2008;390:13-22.http://www.ncbi.nlm.nih.gov/pubmed/17991511?tool=bestpractice.com
工作在可能有铅暴露环境的所有成人也应该定期进行筛查。 许多行业已有类似要求,但私人业主和小生产者可能不会有这样的要求。[5]Association of Occupational and Environmental Clinics. Medical management guidelines for lead-exposed adults. April 2007. http://www.aoec.org (last accessed 22 March 2016).http://www.aoec.org/documents/positions/MMG_FINAL.pdf 需要注意的是当前标准不足以保护工人,也不能为妊娠期的工人提供足够的胎儿保护。
涉及染色玻璃、制造子弹或钓鱼坠或参与其他可能具有铅暴露兴趣活动的人员也应该接受检测。[4]Harvey B, ed. Managing elevated blood lead levels among young children: recommendations from the Advisory Committee on Childhood Lead Poisoning Prevention. Atlanta, GA: CDC; 2002.http://www.cdc.gov/nceh/lead/casemanagement/managingEBLLs.pdf[10]Mahaffey KR. Nutrition and lead: strategies for public health. Environ Health Perspect. 1995;103(suppl 6):191S-196S.http://www.pubmedcentral.nih.gov/picrender.fcgi?artid=1518938&blobtype=pdfhttp://www.ncbi.nlm.nih.gov/pubmed/8549473?tool=bestpractice.com
经常进行手枪和步枪室内发射的人员也存在铅暴露风险。 应该仔细询问射击环境的一般条件、射击手的卫生习惯和饮食习惯等问题。 许多这样的人员应该接受全血铅检测筛查。[6]Tripathi RK, Sherertz PC, Llewellyn GC, et al. Lead exposure in outdoor firearm instructors. Am J Public Health. 1991;81:753-755.http://ajph.aphapublications.org/doi/pdf/10.2105/AJPH.81.6.753http://www.ncbi.nlm.nih.gov/pubmed/2029046?tool=bestpractice.com
有大量证据表明住在老旧房屋中的家庭在翻修房屋过程中,如果铅油漆表面破损的话存在铅暴露风险。 强烈建议在翻新期间,不要居住在屋内。 如果继续住在屋内,则应该进行全血铅检测筛查来评估铅暴露。[4]Harvey B, ed. Managing elevated blood lead levels among young children: recommendations from the Advisory Committee on Childhood Lead Poisoning Prevention. Atlanta, GA: CDC; 2002.http://www.cdc.gov/nceh/lead/casemanagement/managingEBLLs.pdf[5]Association of Occupational and Environmental Clinics. Medical management guidelines for lead-exposed adults. April 2007. http://www.aoec.org (last accessed 22 March 2016).http://www.aoec.org/documents/positions/MMG_FINAL.pdf
有报道应用民间药物的人员或是有应用此类民间药物传统的少数民族,也应该考虑进行筛查。 特别是如果这些药物是用来治疗胃肠道症状时,则必须进行筛查,因为许多含铅的民间药物用于治疗此类疾病。[4]Harvey B, ed. Managing elevated blood lead levels among young children: recommendations from the Advisory Committee on Childhood Lead Poisoning Prevention. Atlanta, GA: CDC; 2002.http://www.cdc.gov/nceh/lead/casemanagement/managingEBLLs.pdf[5]Association of Occupational and Environmental Clinics. Medical management guidelines for lead-exposed adults. April 2007. http://www.aoec.org (last accessed 22 March 2016).http://www.aoec.org/documents/positions/MMG_FINAL.pdf