Increased Blood Lead Levels Research Articles

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.

Plomo en sangre y su relación con hemoglobina y hematocrito en niños expuestos a la contaminación minera, Apurímac 2023

Exposure to heavy metals causes a high level of lead in the blood, which causes various problems in various organs, including a deficit in the production of hemoglobin, which causes anemia. This circumstance was the impetus to carry out this research study. The objective of the research was to determine the relationship between blood lead levels and hemoglobin and hematocrit levels in children aged 0 to 11 years exposed to mining pollution in the community of the district and province of Andahuaylas in the department of Apurímac. . A non-experimental quantitative and descriptive design was used. 98 minors from 0 to 11 years of age, registered in the district and province of Andahuaylas in the department of Apurímac, participated in the "lead in blood and its relationship with hemoglobin and hematocrit" campaign from April to May 2023. The study on anemia found that fifty percent (50%) of the subjects did not have anemia. The percentages of mild (6 subjects), moderate (33 subjects), and severe (9 subjects) anemia were 6.1% to 33.7% and 9.2%, respectively. Regarding lead poisoning, 64 (65.3%) of the subjects did not show significant levels, while 34 (34.7%) of the subjects showed toxic levels. The relationship of lead levels with hemoglobin was not significantly influenced by age group, sex or area of ​​residence. Hemoglobin decreases by 0.755 for every one unit increase in blood lead level, with a p-value &lt;0.001 and a 95% confidence interval of -0.839 - 0.671. This study demonstrates a significant correlation between blood lead levels and low hemoglobin levels (corrected for height), underscoring the importance of interventions focused on prevention and health promotion in at-risk populations.

Comparison of empirical and mechanistic blood lead models for children

Childhood exposure to lead can result in increased blood lead levels, which can have detrimental health effects. Models that can predict blood lead level based on exposure to floor and window sill dust lead at varying concentrations are useful tools for informing policy decisions. We compare an empirical model relating blood lead in children to the lead content of household dust, with a mechanistic model that simulates lead exposure in children through their daily activities. The empirical model is constructed using 1999–2004 NHANES data, while the mechanistic model is validated using 2011–2016 NHANES data. The models are evaluated at dust loadings ranging from 0.18 – 43 µg/ft2 and the resulting blood leads are compared. Specific demographic variables are chosen to simulate individuals are generated with “typical,” “high end,” and “low end” exposures in the empirical model; these are directly compared with the median, 95th, and 5th percentile results from the mechanistic model. For a child with “typical” lead exposure, the 95 % confidence interval for computed blood lead values contained the median blood lead value from the mechanistic model at all dust lead exposure levels considered. Similar results hold when comparing the 95th percentile to “high end” and 5th percentile to “low end”. The blood lead level computed by the mechanistic model increases more quickly with respect to dust loading than the empirical model, particularly at higher loadings. The empirical and mechanistic models generate similar blood lead distributions across the range of dust loadings considered, particularly at low loadings. The mechanistic model may be more appropriate for higher loadings due to limitations inherit in the structure of the empirical model.

Effect of blood lead levels on periodontitis in American adults: a cross-sectional analysis from the national health and nutrition examination survey

BackgroundThe primary objective of this study was to assess the impact of blood lead levels on the development and progression of periodontitis.MethodsThis study included 8600 participants from the National Nutrition and Health Examination Survey conducted the United States between 2009 and 2014. The exposure variable was the blood lead level, while the outcome variable was periodontitis. To evaluate the relationship between the blood lead level and periodontitis, a multivariate logistic regression model was used.ResultsA positive association was observed between blood lead levels and the risk of periodontitis in Model 1 (OR = 7.04, 95% CI = 5.95–8.31). After adjusting for age (continuous), sex, ethnicity, and BMI (continuous) in Model 2, the significant association between blood lead levels and periodontitis risk remained evident (OR = 3.06, 95% CI: 2.54–3.70). Consequently, even after comprehensive adjustment for potential confounding factors in Model 3, the robust association between blood lead levels and periodontitis risk persisted (OR = 2.08, 95% CI = 1.67–2.60). When considering the serum lead concentration as a categorical variable and after adjusting for potential confounders in Model 3, we observed that the odds ratios (ORs) of periodontitis in the T2 (0.94 µg/dL-1.60 µg/dL) and T3 (lead ≥ 1.60 µg/dL) groups increased from 1.27 (OR = 1.27, 95% CI: 1.11–1.44) to 1.57 (OR = 1.57, 95% CI: 1.36–1.81) compared to T1 group. Subgroup analysis revealed no effect modifiers.ConclusionsOur main findings suggest that there is no safe range of blood lead levels regarding periodontitis risk and that increasing blood lead levels can significantly increase the prevalence of periodontitis.

IEUBK Modeling of Children's Blood Lead Levels in Homes Served by Private Domestic Wells in Three Illinois Counties.

Lead is known to impair neurocognitive development in children. Drinking water is routinely monitored for lead content in municipal systems, but private well owners are not required to test for lead. The lack of testing poses a risk of lead exposure and resulting health effects to rural children. In three Illinois counties, we conducted a cross-sectional study (n = 151 homes) examining water lead levels (WLLs), water consumption, and water treatment status to assess risk of lead exposure among residents using private water wells. Since blood lead levels (BLLs) were not available, EPA's Integrated Exposure Uptake Biokinetic (IEUBK) modeling was used to estimate the incremental contribution of WLL to BLL, holding all other sources of lead at their default values. Nearly half (48.3%) of stagnant water samples contained measurable lead ranging from 0.79 to 76.2 µg/L (median= 0.537 µg/L). IEUBK modeling showed BLLs rose from 0.3 to 0.4 µg/dL when WLLs rose from 0.54 µg/L (the tenth percentile) to 4.88 µg/L (the 90th percentile). Based on IEUBK modeling, 18% of children with a WLL at the 10th percentile would have a BLL above 3.5 µg/dL compared to 27.4% of those with a WLL at the 90th percentile. These findings suggest that the consumption of unfiltered well water likely results in increased blood lead levels in children.

The role of geophagy and artisanal gold mining as risk factors for elevated blood lead levels in pregnant women in northwestern Tanzania.

Neither artisanal and small-scale gold mining (ASGM) or geophagy practices have received substantial attention related to blood lead levels despite the well documented deleterious effects of lead. This cross-sectional analytical study aimed to document the risk of lead exposure from geophagy and mining-related occupational activities for pregnant women. The study recruited 1056 pregnant women (883 in an ASGM area and 173 in a non-ASGM area) between April 2015 -April 2017. Generalized Linear Model with an identity link function was used to model the association between blood lead levels (BLLs) and geophagy practices and involvement in gold mining. The prevalence of geophagy was 36.2% (95% CI: 33.6, 39.4%) and 6.3% engaged in mining as a primary occupation. Practicing geophagy increased BLLs by 22% (β = 1.22, 95% CI: 1.116, 1.309, p<0.0001). Living in a gold mining area increased BLLs by 33.4% (β = 1.334, 95% CI: 1.2, 1.483, p<0.0001). Having mining as a primary occupation increased BLLs by 1.3% β = 1.013, 95% CI: 0.872, 1.176, p = 0.869) even though the association was not statistically significant. Socioeconomic wealth quantile (β = 1.037, 95% CI: 1.021, 1.054, p<0.001) increased blood lead levels by 3.7%. Developing a comprehensive inventory capturing sources of community-level lead exposure is essential. Further, increasing public health campaigns and education are crucial to limit geophagy practices and to minimize work in gold mining activities during pregnancy.

Association of blood lead level with cognitive performance and general intelligence of urban school children in ten cities of India

BackgroundLead is toxic to children and effects the cognitive development. The primary objective was to assess the association of blood lead level (BLL) with cognitive performance and general intelligence, of urban school going children aged 6–16 years from ten cities of India. Secondary objective was to assess the association of anaemia with cognitive performance and general intelligence. MethodIn this cross-sectional multicentric study, general intelligence was assessed by colored progressive matrices (CPM)/standard progressive matrices (SPM) test, visual-spatial ability through coding, attention and concentration ability through digit span and working memory through arithmetic tests. Blood samples of participants were collected to assess lead levels. Socioeconomic status and anthropometric measures were also collected. ResultsFrom April 2019–February 2020, 2247 participants with equal gender distribution were enrolled from 60 schools. The median (IQR) BLL was 8.8 (4.8, 16.4) μg/dl. We found that BLL was significantly associated with attention and concentration ability and 1 μg/dl increase in BLL decreases the performance by odds of 1.02 (95 % CI 1.01–1.03). Anaemia is found to be associated with ‘borderline or dull normal’ performance for general intelligence [Adjusted Odds Ratio (AOR) = 1.93 (95 % CI 1.53–2.45)], visual-spatial [AOR = 1.35 (95 % CI 1.03–1.76)], attention and concentration [AOR = 1.30 (95 % CI 1.02–1.66)], working memory [AOR = 1.69 (95 % CI 1.34–2.12)] abilities. ConclusionSince increasing BLL decreases cognitive performance and anaemia decreased both cognitive performance and intelligence, attempts must be made to keep BLL as low as possible and prevent exposure in school going children.

Abstract 11969: Association Between Blood Lead Levels and Silent Myocardial Infarction in the General Population

Background: While the connection between environmental lead exposure and cardiovascular disease (CVD) is well-known, the association with silent myocardial infarction (SMI) remains unexplored. Aims: Our objective was to examine if there is a connection between higher blood lead levels (BLL) and increased prevalence of SMI in the general population. Methods: This analysis included 7,283 (mean age 56.1±2.52 years, 52.5% women, 49.8% Whites) participants from the Third National Health and Nutrition Examination Survey who were free of CVD. Graphite furnace atomic absorption spectrophotometry was used to measure blood lead levels (BLL). SMI was defined as the presence of electrocardiographic evidence of myocardial infarction (MI) without a prior history of MI. Multivariable logistic regression analysis was used to examine the cross-sectional association between baseline BLL and SMI. Results: Participants with higher levels of BLL had a higher prevalence of SMI (SMI prevalence 0.4%, 0.9% and 2.4% across BLL tertiles). In a multivariable-adjusted model, the highest BLL tertile was associated with over three times the odds of SMI compared to the first tertile, with an odds ratio of 3.42 (95% CI: 1.76-6.63). There was a 9% increase in the odds of SMI for every 1 μg/dL increase in BLL (Table). This association was consistent across subgroups stratified by median age, sex, and race. Conclusion: Higher BLL levels are associated with a higher likelihood of SMI in the general US population. These results underscore the ongoing need for efforts to minimize lead exposure among the general public.

Pubertal progression in relation to peripubertal exposure to organochlorine chemicals in a cohort of Russian boys.

Peripubertal concentrations of serum dioxins and polychlorinated biphenyls (PCBs) have demonstrated associations with altered age of pubertal onset and sexual maturity in boys, but associations with pubertal progression have received less attention. The Russian Children's Study is a prospective cohort of 516 boys enrolled in 2003-2005 at age 8 or 9 and followed annually up to 19 years of age. Serum concentrations of dioxin-like toxic equivalents (TEQs), polychlorinated dibenzodioxins (PCDDs), polychlorinated dibenzofurans (PCDFs), and non-dioxin-like PCBs (NDL-PCBs) and whole blood lead levels (BLLs) were quantified from blood samples collected at study entry (age 8-9). Testicular volume (TV) was assessed annually using a Prader orchidometer. Pubertal trajectories were identified by applying Group-Based Trajectory Models (GBTMs) to TV measured from ages 8-19. Associations of peripubertal serum TEQs, PCDDs, PCDFs, and NDL-PCBs with specific progression trajectories were modeled using multinomial logistic regression, adjusting for each boy's birthweight, and for BLL, body mass index and nutritional factors at study entry. Among 489 eligible boys with available exposure measures, we identified three pubertal trajectories using GBTMs: slower (34% of boys), moderate (48%) and faster (18%). Boys with higher peripubertal serum TEQs had higher adjusted odds of being in the moderate versus faster trajectory (adjusted odds ratio (aOR) 1.79, 95% CI 1.01, 3.13) and the slower versus faster trajectory (aOR 1.52, 95% CI 0.82, 2.78) per 1 log unit increase in serum TEQs. Boys with higher peripubertal serum PCDFs had higher adjusted odds of being in the moderate compared to the faster trajectory (aOR 1.92, 95% CI 1.20, 3.03) and of being in the slower versus the faster trajectory (aOR 1.42, 95% CI 0.91, 2.33) per 1 log unit increase. Boys with higher NDL-PCBs had higher adjusted odds of being in the faster trajectory versus the moderate (aOR 2.56, 95% CI 0.91-7.20) or slower (aOR 3.31, 95% CI 1.07, 10.25) trajectory. Boys with higher blood lead levels also had higher adjusted odds of being in the slower trajectory of pubertal progression, compared to either the faster (aOR 1.47, 95% CI 0.89, 2.44) or moderate (aOR 1.20, 95% CI 0.83, 1.75) trajectories, per 1 log unit increase in BLL, although these associations did not attain statistical significance. Boys' peripubertal exposure to dioxins and certain PCBs may alter pubertal progression.

Association between Chronic Environmental Lead (Pb) Exposure and Cytokines in Males and Females of Reproductive Age from Kabwe, Zambia.

Lead (Pb) poisoning remains a great public health challenge globally known to induce a wide range of ailments in both children and adults. The current study investigated the association of chronic environmental Pb exposure and immunomodulatory cytokines tumor necrosis factor alpha (TNF-α) and interleukin-8 (IL-8) in adult males and females living in Kabwe, Zambia. The standard human cytokine/chemokine Milliplex assay was used to quantify plasma cytokines from four groups categorized as low (<10 μg/dL) and high (>10 μg/dL) blood lead level (BLL) groups, namely, low BLL female (n = 47; BLL = 3.76 μg/dL), low BLL Male (n = 43; BLL = 4.13 μg/dL), high BLL female (n = 21; BLL = 23.5 μg/dL), and high BLL male (n = 18; BLL = 23.7 μg/dL), respectively. The low BLL group was associated with increased TNF-α levels, and the high BLL group was associated with reduced TNF-α levels in female subjects. No associations between BLL and the levels of IL-8 and TNF-α cytokines were observed in either females or males, respectively. A negative correlation between BLL and TNF-α was found in female subjects, suggesting that an increase in BLL accompanied by a reduction in TNF-α. The reduced levels of circulating TNF-α in female subjects suggest that chronic Pb exposure could predispose females to immune and inflammation-related disorders than their male counterparts. Further studies are recommended to ascertain the impact of chronic Pb exposure on immunomodulatory cytokines, especially in females.

Melatonin therapy reverses lead exposure-induced testicular damage in rats despite the lack of effect on serum testosterone levels.

Lead (Pb) exposure induces testicular damage and infertility. The aim of this study was to analyze and compare the therapeutic effects of antioxidants or vitamin D and calcium, which have previously been shown to reduce the toxic effects of Pb co-exposure, in rats. Rats were exposed to Pb for 28 days and subsequently treated with antioxidant (melatonin, silymarin), vitamin D and calcium (VitDCa) or a combination (melatonin or silymarin with VitDCa) for 28 days. Control groups included untreated rats (no Pb exposure or therapy), rats exposed only to melatonin or silymarin and rats exposed to Pb without post exposure therapy. Pb exposure induced testicular damage, increased blood lead level (BLL) and reduced serum testosterone level (STL). Rats exposed to Pb and left untreated for 28 days showed persistent pathological testicular alterations. The two treatments that were most effective in reversing pathological testis damage and restoring spermatogenesis were melatonin and silymarin. However, silymarin and melatonin treatment resulted in significantly different serum testosterone levels in rats. Whereas melatonin therapy reduced serum testosterone to levels lower than those in control rats, silymarin increased serum testosterone to levels higher than those in controls. Our pathological analysis of testes revealed that melatonin promoted spermatogenesis and regression of Pb exposure-induced degenerative changes, despite the associated reduction in serum testosterone levels. This result suggests that circulating testosterone may not have an important role in spermatogenesis. Collectively, our results suggest that melatonin and silymarin are effective therapies against the toxic effects Pb exposure in the male reproductive system.

Searching the Blood Lead Level in Children with Attention Deficit Hyperactivity Disorder: A Case-control Study in Tehran, Iran

Background: Attention deficit hyperactivity disorder (ADHD) is a common behavioral problem in children. Identifying the associated risk factors of ADHD is very important for the prognosis and early diagnosis of the disease. Here, we evaluated the association between lead exposure and growth indexes in children with ADHD. Materials and Methods: This case-control study was conducted on 30 children with ADHD and 50 healthy subjects. The patient’s age was between 5-12 years. Demographic and clinical information of children were recorded. Blood lead levels were measured in all samples by atomic absorption spectrometry. Results: Children with ADHD had significantly higher mean BMI than the control group (16.54 ± 2.8 kg/m2 vs. 14.82 ± 1.68 kg/m2; p=0.001). The mean of blood lead in children with ADHD was significantly higher than the normal group (10.58 ± 8.06 μg/dl vs. 7.52 ± 2.26 μg/dl; p=0.01). Multiple logistic analysis revealed one unit increase in BMI was associated with a higher risk of ADHD by 1.5 times (P=0.005; OR = 1.50), while one unit increase in blood lead level increased the risk of ADHD by 1.15 times (P=0.03, OR=1.15). Conclusion: Higher BMI and blood lead concentration are risk factors for ADHD among Iranian children.

Lead exposure and impaired glucose homeostasis in Chinese adults: A repeated measures study with 5 years of follow-up

Experimental studies suggest the diabetogenic effects of lead, but relevant data in humans are limited and have been primarily based on cross-sectional study design. We aimed to prospectively examine the association between lead exposure and glucose homeostasis in general population using repeated measurements. This cohort study included 5505 Chinese adults free of glucose-lowering medication use at baseline in 2014 and followed up 5 years later. Blood lead and glucose metabolic traits including fasting plasma glucose (FPG), fasting serum insulin, the homeostasis model assessment of insulin resistance (HOMA-IR), and HOMA of beta-cell function (HOMA-B) were measured at baseline and follow-up. Linear mixed models and linear regression models were performed to evaluate the associations between blood lead and markers of glucose homeostasis. After full adjustment for confounders including BMI, an interquartile range (IQR) increase in blood lead levels was associated with a 2.26 % increase in FPG (95 % CI: 0.16 %, 4.39 %) and an 11.3 % decrease in HOMA-B (95 % CI: − 19.1 %, − 2.71 %) in women. The odds ratios of hyperglycemia and beta-cell dysfunction corresponding to an IQR increase in blood lead levels were 1.39 (95 % CI: 0.99, 1.95) and 1.74 (95 % CI: 1.00, 3.03), respectively. Similar results were found for 5-year changes of glucose metabolic markers. Compared with the first quartile of baseline lead levels, the highest lead quartile was associated with an additional 3.03 % increase in FPG (95 % CI: 0.84 %, 5.26 %) and an additional 13.3 % decrease in HOMA-B (95 % CI: − 20.4 %, − 5.53 %) in women during follow-up. We observed no overall associations between blood lead levels and glucose metabolic markers in men. Our findings provide suggestive evidence that environmental exposure to lead might contribute to sex-dependent disruption of glucose homeostasis in general adult population.

Blood Lead Level Is Negatively Associated With Bone Mineral Density in U.S. Children and Adolescents Aged 8-19 Years.

ContextThe relationship of lead (Pb) exposure with bone health in children and adolescents remains controversial.ObjectionWe aimed to investigate the association of blood lead levels (BLL) with bone mineral density (BMD) in American children and adolescents using data from the National Health and Nutrition Examination Survey (NHANES), 2005-2010.MethodsWe analyzed 5,583 subjects aged 8-19 years (mean age, 13.49 ± 3.35 years) from the NHANES 2005-2010. BLL was tested using inductively coupled plasma mass spectrometry. BMD was measured by dual-energy X-ray absorptiometry (DXA) at the lumbar spine, total femur, and femur neck. Multivariate linear regression models were used to explore the association between BLL and BMD, adjusting for age, gender, race/ethnicity, poverty income ratio (PIR), body mass index (BMI), serum calcium, and serum phosphorus.ResultsBLL was negatively correlated with BMD at different sites of interest in children and adolescents. For every 1mg/dl increase in BLL, the BMD of the total spine, total hip, and femoral neck decreased by 0.011 g/cm2, 0.008 g/cm2, and 0.006 g/cm2. In addition, Pb affected the lumbar spine more than the femur. The effect estimates were stronger in girls than boys at the lumbar spine (P for interaction= 0.006). This negative association remained significant in American children and adolescents after excluding individuals with BLL more than 3.5 ug/dl.ConclusionOur study indicates that BLL is negatively correlated with BMD at different sites of interest in children and adolescents aged 8-19 years, even in the reference range. More research is needed to elucidate the relationships between Pb and bone health in children and adolescents, including specific mechanisms and confounding factors like race/ethnicity, gender, and age.

Risk of lead exposure from wild game consumption from cross-sectional studies in Madre de Dios, Peru

SummaryBackgroundStudies have shown elevated blood lead levels (BLL) in residents of remote communities in the Amazon, yet sources of lead exposure are not fully understood, such as lead ammunition consumed in wild game.MethodsData was collected during two cross-sectional studies that enrolled 307 individuals in 26 communities. Regression models with community random effects were used to evaluate risk factors for BLLs, including diet, water source, smoking, sex, age, and indigenous status. The All-Ages Lead Model (AALM) from the Environmental Protection Agency (EPA) was used to estimate background and dose from wild game consumption.FindingsIndigenous status and wild game consumption were associated with increased BLLs. Indigenous participants had 2.52 μg/dL (95% CI: 1.95−3.24) higher BLLs compared to non-indigenous. Eating wild game was associated with a 1.41 μg/dL (95% CI: 1.20−1.70) increase in BLLs. Two or more portions per serving were associated with increased BLLs of 1.66 μg/dL (95% CI: 1.10−2.57), compared to smaller servings. Using the AALM, we estimate background lead exposures to be 20 μg/day with consumption of wild game contributing 500 μg/meal. Lastly, we found a strong association between BLLs and mercury exposure.InterpretationConsumption of wild game hunted with lead ammunition may pose a common source of lead exposure in the Amazon. Communities that rely on wild game and wild fish may face a dual burden of exposure to lead and mercury, respectively.

Blood Lead Levels and Risk of Deaths from Cardiovascular Disease

Environmental exposure could be an important modifiable risk factor for cardiovascular disease (CVD). In this study, we investigated the relation between lead exposure, measured as blood lead levels (BLLs) and CVD mortality in a national cohort. A total of 15,036 adults aged ≥19 who participated in the National Health and Nutrition Examination Survey (1988 to 1994) as the baseline examination were followed up through December 31, 2010. Adjusted hazard ratios (HRs) derived from Cox proportional hazard regressions were used to estimate the risk of dying from CVD in association with BLLs. Cardiovascular mortality was 3.76, 8.11, and 14.77 per 1,000 person-years for patients in low, moderate, and high BLLs, respectively. After adjusting for potential confounders, patients in the high lead level had a significantly increased risk of death from all CVD (HR 1.35, 95% confidence interval 1.03 to 1.77), compared with those with low level. Participants in both moderate and high lead levels showed a significantly increased risk of death from heart disease, with an HR of 1.37 (1.04 to 1.81) and 1.60 (1.21 to 2.13), respectively. A significant linear association with all CVD and heart disease deaths was also seen with an HR of 1.08 (1.00 to 1.16) and 1.09 (1.02 to 1.16), respectively, per 1-unit increase in BLLs. In conclusion, the study demonstrates that increasing BLLs were associated with an increased risk of cardiovascular deaths, especially from heart disease. This further supports the possible cardiovascular effects that lead poses on patients at low levels of exposure and the importance of further reducing lead exposure in the general population.

Occupational lead exposure is an independent modulator of hypertension and poor pulmonary function: A cross-sectional comparative study in lead-acid battery recycling workers.

Blood lead level (BLL) is the primary biomarker for lead-exposure monitoring in occupationally exposed workers. We evaluated occupational lead-exposure (OE) impact on cardiopulmonary functions in lead-acid battery recycling unit workers. Seventy-six OE cases and 30 control subjects were enrolled for questionnaire-based socio-demographic, dietary, tobacco usage, and medical history data. Anthropometric measurements, systolic and diastolic blood pressure (SBP and DBP), and pulmonary function tests were performed. Venous blood was collected for BLL, hematological analysis, and biochemical analysis. OE caused a significant increase in BLL, SBP, DBP, and small airways obstruction in lung function tests. It also impaired platelet indices, affected renal and liver biochemical measurements, and promoted oxidative stress and DNA damage. Multilinear regression analysis suggested that BLL affected SBP (β = 0.314, p = .034) and increased small airways obstruction (FEV1/FVC, β = -0.37, p = .05; FEV25-75%, β = -0.351, p = .016). Higher BLL appears to be an independent modulator of hypertension and poor pulmonary function upon occupational lead exposure in lead-acid battery recyclers.

Evaluation of calcium-fortified municipal water as a public health intervention to mitigate lead burdens

Abstract Lead has adverse effects on health, society, and the economy. Lead exposure results in increased blood lead levels and storage in bones. Calcium and lead are competitively absorbed and as such calcium can be used to mitigate the body lead burden. Twenty-eight quantitative research studies were reviewed that examined lead exposure (in blood, bone, or breastmilk) and calcium intake or serum calcium to evaluate the efficacy and safety of fortifying potable water supplies with calcium to mitigate lead absorption or resorption. Eighteen of the studies reported a significant inverse relationship between biomarker lead levels and calcium intake or serum calcium. The relationship was most evident with high calcium intake, suggesting a dose-dependent relationship. An intervention with calcium-fortified water could offer an accessible source of supplemental calcium to help meet the recommended dietary allowance (RDA) and mitigate lead absorption. A concentration of 60 mg-Ca/L can supply 22.0 and 16.3% of a 1,000 mg-Ca RDA for men and women, respectively, at the recommended daily water intake.