Childhood Lead Poisoning Research Articles

Poor tap water quality experiences and poor sleep quality during the Flint, Michigan Municipal Water Crisis

ObjectivesAfter inadequate official response to community concerns over water quality following changes in Flint's municipal water supply, this study sought evidence for a relationship between water quality and community mental health. DesignThe Speak to Your Health Community Survey is a community-based participatory component of the health surveillance system in Genesee County, Michigan. This cross-sectional survey recruits participants from every residential Census Tract of the county and strives for demographic representativeness. ResultsRespondents (n=834) rated their tap water quality (taste, smell, appearance) as poor (36%), fair (18%), good (20%), very good (17%), and excellent (10%). They rated their sleep quality as poor (12%), fair (28%), good (39%), very good (18%), and excellent (4%), and had an average (SD) sleep length of 408(90) minutes. Controlling for age, sex, years of education, and whether respondents were African American and Hispanic/Latino/a, lower perceived tap water quality was associated with lower sleep quality and shorter sleep length. ConclusionResults indicate that adverse health conditions related to the water crisis extend beyond lead poisoning in children and include deterioration of sleep conditions among adult residents.

Analysis of intravenous chelation therapy of moderate lead poisoning in children and the effect of essential elements

目的： 探讨依地酸钙钠驱铅对儿童中度铅中毒的治疗效果和对必需元素的影响。 方法： 选取2014年10月至2015年9月32例驱铅试验阳性的中度铅中毒患儿，给予依地酸钙钠驱铅治疗，采用电感耦合等离子质谱（ICP-MS）测定驱铅治疗前后全血中铅、钙、镁、铁、铜、锌、锰、钼、钒、硒、镍、铷水平。 结果： 32例患儿驱铅治疗后血铅水平为（142.2±30.8）μg/L，明显低于治疗前[（274.0±46.4）μg/L]，差异有统计学意义（P<0.05）。全血钙、镁、铁、铜、锌、锰、钼、钒、钛、铝元素含量均下降，差异均有统计学意义（P<0.05）；全血钙、镁、铁、铜、锌、锰、钒下降范围为4.5%~9.5%；全血硒、镍、铷、锗变化差异无统计学意义（P>0.05）。32例患儿均未出现其他不良反应。 结论： 依地酸钙钠静脉驱铅治疗儿童铅中毒较为安全有效，但也会造成一定程度的必需元素丢失，应注意补充必需元素。.

Assessing Child Lead Poisoning Case Ascertainment in the US, 1999-2010.

To compare prevalence estimates for blood lead level ≥10.0 μg/dL (elevated blood lead level [EBLL]) with numbers reported to the Centers for Disease Control and Prevention (CDC) for children 12 months to 5 years of age from 1999 to 2010 on a state-by-state basis. State-specific prevalence estimates were generated based on the continuous NHANES according to newly available statistical protocols. Counts of case reports were based on the 39 states (including the District of Columbia) reporting to the CDC Childhood Lead Poisoning Prevention Program during the study period. Analyses were conducted both including and excluding states and years of nonreporting to the CDC. Approximately 1.2 million cases of EBLL are believed to have occurred in this period, but 607 000 (50%) were reported to the CDC. Including only states and years for which reporting was complete, the reporting rate was 64%. Pediatric care providers in 23 of 39 reporting states identified fewer than half of their children with EBLL. Although the greatest numbers of reported cases were from the Northeast and Midwest, the greatest numbers based on prevalence estimates occurred in the South. In southern and western states engaged in reporting, roughly 3 times as many children with EBLL were missed than were diagnosed. Based on the best available estimates, undertesting of blood lead levels by pediatric care providers appears to be endemic in many states.

Spatiotemporal exposome dynamics of soil lead and children's blood lead pre- and ten years post-Hurricane Katrina: Lead and other metals on public and private properties in the city of New Orleans, Louisiana, U.S.A.

BackgroundAnthropogenic re-distribution of lead (Pb) principally through its use in gasoline additives and lead-based paints have transformed the urban exposome. This unique study tracks urban-scale soil Pb (SPb) and blood Pb (BPb) responses of children living in public and private communities in New Orleans before and ten years after Hurricane Katrina (29 August 2005). ObjectivesTo compare and evaluate associations of pre- and ten years post-Katrina SPb and children's BPb on public and private residential census tracts in the core and outer areas of New Orleans, and to examine correlations between SPb and nine other soil metals. MethodsThe Louisiana Healthy Housing and Childhood Lead Poisoning Prevention Program BPb (µg/dL) data from pre- (2000–2005) and post-Katrina (2010–2015) for ≤6-year-old children. Data from public and adjacent private residential census tracts within core and outer areas are stratified from a database that includes 916 and 922 SPb and 13,379 and 4830 BPb results, respectively, from pre- and post-Katrina New Orleans. Statistical analyses utilize Multi-Response Permutation Procedure and Spearman's Rho Correlation. ResultsPre- to Post-Katrina median SPb decreases in public and private core census tracts were from 285 to 55mg/kg and 710–291mg/kg, respectively. In public and private outer census tracts the median SPb decreased from 109 to 56mg/kg and 88–55mg/kg. Children's BPb percent ≥5µg/dL on public and private core areas pre-Katrina was 63.2% and 67.5%, and declined post-Katrina to 7.6% and 20.2%, respectively. BPb decreases also occurred in outer areas. Soil Pb is strongly correlated with other metals. ConclusionsPost-Katrina re-building of public housing plus landscaping amends the exposome and reduces children's BPb. Most importantly, Hurricane Katrina revealed that decreasing the toxicants in the soil exposome is an effective intervention for decreasing children's BPb.

Lead Poisoning in Children and Adults.

Lead poisoning is receiving much attention and increased awareness lately owing to the tainted water supply crisis in Flint, Michigan. This article provides an important review about lead poisoning in both children and adults, potential causes, signs and symptoms, long-term effects, prevention, and recommendations for nursing practice. This article is not an in-depth examination of the topic, but rather a quick review.

Prevalence and Risk Factors of Elevated Blood Lead in Children in Gold Ore Processing Communities, Zamfara, Nigeria, 2012.

In March 2010, Medecins Sans Frontieres/Doctors Without Borders detected an outbreak of acute lead poisoning in Zamfara State, northwestern Nigeria, linked to low-technology gold ore processing. The outbreak killed more than 400 children ≤5 years of age in the first half of 2010 and has left more than 2,000 children with permanent disabilities. The aims of this study were to estimate the statewide prevalence of children ≤5 years old with elevated blood lead levels (BLLs) in gold ore processing and non-ore-processing communities, and to identify factors associated with elevated blood lead levels in children. A representative, population-based study of ore processing and non-ore-processing villages was conducted throughout Zamfara in 2012. Blood samples from children, outdoor soil samples, indoor dust samples, and survey data on ore processing activities and other lead sources were collected from 383 children ≤5 years old in 383 family compounds across 56 villages. 17.2% of compounds reported that at least one member had processed ore in the preceding 12 months (95% confidence intervals (CI): 9.7, 24.7). The prevalence of BLLs ≥10 µg/dL in children ≤5 years old was 38.2% (95% CI: 26.5, 51.4) in compounds with members who processed ore and 22.3% (95% CI: 17.8, 27.7) in compounds where no one processed ore. Ore processing activities were associated with higher lead concentrations in soil, dust, and blood samples. Other factors associated with elevated BLL were a child's age and sex, breastfeeding, drinking water from a piped tap, and exposure to eye cosmetics. Childhood lead poisoning is widespread in Zamfara State in both ore processing and non-ore-processing settings, although it is more prevalent in ore processing areas. Although most children's BLLs were below the recommended level for chelation therapy, environmental remediation and use of safer ore processing practices are needed to prevent further exposures. Obtained. The study protocol was approved by the US Centers for Disease Control Institutional Review Board-A and the National Health Research Ethics Committee of Nigeria. The authors declare no competing financial interests.

Lead intoxicated children in Kabwe / Zambia

Introduction: Kabwe was an important lead and zinc mining town in Zambia for over 90 years, leaving large quantities of lead contaminated waste tailings behind as well and extensive topsoil contamination through dry deposition. Lead is a well-known serious health hazard, causing anemia, seizures, encephalopathy and death. Soil in many of Kabwe’s residential areas is highly contaminated and serious ongoing childhood exposure persists today. The purpose of this presentation is to describe the current lead contamination problem and environmental health consequences for this community. Methods: Environmental lead assessments and health data for Kabwe’s children were collected and analyzed. Data is available from three different sources: Copperbelt Environment Project; Blacksmith Institute/ Pure Earth and University of Zambia / Hokkaido University in Sapporo/ Japan. The data was compiled and analyzed to provide a summary of the current environmental health impact from lead contamination. Results: In most housing areas the tolerable soil lead levels of 400 ppm (mg/kg) were surpassed. Ninety five percent (95%) of children’s blood lead levels in the most affected townships in over the 10 µg/dL, the accepted definition of lead poisoning in children. In many cases, child BLL reached levels where chelation therapy would normally be prescribed (i.e. ≥ 45 µg/dL). In the most affected townships over 50% of the children tested reached such levels. A review of existing data clearly establishes the severity of widespread lead exposure and poisoning in Kabwe. Conclusion: Large proportions of children in Kabwe are highly exposed, with seriously elevated blood lead levels. According to threshold levels and international recommendation they need to be treated and the exposure must be considerably reduced.

Lead poisoning in children; evaluation of a pilot surveillance system in England, 2014-15.

Introduction: Exposure to lead in children may result in neurodevelopmental problems. The extent of lead poisoning in England is not currently known, and there is no national screening programme. However, a study in the mid 1990’s suggested that 6% of children had blood lead levels (BLL) &gt;10μg/dl, a level requiring public health investigation. In March 2014, a pilot Lead Poisoning in Children (LPIC) surveillance system for England was developed to improve the timeliness of reporting of LPIC cases to Health Protection Teams (HPTs) for investigation. Trace Element Laboratories report eligible cases (aged ≤16 years, BLL ≥10µg/dl) via the system to HPTs. We undertook an evaluation of the system at 12 months to determine if the pilot met its objective to provide timely information for the public health investigation of cases. Methods: Cases were described by sex, age and blood lead levels. The timeliness of case reporting was evaluated, calculated as time between specimen date and reporting date to HPTs; the difference between the pilot period and preceding 2 years was tested using a Mann-Whitney test. Results: Thirty-eight cases were reported in the pilot phase (2014-15), including 26 new cases previously unknown to HPTs. 28/38 (74%) of cases were male, the median age was 5 years (range 1-11); 17/35 (49%) were under 5 years old. Mean BLL was 24.6 µg/dl (max= 64.6 µg/L) with no difference in sex (p=0.484). The mean number of days between specimen date of first elevated BLL and date of report to HPTs was 14 days (range 4-50, n=20) during the pilot, compared to 241 days (range 0-1,460, n=16) in the 2 years before the pilot started (p=0.006). Conclusions: During a one-year pilot of LPIC surveillance, timeliness of case reporting was greatly improved. Recommendations are to continue the surveillance as routine work, enabling earlier public health investigations.

Congress members seek data on lead poisoning

The public health crisis in Flint, Mich., has spurred four high-ranking Democrats in the U.S. House of Representatives to ask health departments in seven states for information about efforts to prevent childhood lead poisoning. Six of those states—Illinois, Massachusetts, New Jersey, New York, Ohio, and Pennsylvania—are identified as having the nation’s highest reported numbers of children with blood lead levels at or above an actionable level. “These children are at risk for serious intellectual, behavioral, and academic deficits, with lifelong and irreversible consequences,” the lawmakers say in letters to those six states and Michigan. They ask state health officials to provide details about their lead poisoning prevention strategies, including use of federal funds for these efforts and data collection methods. The information would be used to better understand how data are collected and whether current federal investments are “up to the task of addressing this public health challenge” as well

Environmental Remediation to Address Childhood Lead Poisoning Epidemic due to Artisanal Gold Mining in Zamfara, Nigeria.

Background:From 2010 through 2013, integrated health and environmental responses addressed an unprecedented epidemic lead poisoning in Zamfara State, northern Nigeria. Artisanal gold mining caused widespread contamination resulting in the deaths of > 400 children. Socioeconomic, logistic, and security challenges required remediation and medical protocols within the context of local resources, labor practices, and cultural traditions.Objectives:Our aim was to implement emergency environmental remediation to abate exposures to 17,000 lead poisoned villagers, to facilitate chelation treatment of children ≤ 5 years old, and to establish local technical capacity and lead health advocacy programs to prevent future disasters.Methods:U.S. hazardous waste removal protocols were modified to accommodate local agricultural practices. Remediation was conducted over 4 years in three phases, progressing from an emergency response by international personnel to comprehensive cleanup funded and accomplished by the Nigerian government.Results:More than 27,000 m3 of contaminated soils and mining waste were removed from 820 residences and ore processing areas in eight villages, largely by hand labor, and disposed in constructed landfills. Excavated areas were capped with clean soils (≤ 25 mg/kg lead), decreasing soil lead concentrations by 89%, and 2,349 children received chelation treatment. Pre-chelation geometric mean blood lead levels for children ≤ 5 years old decreased from 149 μg/dL to 15 μg/dL over the 4-year remedial program.Conclusions:The unprecedented outbreak and response demonstrate that, given sufficient political will and modest investment, the world’s most challenging environmental health crises can be addressed by adapting proven response protocols to the capabilities of host countries.Citation:Tirima S, Bartrem C, von Lindern I, von Braun M, Lind D, Anka SM, Abdullahi A. 2016. Environmental remediation to address childhood lead poisoning epidemic due to artisanal gold mining in Zamfara, Nigeria. Environ Health Perspect 124:1471–1478; http://dx.doi.org/10.1289/ehp.1510145

Revisiting Nonresidential Environmental Exposures and Childhood Lead Poisoning in the US: Findings from Kansas, 2000–2005

Although blood lead levels (BLLs) in US children have dramatically declined over the past 40 years, there remain pockets of children living in areas with elevated BLLs. While some increases (≥10 μg/dL) may be associated with legacy lead paint, ambient air lead may be contributing to the problem. A deidentified dataset of information on over 60,000 Kansas children under 3 years of age who were tested for BLL was provided through the Kansas Environmental Public Health Tracking Network for the period 2000–2005. Using ArcGIS, we calculated distance (in miles) from a lead-emitting industry referred to as a toxic release inventory (TRI) site. The USEPA TRI database tracks the management of certain toxic chemicals that may pose a threat to human health. US facilities in different industry sectors must report annually amount of substances like lead into the environment including their exact location. Distance from a TRI site was inversely related to BLL after controlling for area-level poverty and pre-1950 housing. The results of our evaluation indicate there is a significant relationship between proximity to lead industry and childhood BLLs. Proximity to sources of lead emissions should be evaluated as a possible factor when identifying children for targeted BLL testing.

Prediction of blood lead levels in children before and after remediation of soil samples in the upper Meza Valley, Slovenia

The Meza Valley, Slovenia, has been contaminated by Pb smelting, resulting in an epidemic of lead poisoning in childhood. The potential of remediation with EDTA soil washing to mitigate the risk from Pb poisoning was investigated by applying the Integrated Exposure Uptake Bio-kinetic (IEUBK) model. Soils from 79 locations were collected and the total and bio-accessible Pb concentrations were determined before and after extraction with 60mmolkg−1 EDTA. Extraction reduced the soil Pb concentration in towns of Mezica, Zerjav and Crna by 53, 67 and 62%, respectively, and the concentration of in vitro bio-accessible Pb in the simulated human gastric phase by 2.6-, 3.2- and 2.9-times, respectively. The predictions of the IEUBK model based on Pb contamination data were verified with data on blood Pb levels in children. The IEUBK model predicted that, after soil remediation, the number of locations at which the expected blood Pb level in children was higher than the stipulated 10μgdL−1 would decrease by 90, 38 and 91% in the towns of Mezica, Zerjav and Crna, respectively. The results confirmed the feasibility of soil washing with EDTA as an efficient remediation measure in Mezica and Crna and advice for soil capping/removal for the most polluted town of Zerjav.

Reducing lead in air and preventing childhood exposure near lead smelters: learning from the U.S. experience.

Childhood lead exposure and poisoning near primary lead smelters continues in developed and developing countries. In the United States, the problem of lead poisoning in children caused by smelter emissions was first documented in the early 1970s. In 1978, Environmental Protection Agency set National Ambient Air Quality Standards for lead. Attainment of this lead standard in areas near operating lead smelters took twenty to thirty years. Childhood lead exposure and poisoning continued to occur after the lead National Ambient Air Quality Standards were set and before compliance was achieved. This article analyzes and discusses the factors that led to the eventual achievement of the 1978 lead National Ambient Air Quality Standards near primary smelters and the reduction of children's blood lead levels in surrounding communities. Factors such as federal and state regulation, monitoring of emissions, public health activities such as blood lead surveillance and health education, relocation of children, environmental group and community advocacy, and litigation all played a role.

Using environmental public health tracking to identify community targets for public health actions in childhood lead poisoning in Wisconsin.

In an effort to improve the ability of local public health departments to target resources to the highest need regions, the Wisconsin Environmental Public Health Tracking (WI EPHT) Program worked to enhance its public portal to benefit the Wisconsin Childhood Lead Poisoning Prevention Program (WCLPPP) and other programs. The WI EPHT Program conducted this enhancement in collaboration with WCLPPP. The WI EPHT enhanced public portal is the next phase of Wisconsin's ongoing efforts in environmental public health tracking. As part of this process, this new mapping application includes mapping capacity that provides information on childhood lead testing and results at county and census tract levels in Wisconsin. The WI EPHT Program will update its public portal to have the capability to map data at a subcounty level (ie, census tract or zip code) for some data topics when such data are available. This tool is available to local public health departments and other public health organizations throughout Wisconsin as a resource to identify communities most affected by the Centers for Disease Control and Prevention's new guidelines with regard to childhood lead poisoning. The collaboration between WI EPHT and WCLPPP on updating and enhancing the portal exemplifies the power of environmental health data to inform a more accurate understanding of public health problems.

Investigating lead poisoning in children—could surveillance help?

Lead poisoning in children (LPIC) is associated with serious health effects including neurodevelopmental problems. Population-level preventive measures have helped to reduce exposures to new sources of lead for children in high-income countries such as England. However, new LPIC cases can still occur through exposure to existing sources of lead in the environment. In this article, we discuss how development of laboratory surveillance of LPIC could aid investigation and control of environmental sources of lead. Environmental risks are a particular concern for child health due to the higher exposures in comparison to adults and also the potential effects for growth and development. In recognition of this, the World Health Organization European Region (WHO EURO) has developed The Children’s Environment and Health Action Plan for Europe (CEHAPE) to help tackle environment-related child disease among European member states. In addition to tackling morbidity related to air pollution and inadequate sanitation, a key goal of this plan is ‘to reduce the risk of disease and disability arising from exposure to hazardous chemicals (such as heavy metals)’.1 The UK is one of the EURO member states committed to CEHAPE and has a number of pre-existing policies related to environmental risks. However, a need has been identified in the UK to improve knowledge of patterns of poisoning in children and information about the settings in which children are exposed.2 High-income countries such as the UK and USA have been successful in using population-wide measures such as legal restrictions to restrict the use of lead such as drinking water pipes, toys and paint. However, children can still be exposed to environmental lead that had accumulated prior to these interventions. These exposures can be associated with a range of health effects such as headaches, fatigue and abdominal pain. The most recently published evidence for childhood lead …

Peeling lead paint turns into poisonous dust. Guess where it ends up? A media campaign to prevent childhood lead poisoning in New York City.

Successful public health media campaigns promote messages, increase awareness, engage the public, and encourage behavior change. Between 2004 and 2006, the Lead Poisoning Prevention Program of the New York City Department of Health and Mental Hygiene conducted a media campaign grounded in social learning theory and the social marketing model to increase parents' awareness of childhood lead poisoning, ways to protect their children, and property owners' legal responsibility to fix peeling lead paint safely, and increase awareness of regulatory changes and encourage enforcement of New York City's Local Law 1 of 2004. Campaign materials were focus group tested and the campaign was refined annually. The campaign ran city-wide and in targeted high-risk neighborhoods. Neighborhoods and media venue (bus, train, kiosk, and store) changed annually, based on population risk factors and venue availability. Exposure to the campaign, campaign-related knowledge, and behavior were assessed using pre- and postcampaign street intercept surveys. Results showed that campaign reached the targeted population, and had an impact on knowledge of lead poisoning prevention measures as evidenced by increased knowledge of lead paint exposures sources in one year and increased knowledge of preventive behaviors in another year; these improvements were observed for both genders and most ethnic, primary language, educational attainment, and age groups in each year. Lessons learned indicate that well-targeted media campaigns, designed with audience participation, can reach parents through various venues, and improve key knowledge areas. Evaluation challenges faced include high levels of knowledge at baseline, competing media messages, and balancing between program needs and evaluation design.

Green &amp; Healthy Homes Initiative: Improving Health, Economic, and Social Outcomes Through Integrated Housing Intervention

Poor quality housing is an ongoing environmental injustice placing a significant burden on low-income and minority families. The Green & Healthy Homes Initiative (GHHI) in Baltimore, MD, grew out of the historical healthy homes work of the Coalition to End Childhood Lead Poisoning, an organization dedicated to using housing as a platform for health to ensure environmental and social justice for families and children in low-income communities. GHHI's Healthy Homes Demonstration Project utilized the standards and practices created by GHHI: A Holistic Housing Assessment coupled with environmental health education and combined as an integrated environmental health and energy housing intervention for children with asthma, ages 2–14. The project braids resources from healthy homes, lead hazard reduction, weatherization, and energy efficiency projects to form a single multi-component, multi-factorial intervention. Findings from the health surveys at intake and six months after the intervention provide evidence of the impact on the reduction of asthma symptomatic episodes, emergency room visits, and hospitalizations, while showing improvements in school attendance and parents' work attendance. Findings will provide evidence that improved health outcomes and more stable and productive homes in primarily African American, low-income neighborhoods are related to the mitigation of asthma triggers and home-based environmental health hazards. Upstream integrated housing interventions are an effective means to improve health, economic, and social outcomes for children diagnosed with asthma.

Primary prevention of lead poisoning in children: a cross-sectional study to evaluate state specific lead-based paint risk reduction laws in preventing lead poisoning in children.

BackgroundChildren younger than 72 months are most at risk of environmental exposure to lead from ingestion through normal mouthing behavior. Young children are more vulnerable to lead poisoning than adults because lead is absorbed more readily in a child’s gastrointestinal tract. Our focus in this study was to determine the extent to which state mandated lead laws have helped decrease the number of new cases of elevated blood-lead levels (EBLL) in homes where an index case had been identified.MethodsA cross-sectional study was conducted to compare 682 residential addresses, identified between 2000 and 2009, in two states with and one state without laws to prevent childhood lead poisoning among children younger than 72 months, to determine whether the laws were effective in preventing subsequent cases of lead poisoning detected in residential addresses after the identification of an index case. In this study, childhood lead poisoning was defined as the blood lead level (BLL) that would have triggered an environmental investigation in the residence. The two states with lead laws, Massachusetts (MA) and Ohio (OH), had trigger levels of ≥25 μg/dL and ≥15 μg/dL respectively. In Mississippi (MS), the state without legislation, the trigger level was ≥15 μg/dL.ResultsThe two states with lead laws, MA and OH, were 79% less likely than the one without legislation, MS, to have residential addresses with subsequent lead poisoning cases among children younger than 72 months, adjusted OR = 0.21, 95% CI (0.08-0.54).ConclusionsFor the three states studied, the evidence suggests that lead laws such as those studied herein effectively reduced primary exposure to lead among young children living in residential addresses that may have had lead contaminants.

Blood lead levels and associated factors among children in Guiyu of China: a population-based study.

ObjectivesChildren's health problems caused by the electronic waste (e-waste) lead exposure in China remains. To assess children's blood lead levels (BLLs) in Guiyu of China and investigate risk factors of children's elevated BLLs in Guiyu.Material and Methods842 children under 11 years of age from Guiyu and Haojiang were enrolled in this population-based study during 2011–2013. Participants completed a lifestyle and residential environment questionnaire and their physical growth indices were measured, and blood samples taken. Blood samples were tested to assess BLLs. Children's BLLs between the two groups were compared and factors associated with elevated BLLs among Guiyu children were analyzed by group Lasso logistic regression model.ResultsChildren living in Guiyu had significant higher BLLs (7.06 µg/dL) than the quantity (5.89 µg/dL) of Haojiang children (P<0.05). Subgroup analyses of BLLs exceeding 10 µg/dL showed the proportion (24.80%) of high-level BLLs for Guiyu children was greater than that (12.84%) in Haojiang (P<0.05). Boys had greater BLLs than girls, irrespectively of areas (P<0.05). The number of e-waste piles or recycling workshops around the house (odds ratio, 2.28; 95% confidence interval [CI], 1.37 to 3.87) significantly contributed to the elevated BLLs of children in Guiyu, and girls had less risk (odds ratio, 0.51; 95% CI, 0.31 to 0.83) of e-waste lead exposure than boys.ConclusionsThis analysis reinforces the importance of shifting e-waste recycling piles or workshops to non-populated areas as part of a comprehensive response to e-waste lead exposure control in Guiyu. To correct the problem of lead poisoning in children in Guiyu should be a long-term mission.

Childhood lead poisoning and the new Centers for Disease Control and Prevention guidelines for lead exposure

This article will give a brief history, review the latest guidelines, discuss risk factors and sources, and discuss screening, diagnosis, and management of lead poisoning in children. Additionally, the role of the nurse practitioner (NP) caring for children will be reviewed. Review of published literature on lead poisoning and the 2012 lead prevention guidelines of the Advisory Committee on Childhood Lead Poisoning Prevention (ACCLPP) of the Centers for Disease Control and Prevention (CDC). While lead poisoning levels have decreased over the past several decades, newer research has shown that even low levels of lead in the blood can have negative effects on children's intelligence and neurodevelopment. As a result, ACCLPP of the CDC issued new, stricter lead prevention guidelines in 2012. Lead exposure and lead poisoning are pediatric public health risks. Studies have shown that no level of lead is considered safe, and the emphasis has shifted to primary prevention of lead exposure. Despite the focus on primary prevention, the NP must remain vigilant in history taking, exploring risk factors, and screening children in order to assure the best possible outcome.