Abstract
We aimed to examine the associations between blood lead and mercury levels and individual and community level socioeconomic positions (SEPs) in school-aged children. A longitudinal cohort study was performed in 33 elementary schools in 10 cities in Korea. Among a total of 6094 children included at baseline, the final study population, 2281 children followed-up biennially, were analyzed. The geometric mean (GM) levels of blood lead were 1.73 μg/dL (range 0.02–9.26) and 1.56 μg/dL (range 0.02–6.83) for male and female children, respectively. The blood lead levels were significantly higher in males, children living in rural areas, and those with lower individual SEP. The GM levels of blood mercury were 2.07 μg/L (range 0.09–12.67) and 2.06 μg/L (range 0.03–11.74) for males and females, respectively. Increased blood mercury levels were significantly associated with urban areas, higher individual SEP, and more deprived communities. The risk of high blood lead level was significantly higher for the lower individual SEP (odds ratio (OR) 2.18, 95% confidence interval (CI) 1.36–3.50 in the lowest educational attainment of the father), with a significant dose-response relationship observed after adjusting for the community SEP. The association between high blood lead levels and lower individual SEP was much stronger in the more deprived communities (OR 2.88, 95% CI 1.27–6.53) than in the less deprived communities (OR 1.40, 95% CI 0.76–2.59), and showed a significant decreasing trend during the follow-up only in the less deprived communities. The risk of high blood mercury levels was higher in higher individual SEP (OR 0.64, 95% CI 0.40–1.03 in the lowest educational attainment of the father), with a significant dose-response relationship noted. Significant decreasing trends were observed during the follow-up both in the less and more deprived communities. From a public health point-of-view, community level intervention with different approaches for different metals is warranted to protect children from environmental exposure.
Highlights
Children are more vulnerable to adverse health outcomes from environmental exposure than adults.From the prenatal period to adolescence, children are exposed to different environmental exposure sources via their diets and behaviors such as hand-to-mouth behaviors and indoor activities [1].In addition, children drink more water, breathe more air, and consume more food per kg body weight than adults in order to meet their higher metabolic rates [2]
Socioeconomic position (SEP) is an important factor in children’s health, with a low SEP linked to increased exposure and absorption of environmental contaminants, and enhanced toxic effects [3]
This study aimed to determine if there was an association between blood lead and mercury levels and socioeconomic factors in Korean children at the community and individual levels, and if the patterns of the levels according to children’s growth differed according to different individual and community level SEPs, using longitudinal follow-up data
Summary
Children are more vulnerable to adverse health outcomes from environmental exposure than adults.From the prenatal period to adolescence, children are exposed to different environmental exposure sources via their diets and behaviors such as hand-to-mouth behaviors and indoor activities [1].In addition, children drink more water, breathe more air, and consume more food per kg body weight than adults in order to meet their higher metabolic rates [2]. Children who live in socioeconomically disadvantaged environments could be exposed to various hazards through substandard housing conditions, houses with lead-based paint, persistent organic pollutants, air pollution, noise, mold, pesticides, and secondhand smoke [3,4,5,6,7] Their houses are more likely to be located in environmentally polluted places, such as near highways, intersections, municipal waste sites or incinerators, and industrial facilities [1]. Low SEP communities play an important role in increasing the burden of exposure to environmental contaminants through direct and indirect mechanisms with the physical, chemical, psychological, and social environments where children are living These communities are characterized by a lack of green spaces, lower accessibility to health care services, more psychologically stressful environments, high crime rates, poorer healthrelated behaviors, lack of social networks, and higher levels of problematic child behaviors [1,8]
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