Abstract
BackgroundElevated blood lead level (EBLL) is a public health problem in both developing and industrialized countries. Being a petrochemical-based economy, lead (Pb) levels are expected to be high in Kuwait, but systematic data on population exposure are lacking. This study aimed at determining the prevalence of EBLL in adolescents in Kuwait.MethodsAdolescents (N = 1385; age range 11–16 years) were cross-sectionally selected from public middle schools from all Governorates of Kuwait, utilizing multistage cluster random sampling. Pb in whole blood was analyzed by inductively coupled plasma mass spectrometry. Distribution of blood Pb levels (BLL) among Governorates and sexes were compared by non-parametric tests and the prevalence of EBLL (defined as BLL above the CDC reference level of ≥5 μg/dL) was estimated by χ2 test. Binary logistic regression was used for assessing the association between EBLL and Governorate.ResultsMedian (IQR) BLL was 5.1(3.6–7.1) μg/dL [4.9 (3.8–6.5) μg/dL in males and 5.4 (3.3–7.6) μg/dL in females; p = 0.001]. In the overall sample, 51% had BLL ≥5 μg/dL; 13% had ≥10 μg/dL and 3% > 20 μg/dL. Prevalence of EBLL was 47% in males and 56% in females (p < 0.001). EBLLs were clustered in Al-Asima, Al-Ahmadi (in both sexes); Al-Jahra (in males) and Mubarak Al-Kabeer (in females) Governorates.ConclusionsEBLL is a significant public health problem in adolescents in Kuwait. Urgent public health intervention is required in areas with EBLL, and the sources of exposure need to be identified for prevention.
Highlights
Elevated blood lead level (EBLL) is a public health problem in both developing and industrialized countries
The objective of this study was to evaluate the prevalence of elevated blood lead levels (EBLL), defined as the blood Pb levels (BLL) above the CDC reference level (5 μg/dL), in a representative sample of adolescents selected from public middle schools from all Governorates of Kuwait
Pb data were available for 1385 adolescents, of which 673 (48.6%) were males
Summary
Elevated blood lead level (EBLL) is a public health problem in both developing and industrialized countries. Being a petrochemical-based economy, lead (Pb) levels are expected to be high in Kuwait, but systematic data on population exposure are lacking. Lead (Pb) is a toxic metal with serious and long-lasting health consequences, in children [1]. Due to its high malleability and resistance to corrosion, Pb has been used in various industries like plumbing, mining and metals recycling, in paint, pipes, batteries, cans, and cable covers, and in gasoline as an anti-knocking agent [2]. Based on accumulating evidence regarding the neurotoxic effects of Pb in children, the reference blood lead level (BLL) at which intervention needs to be initiated has progressively decreased from 60 μg/dL in the 1960s to 10 μg/dL in 1991 [6]. In 2012, the CDC stated that no level of Pb exposure in children is safe and established a new cutoff of 5 μg/dL
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