Blood Lead Levels Research Articles

Association between blood lead and periodontitis among American adults: a cross-sectional study of the national health and nutrition examination survey

BackgroundLead is persistent in the environment as a toxic substance and accumulates in the human body. Lead exposure has far-reaching harmful effects on all human systems and is widely recognized as a health and public health concern. Lead exposure poses a significant risk to oral health, as it destroys salivary glands and alveolar bone. It also induces oxidative stress which results in an immune response. Lead exposure appears to adversely affect periodontal tissues. Currently, the available evidence on the relationship between blood lead and periodontitis is insufficient and further research is necessary.ObjectiveIn this study, the objectives were to clarify the association between blood lead and periodontitis, as well as to explore potential dose-response relationships between blood lead exposure and periodontitis, as well as to determine appropriate thresholds for the effects of blood lead on periodontitis.MethodsWe conducted a cross-sectional study involving 8,550 participants with American adults aged 30 or older. blood Lead, periodontitis, age, sex, race, heart rate, education level, poverty index, marital status, body mass index, smoking status, alcohol drinking status, hypertension, diabetes and stroke. were collected from participants. Logistic regression, smooth curve fittingwere utilized to substantiate the research objectives.ResultsThere were a total of 8,550 participants of which 52.2% (4,467/8,550) had moderate/severe periodontitis. Compared with Q1 (0.15–0.93 ug/L), where blood lead levels were lower, the OR values for adjusted blood lead and periodontitis in Q2 (0.93–1.60 ug/L) and Q3 (1.60–61.29 ug/L) were 1.18 (95% CI: 1.12–1.25, P < 0.001) and 1.43 (95% CI: 1.34–1.52, P < 0.001). The association between blood lead levels and periodontitis exhibited a curve (non-linear, P < 0.001), with an inflection point of roughly 2.700 ug/L. The OR values for moderate/severe periodontitis in participants with blood lead levels <2.700ug/L was 1.318 (95% CI: 1.193–1.457, P < 0.001).ConclusionBlood lead levels are positively associated with periodontitis. Blood lead levels increased by five units and were associated with an increase in moderate and severe periodontitis risk by 36%. There is a curvilinear relationship between blood lead and periodontitis with a threshold effect and an inflection point of approximately 2.7 ug/L.

Lead exposure and physical frailty in patients with type 2 diabetes mellitus: cross-sectional results from the METAL study.

Chronic lead exposure continues to be a global environmental concern. Previous studies reported high levels of lead exposure in people with diabetes. Frailty is one of the vital comorbidities of type 2 diabetes mellitus (T2DM); however, researchers have not determined whether lead exposure is a risk factor for frailty in people with T2DM. This cross-sectional study explored the association between blood lead levels and frailty in a Shanghai diabetic population cohort. Individuals who met ≥3 of 5 predefined criteria (weight loss, exhaustion, low physical activity, slow walking speed and low grip strength) were defined as frailty. A total of 884 participants with T2DM (50.6% men, mean age 70.6 ± 7.4 years) were included. Among them, 147 (16.6%) patients were frail, and the median (interquartile range) concentration of blood lead was 16.0 µg/L (12.0-23.0). Compared with the participants within the lowest quartile of serum lead, positive associations of the 2nd and 4th lead quartiles with frailty were observed (OR, 95% CI; 1.70 1.01-2.84 and 1.72 1.03-2.88, respectively) after adjusting for age, sex and body mass index (BMI). After further adjustment for drinking status, smoking status, diet, education, blood pressure, triglycerides and glycosylated hemoglobin, the associations of serum lead with frailty were still significant for the 4th and 2nd-4th quartiles of lead (1.71, 1.01-2.91 and 1.57, 1.02-2.41, respectively). In the subgroup analyses, we found positive associations of serum lead with frailty in elderly individuals (1.77, 1.13-2.79), those with obesity (2.14, 1.02-4.51), those with unhealthy diets (2.52, 1.26-5.04), and those without hyperlipidemia (2.09, 1.12-3.88), although the interactions were not statistically significant (P for interaction all >0.05). This work provides evidence of an association between chronic lead exposure and physical frailty in a diabetic population in a Chinese cohort. Future prospective and mechanistic studies are warranted to confirm our findings.

Association between blood lead levels and serum creatinine: a cross-sectional study.

The aim of this cross-sectional study was to investigate the association between blood lead levels and serum creatinine. In the present study, sample data were derived from the National Health and Nutrition Examination Survey (NHANES) 2015-2018 of participants with complete data of blood lead levels and serum creatinine. Multivariate linear regression models were used to examine the association between blood lead levels and serum creatinine. The nonlinear connection was described using fitted smoothing curves and threshold effect analysis. Furthermore, subgroup analyses and interaction tests were performed. A total of 9026 participants were enrolled in this study, and the mean serum creatinine for all subjects was 0.86 ± 0.34mg/dL. When blood lead levels were divided into quartiles, it was found that participants' serum creatinine levels gradually increased with increasing blood lead levels (Q1: 0.77 ± 0.19mg/dL, Q2: 0.84 ± 0.23mg/ dL, Q3: 0.89 ± 0.34mg/dL, Q4: 0.94 ± 0.50mg/dL). Compared to the lowest serum quartile, the highest quartile of blood lead levels had a positive correlation with serum creatinine in the fully adjusted model (β = 0.05 95% CI 0.01-0.08). Smooth curve fittings and threshold effect analysis showed an inverted J-shaped nonlinear relationship between blood lead levels and serum creatinine, with an inflection point of 3.10 (μg/dL). Subgroup analyses and interaction tests revealed that diabetes mellitus impacted the relationship between serum creatinine and blood lead levels. This study suggests a positive correlation between blood lead levels and serum creatinine.

Impact of acute PM2.5 exposure on pediatric blood lead levels: evidence from Beijing, China

Research on the effects of fine particulate matter (PM2.5) on blood lead levels (BLL), particularly in children, remains limited. This study aimed to investigate the relationship between acute ambient PM2.5 exposure and BLL in children aged below 14. A total of 23,732 children were included in the study, with BLL measured using atomic absorption spectrometry. Generalized additive models (GAM) were employed to analyze the connection between children’s BLL and acute PM2.5 exposure. From April 2008 to June 2017, Beijing’s average PM2.5 concentration was 91.71 ± 74.55 μg/m³, approximately 2.62 times higher than the annual average concentration recommended by the WHO Ambient Air Quality Standard (35 μg/m³). The mean (±SD) BLL of children was 0.2105 ± 0.0963 μmol/L, with a median of 0.20 μmol/L. The data indicated an increase in BLL with age and a significant difference in BLL between boys and girls (p < 0.05). The analysis revealed a non-linear relationship between BLL and PM2.5 exposure after adjusting for variables such as gender, age, blood levels of Cu, Fe, Ca, Mg, Zn, analysis batch, and heating season. PM2.5 exposure significantly impacted children’s BLL.

The Association Between Blood Lead Levels and Urgency Urinary Incontinence Among Adult Females: A Retrospective Study Based on NHANES 2005-2020.

The purpose of this study is to investigate whether blood lead levels influence the risk of urgency urinary incontinence (UUI) in adult females. This study utilized data from the National Health and Nutrition Examination Survey from 2005 to 2020, involving 9509 adult women aged 20 and older. The effect of blood lead levels on UUI was assessed using weighted multivariate logistic regression models. Additionally, the relationship between the two was illustrated using restricted cubic splines. Stratified analyses based on covariate categories were used to explore if factors influenced the relationship between blood lead levels and UUI. Adjusted multivariate logistic regression analysis indicated that for each unit increase in blood lead levels, the risk of UUI increased by 10% (OR = 1.10; 95% CI, 1.02-1.17; P = 0.01). After categorizing blood lead levels into weighted tertiles, compared to the first tertile, the third tertile increased the risk of UUI by 1.34 times in Model 1 (OR = 1.34; 95% CI, 1.13-1.59; P < 0.001). A restricted cubic spline analysis demonstrated a nonlinear relationship between blood lead levels and UUI (P for nonlinearity = 0.016). Stratified analysis revealed that baseline characteristics such as age, BMI, and PIR did not have an impact on the association between blood lead levels and UUI. This study demonstrated a close association between the risk of blood lead levels and UUI in adult women aged 20 and above. High blood lead levels were found to increase the risk of UUI.

The relationship between fixed dental prostheses, blood lead levels, and liver function: Mediating effects and gender differences

Metal alloys, pure titanium, metal-ceramics, and ceramic materials are used for fixed dental prostheses, which contained lead and potentially involved hepatotoxicity. To investigate the connection between fixed dental prostheses, blood lead levels, and liver function. A cross-sectional study enrolled 3624 American adults were conducted. Multivariate linear regression models and smooth curve fittings were used to describe correlations between the number of fixed dental prostheses, blood lead levels, and four liver function markers. Mediation analysis suggested an intermediary association of blood lead levels between prosthesis count and liver function. Here, number of fixed dental prostheses was significantly positive correlated with blood lead levels (p < 0.0001), but specifically negative correlated with alanine aminotransferase, lactate dehydrogenase, and gamma glutamyl transferase levels in males. Moreover, mediation analysis confirmed a mediating role for blood lead levels in the association between the number of prostheses and alanine aminotransferase levels in males only, with a mediation effect rate of 74.27% (p = 0.0020). An increased count of fixed prostheses is associated with changes in liver function markers in a gender-dependent manner, with blood lead levels serving as a potential mediator in males.

Investigating Blood Lead Levels and Its Health Effects on Employees of a Petroleum Industry and the Surrounding Residents: A Case Study of Kirkuk City, Iraq.

This study has been aimed to investigate factors associated with elevated blood lead levels (BLLs) across different percentiles in individuals employed in the petroleum industry and residents of Kirkuk City . In addition, to provide evidence-based approaches to mitigate exposure risks and safeguard vulnerable populations. The study involved 357 participants and utilized quantile regression to examine BLL in petroleum industry workers and Kirkuk residents. Median BLLs were higher among workers (17.5 μg/dL) compared to residents in the city (9.9 μg/dL) and suburbs (7.4 μg/dL). Factors such as smoking, outdoor work, and lower education were associated with elevated BLLs, as confirmed by quantile regression. This study found higher BLLs in petroleum workers compared to Kirkuk residents, associated with smoking, outdoor work, and lower education. The results emphasize the need for targeted interventions and policies to mitigate lead exposure risks in this industrial region.

DNA Methylation Biomarkers for Cumulative Lead Exposures and Cognitive Impairment

BackgroundRecent evidence suggests that cumulative low-level lead exposure has adverse effects on cognitive function in the elderly. To date, the few studies that have measured bone lead exposure relied on K-X-ray fluorescence (KXRF), methods that are mostly unavailable in large community-based studies. Here, we employ a methylation-based estimation method for bone and blood lead in the Alzheimer’s Disease Neuroimaging Initiative (ADNI) cohort. MethodsTibia, patella, and blood lead levels were estimated using blood DNA methylation (DNAm) biomarkers in 625 participants from the ADNI cohort. Cognitive function was assessed using the Montreal Cognitive Assessment (MoCA). Longitudinal analyses were conducted using linear mixed-effect regression models. Participants had different years of baseline (2010-2014) and follow-up visits (2014-2015). ResultsDNAm derived tibia and patella lead levels were negatively associated with MoCA scores throughout follow-up, while DNAm derived blood lead level was not associated with MoCA scores. On average, we observed lower MoCA scores with increasing DNAm tibia lead (per interquartile range (IQR): β=-0.23; 95%CI: -0.44, -0.03) and DNAm patella lead, albeit the latter was weaker (per IQR: β=-0.19; 95%CI: -0.41, 0.04). When stratifying by gender, women showed a stronger decrease in cognitive function with increasing DNAm tibia lead (per IQR β=-0.34; 95%CI: -0.65, -0.04) than men (per IQR β=-0.15; 95%CI: -0.42, 0.13). The estimated decrease in MoCA scores per DNAm tibia lead IQR increase was stronger among participants with one or two APOE4 alleles (per IQR β=-0.37; 95%CI: -0.74, -0.01) than those with zero alleles (per IQR β=-0.14; 95%CI: -0.38, 0.10). ConclusionThese findings strengthen the evidence that cumulative long-term lead exposures levels are associated with decreased cognitive function in the elderly, especially among women and carriers of one or two APOE4 alleles. These findings based on whole blood methylation data corroborate previous epidemiologic studies that used KXRF for measuring bone lead.

Associations of mixed metals exposure with cognitive impairment risk: a cross-sectional study in Chinese adults.

Associations between exposure to single metals and cognitive impairment or related outcomes have been reported in many previous studies. However, co-exposure to more than one metal is common situation. In recent years, studies on the effects of exposure to multiple metals on cognitive impairment or related outcomes have increased, but remain very limited, with a focus on populations with occupational exposure to metals, children, and adolescents. The potential relationships between exposure to metal mixtures and risk of cognitive impairment in adults remain to be clarified. To determine the associations between blood metal mixtures and cognitive impairment risk. Inductively coupled plasma mass spectrometry (ICP-MS) was utilized to detect the blood levels of lead (Pb), iron (Fe), copper (Cu), calcium (Ca), magnesium (Mg), and zinc (Zn). Multivariable logistic regression and Bayesian kernel machine regression (BKMR) models were employed to assess the relationships of exposure to these blood metal mixtures with the risk of cognitive impairment. It was found that four metals (Pb, Fe, Cu, and Mg) were positively correlated with cognitive impairment in each single metal model. The association of Pb and Cu remained significant after adjusting for these six metals, with the odds ratios (95% confidence intervals) in the highest quartiles of 9.51 (4.41-20.54, p-trend <0.01) and 4.87 (2.17-10.95, p-trend <0.01), respectively. The BKMR models indicated that co-exposure levels of Ca, Cu, Fe, Mg, Pb, and Zn were related to increased risk of cognitive impairment at ≥25th percentile compared with median, and Pb and Cu mainly contributed to the joint effect. In addition, the interaction effects of Mg and Pb/Pb and Cu on the risk of cognitive impairment were observed. Co-exposure of six metals (Pb, Fe, Cu, Ca, Mg, and Zn) increased the risk of cognitive impairment in Chinese adults, with Pb and Cu likely to have greater impact. Potential interaction effects of Mg and Pb, Pb and Cu on the risk of cognitive impairment may exist.

Time-trends of blood lead levels from 2020 to 2023 in pregnant and breastfeeding women from Adjara, Georgia—A birth registry-based study

BackgroundIn response to substantial lead exposure, the autonomous republic of Adjara in Georgia initiated complementary blood lead level (BLL) testing for pregnant women as part of their antenatal care services in 2020. ObjectivesTo study the background BLLs in pregnant and breastfeeding women in Adjara and explore the time-trends of BLLs from September 2020 to July 2023. MethodsWe used data on BLLs during pregnancy or postpartum from the lead screening program in Adjara, combined with data from the Georgian Birth Registry, totaling 9,510 women. To study the temporal changes in BLLs, we used independent samples t-tests and chi-square tests. ResultsIn 2020, the mean (standard deviation [SD]) BLL was 8.8 (5.4) μg/dL, declining annually by 1.0–2.2 μg/dL to reach 3.6 (2.5) μg/dL in 2023. The prevalence of pregnant women with BLLs ≥3.5, ≥5.0, and ≥10.0 μg/dL also decreased from 2020 to 2023. Specifically, 21.2% of women in their first trimester had BLLs ≥10 μg/dL in 2020, compared with 2.3% in 2023. Similarly, 73.5% had BLLs ≥5.0 μg/dL in 2020, which declined to 20.4% in 2023. Lastly, 89.1% had BLLs ≥3.5 μg/dL in 2020, decreasing to 38.6% in 2023. DiscussionIn 2023, nearly 40% of women in their first trimester had BLLs of ≥3.5 μg/dL, a level considered the reference value in the United States (US) and corresponding to the 97.5th percentile among US children. From 2020 to 2023, the mean BLL in pregnant women decreased by 59%, accompanied by a considerable decline in the prevalence of women with BLLs ≥3.5, ≥5.0, and ≥10.0 μg/dL. Despite the encouraging downward trend in BLLs throughout the study period, our data indicate that a considerable number of fetuses continue to be exposed to harmful levels of lead and that lead exposure remains a significant public health challenge in Adjara.

Simultaneous Fixed and Random Effects Selection in Order-restricted Mixed Effects Models

When dealing with longitudinal data, if we directly select a specific model for modeling without any prior information about the existence of significant random effects before utilizing the mixed model, it may result in the misuse of the model, thereby affecting the final estimation results. This paper investigates a variable selection method that can jointly select both fixed and random effects in Bayesian mixed model under order constraints. This method can effectively prevent model misuse. A computationally feasible Gibbs algorithm is proposed for posterior inference. The performance of our proposal is evaluated by simulated data and two real applications related to Blood lead levels and Ramus bone heights. Results show that the proposed approaches perform very well in various situations.

Assessing the sustainability and safety of polyethylene terephthalate (PET) liners for lead service lines (LSL) upgrades

Polyethylene Terephthalate (PET) liners have been proposed by industry as a more cost effective and less disruptive alternative to lead service lines (LSL) replacement. However, concerns have been raised about their aging under real-use conditions and their potential health and environmental impacts. In this study, two approaches were implemented. First, bench and pilot scale experiments were carried out to investigate the aging of a PET liner under conditions that simulate normal usage. Results show early surface oxidation and leaching of potentially hazardous metals (lead, zinc and titanium). No short-term fragmentation of the PET liner into microplastics was observed. Next, a life cycle assessment (LCA) compared the health and environmental impacts of three LSL upgrade alternatives: PET liners and full LSL replacement using either copper or PEX pipes. The installation phase was shown to be the main contributor to impact scores, while the benefits of PET liners are highly dependent on their lifespan. PEX pipes installed by torpedoing lower impacts as compared to PET liners and copper pipes for equal lifespan, while the use of PET liners remains less impactful regarding human health and ecosystem quality when a complete excavation is needed. LCA derived global human health effects due to ingestion of leached metals from PET liners, copper pipes and unreplaced LSL, and showed that PET liners and copper pipes significantly reduce health impacts by 14 and 80 DALY respectively compared to unreplaced LSL. Finally, the Integrated Exposure Uptake Biokinetic (IEUBK) model was used to assess the impact of lead exposure specifically for drinking water ingestion. Estimated Blood Lead Levels (BLL) in children and infants in households with long unreplaced LSL was up to 263.7% and 207.8% greater compared to either replacement with copper pipes or rehabilitation with PET liners, showing the clear benefits of corrective action. Combining experimental results, LCA and biokinetic modeling provides actionable information for utilities to select the best upgrade options, considering environmental, health and practical constraints, whilst identifying remaining data gaps. The relative benefits of PET liners should be carefully evaluated considering their lifespan under real-life conditions, the complete replacement costs after failure, and the growing evidence of micro- and nanoplastics (MNP) risks.

Association between trace elements and cognitive function among hemodialysis patients in Turkey.

Cognitive impairment is common among patients with hemodialysis. Hemodialysis patients have theoretical risks for both deficiency and accumulation of trace elements. We aimed to investigate the relationship between cognitive dysfunction and whole blood levels of trace elements in hemodialysis patients. We also aimed to examine the effect of baseline trace element status and cognitive dysfunction on mortality. Maintenance hemodialysis patients and age-and sex-matched controls were included. The whole blood levels of trace elements were measured by inductively coupled plasma mass spectrometry. Cognitive impairment was defined as a score of ≤24 points on the Montreal Cognitive Assessment test. Executive dysfunction was also defined as Trails A score of more than 75 s and Trails B score of more than 180 s. Forty-two patients and 35 controls were included. Cognitive impairment was detected in 69% of the patients and 45.7% of the controls (p = 0.039). Cognitively impaired patients had lower education years (p = 0.003) and higher whole blood levels of manganese (Mn) and lead (Pb) (p = 0.026, p = 0.019, respectively) compared to patients without cognitive impairment. Mn levels were also found statistically higher in patients with executive dysfunction compared to patients without executive dysfunction (p = 0.005). Lower education years and higher Pb levels were independent risk factors for cognitive impairment in hemodialysis patients (odds ratio [OR] 0.589 [95% confidence interval, CI 0.400-0.866, p = 0.007] and OR 1.047 [95% CI 1.001-1.096, p = 0.047, respectively]). Cognitive impairment, especially impaired executive function, is common among patients with hemodialysis patients. Cognitive impairment is not found to be associated in cross-sectional analysis with several modifiable end-stage renal disease- and dialysis-associated factors. The accumulation of trace elements especially Mn and Pb might exacerbate the cognitive dysfunction in hemodialysis patients.

The Assessment of Anthropometric Measures and Changes in Selected Biochemical Parameters in Obese Children in Relation to Blood Lead Level.

Our paper draws attention to the impact of lead (Pb) on the specificity of obesity development in children exposed to environmental pollution. An advantage of this paper is the homogeneous study group comprising children of identical age from a single geographic region. Moreover, while the influence of environmental toxins on adults has been extensively explored, this study delves into pediatric populations, which have yet to receive comprehensive scrutiny within the scientific literature. Initially, a group of 136 obese children (the research program lasted three consecutive years: 2016, 2017, and 2018) living in the north-western region of Poland, from whom biochemical tests and auxological data were obtained, were enrolled for analysis. Blood lead levels (BLLs) were determined in 115 children. The age of the children ranged from 7.1 to 10.4 years. The body mass index (BMI) of children averaged 21.5 ± 2.2. The results showed that a large proportion of the participants had BLLs above the threshold for Pb. BLLs ≤ 5 µg/dL (considered safe for children and pregnant women) were found in over 70% of the participants, with BLLs in the range of 5.01-10.00 µg/dL in over 26% of the children, and concentrations > 10 µg/dL (considered toxic threshold for adults) in nearly 2% of the children. The results of our research revealed a positive association between BLLs and average systolic and diastolic blood pressure in the studied children. Moreover, we found a negative correlation between BLLs and absolute fat tissue content and triglyceride concentration. Among the included biochemical factors, only insulin demonstrated a statistically significant relationship with fat mass. This result suggests that early carbohydrate metabolism disorders in overweight children involve decreased peripheral tissue insulin sensitivity. Lead exposure may significantly contribute to the development of hypertension, insulin resistance, and glucose metabolism disorders in overweight and obese children. It is essential to implement multidirectional actions to increase awareness of the harmful effects of xenobiotic exposure, including lead, in order to prevent early-life exposure.

Analyzing and Optimizing the Distribution of Blood Lead Level Testing for Children in New York City: A Data-Driven Approach.

This study investigates blood lead level (BLL) rates and testing among children under 6 years of age across the 42 neighborhoods in New York City from 2005 to 2021. Despite a citywide general decline in BLL rates, disparities at the neighborhood level persist and are not addressed in the official reports, highlighting the need for this comprehensive analysis. In this paper, we analyze the current BLL testing distribution and cluster the neighborhoods using a k-medoids clustering algorithm. We propose an optimized approach that improves resource allocation efficiency by accounting for case incidences and neighborhood risk profiles using a grid search algorithm. Our findings demonstrate statistically significant improvements in case detection and enhanced fairness by focusing on under-served and high-risk groups. Additionally, we propose actionable recommendations to raise awareness among parents, including outreach at local daycare centers and kindergartens, among other venues.

Association of urinary and blood lead concentrations with all-cause mortality in US adults with chronic kidney disease: a prospective cohort study.

Epidemiological evidence on the relationship between lead exposure and mortality in specific chronic kidney disease (CKD) populations is limited. We aimed to examine the relationship between urinary lead and blood lead concentrations and all-cause mortality in US patients with CKD. This cohort study included 2320 participants with CKD from the National Health and Nutrition Examination Survey (2005-2018), with follow-up until December 31, 2019. All-cause mortality was ascertained by matching US National Death Index records. Hazard ratios (HRs) and 95% confidence intervals (CI) for urinary lead and blood lead concentrations in relation to all-cause mortality were estimated using a weighted Cox regression model. During a median follow-up period of 79months, a total of 625 participants with CKD succumbed to mortality. Compared to the lowest quartile, the highest quartile of urine and blood lead concentrations was associated with an increased risk of all-cause mortality, with HRs and corresponding 95% CIs of 1.77 (1.05-2.99) and 2.65 (1.38-5.10), respectively. Furthermore, each additional unit increase in urinary and blood lead concentrations was associated with HRs for all-cause mortality of 1.21 (95% CI 1.06-1.38) and 1.09 (95% CI 1.01-1.19), respectively. Kaplan-Meier survival curve analysis and restricted cubic regression spline curve analysis demonstrated significant positive associations between elevated blood lead levels, elevated urinary lead levels, and all-cause mortality risk (P < 0.05). A nonlinear concentration-response relationship was observed between blood lead level and all-cause mortality risk (PNonlinear < 0.05), with an inflection point at a concentration of 1.613µg/dL. Subgroup analysis as well as sensitivity analysis yielded consistent findings. Our findings demonstrate that elevated levels of lead in urine and blood are associated with a significantly increased mortality risk among patients with CKD, underscoring the importance of reducing lead exposure to mitigate mortality risk in individuals at high risk for CKD.

Combined Effects of Environmental Metals and Physiological Stress on Lipid Dysregulation.

Cardiovascular diseases (CVD) are a leading cause of mortality worldwide, influenced by genetic, environmental, and behavioral factors. This study examines the relationship between heavy metal exposure, chronic physiological stress (allostatic load), and lipid profiles, which are markers of CVD risk, using data from the National Health and Nutrition Examination Survey (NHANES) 2017-2018. We utilized structural equation modeling (SEM) to explore the associations between blood levels of lead, cadmium, allostatic load (AL), and lipid measures (low-density lipoprotein (LDL), high-density lipoprotein (HDL), and triglycerides). The AL index was derived from cardiovascular, inflammatory, and metabolic biomarkers and categorized into quartiles to identify high-risk individuals, with an index out of 10 subsequently developed. The SEM analysis revealed that both heavy metal exposure and allostatic load are significantly associated with lipid profiles. Higher levels of lead and cadmium were associated with increased LDL and triglycerides, while higher AL scores were linked to increased LDL and triglycerides and decreased HDL levels. Age was also a significant factor, showing positive correlations with LDL and triglycerides, and a negative correlation with HDL. This study underscores the multifactorial nature of CVD, highlighting the combined impact of environmental pollutants and physiological stress on lipid dysregulation. These findings suggest the need for integrated public health strategies that address both environmental exposures and chronic stress to mitigate cardiovascular risk. Further research is warranted to explore the underlying mechanisms and develop targeted interventions.

Lead poisoning as a differential diagnosis in pediatric patients with chronic abdominal pain: a case–control study in Tehran-Iran

BackgroundChronic abdominal pain is a potential symptom of lead poisoning, which is often challenging to diagnose. This case–control study aimed to evaluate blood lead levels in pediatric patients with chronic abdominal pain.MethodsThe case–control study was conducted on 190 pediatrics who presented to the Children's Medical Center Hospital clinics, Tehran between April 2021- 2023. The children were divided into two groups: the case group, consisting of 81 patients with chronic abdominal pain, and the matched control group; 109 children without any gastrointestinal symptoms. The statistical analysis of the data was performed using STATA 16. A multiple logistic regression model was used to assess the association of different independent variables with chronic abdominal pain.ResultsThere was no significant difference between mean (± standard deviation [SD]) of age (8.80(2.7) years vs. control group: 9.23(3.9) years), sex, and BMI (16.55(4.6) vs. 17.32(4.7)) of the patients with chronic abdominal pain (case group) and the control group, whereas the mean weight was remarkably low in patients with chronic abdominal pain: 27.25(± 12.1) kg vs. 31.70(± 14.7) kg (P value = 0.028). Fifty-nine percent of children with chronic abdominal pain had serum lead levels ≥ 10 µg/dL. The mean (SD) of blood lead levels was statistically high in the case group: 11.09 (± 5.35) µg/dL vs. control group: 8.26 (± 5.01) µg/dL) (P value ≤ 0.05). The appetite level was significantly low in the case group: 3.8 (± 2.5) vs. control group 5.4 (± 1.3).ConclusionsLead poisoning could be a possible cause of children's chronic abdominal pain. Regarding the high rate of lead poisoning in children exerting appropriate measures to reduce their exposure to lead is necessary.

Effects of Blood Lead Levels

Lead exposures among school-age children are a major public health issue. Although the harmful effects of lead exposure during the first years of life are well known, there is not as much understanding of the effects of low levels of lead exposure during later childhood. To review the effects of blood lead levels (BLLs) <10 µg/dL in school-age children and adolescents. We searched Medline, Embase, Global health, CINAHL, Scopus, and Environmental Science Collection databases between January 1, 2000, and May 11, 2023. We included peer-reviewed English-language articles that presented data on the effects of BLLs <10 µg/dL in individuals ages 5 through 18 years. Data on country, population, analytic design, sample size, age, BLLs, outcomes, covariates, and results were extracted. Overall, 115 of 3180 screened articles met the inclusion criteria. The reported mean or median BLL was <5 µg/dL in 98 articles (85%). Of the included articles, 89 (77%) presented some evidence of an association between BLLs <10 µg/dL during school age and detrimental outcomes in a wide range of categories. The strongest evidence of an association was for the outcomes of intelligence quotient and attention-deficit/hyperactivity disorder diagnoses or behaviors. Few articles controlled for BLLs at age <5 years, limiting conclusions about the relation between later BLLs and outcomes. BLLs <10 µg/dL in school-age children and adolescents may be associated with negative outcomes. This review highlights areas that could benefit from additional investigation.

Low-Level, Early Life Lead Exposure and School Behavior.

To measure how early childhood exposure to lead affects school behavior from third to eighth grade, measured by the number and days of total school suspensions and out-of-school suspensions (OSS). We estimate Poisson models using a cohort of 284 701 students with school records from 2006-2008 in North Carolina. We adjust for demographic and socioeconomic variables and school-grade-year cohort effects, and use coarsened exact matching to ensure similar characteristics across children with blood lead levels (BLLs) 2-10 μg/dL and children in the reference group with BLLs ≤1 μg/dL. BLLs ≥3 µg/dL are positively and significantly associated with all school suspension measures for sixth through eighth graders. The estimated effects on OSS for sixth through eighth graders are larger than the effects on total suspensions. For example, students with BLL = 3 µg/dL receive OSS 16% (95% confidence interval 3.6%-30%) more often and for 22% (95% confidence interval 7.3%-33%) more days than students with BLL ≤1 µg/dL. For third through fifth grade students, we only find a significant effect of lead exposure on suspensions at relatively high BLLs of 8-10 µg/dL. Our analysis demonstrates that BLL has significant adverse effects on third through eighth grade students' behavior, including at levels below the current Centers for Disease Control and Prevention's blood lead reference value of 3.5 μg/dL. We find that the adverse effects of lead are most strongly associated with more severe disruptive behavior in sixth through eighth graders, as measured by OSS. Our results underscore the long-term benefits of preventing early childhood exposure to lead.