Decrease In Blood Lead Levels Research Articles

Reductions in Children's Blood Lead Levels from a Drinking-Water Intervention in Madagascar, Sub-Saharan Africa.

One in three children globally is estimated to have blood lead levels (BLL) at or above the BLL reference value of 5 μg/dL with increased burden falling on low- and middle-income countries (LMIC). Within developed countries, aqueous lead is the predominant exposure route. However, aqueous lead exposure is rarely examined in the LMIC, leaving a gap in the literature that ignores a potentially significant route of exposure. Furthermore, limited lead-based remediation efforts around consumer products have been examined. This study investigates the importance of lead exposure from the water supply through a case study in Toamasina, Madagascar. The project measured aqueous lead and BLL of children pre- and postremediation efforts (i.e., removal of leaded pump components in hand pumps) to verify the impact of aqueous lead exposure within this community. Removal of the leaded pump components (i.e., piston and foot valves) and replacement with nonleaded components decreased aqueous lead levels below the World Health Organization provisional guideline of 10 μg/L in all but 4% of pumps tested. Measured BLL concentrations indicated a statistically significant decrease in BLL from pre- to postremediation. Furthermore, the remediation resulted in a decrease in BLL for 87% of children with the greatest changes in BLL observed for children with the highest preremediation concentrations. These findings point to a need for greater consideration of lead in drinking and cooking waters as an important exposure route in LMIC.

Oral placement therapy

Objective: To investigate the effect of OPT (Oral Placement Therapy) on Blood lead levels (BLL) measured in microgram/dl and CARS 2 ST (Childhood Autistic Rating Scale 2nd edition Standard version) scores of autistic children both in the short and long term. It also studied the clinical views in speech, feeding and sensory needs by using OPT to bring down the BLL along with levels of CARS2-ST scores in children under autism spectrum disorder. Methods: This comparative observational study was conducted from April 2019 to January 2020, used repeated measures design involving 40 children under autism spectrum aged between 3 to 8 years with concerns of mouthing and smelling of inedible things. 40 participants were recruited to understand the performance benefits of a 5 months OPT versus 10 months OPT on severity of autism as measured by the CARS2-ST from 5 months to 10 months. An asymp sign test was used to compare the differences in CARS2-ST scores in the two repeat measures.Results: Wilcoxon signed-rank test showed statistically significant median decrease in BLL (7.3) and (6.8) at 5 and 10 months respectively when compared before therapy (7.75).

Mapping blood lead levels in French children due to environmental contamination using a modeling approach

The decrease in levels of lead in air and drinking water over the last 40 years has resulted in an overall decrease in blood lead levels (BLLs). However, there is no known safe level of lead regarding developmental effects in children. This paper maps predicted BLLs of children in France, resulting from a simulated chronic exposure in two steps, with the aim of identifying areas with environmentally overexposed populations. Probabilistic estimates of BLLs based on environmental contamination were obtained and compared to biomonitoring data. First, the contribution of various environmental exposure pathways was estimated using a multimedia exposure model: spatialized data on soil, drinking water and air contamination, together with data on food contamination and ingestion, was joined using geostatistical approaches. In a second step, a Physiologically Based Toxicokinetic (PBTK) model provided estimates of BLLs. Probabilistic estimates of BLLs were obtained by simulating uncertainty and variability of exposure levels, physiological characteristics and lead-specific parameters in the PBTK model.The median and 95th percentile of predicted BLLs in children aged 1 to 11 were compared to recent biomonitoring data obtained in France in young children (SATURNINF study): median predictions were overestimated in infants and in agreement with median observed BLLs in children aged 3 to 6. Upper bounds of predicted BLLs were protective due to uncertainties in exposure estimates. The main source of exposure appeared to be drinking water in children over 2 years old, and vegetal food and milk in children under 2 years old. Although elevated drinking water lead levels were not related to large geographical areas, the relatively fine resolution map also pinpointed geographical areas of concern due to elevated soil lead levels.

Lead screening in children presenting to three hospitals in Lebanon

BackgroundLead damages most body organs and its effects are most profound in children. In a study in Beirut in 2003, before banning the leaded gasoline, 79% of the participants showed...

Lead contamination among Paris Fire Brigade firefighters who fought the Notre Dame Cathedral fire in Paris.

On 15th April 2019, the fire at Notre Dame Cathedral, Paris, resulted in the melting of 410 tons of lead. Four hundred fourteen Paris firefighters were involved. For the purpose of preventive medicine, the level of lead contamination among the firefighters was assessed. This study objectives' were to describe the blood lead levels (BLLs) in the firefighters, to study the influence of some parameters such as the function of firefighters and the decrease in BLLs during the follow-up investigations. The emission of 138kg of melted lead from the roof and spire of the Notre Dame Cathedral during the fire was estimated by the National Institute for Industrial Environment and Risks. Three categories were defined according to the estimated levels of external lead exposure and fire proximity: high (category 1, n=170), medium (category 2, n=151), and low (category 3, n=93). Two to three weeks after the fire, blood samples to assess the BLLs were taken from firefighters in category 1 (N=164) and from every female firefighter in category 1 and 2 (N=4). When the BLL was above 50μg/L (95th percentile of reference range concentrations for a sample of the French population), it was checked again at one month later (N=31) and then, if still above 50μg/L, at six months later (N=10). The geometric mean of initial blood lead level was 31.5μg/L (CI 95% [27.7-35.9]; Min-Max: 7.0-307.6μg/L). Twenty-five percent (n=42) of initial BLLs were above 50μg/L, versus 10% (n=16) at 1 month, and 2% (n=3) at 6 months. The French binding biological BLL limit value (400μg/L for men and 300μg/L for women was never exceeded and all BLLs decreased over time. BLLs varied according to the function occupied during the extinguishing of the fire: operators', officers' and those of unknown function. BLLs were significantly higher compared to drivers reflecting their lower distance to fire and fume. The fire at Notre Dame Cathedral, Paris, resulted in moderate lead contamination among firefighters. Individual and collective protection measures probably helped to limit the contamination. Nevertheless, an effort could be made to improve the working conditions by rethinking the respiratory protection.

Continual decrease in blood lead levels in children of Hoboken (Antwerp, Belgium)

TPS 621: Exposure to metals, Johan Friso Foyer, Floor 1, August 26, 2019, 3:00 PM - 4:30 PM Background: In the early 1970s, in the district northeast of a non-ferrous metallurgy in Hoboken, health problems were observed and related to environmental heavy metal exposure. As a result, lead exposure in children living in the neighbourhood of this industry has been monitored via blood tests twice a year since 1978. The study focuses on children because they have both higher health risk at lower doses and higher exposure risk e.g. due to more frequent hand-to-mouth contact and higher intestinal absorption. Method: From 1978 to 2018, all children between the age of 1 and 12 years living in the district approximate to the metallurgy were invited for a blood test at school or at a service centre. Capillary blood samples were obtained through a finger prick. A control school was included since autumn 1993. Results: Over the last thirty years, the mean blood lead level declined from 21.5 µg/dl to 3.9 µg/dl. Blood lead levels were higher in children living in the zone close to the factory and in the youngest age group (preschool children). In the most recent campaign, i.e. in autumn 2018, 206 of the 404 children from the district were investigated. The mean blood lead level of children living in the district was significantly higher than the control group (district: 3.9 μg/dl; control: 1.9 µg/dl). Twenty-three percent of the children living in the district had a blood lead level above the reference value of 5 μg/dl. Conclusion: Even though the levels of lead in blood are decreasing over time, we still observe elevated blood lead levels in children living in the neighbourhood compared to those living outside the neighbourhood. A quarter of the children exceeds the health-based guideline. Therefore, continuous monitoring in hotspot areas is important and further actions are needed to promote and protect public health.

Changes of Atmospheric and Blood Concentrations of Lead and Cadmium in the General Population of South Korea from 2008 to 2017.

We measured changes in atmospheric and blood levels of lead and cadmium in the South Korean general population during the past decade. Blood data of 16,873 adults were taken from the Korean National Health and Nutrition Examination Survey (KNHANES, 2008–2017). Atmospheric data were taken from 66 air quality monitoring sites in 16 different regions in South Korea. From 2008 to 2017, the geometric mean (GM) blood lead level decreased from 2.37 to 1.46 μg/dL (38.4% decrease), and the atmospheric lead concentration decreased by 61.0% in the overall population. During this time, the GM blood cadmium level decreased from 0.88 to 0.72 μg/L (18.2% decrease), and the atmospheric cadmium concentration decreased by 63.6%. Multiple linear regression analysis indicated that a half reduction in air lead was associated with a 0.09 μg/dL decrease in blood lead (95% CI: 0.03 to 0.15) in a subgroup of the metropolitan city population. However, a half reduction in air cadmium had no significant effect on blood cadmium. Multiple linear regression analyses indicated that the decrease in blood lead level over 10 years in Korea was related to the decrease in atmospheric lead concentration. However, the decrease in blood cadmium level during this time was not significantly associated with the decrease in atmospheric cadmium concentration. Our findings suggest that inhalation is a major source of lead exposure, but not of cadmium exposure. Ingestion of dietary cadmium presumably has a stronger impact on blood cadmium levels.

Pediatric Blood Lead Levels Within New York City Public Versus Private Housing, 2003-2017.

Objectives. To compare blood lead levels (BLLs) among children residing in public and private housing in New York City and examine the implications for lead identification and remediation policies. Methods. We examined electronic medical records for BLLs among 4693 children receiving care at a multisite Federally Qualified Health Center during 2003 to 2017. We plotted home addresses against city housing data to assess BLL differences between children living in public housing and private housing. Results. Only 0.25% of children residing in public housing had BLLs exceeding the upper reference limit of 5 micrograms per deciliter, as compared with 2.76% of children residing in private housing. After adjustment for age, gender, and race/ethnicity, public housing was associated with 92% lower odds of having a BLL of 5 micrograms per deciliter or above (odds ratio [OR] = 0.08; 95% confidence interval [CI] = 0.02, 0.33; P = .001). Decreases in BLLs were observed in both public and private housing over time. Conclusions. Children living in public housing in New York City were significantly less likely to have elevated BLLs than were children living in private housing. Decreases in BLLs over time were likely a result of lead reduction legislation.

Blood Lead Levels of Children in Flint, Michigan: 2006-2016

We evaluated the increases in blood lead levels (BLLs) observed in young children in Flint, Michigan, during their exposure to corrosive Flint River water during the years 2014 and 2015 and compared their BLLs to those of Flint children measured during the years 2006-2013 and 2016. This was a retrospective study design using BLLs extracted from databases from 2006 to 2016. We analyzed a population sample of 15 817 BLLs from children aged ≤5 years with potential exposure to contaminated Flint River water. Percentages of BLLs ≥5.0 µg/dL and geometric mean (GM) BLLs were analyzed over time. A significant decline in the percentages of BLLs ≥5.0 µg/dL from 11.8% in 2006 to 3.2% in 2016 was observed (P < .001). GM ± SE BLLs decreased from 2.33 ± 0.04 µg/dL in 2006 to 1.15 ± 0.02 µg/dL in 2016 (P < .001). GM BLLs increased twice: from 1.75 ± 0.03 µg/dL to 1.87 ± 0.03 µg/dL (2010-2011) and from 1.19 ± 0.02 µg/dL to 1.30 ± 0.02 µg/dL (2014-2015). Overall, from 2006 to 2016, there was a 72.9% decrease in the percentage of children with BLLs ≥5.0 µg/dL and a 50.6% decrease in GM BLLs. These findings suggest that the 11 year trend of annual decreases in BLLs in children in Flint, Michigan, reversed to a degree consistent with random variation from 2010 to 2011, and again during the exposure to Flint River water in 2014-2015. Historically, public health efforts to reduce BLLs of young children in Flint have been effective over the 11-year period studied.

Effects of Launaea taraxacifolia on Lead - Induced Hepatotoxicity in Rats

Lead is a cumulative, multi-systemic toxicant which affects major body systems; it is associated with number of changes that include impairment of liver function. This study investigated the effects of extract of Launaea taraxacifolia on sub-chronic lead poisoning in adult wistar rats; it evaluated the effects of one of dimecarptosuccinic acid (DMSA), Vitamin C (VC); and combination therapy (DMSA + VC, DMSA + LT) on sub-chronic lead poisoning in adult rats. This was with a view to providing scientific basis for the use of L. taraxacifolia in the management of lead poisoning. Sixty rats (180-200 g) of both sex were randomly grouped into ten (n=6). One group was allowed free access to distilled water only, while eight groups were allowed free access to lead acetate (2 mg/ml) in drinking water, for 5 weeks consecutively. Seven out of the eight groups were later administered Launaea taraxacifolia extract (50, 100 and 200 mg/kg, p. o), DMSA, DMSA + LT, DMSA + VC and VC only for 21 days consecutively. The tenth group was administered LT (100 mg/kg) for 21 days, and later allowed free access to lead acetate in drinking water (2 mg/ml) for 5 weeks. Blood sample was collected and analysed for blood lead level (BLL), urine lead level (ULL), Alanine transaminase (ALT), Aspartate transaminase (AST), antioxidant activity of the extract [Reduced gluthatione (GSH), catalase and superoxide dismutase (SOD)] on day 20 and 22. Liver was harvested and processed for histological study: There was significant decrease in BLL, ALT, AST and glucose level in lead exposed rats treated with LT (100 mg/kg), however, combination of DMSA with LT or VC showed marked improvement than LT, DMSA or VC alone. GSH, SOD and catalase level were significantly increased in lead exposed rats treated with LT (p<0.05). Micrograph of the liver revealed remarkable improvement in the lead exposed rats treated with LT. In conclusion, leaf extract of Launaea taraxacifolia has ameliorative and preventive effect on hepatotoxicity of lead poisoning, thereby supporting its ethno medicinal use in the management of poisoning.

Metal exposures from aluminum cookware: An unrecognized public health risk in developing countries.

Removing lead from gasoline has resulted in decreases in blood lead levels in most of the world, but blood lead levels remain elevated in low and middle-income countries compared to more developed countries. Several reasons for this difference have been investigated, but few studies have examined the potential contribution from locally-made aluminum cookware. In a previous study of cookware from a single African country, Cameroon, artisanal aluminum cookware that is made from scrap metal released significant quantities of lead. In this study, 42 intact aluminum cookware items from ten developing countries were tested for their potential to release lead and other metals during cooking. Fifteen items released ≥1 microgram of lead per serving (250mL) when tested by boiling with dilute acetic acid for 2h. One pot, from Viet Nam, released 33, 1126 and 1426 micrograms per serving in successive tests. Ten samples released >1 microgram of cadmium per serving, and fifteen items released >1 microgram of arsenic per serving. The mean exposure estimate for aluminum was 125mg per serving, more than six times the World Health Organization's Provisional Tolerable Weekly Intake of 20mg/day for a 70kg adult, and 40 of 42 items tested exceeded this level. We conducted preliminary assessments of three potential methods to reduce metal leaching from this cookware. Coating the cookware reduced aluminum exposure per serving by >98%, and similar reductions were seen for other metals as well. Potential exposure to metals by corrosion during cooking may pose a significant and largely unrecognized public health risk which deserves urgent attention.

Continual Decrease in Blood Lead Level in Americans: United States National Health Nutrition and Examination Survey 1999-2014

BackgroundLead is toxic and affects neurodevelopment in children even at low levels. There has been a long-term effort in the United States to reduce exposure to lead in the environment. We studied the latest US population blood lead levels and analyzed its trend. MethodBlood lead levels in 63,890 participants of the National Health Nutrition and Examination Survey 1999-2014 were analyzed using SPSS Complex Samples v22.0 (IBM Corp, Armonk, NY). ResultsMean blood lead levels and 95% confidence intervals (CIs) were 1.65 μg/dL (1.62-1.68), 1.44 μg/dL (1.42-1.47), 1.43 μg/dL (1.40-1.45), 1.29 μg/dL (1.27-1.32), 1.27 μg/dL (1.25-1.29), 1.12 μg/dL (1.10-1.14), 0.97 μg/dL (0.95-0.99), and 0.84 μg/dL (0.82-0.86) in 1999-2000, 2001-2002, 2003-2004, 2005-2006, 2007-2008, 2009-2010, 2011-2012, and 2013-2014, respectively. Blood lead levels decreased significantly (P <.001), and the trend remained significant when stratified by age, gender, ethnicity, and pregnancy status (P <.05). Estimated percentages of children with blood lead level ≥5 μg/dL were 9.9% (95% CI, 7.5-12.9), 7.4% (95% CI, 5.9-9.4), 5.3% (95% CI, 4.1-6.9), 2.9% (95% CI, 2.1-3.9), 3.1% (95% CI, 2.0-4.8), 2.1% (95% CI, 1.5-3.1), 2.0% (95% CI, 1.0-3.6), and 0.5% (95% CI, 0.3-1.0) in 1999-2000, 2001-2002, 2003-2004, 2005-2006, 2007-2008, 2009-2010, 2011-2012, and 2013-2014, respectively. The decreasing trend was significant (P <.05). In children aged 1 to 5 years in the National Health Nutrition and Examination Survey 2011-2014, the estimated 97.5 percentile of blood lead level was 3.48 μg/dL. ConclusionsBlood lead levels have been decreasing in the US population. The reference level also should decrease. It is still important to monitor blood lead levels in the population, especially among pregnant women and children aged 1 to 5 years.

E-Waste Informal Recycling: An Emerging Source of Lead Exposure in South America

BackgroundPrimitive electronic waste (e-waste) recycling creates exposures to several hazardous substances including lead. In Uruguay, primitive recycling procedures are a significant source of lead exposure. ObjectivesThe aim of this study was to examine lead exposure in blood lead levels (BLLs) in low-income children exposed to lead through burning cables. MethodsA sample of children and adolescents exposed to lead through burning cable activities were assessed at the Department of Toxicology in Montevideo, Uruguay, between 2010 and 2014. Soil lead levels of residences were taken shortly after their assessment. FindingsThe final sample included 69 children and adolescents (mean age 7.89 years). More than 66% of participants had an additional source of lead exposure—manual gathering of metals—and <5% were exposed to lead through landfills or paint. Average BLLs at first consultation were 9.19 ug/dL and lower at the second measurement (5.86 μg/dL). Data from soil lead levels ranged from 650 to 19,000 mg of lead/kg of soil. The interventions conducted after the assessment included family education in the clinic and at home, indoor and outdoor remediation. We found a decrease in BLLs of 6.96 μg/dL. Older children had lower BLLs (r = −0.24; P = 0.05). Statistical analyses also showed that children living in areas with higher soil lead levels had significantly higher BLLs (r = 0.50; P < 0.01). Additionally, we found greater BLLs from burning cable activities when children had been exposed to lead-based paint (r = 0.23; P < 0.1). ConclusionAmong children exposed to e-waste recycling, the most common additional source of lead exposure was the manual gathering of metals. The average BLL among children and adolescents in this study is higher than the BLLs currently suggested in medical intervention. Future research should focus on exploring effective interventions to reduce lead exposure among this vulnerable group.

Evaluación económica del impacto de la prohibición de plomo en las gasolinas en el cociente intelectual de los niños de 7 y 8 años de la Comunidad de Madrid

The repercussions on health of public policies are hard to assess from an economic point of view, which is why this is rarely done. The purpose of this study was to financially quantify the benefits of reducing blood lead levels in children aged 7-8 years in the Community of Madrid (Spain) as a result of the ban on the use of lead in gasoline. The decrease the intellectual quotient (IQ) points was calculated through two studies on children aged 7-8 years according to their blood lead levels. A geometric mean of 3.8 μg/dl was obtained in the 1995 study and of 0.9 μg/dl in the 2010 study. The net increase in IQ was measured in terms of productivity gained throughout the working life as per the methods of Schwartz and Salkever. The decrease in blood lead levels in these children prevented a loss of between 135,391 and 144,153 IQ points; the current economic valuation of these points in terms of the productivity gained throughout the working life of this cohort of children was estimated to fall within the €626.4m- €865.4m range (2009). The figures of the economic benefits derived from the decision to ban leaded gasoline are very high.

The possible societal impact of the decrease in U.S. blood lead levels on adult IQ

BackgroundThe dramatic decrease in U.S. blood lead levels (BLLs) since the 1970s has been documented—however, the anticipated societal impact on intelligence quotient (IQ) has not. The objectives of this study were to determine whether mean IQs of American adults, adjusted for demographics, have increased in concert with society׳s decreasing BLL. MethodsMean IQs of eight normal adult cohorts (N=800), tested individually in 2007 by trained clinicians, were compared using ANCOVA and correlation analysis. Cohorts ranged in mean societal BLLs from 4 1/2μg/dL (born 1985–1987) to 19μg/dL (born 1963–1972). IQs were adjusted for confounders—education, gender, ethnicity, region, urban status. To control for age, we analyzed IQ data for a second adult sample (N=800), tested in 1995—all born when BLLs were high (1951–1975, BLL ≥15μg/dL). ResultsWhen controlling for education, gender, ethnicity, and region, the regression of IQs on BLLs was significant (r=−0.84, p<0.01); the modeled change in BLLs from 20 to 4μg/dL suggests predicted increases of 3.8 IQ points (95% CI, 1.4–6.2). Also controlling for urban status produced significance (r=−0.88, p<0.01) with predicted increases of 5.2 points (95% CI, 2.4–8.0). Control analyses ruled out aging as a confounder. ConclusionsThe dramatic societal decreases in BLLs in the U.S. since the 1970s were associated with a 4–5-point increase in the mean IQs of Americans. This effect is consistent with researchers’ predictions; however, other variables (e.g., medical advances) may have contributed to the IQ gains.

English

&nbsp; To investigate the comparative effects of ascorbate and chelating agents on some markers of lipid metabolism in lead exposed rats, 35 male Wistar rats were used. They were grouped randomly into five (n=7); 28 of which were administered 75 mg/kg body weight lead acetate (PbAc) orally for 14 days after which their blood samples were assayed for lead. Three of the groups were further administered 30 mg/kg body weight D-penicillamine (D-pen), 30 mg/kg body weight succimer (DMSA) and 500 mg/kg body weight ascorbate (Asc) daily orally, respectively. The control group was however administered normal saline. The blood lipid profiles were determined spectrophotometrically. Lead exposure resulted in significant dyslipidemia (p &lt; 0.05), characterized by 50% hypercholesterolemia and hypertriglyceridemia and 132% hyperphospholipidemia (plasma) while in the red blood cells, hypocholesterolemia and hypophospholipidemia were observed. During the therapeutic doses, the groups administered chelating agents and Asc showed a significant amelioration in the plasma and red blood cell levels of total cholesterol, triacylglycerols and phospholipids in the order, DMSA &gt; Asc &gt; D-pen. Decrease in blood lead levels after therapy indicated that the chelating agents have an advantage over Asc. The study indicates that administration of the antioxidant, Asc may not be more efficacious than the chelating agents but could be a cheaper and more convenient therapy for lead toxicity. &nbsp; Key words:&nbsp;Ascorbate, chelating agents, dyslipidemia, lead exposure, plumbism.

Blood lead levels in children after phase-out of leaded gasoline in Kinshasa, the capital of Democratic Republic of Congo (DRC)

BackgroundThe phasing out of lead from gasoline has resulted in a significant decrease in blood lead levels (BLLs) in children during the last two decades. Tetraethyl lead was phased out in DRC in 2009. The objective of this study was to test for reduction in pediatric BLLs in Kinshasa, by comparing BLLs collected in 2011 (2 years after use of leaded gasoline was phased out) to those collected in surveys conducted in 2004 and 2008 by Tuakuila et al. (when leaded gasoline was still used).MethodsWe analyzed BLLs in a total of 100 children under 6 years of age (Mean ± SD: 2.9 ± 1.6 age, 64% boys) using inductively coupled argon plasma mass spectrometry (ICP – MS).ResultsThe prevalence of elevated BLLs (≥ 10 μg/dL) in children tested was 63% in 2004 [n = 100, GM (95% CI) = 12.4 μg/dL (11.4 – 13.3)] and 71% in 2008 [(n = 55, GM (95% CI) = 11.2 μg/dL (10.3 – 14.4)]. In the present study, this prevalence was 41%. The average BLLs for the current study population [GM (95% CI) = 8.7 μg/dL (8.0 – 9.5)] was lower than those found by Tuakuila et al. (F = 10.38, p <0.001) as well as the CDC level of concern (10 μ/dL), with 3% of children diagnosed with BLLs ≥ 20 μg/dL.ConclusionThese results demonstrate a significant success of the public health system in Kinshasa, DRC-achieved by the removal of lead from gasoline. However, with increasing evidence that adverse health effects occur at BLLs < 10 μg/dL and no safe BLLs in children has been identified, the BLLs measured in this study continue to constitute a major public health concern for Kinshasa. The emphasis should shift to examine the contributions of non-gasoline sources to children’s BLLs: car batteries recycling in certain residences, the traditional use of fired clay for the treatment of gastritis by pregnant women and leaded paint.

RESULTS OF AN INTERVENTION STRATEGY TO REDUCE LEAD EXPOSURE IN SUSCEPTIBLE POPULATION GROUPS IN COPSA MICA AREA, ROMANIA

Background and Aims: High levels of lead have entered the environment through human activities such as mining, industrial processes and burning fuels. Studies conducted between 1991 and 2002 focused on lead exposure in children in Copsa Mica area where a primary smelter was processing zinc and lead from mining ores. The results showed an important exposure of the children to lead, impacting somatic development, heme synthesis and neuropsychological development. An intervention program was elaborated and implemented in 2002 in Copsa Mica and blood lead levels (BLL) in children aged 4-15 years were monitored over time to measure the progress along with the intervention. Methods: Data on lead sources, risk factors (playing with soil, putting dirty toys in the mouth, hand washing, cleaning practices etc.), and socio-economic factors were collected using a questionnaire. BLL in children were measured by atomic absorption graphite furnace spectometry. A social marketing program have been implemented in the investigated area. Results: The mean measured BLL decreased between 2002-2009 from 46 μg/dL in 2002 to 22 μg/dL in 2007 and to 16 μg/dL in 2009. Statistically significant correlations were found betwen blood lead levels in children and some behaviours/practices/ attitudes: dirty hands/toys to mouth behaviour, and the use of the vacuum cleaner to clean the house in 2009. Conclusions: In spite of such a major decrease in BLL (three fold) during a relatively short period of time (2002-2009) and taking into account the huge amount of resources which have been allocated to the intervention program, there is still a great need for work to be done on formulating, elaborating and implementing additional measures along with specific indicators to measure the process and progress of intervention at individual level.

The Effect of Calcium Supplementation on Blood Lead Levels in Nigerian Children

To determine whether calcium supplementation alters the risk of lead toxicity. Children aged 12-18 months from 3 communities in Nigeria were assigned to receive daily calcium supplementation, as either calcium carbonate (400 mg) or ground dried fish (529 ± 109 mg), or placebo. All children received 2500 IU of vitamin A. Levels of blood lead, calcium, and vitamin D metabolites were measured at baseline and after 12-18 months (n = 358). The mean (± SD) baseline lead level was 11.1 ± 7.8 μg/dL (range, 1-43 μg/dL; median, 9 μg/dL); 44.7% of subjects had a lead level >10 μg/dL. After 12-18 months, the mean lead level was 8.1 ± 6.3 μg/dL (range, 1-48 μg/dL; median, 6 μg/dL), with 22.6% with a level >10 μg/dL. Lead levels at baseline varied among communities (P = .01) and were higher in children who used eye cosmetics or lived near a lead-acid battery melter (both P < .001). In a multiple regression model, the decrease in blood lead level was predicted by age, baseline lead level, and time of final lead value at 12-18 months (R(2) = 31%), but not by calcium supplementation (P = .98). Lead toxicity is common in Nigerian children, but calcium supplementation does not affect blood lead levels.

LEAD POISONING IN MUTE SWANS (CYGNUS OLOR) IN IRELAND: RECENT CHANGES

Studies over two decades have shown a marked trend towards a decrease in blood lead levels in the mute swan (Cygnus olor) in parts of Ireland. However, this study shows that a small percentage of some populations of mute swans in Co. Cork still have significantly elevated lead levels, causing some potentially sublethal effects to the health status of the swans. Overall, at both urban and rural sites the median blood lead levels in adults and cygnets of both sexes were below a threshold level of 1.21μmol l⁻¹, which is indicative of elevated lead. However, 27% of the population at Cork Lough had elevated lead levels, with the highest blood lead level being 27.66μmol l⁻¹, indicating that acute poisoning is still a problem in some individuals. Mute swans from rural sites generally showed no variation, and median blood lead levels were generally low. Lead levels reached a peak in October 2004 and again during the spring months of 2005. Swans may be more susceptible to lead poisoning during spring, as it follows the winter months when natural food is scarce and lead is easily absorbed across the gut after ingestion. Autumn peaks may be explained by an increase in fishing activity over the summer months. A positive association was found between elevated lead levels and packed cell volume—an indicator of health status. Overall, a decline in acute lead poisoning at urban and rural sites is apparent from this study. However, due to its continued and persistent use in the environment, lead still poses a threat at a sublethal level.