Abstract
BackgroundLead toxicity is of particular public health concern given its near ubiquitous distribution in nature and established neurotoxicant properties. Similar in its ubiquity and ability to inhibit neurodevelopment, early childhood stunting affects an estimated 34 % of children under 5 in low- and middle-income countries. Both lead and stunting have been shown to be associated with decreased neurodevelopment, although the relationship between these childhood burdens is underexplored. The association between lead exposure and stunting has been previously established, yet limited data are available on susceptibility windows.MethodsWhole blood lead samples were collected from rural Bangladeshi children at delivery (umbilical cord blood) and at age 20–40 months (fingerstick blood). Stunting was determined using the Child Growth Standards developed from the World Health Organization Multicentre Growth Reference Study. Children with height for age < -2 z-scores below the median of the WHO Child Growth Standards were classified as stunted in all analyses.ResultsMedian (IQR) umbilical cord and fingerstick blood lead levels were 3.1 (1.6–6.3) μg/dl and 4.2 (1.7–7.6) μg/dl, respectively. In adjusted multivariable regression models, the odds of stunting at 20–40 months increased by 1.12 per μg/dl increase in blood lead level (OR = 1.12, 95 % CI: 1.02–1.22). No association was found between cord blood lead level and risk of stunting (OR = 0.97, 95 % CI: 0.94–1.00).ConclusionsThere is a significant association between stunting and concurrent lead exposure at age 20–40 months. This association is slightly attenuated after controlling for study clinic site. Additional research including more precise timing of lead exposure during these critical 20–40 months is needed.Electronic supplementary materialThe online version of this article (doi:10.1186/s12940-016-0190-4) contains supplementary material, which is available to authorized users.
Highlights
Lead toxicity is of particular public health concern given its near ubiquitous distribution in nature and established neurotoxicant properties
Between 2010 and 2013, when children were aged 12 to 40 months, healthcare workers from Dhaka Community Hospital (DCH) invited families to enroll their children in follow-up studies; all children born to mothers in the original study were eligible
Compared to children from Pabna, children from Sirajdikhan were more likely to be stunted (62.2 % vs. 42.6 %) but were less likely to be exposed to cigarette smoke (33.9 % vs. 49.8 %)
Summary
Lead toxicity is of particular public health concern given its near ubiquitous distribution in nature and established neurotoxicant properties. Children are susceptible to, and increasingly confronted by, a myriad of health burdens resulting from exposure to environmental toxins Toxic metals such as lead (Pb) are of particular public health concern given their near ubiquitous distribution and persistency in nature [1]. The inconsistent regulations surrounding the use of lead across the globe have resulted in disproportionate exposure potentials, with developing countries at the highest risk for heavy metal over-exposure [13] Further compounding this disparity in global exposure is the overwhelming prevalence of chronic stunting, which
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