Ityhefu yelothe engapheliyo ingunobangela obalulekileyo wesifo sentliziyo kubantu abadala kunye nokuphazamiseka kwengqondo ebantwaneni, kwaye kunokubangela ubungozi nakumanqanaba elothe ebekade ebonwa njengekhuselekile. Ngo-2019, ukuvezwa okukhokelayo kwaba noxanduva lokusweleka kwezigidi ezi-5.5 ngenxa yesifo sentliziyo kwihlabathi liphela kunye nelahleko iyonke yamanqaku angama-765 ezigidi ze-IQ ebantwaneni nyaka ngamnye.
Ukuchanabeka kwelothe phantse kuyo yonke indawo, kuquka ipeyinti enelothe, ipetroli enelothe, eminye imibhobho yamanzi, iiseramikhi, izinto zokuthambisa, iziqholo, kunye nokunyibilikisa, ukuveliswa kweebhetri neminye imizi-mveliso, ngoko ke amacebo akumgangatho wabemi abalulekile ukuze kupheliswe ityhefu yelothe.
Ityhefu yelothe sisifo samandulo. UDioscorides, ugqirha ongumGrike nosokhemesti kwiRoma yamandulo, wabhala uDe
UMateria Medica, owona msebenzi ubalulekileyo kwi-pharmacology kumashumi eminyaka, wachaza iimpawu zetyhefu yelothe ethe kratya phantse kwiminyaka engama-2,000 eyadlulayo. Abantu abanetyhefu yelothe ethe kratya baye badinwe, baphathwe yintloko ebuhlungu, bacaphuke, baqaqanjelwe kakhulu esiswini, baqhinelwe isisu. Xa ingxinano yelothe yegazi idlula i-800 μg/L, ityhefu yelothe ebukhali inokubangela ukuxhuzula, i-encephalopathy, kunye nokufa.
Ityhefu yelothe engapheliyo yaqatshelwa ngaphezu kwenkulungwane eyadlulayo njengonobangela we-atherosclerosis kunye negout “eyityhefu yelothe”. Kuhlolisiso lwesidumbu, abaguli abangama-69 kwabali-107 abanegawuthi ebangelwa ilothe “baye baba lukhuni udonga lomthambo ngenxa yokutshintsha kweatheromatous.” Ngowe-1912, uWilliam Osler (uWilliam Osler)
Utywala, ukukhokela, kunye ne-gout zidlala indima ebalulekileyo kwi-pathogenesis ye-arteriosclerosis, nangona iindlela ezichanekileyo zokwenza izinto aziqondwa kakuhle, "u-Osler wabhala. Umgca okhokelayo (idiphozithi eluhlaza eluhlaza yesulfide yelothe ecaleni kweentsini) luphawu lwetyhefu yelothe engapheliyo kubantu abadala.
Ngo-1924, iNew Jersey, iPhiladelphia kunye nesiXeko saseNew York zayekisa ukuthengiswa kwepetroli ekhokelayo emva kokuba iipesenti ezingama-80 zabasebenzi abavelisa ilothe ye-tetraethyl kwi-Standard Oil eNew Jersey bafunyanwa benetyhefu yelothe, abanye babo basweleka. NgoMeyi 20, 1925, uHugh Cumming, ugqirha wotyando jikelele waseUnited States, wabiza izazinzulu nabameli bemizi-mveliso ukuze babone enoba kukhuselekile kusini na ukongeza itetraethyl ilothe kwipetroli. UYandell Henderson, isazi ngokusebenza komzimba nengcali kwimfazwe yemichiza, walumkisa ngelithi “ukongezwa kwelothe yetetraethyl kuya kubhenca ngokucothayo inani elikhulu labantu kwityhefu yelothe nokuqina kwemithambo”. URobert Kehoe, igosa eliyintloko lezonyango le-Ethyl Corporation, ukholelwa ukuba ii-arhente zikarhulumente akufuneki zithintele i-tetraethyl lead kwiimoto de ibe ibonakaliswe inetyhefu. “Umbuzo awungowokuba ilothe iyingozi na, kodwa ingaba umlinganiselo othile welothe uyingozi,” utshilo uKehoe.
Nangona imigodi ekhokelayo ibiqhubeka kangangeminyaka engama-6,000, ukusetyenzwa kwelothe kwanda kakhulu kwinkulungwane yama-20. Ilothe sisinyithi esithambileyo, esomeleleyo esisetyenziselwa ukuthintela amafutha ekutshisweni ngokukhawuleza, ukunciphisa “injini yokunkqonkqoza” ezimotweni, ukuthutha amanzi okusela, iinkonkxa zokutya ezithengiswayo, ukwenza ipeyinti ibengezele kwaye ibulale izinambuzane. Ngelishwa, uninzi lokhokelo olusetyenziselwa ezi njongo luphelela emizimbeni yabantu. Kwincopho yobhubhani wetyhefu yelothe eUnited States, amakhulu abantwana alaliswa esibhedlele sihlandlo ngasinye ngenxa yelothe, yaye ikota yabo yafa.
Kungoku nje abantu basesichengeni sobukho belothe kumanqanaba angaphezu kwemvelaphi yendalo. Ngeminyaka yoo-1960, i-geochemist uClair Patterson, owayesebenzisa i-isotopes ekhokelayo ukuqikelela ubudala boMhlaba kwi-4.5 yezigidigidi zeminyaka.
UPatterson wafumanisa ukuba imigodi, ukunyibilikiswa kunye nokukhutshwa kwezithuthi kukhokelele kwidiphozithi ekhokelela kwi-atmospheric ngamaxesha angama-1,000 aphezulu kunamanqanaba angasemva kwendalo kwiisampulu ezingundoqo zomkhenkce. Kwakhona uPatterson wafumanisa ukuba ukuxinana kwelothe emathanjeni abantu abakumazwe ahambele phambili kwezoshishino kwakuphindwe kali-1 000 kunabantu ababephila kumaxesha angaphambi koshishino.
I-lead exposure yehlile ngaphezu kwe-95% ukususela kwi-1970s, kodwa isizukulwana sangoku sisaphethe amaxesha angama-10-100 ngaphezu kwabantu abahlala kumaxesha angaphambi kwamashishini.
Ngaphandle kwezinto ezimbalwa, ezifana nelothe kumafutha eenqwelo-moya neembumbulu neebhetri ezineasidi yelothe kwiimoto, ilothe ayisasetyenziswa eUnited States naseYurophu. Oogqirha abaninzi bakholelwa kwelokuba ingxaki yetyhefu yelothe yinto yexesha elidluleyo. Noko ke, ipeyinti yelothe kumakhaya amadala, ipetroli enelothe egalelwa emhlabeni, ilothe ephuma kwimibhobho yamanzi, nokukhutshwa kwezinto ezikhutshwa kwimizi-mveliso nakwizixhobo zokutshisa ezo zinto zonke zifak’ isandla ekubeni sesichengeni selothe. Kumazwe amaninzi, ilothe ikhutshwa kwi-smelting, ukuveliswa kwebhetri kunye ne-e-waste, kwaye ifumaneka rhoqo kwiipeyinti, iiseramikhi, izithambiso kunye neziqholo. Uphando luqinisekisa ukuba ityhefu engapheliyo yomgangatho ophantsi welothe ingunobangela womngcipheko wesifo sentliziyo kubantu abadala kunye nokuphazamiseka kwengqondo ebantwaneni, kwanakwinqanaba ebekade lithathwa njengelikhuselekileyo okanye alinabungozi. Eli nqaku liza kushwankathela iziphumo zokutyhefwa okungapheliyo kwinqanaba eliphantsi
Ukuvezwa, ukufunxa kunye nomthwalo wangaphakathi
Ukungeniswa ngomlomo kunye nokuphefumla zezona ndlela ziphambili zokuvezwa kwelothe. Iintsana ezikhula ngokukhawuleza kunye nophuhliso zinokufunxa ilothe ngokulula, kwaye ukunqongophala kwentsimbi okanye ukunqongophala kwecalcium kunokukhuthaza ukufunxa ilothe. Ilothe elinganisa i-calcium, i-iron, kunye ne-zinc ingena kwiseli ngemijelo ye-calcium kunye nabathuthi bentsimbi njenge-divalent metal transporter 1[DMT1]. Abantu abaneepolymorphisms zofuzo ezikhuthaza ukufunxwa kwesinyithi okanye i-calcium, njengalezo ezibangela i-hemochromatosis, ziye zanda i-lead absorption.
Yakuba ifunkile, i-95% yelothe eseleyo kumzimba womntu omdala igcinwa emathanjeni; I-70% yelothe eyintsalela kumzimba womntwana igcinwa emathanjeni. Malunga ne-1% yomthwalo welothe uwonke emzimbeni womntu ojikeleza egazini. I-99% yelothe esegazini ikwiiseli ezibomvu zegazi. Uxinzelelo lwegazi elipheleleyo (ilothe esandul' ukufunxwa kunye nelothe ebuyiselweyo ethanjeni) yeyona nto isetyenziswa kakhulu kwi-biomarker yenqanaba lokuvezwa. Izinto eziguqula i-metabolism yamathambo, njengokuyeka ukuya exesheni kunye ne-hyperthyroidism, inokukhulula ilothe ethe kratya emathanjeni, ibangele amanqanaba okukhokela kwegazi ukuba abe spike.
Ngo-1975, xa ilothe yayisafakwa kwipetroli, uPat Barry wenza uphononongo lwe-autopsy lwabantu baseBritani abali-129 kwaye balinganise umthwalo wabo welothe uwonke. Umyinge womthwalo opheleleyo kumzimba wendoda yi-165 mg, ilingana nobunzima bekliphu yephepha. Umthwalo womzimba wamadoda anetyhefu yelothe wawuyi-566 mg, kuphela ngokuphindwe kathathu kunomthwalo oqhelekileyo wesampuli yonke yamadoda. Xa kuthelekiswa, umyinge womthwalo opheleleyo kumzimba womfazi ngu-104 mg. Kuwo omabini abesilisa nabasetyhini, eyona nto iphezulu yelothe kwizicubu ezithambileyo yayikwi-aorta, ngelixa emadodeni ugxininiso lwaluphezulu kwiiplagi ze-atherosclerotic.
Abanye abantu basemngciphekweni owongeziweyo wetyhefu yelothe xa kuthelekiswa noluntu ngokubanzi. Iintsana nabantwana abancinci basemngciphekweni omkhulu wokuginya ilothe ngenxa yokungatyi kwabo ngomlomo, kwaye badla ngokufunxa ilothe kunabantwana abadala kunye nabantu abadala. Abantwana abancinane abahlala kumakhaya angakhathalelwanga kakuhle awakhiwe ngaphambi kowe-1960 basengozini yetyhefu yelothe ngenxa yokusela iitshiphu zepeyinti nothuli lwendlu olunelothe. Abantu abasela amanzi aphuma empompo kwimibhobho enelothe okanye abahlala kufuphi nezikhululo zeenqwelo-moya okanye ezinye iindawo ezinelothe basengozini eyongezelelekileyo yokuba netyhefu yelothe ekumgangatho ophantsi. EUnited States, ugxininiso lwelothe emoyeni luphezulu kakhulu kuluntu olwahlukileyo kunoluntu oludibeneyo. Abasebenzi kwimizi-mveliso yokunyibilikisa, yokuhlaziya iibhetri neyokwakha, kwanabo basebenzisa imipu okanye abaneenxalenye zembumbulu emizimbeni yabo, nabo basengozini eyongezelelekileyo yetyhefu yelothe.
Ilothe yikhemikhali yokuqala eyityhefu elinganiswe kuPhando lweSizwe lweMpilo kunye neSondlo (i-NHANES). Ekuqaleni kwesigaba sokuphuma kwepetroli ekhokelayo, amanqanaba okukhokela kwegazi ehla ukusuka kwi-150 μg/L ngo-1976 ukuya kuma-90 ngo-1980.
μg/L, inani lokomfuziselo. Amanqanaba elothe yegazi ekucingelwa ukuba anokuba yingozi aye athotywa amaxesha amaninzi. Ngo-2012, iCenters for Disease Control and Prevention (CDC) yenza isaziso sokuba umlinganiselo okhuselekileyo welothe egazini labantwana awukaqinisekiswa. I-CDC yehlisa umgangatho wezinga eligqithisiweyo legazi elikhokelela kubantwana - lidla ngokusetyenziswa ukubonisa ukuba kufuneka kuthathwe amanyathelo okunciphisa ukubonakaliswa kwe-lead - ukusuka kwi-100 μg / L ukuya kwi-50 μg / L ngo-2012, kunye ne-35 μg / L ngo-2021. isetyenziswe i-μg/dL, ebonisa ubungqina obuninzi betyhefu yelothe kumanqanaba asezantsi.
Ukufa, ukugula kunye nokukhubazeka
"Ukhokelo lunokuba yingozi naphi na, kwaye ukukhokela kuyo yonke indawo," wabhala uPaul Mushak kunye no-Annemarie F. Crocetti, bobabini amalungu eBhodi yeSizwe yoMgangatho woMoya oqeshwe nguMongameli uJimmy Carter, kwingxelo yeCongress ngo-1988. Amanqanaba asezantsi etyhefu yelothe ngumba womngcipheko wokuzalwa kwangaphambi kwexesha, kunye nokuphazamiseka kwengqondo kunye nokusilela kwengqwalasela (ADHD), ukwanda koxinzelelo lwegazi kunye nokunciphisa ukuguquguquka kwentliziyo ebantwaneni. Kubantu abadala, amanqanaba aphantsi etyhefu yelothe ngunobangela wokungaphumeleli kwezintso, uxinzelelo lwegazi kunye nesifo sentliziyo
Ukukhula kunye neurodevelopment
Xa kuxinaniswe ilothe edla ngokufunyanwa kubasetyhini abakhulelweyo, ukuba sesichengeni selothe ngunobangela wokuzalwa ngaphambi kwexesha. Kubantu abaza kuzalwa eKhanada, ukunyuka kwe-10 μg/L kumanqanaba okukhokela kwigazi likamama kwanxulunyaniswa ne-70% yokwanda komngcipheko wokuzalwa kwangaphambi kwexesha. Kwabasetyhini abakhulelweyo kunye namanqanaba e-serum vitamin D angaphantsi kwe-50 mmol / L kunye namanqanaba okukhokela kwegazi anyuke nge-10 μg / L, umngcipheko wokuzalwa kwangaphambi kokuzalwa wanda ukuya kathathu.
Kuphononongo olubalulekileyo lwangaphambili lwabantwana abaneempawu zeklinikhi zetyhefu yelothe, uNeedleman et al. bafumanise ukuba abantwana abanamanqanaba aphezulu okulothe kunokwenzeka ukuba baphuhle iintsilelo ze-neuropsychological kunabantwana abanamanqanaba asezantsi elothe, Kwaye babonakala bengathathi ntweni ngootitshala kwimimandla efana nokuphazamiseka, izakhono zombutho, ukungxama kunye nezinye iimpawu zokuziphatha. Kwiminyaka elishumi kamva, abantwana abakwiqela elinamanqanaba aphezulu e-dentin lead babenethuba eliphindwe kayi-5.8 lokuba ne-dyslexia kunye namathuba angama-7.4 okuyeka isikolo kunabantwana abakwiqela abanamanqanaba okukhokela asezantsi.
Umlinganiselo wokuhla kwengqondo ukunyuka kumanqanaba elothe wawumkhulu kubantwana abanamanqanaba elothe aphantsi. Kuhlalutyo oludityanisiweyo lwamaqela asixhenxe alindelekileyo, ukunyuka kwamanqanaba okukhokela kwegazi ukusuka kwi-10 μg / L ukuya kwi-300 μg / L kwakudityaniswa nokuncipha kwamanqaku angama-9 kwi-IQ yabantwana, kodwa ukuncipha okukhulu (ukuncipha kwe-6-point) kwenzeka xa amanqanaba okukhokela kwegazi aqala ukwanda nge-100 μg / L. I-Dose-response curves yayifana nokuncipha kwengqondo ehambelana namanqanaba okukhokelela kwithambo kunye neplasma.
Ukuvezwa okukhokelayo kungumngcipheko wokuphazamiseka kokuziphatha okunje nge-ADHD. Kuphononongo olumele ilizwe lase-US lwabantwana abaneminyaka eyi-8 ukuya kwi-15, abantwana abanamanqanaba elothe egazi angaphezu kwe-13 μg/L babenokwenzeka ngokuphindwe kabini ukuba babe ne-ADHD kunabo banamanqanaba okukhokela kwegazi kwelona nqanaba lisezantsi le-quintile. Kwaba bantwana, malunga ne-1 kwi-5 yeemeko ze-ADHD ingabalelwa kukuvezwa okukhokelayo.
Ukuvezwa kwesikhokelo sobuntwana ngumngcipheko wokuziphatha okungathandekiyo, kubandakanya ukuziphatha okuhambelana nokuphazamiseka kokuziphatha, ubunjubaqa, kunye nokuziphatha kolwaphulo-mthetho. Kuphononongo lwe-meta lwezifundo ezili-16, amanqanaba aphezulu okukhokela kwegazi ahlala enxulunyaniswa nokuphazamiseka kokuziphatha ebantwaneni. Kwizifundo ezibini ezilindelekileyo zeqela, ukukhokela kwegazi okuphezulu okanye amanqanaba okukhokela kwi-dentin ebuntwaneni aye anxulunyaniswa namazinga aphezulu obugebenga kunye nokubanjwa kwabantu abadala abancinci.
Ukuboniswa okuphezulu kwesikhokelo ebuntwaneni kwakunxulunyaniswa nomthamo wobuchopho ocuthiweyo (mhlawumbi ngenxa yokuncipha kobungakanani be-neuron kunye ne-dendrite branching), kunye nomthamo wobuchopho ocuthiweyo uqhubekile waba ngumntu omdala. Kuphononongo olubandakanya abantu abadala, igazi eliphakamileyo okanye amanqanaba okukhokela amathambo ayenxulunyaniswa nokuhla okukhawulezileyo kwengqondo, ngakumbi kwabo baphethe i-APOE4 allele. Ukuchaneka kwesikhokelo sobuntwaneni kusenokuba ngumngcipheko wokuphuhlisa isifo i-Alzheimer's, kodwa ubungqina abucacanga.
I-Nephropathy
Ukubonakaliswa kwelothe ngumngcipheko wokuphuhlisa isifo sezintso esingapheliyo. Imiphumo ye-nephrotoxic yelothe ibonakaliswe kwimizimba efakwe kwi-intranuclear ye-proximal renal tubules, i-tubule interstitial fibrosis kunye nokungaphumeleli kwezintso ezingapheliyo. Phakathi kwalabo bathathe inxaxheba kwi-survey ye-NHANES phakathi kwe-1999 kunye ne-2006, abantu abadala abanezinga legazi elikhokelayo ngaphezu kwe-24 μg / L babengama-56% amathuba okuba neqondo lokuncitshiswa kwe-glomerular filtration (<60 mL / [min · 1.73 m2]) kunabo abanamanqanaba okukhokela kwegazi ngaphantsi kwe-11 μg / L. Kuphononongo olulindelweyo lweqela labantu, abantu abanamanqanaba okukhokela kwegazi ngaphezulu kwe-33 μg / L babenomngcipheko we-49 wepesenti ephezulu wokuba nesifo sezintso esingapheliyo kunabo banamanqanaba asezantsi elothe yegazi.
Isifo senhliziyo
Utshintsho lweeseli ezibangelwa yi- lead luphawu loxinzelelo lwegazi oluphezulu kunye ne-atherosclerosis. Kwizifundo zaselabhoratri, amanqanaba asezantsi okuvezwa kwelothe anyusa uxinzelelo lwe-oxidative, anciphisa amanqanaba e-nitric oxide ye-bioactive, kwaye enze i-vasoconstriction ngokuvula iprotein kinase C, ekhokelela kuxinzelelo lwegazi oluzingisileyo. I-lead exposure yenza i-nitric oxide isebenze, ikhulise ukubunjwa kwe-hydrogen peroxide, inqanda ukulungiswa kwe-endothelial, iphazamise i-angiogenesis, ikhuthaza i-thrombosis, kwaye ikhokelela kwi-atherosclerosis (Umfanekiso 2).
Uphononongo lwe-in vitro lubonise ukuba iiseli ze-endothelial ezikhuliswe kwindawo ene-lead concentrations ye-0.14 ukuya kwi-8.2 μg / L kwiiyure ze-72 zenza umonakalo we-cell membrane (iinyembezi ezincinci okanye ukutyhulwa okubonwa ngokuskena i-electron microscopy). Olu phononongo lubonelela ngobungqina obucacileyo bokuba ilothe esandul’ ukufunxwa okanye ilothe ephinda ingena egazini isuka ethanjeni inokubangela ukungasebenzi kakuhle kwe-endothelial, olona tshintsho lokuqala lubonakalayo kwimbali yendalo yezilonda ze-atherosclerotic. Kuhlalutyo olunqamlezayo lwesampulu emele abantu abadala kunye nenqanaba legazi eliphakathi kwe-27 μg / L kwaye akukho mlando wesifo senhliziyo, amanqanaba okukhokela kwegazi anyuke nge-10%
Kwi-μg, i-odds ratio ye-calcification ye-coronary artery calcification (okt, i-Agatston score> 400 kunye noluhlu lwamanqaku e-0[0 ebonisa ukuba akukho calcification] kunye namanqaku aphezulu abonisa uluhlu olukhulu lokubala) yayiyi-1.24 (i-95% yexesha lokuzithemba 1.01 ukuya kwi-1.53).
Ukuba sesichengeni selothe ngowona mngcipheko mkhulu wokusweleka sisifo sentliziyo. Phakathi kwe-1988 kunye ne-1994, i-14,000 yabantu abadala baseMerika bathatha inxaxheba kwi-survey ye-NHANES kwaye balandelwa iminyaka eyi-19, apho i-4,422 yafa. Umntu omnye kwabahlanu ubulawa sisifo sentliziyo. Emva kokulungelelaniswa kweminye imingcipheko, ukunyuka kwamanqanaba okukhokela kwegazi ukusuka kwi-10th percentile ukuya kwi-90th percentile kwakudityaniswa nokuphindwe kabini komngcipheko wokufa kwi-coronary heart disease. Ingozi yesifo se-cardiovascular disease kunye nokufa kwesifo senhliziyo kuphakama ngokukhawuleza xa amanqanaba okukhokela angaphantsi kwe-50 μg / L, kungekho mqobo ocacileyo (Amanani 3B kunye ne-3C). Abaphandi bakholelwa ukuba ikota yesigidi yokufa ngaphambi kwexesha kwimithambo yentliziyo nyaka ngamnye kubangelwa yityhefu yelothe engapheliyo. Kwaba, abali-185 000 babulawa sisifo sentliziyo.
Ukuba sesichengeni selothe kusenokuba sesinye sezizathu zokuba ukufa kwesifo sentliziyo kuqala kunyuke kwaza kwawa kwinkulungwane edluleyo. EUnited States, umlinganiselo wokufa kwabantu ngenxa yesifo sentliziyo onyuke ngokukhawuleza kwisiqingatha sokuqala senkulungwane yama-20, ufikelela incopho ngowe-1968, waza wehla ngokuthe ngcembe. Ngoku i-70 pesenti ingaphantsi kwencopho yayo yowe-1968. Ukuvezwa okukhokelayo kwipetroli ekhokelayo kunxulunyaniswa nokuncipha kokusweleka kwabantu kwi-coronary heart disease (Umfanekiso 4). Phakathi kwalabo bathathe inxaxheba kwi-survey ye-NHANES, eyalandelwa ukuya kuthi ga kwiminyaka eyisibhozo phakathi kwe-1988-1994 kunye ne-1999-2004, i-25% yokunciphisa ngokupheleleyo iziganeko zesifo senhliziyo ngenxa yokunciphisa amanqanaba okukhokela kwegazi.
Kwiminyaka yokuqala yokupheliswa kwepetroli enelothe, iimeko zoxinzelelo lwegazi eUnited States zehla ngokukhawuleza. Phakathi kowe-1976 nowe-1980, ama-32 ekhulwini abantu abadala baseMerika babenoxinezeleko oluphezulu lwegazi. Ngo-1988-1992, umlinganiselo wawungama-20 kuphela ekhulwini. Izinto eziqhelekileyo (ukutshaya, amayeza oxinzelelo lwegazi, ukutyeba, kunye nobukhulu obukhulu bekhafu esetyenziselwa ukulinganisa uxinzelelo lwegazi kubantu abatyebe kakhulu) ayichazi ukuhla koxinzelelo lwegazi. Nangona kunjalo, inqanaba eliphambili legazi eliphakathi e-United States lehla ukusuka kwi-130 μg / L kwi-1976 ukuya kwi-30 μg / L kwi-1994, ebonisa ukuba ukuhla kwe-lead exposure yisinye isizathu sokuhla kwengcinezelo yegazi. KwiSifundo seNtsapho yeNtliziyo eSomeleleyo, ebandakanya i-American Indian cohort, amanqanaba okukhokela kwegazi ancipha ngo-≥9 μg / L kunye noxinzelelo lwegazi lwe-systolic lwehla ngomlinganiselo we-7.1 mm Hg (ixabiso elilungisiweyo).
Imibuzo emininzi ihleli ingaphendulwanga malunga neziphumo zokuvezwa kwelothe kwisifo sentliziyo. Ubude bexesha lokuvezwa okufunekayo ukuze kubangele uxinzelelo lwegazi okanye isifo se-cardiovascular disease aliqondwa ngokupheleleyo, kodwa utyhileko lwexesha elide olongezelekayo olulinganiswe ethanjeni lubonakala lunamandla okuxela kwangaphambili kunokuba sesichengeni sexesha elifutshane esilinganiswa egazini. Noko ke, ukunciphisa ukuba sesichengeni selothe kubonakala kunciphisa uxinzelelo lwegazi kunye nobungozi bokufa ngenxa yesifo sentliziyo kwisithuba sonyaka omnye ukuya kwemi-2. Kunyaka emva kokuvalwa kwepetroli ekhokelayo kumdyarho we-NASCAR, uluntu olukufutshane nomzila lwaba namazinga asezantsi kakhulu okusweleka kwesifo sentliziyo xa kuthelekiswa noluntu oluninzi. Ekugqibeleni, kukho isidingo sokufunda iziphumo zexesha elide le-cardiovascular kubantu abavezwe kumanqanaba okukhokela ngaphantsi kwe-10 μg / L.
Ukuncipha kokuchanabeka kwezinye iikhemikhali eziyityhefu nako kube negalelo ekwehleni kwesifo sentliziyo. Ukukhutshwa kwepetroli enelothe ukusuka ngo-1980 ukuya kowama-2000 kunciphise intwana yenkunkuma kwiindawo ezingama-51 zedolophu, nto leyo ekhokelele kukwanda kwe-15 lepesenti yokuphila ubomi. Bambalwa abantu abatshayayo. Ngowe-1970, malunga nama-37 ekhulwini abantu abadala baseMerika babetshaya; Ngowe-1990, yayingama-25 ekhulwini kuphela abantu baseMerika ababetshaya. Abatshayayo banamanqanaba aphezulu elothe egazini kunabo bangatshayiyo. Kunzima ukukhupha iimpembelelo zembali kunye nezangoku zongcoliseko lomoya, umsi wecuba kunye nokukhokelela kwisifo senhliziyo.
Isifo sentliziyo sesona sizathu siphambili sokufa kwihlabathi liphela. Uphononongo olungaphezulu kweshumi elinesibini lubonise ukuba ukuba sesichengeni ilothe yeyona nto iphambili kwaye idla ngokungahoywayo yokufa ngenxa yesifo sentliziyo. Kwi-meta-analysis, u-Chowdhury et al wafumanisa ukuba amanqanaba aphezulu e-lead yegazi yinto ebalulekileyo yengozi yesifo senhliziyo. Kuphononongo olusibhozo olulindelekileyo (inani lilonke labathathi-nxaxheba abangama-91,779), abantu abanoxinzelelo lwelothe yegazi kwelona nqanaba liphezulu lentlupheko babenomngcipheko ophezulu wama-85% we-non-fatal myocardial infarction, utyando lwe-bypass, okanye ukusweleka ngenxa yesifo sentliziyo kunabo bakwelona nqanaba lisezantsi lokuqukunjelwa. Ngo-2013, i-Arhente yoKhuseleko lweNdalo (EPA)
I-Arhente yoKhuseleko yagqiba ukuba ukuvezwa kwe-lead kuyingozi kwi-coronary heart disease; Kwiminyaka elishumi kamva, iAmerican Heart Association yasixhasa eso sigqibo.
Ixesha lokuposa: Nov-02-2024