編(譯)者按：鉛是一種對人體有劇毒的金屬，尤其對兒童危害極大。即使血鉛濃度僅為3.5微克/100毫升，也可能引發智力下降、發育遲緩和注意力缺陷多動障礙等問題。血鉛濃度達到20微克/100毫升時，可能出現腹痛、食欲不振、易怒等癥狀，但這些往往與其他兒童常見疾病混淆，容易被忽視。若血鉛濃度超過80微克/100毫升，則可能導致抽搐、昏迷甚至死亡。

鉛一旦進入體內，便會在大腦、腎臟、肝臟和骨骼中累積，影響中樞神經系統發育，造成永久性智力損傷、行為紊亂和學習障礙。尤其是營養不良的兒童更易吸收鉛，風險更高。長期低劑量暴露還可能引起貧血、高血壓、免疫功能減弱和生殖毒性。

根據《澎湃新聞》報道，甘肅天水麥積區褐石培心幼兒園部分兒童被檢測出血鉛值超過400微克/升(即40微克/100毫升)，遠高于世界衛生組織、美國CDC等機構建議的安全上限(10微克/100毫升)。這意味著：

1.已經達到顯性中毒閾值：這些兒童可能已經處于可出現明顯臨床癥狀的階段，例如：食欲不振、情緒暴躁、腹痛、嘔吐等。

2.極高風險的神經損害：血鉛40微克/100毫升已足以干擾大腦發育，可能導致智商下降、注意力障礙、學習能力降低和行為異常，部分影響可能不可逆轉。

3.存在更嚴重中毒的隱患：若部分個體血鉛持續升高至80微克/100毫升以上，生命安全也可能受到威脅（如抽搐、昏迷等嚴重表現）。

3.長期健康問題隱憂：即便短期內癥狀不明顯，長期來看，這些兒童可能面臨慢性腎功能損傷、免疫系統紊亂和成人期高血壓等問題。

簡單總結為：鉛對兒童危害極大，血鉛超標可致智力下降、發育遲緩和行為異常，嚴重者引發抽搐、昏迷甚至死亡。天水部分兒童血鉛高達40微克/100毫升，遠超安全上限，已達中毒閾值，存在神經損傷和長期健康風險，需盡快干預與治療。

以下文章選自世界衛生組織官網，美國弗吉利亞州官網，以及官媒《澎湃新聞》、《正官新聞》。

Overview

概述

Lead is a naturally occurring toxic metal found in the Earth’s crust. Its widespread use has caused extensive environmental contamination, human exposure and significant public health problems globally.

鉛是一種在地殼中自然生成的有毒金屬。其廣泛使用在全世界造成大范圍環境污染、人類暴露和重大公共衛生問題。

Important sources of environmental contamination include mining, smelting, manufacturing and recycling activities, and lead use in a range of products. Most global lead consumption is for the manufacture of lead-acid batteries for motor vehicles. Lead is used in many products, including pigments, paints, solder, stained glass, lead crystal glassware, ammunition, ceramic glazes, jewellery, toys, some traditional cosmetics, and some traditional medicines. Lead can contaminate drinking water through plumbing systems containing lead pipes, solders and fittings.

環境污染的重要來源包括采礦、冶煉、制造和回收活動以及在多種產品中的使用。全球大部分鉛消費用于生產機動車的鉛酸蓄電池。然而許多其它產品也會用到鉛，比如顏料、油漆、焊接、彩繪玻璃、鉛水晶玻璃器皿、彈藥、陶瓷釉料、珠寶、玩具、某些傳統化妝品及一些傳統藥物。鉛會通過含鉛管道、含鉛焊料和配件的管道系統污染飲用水。

Young children are particularly vulnerable to the toxic effects of lead and can suffer permanent adverse health impacts, particularly on the development of the central nervous system. Lead causes long-term harm in adults, including increased risk of high blood pressure, cardiovascular problems and kidney damage. Lead exposure during pregnancy can cause reduced fetal growth and preterm birth.

年幼兒童特別容易受到鉛的毒性影響，并可能遭受嚴重且永久的不良健康影響，尤其會影響到中樞神經系統的發育。鉛也會對成人造成長期損害，包括增加高血壓、心血管問題和腎臟損傷的風險。孕期鉛暴露會導致胎兒發育不良和早產。

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Sources and routes of exposure

來源和暴露途徑

People are exposed to lead through occupational and environmental sources. This mainly results from:

人們可能通過職業和環境來源接觸到鉛。這主要是因為：

·inhalation of lead particles generated by burning materials containing lead, for example during smelting, recycling, stripping leaded paint and plastic cables; and

·吸入由于燃燒含鉛材料所產生的鉛顆粒，比如在冶煉、回收、剝離含鉛油漆以及使用含鉛航空汽油時；以及

·ingestion of contaminated dust, soil, water or food.

·攝入受到鉛污染的塵埃、土壤、水或食物。

Young children are particularly vulnerable to lead poisoning as they may absorb up to 4–5 times as much lead as adults from an ingested dose. Moreover, children’s innate curiosity and their age-appropriate and frequent hand-to-mouth and object-to-mouth behaviours increase their risk of exposure to lead-contaminated dust, soil and paint. Children who engage in pica, the compulsive, habitual consumption of non-food items, are at particularly high risk. Exposure to lead-contaminated soil and dust resulting from battery recycling and mining has caused outbreaks of mass lead poisoning, including deaths in young children, in some countries.

年幼兒童吸收的鉛攝入量可能會高達成人的4到5倍，因此特別容易鉛中毒。此外，兒童的天生好奇心以及與其年齡相符的頻繁手口行為以及將物品放入口中增加了他們接觸受鉛污染的塵埃、土壤和油漆的風險。有異食癖(總是強迫性想吃非食用物品)的兒童面臨尤其嚴重的風險。因蓄電池回收和采礦而暴露于受鉛污染的土壤和灰塵，在一些國家的年幼兒童中造成了大規模鉛中毒和眾多死亡情況。

Once lead enters the body, it is distributed to organs including the brain, kidneys, liver and bones. Lead is stored in the teeth and bones, where it accumulates over time. Lead stored in bone may be released into the blood during pregnancy and expose the fetus. Malnourished children are more susceptible to lead as they absorb more lead if other nutrients are deficient, especially calcium or iron.

鉛一旦進入身體，就會分布到大腦、腎臟、肝臟和骨骼等器官。它在牙齒和骨骼中儲存下來，隨著時間不斷累積。儲存在骨骼中的鉛可能在妊娠期間重新游離到血液，從而使胎兒暴露于鉛。營養不良的兒童較易受到鉛影響，因為當缺乏其他營養素時，尤其是缺乏鈣或鐵時，身體會吸收較多鉛。

Health effects in children

對兒童健康的影響

Lead exposure can have serious consequences for the health of children. Exposure to very high levels of lead can severely damage the brain and central nervous system causing coma, convulsions and even death. Children who survive severe lead poisoning may be left with permanent intellectual disability and behavioural disorders. At lower levels of exposure that may have no obvious symptoms, lead can lead to a spectrum of injury across multiple body systems. In particular, lead can permanently affect children’s brain development, resulting in reduced intelligence quotient (IQ), behavioural changes including reduced attention span and increased antisocial behaviour, and reduced educational attainment. Lead exposure also causes anaemia, hypertension, renal impairment, immunotoxicity and toxicity to the reproductive organs.

鉛暴露可對兒童健康造成嚴重后果。高濃度鉛暴露會使大腦和中樞神經系統嚴重受損，引起昏迷、抽搐、甚至死亡。從嚴重鉛中毒中幸存下來的兒童可能會留下永久性智力殘障和行為紊亂問題。沒有引起明顯癥狀的低濃度鉛暴露可在多個身體系統產生一系列傷害。尤其是鉛會永久性影響到兒童大腦發育，造成智商下降，并造成行為變化(例如注意力持續時間縮短)，反社會行為增加，以及學習成績下降。鉛暴露還可引起貧血、高血壓、腎功能損害、免疫毒性以及生殖器官毒性。

There is no known safe blood lead concentration; even blood lead concentrations as low as 3.5 μg/dL may be associated with decreased intelligence in children, behavioural difficulties and learning problems (1).

沒有已知的安全血鉛濃度。即使血鉛濃度低至3.5微克/100毫升，也可能會造成兒童智力下降、行為困難和學習問題。

Burden of disease

Lead exposure causes a significant burden of disease. The Institute for Health Metrics and Evaluation (IHME) estimates that more than 1.5 million deaths globally were attributed to lead exposure in 2021, primarily due to cardiovascular effects.

鉛暴露導致重大疾病負擔。據衛生計量和評估研究所估計，2021年，主要由于心血管疾病，全球共有150多萬人死于鉛暴露。

Additionally, lead exposure was estimated to account for more than 33 million years lost to disability (disability-adjusted life years, or DALYs) worldwide in 2021.

此外，據估計，2021年全球鉛暴露導致的殘疾損失超過3300萬生命年(即殘疾調整生命年)。

另據美國弗吉利亞州衛生廳(Virginia Department of Health)官網的消息：

Lead poisoning at levels as low as 3.5 μg/dL puts children at risk for developmental delay, lowered intelligence quotient (IQ), and attention deficit/hyperactivity disorder (ADHD). However, most children who have levels of lead in the blood at or above the CDC reference value do not have any symptoms.Blood lead levels have to reach around 20 μg/dL before symptoms such as stomach ache, poor appetite, and irritability appear, and these are often confused with other childhood illnesses.Very severe lead exposure (blood lead levels greater than 80 μg/dL) can cause coma, convulsions and even death.

鉛中毒即使在血鉛濃度低至3.5微克/100毫升(μg/dL)時，也會使兒童面臨發育遲緩、智商降低和注意力缺陷多動障礙的風險。然而，大多數血鉛水平達到或超過美國疾病控制與預防中心參考值的兒童，并不會出現任何癥狀。通常血鉛濃度需達到約20微克/100毫升時，才可能出現如腹痛、食欲不振和易怒等癥狀，但這些癥狀往往容易與其他兒童疾病混淆。若鉛暴露非常嚴重(血鉛濃度超過80微克/100毫升)，則可能導致昏迷、抽搐，甚至死亡。

據官媒《澎湃新聞》報道：

7月4日，西安市中心醫院兒科住院病房里，澎湃新聞見到了多名被家長從甘肅天水帶來求醫的孩子，他們均來自天水市麥積區褐石培心幼兒園。多位家長向澎湃新聞提供的西安市中心醫院檢測報告顯示，孩子的血鉛指標超過了正常值，有的孩子血鉛值甚至超400微克/升(譯者注：40微克/100毫升)，而兒童血鉛正常參考值應該是100微克/升(10微克/100毫升)以下。

而據官媒《正官新聞》報道：

血鉛超標的70名幼兒中，血鉛檢驗值20.6至24.9微克/100毫升8人、25.5至29.4微克/100毫升14人、30.5至34.9微克/100毫升11人、35.3至39.9微克/100毫升19人、40至44.8微克/100毫升12人、46.6至47.9微克/100毫升3人、大于50微克/100毫升3人。其中，血鉛檢驗值最高為52.8微克/100毫升。