Children's Lead Levels Research Articles

Community priorities in a landscape of environmental lead contamination: Intersectionality of poverty, well-being, and environmental contamination

Kabwe, Zambia, is known in the global health world for its high concentrations of environmental lead and associated high blood lead levels in children, and thus it is a key region for exploring the intersections of human health and well-being (United Nations Sustainable Development Goal, SGD #3) and environmental health (SGD #12 and #15). Despite multiple efforts to remediate lead from the landscape, lead contamination remains pervasive in some Kabwe neighborhoods. Our study examined to what extent lead remediation was also a priority for community members. Using open-ended oral surveys with 49 household heads as well as ethnographic observational notes, we found that while lead is a concern, it is just one of many concerns. Indeed, economic concerns outweighed other concerns (SGD #1 and #6). Because community buy-in is vital to any global health intervention, these results suggest that externally defined intervention goals, such as lead remediation to address environmental toxicity, may be more successful if interventions also incorporate locally salient concerns. We conclude by arguing that social scientific studies of community members’ perspectives and concerns should be prerequisite to global health interventions. In the context of Kabwe, intervention efforts that incorporate solutions to address local concerns about poverty (SDG #1) and economic opportunity (SDG #6) may result in improved community cooperation with environmental remediation efforts, and thereby improved likelihood of sustainable environmental remediation.

Lead Poisoning in a Mother and Her Four Children Using a Traditional Eye Cosmetic - New York City, 2012-2023.

Even low levels of lead in children's blood are associated with developmental delays, difficulty learning, and behavioral issues. Adults are also vulnerable to the detrimental health effects of lead exposure. The New York City (NYC) Department of Health and Mental Hygiene receives blood lead test results for NYC residents and conducts investigations of lead poisoning cases. Blood lead testing of a child aged 4 years in 2012 led to the discovery of blood lead levels above the CDC blood lead reference value of 3.5 μg/dL in the child as well as four other family members over a period of 11 years, including the child's mother and three younger siblings born during 2012-2016. The only potential source of lead exposure identified for all cases was the use of surma, a traditional eye cosmetic, which was found to contain 390,000 ppm lead. The cases in this report highlight the challenges of risk communication when deeply ingrained cultural practices, such as the use of surma, persist despite health warnings. Moreover, they highlight the intergenerational nature of such practices and the need for comprehensive family follow-up once a member is identified as being at risk. These products continue to be available globally, even in places such as the United States where sales are prohibited. Multistakeholder efforts involving local and global engagement could promote reformulation of these products at the countries of origin to eliminate lead as an ingredient.

Association between Residential Distance to Airport and Blood Lead Levels in Children under 6 Living in North Carolina, 1992-2015.

Association between Residential Distance to Airport and Blood Lead Levels in Children under 6 Living in North Carolina, 1992-2015.

Determinant Factors of Children's Blood Lead Levels in Java, Indonesia

IntroductionLead poisoning contributes to a significant burden of disease as a toxic substance found in air, soil, and water. In Indonesia, the risk of exposure is high due to the inappropriate recycling of used lead batteries. The objective was to investigate the factors that influence lead levels in children's blood. MethodsThis cross-sectional study assessed blood lead levels (BLLs) in children aged 12–59 months in four communities exposed to used lead-acid batteries (ULABs) recycling activities, comparing them to a control area. The study employed a threshold level of 20 μg/dL to identify high BLLs and utilized a sample size of 324 children from exposed sites and 240 from control sites. Questionnaires, blood lead tests and a home-based assessment for environmental exposures were applied. ResultsThe study participants comprised 295 boys and 269 girls, with an average age of 35 months. Significant disparities in soil lead concentrations median: Q1-Q3 were found between exposed (6581.7 : 2432.6–16647.1) ppm and control areas (253.5 : 158.8–417.1) ppm. Children in exposed areas had 3.9 times higher odds of BLL ≥20 μg/dL. Fathers with BLL ≥20 μg/dL had children with similarly elevated BLLs. Multivariate analysis identified socioeconomic status, study areas, environmental factors (cookware, food ware, spices, house cleaning), and children's behavior (breastfeeding duration) as determinants of elevated BLLs. Reported environmental factors had notable impact on BLLs, with aluminum cookware (aOR = 1.4, 95%CI [1.2–1.6]), food ware materials (aOR = 1.15, 95%CI [1.0–1.3]), type of spices (aOR = 2.7, 95%CI [1.7–48.0]), and house cleaning method (aOR = 2.9, 95%CI [1.2–7.1]). ConclusionThis study highlighted key risk factors affecting children's blood lead levels (BLL) and emphasized the urgency of employing effective strategies to remediate lead-contaminated soils in exposed regions. The findings underscore the need for prompt medical intervention and monitoring for children in these areas, with additional research essential to fully understand lead poisoning pathways in the environment.

House Sparrows as Sentinels of Childhood Lead Exposure.

Our understanding of connections between human and animal health has advanced substantially since the canary was introduced as a sentinel of toxic conditions in coal mines. Nonetheless, the development of wildlife sentinels for monitoring human exposure to toxins has been limited. Here, we capitalized on a three-decade long child blood lead monitoring program to demonstrate that the globally ubiquitous and human commensal house sparrow (Passer domesticus) can be used as a sentinel of human health risks in urban environments impacted by lead mining. We showed that sparrows are a viable proxy for the measurement of blood lead levels in children at a neighborhood scale (0.28 km2). In support of the generalizability of this approach, the blood lead relationship established in our focal mining city enabled us to accurately predict elevated blood lead levels in children from another mining city using only sparrows from the second location. Using lead concentrations and lead isotopic compositions from environmental and biological matrices, we identified shared sources and pathways of lead exposure in sparrows and children, with strong links to contamination from local mining emissions. Our findings showed how human commensal species can be used to identify and predict human health risks over time and space.

Mapping Blood Lead Levels in China during 1980-2040 with Machine Learning.

Lead poisoning is globally concerning, yet limited testing hinders effective interventions in most countries. We aimed to create annual maps of county-specific blood lead levels in China from 1980 to 2040 using a machine learning model. Blood lead data from China were sourced from 1180 surveys published between 1980 and 2022. Additionally, regional statistical figures for 15 natural and socioeconomic variables were obtained or estimated as predictors. A machine learning model, using the random forest algorithm and 2973 generated samples, was created to predict county-specific blood lead levels in China from 1980 to 2040. Geometric mean blood lead levels in children (i.e., age 14 and under) decreased significantly from 104.4 μg/L in 1993 to an anticipated 40.3 μg/L by 2040. The number exceeding 100 μg/L declined dramatically, yet South Central China remains a hotspot. Lead exposure is similar among different groups, but overall adults and adolescents (i.e., age over 14), females, and rural residents exhibit slightly lower exposure compared to that of children, males, and urban residents, respectively. Our predictions indicated that despite the general reduction, one-fourth of Chinese counties rebounded during 2015-2020. This slower decline might be due to emerging lead sources like smelting and coal combustion; however, the primary factor driving the decline should be the reduction of a persistent source, legacy gasoline-derived lead. Our approach innovatively maps lead exposure without comprehensive surveys.

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.

Assessment of Ferritin and Lead Levels in Children Living in an Informal Urban Settlement in Kenya

Assessment of Ferritin and Lead Levels in Children Living in an Informal Urban Settlement in Kenya

Community‐driven science and science education: Living in and navigating the edges of equity, justice, and science learning

Community‐driven science and science education: Living in and navigating the edges of equity, justice, and science learning

Stability of blood lead levels in children with low-level lead absorption.

Current child blood lead (Pb) screening guidelines assume that blood lead levels (BLLs) are relatively stable over time, and that only youngest children are vulnerable to the damaging effects of lower-range BLLs. This study aimed to test the stability of lower-range (≤ 10 μg/dL) child BLLs over time, and whether lower-range BLLs diminished with age among children aged 6 months to 16 years living in a lower-income neighborhood with a density of pre-1986 housing and legacy contamination. Age, sex, family income, age of residence, and/or residence proximity to point sources of Pb, were tested as potential additional factors. Capillary blood samples from 193 children were analyzed by inductively coupled plasma mass spectrometry (ICPMS). Multiple imputation was used to simulate missing data for 3 blood tests for each child. Integrated Growth Curve models with Test Wave as a random effect were used to test BLL variability over time. Among N = 193 children tested, at Time 1 testing, 8.7% had the BLLs ≥ 5 μg/dL (CDC "elevated" BLL reference value at the time of data collection) and 16.8% had BLLs ≥ 3.5 μg/dL (2021 CDC "elevated" BLL reference value). Modeling with time as a random effect showed that the variability of BLLs were attributable to changes within children. Moreover, time was not a significant predictor of child BLLs over 18 months. A sex by age interaction suggested that BLLs diminished with age only among males. Of the additional environmental factors tested, only proximity to a major source of industrial or vehicle exhaust pollution predicted child BLL variability, and was associated with a small, but significant BLL increase (0.22 μg/dL). These findings suggest that one or two BLL tests for only infants or toddlers are insufficient for identifying children with Pb poisoning.

Nutritional Status, Anemia and Eating Behavior among Children with Elevated Blood Lead Levels in a Primary Health Care of Peru

Aim: Malnutrition, anemia, and lead exposure are important public health problems. Introduction: To assess nutritional status, anemia, and eating habits and their relationship to elevated blood lead levels in children. Materials and Methods: Descriptive study conducted with data from children evaluated in a district of Callao, Peru. The variables studied were: nutritional status, based on anthropometric measurements; anemia, determined by blood hemoglobin concentration; dietary habits, evaluated by the 24-hour dietary recall method and food consumption frequency; and blood lead, determined by LeadCare II analyzer. Results and Discussion: A total of 425 children participated, with a median age of 6 years (IQR=5; Q3=9, Q1=4), 52.2% (n=222) were female and 71.3% (n=303) had blood lead level (BLL) ≥5μg/dL. Among children with BLL ≥5 μg/dL, 11.6% (n=35) presented poor nutritional status, 9.9% (n=30) had anemia, and 63% (n=191) had inadequate eating habits. Of the children with inadequate eating habits, 17.4% (n=47) had poor nutritional status and 15.9% (n=43) had anemia, compared to children with adequate eating habits (p<0.001). In children with BLL ≥5 μg/dL, the children's median hemoglobin, body weight, and height were 12.2 g/dL, 21.6 Kg, and 114.8 cm, respectively; while in those with Pb levels <5 μg/dL it was 12.5 g/dL, 29 Kg and 126.55 cm, respectively (p<0.05). Conclusion: Nutritional status, anemia, and eating habits did not differ according to BLL; however, lower median hemoglobin, weight, and height were found in children with elevated lead levels. Children with subnormal nutritional status and children with anemia presented a shorter time to reach elevated blood lead levels.

Blood lead levels in children residing in a 115-year old urban settlement in Harare, Zimbabwe: a cross sectional study

BackgroundElemental lead (Pb) toxicity in children, irreversibly affects their growth and development. We assessed the prevalence of high blood Pb levels (BLL) in children living in a potentially high risk residential area and also assessed Pb levels in environmental specimens.MethodsThis cross sectional study measured blood lead levels (BLL) in 86children living in Mbare, a densely populated suburb in Harare, Zimbabwe, characterised by dwellings progressively constructed from 1907 through to the 1940s, before the ban of leaded paint. Study participants of both genders were under 6 years of age. Potential risk factors of Pb poisoning were assessed. Pb levels were also assessed in soil, water and paint chip specimens from the study area.ResultsThe mean (standard deviation) BLL was 4.3 ± 0.75 g/dL. Twelve (13.95%) participants had BLL of > 5.0ug/dL. Our results showed no significant association between BLL and household income, participant behaviour/habits/activities, sources of drinking water, and the types of cookware used to prepare meals in their households.ConclusionMean BLL observed in the current study were higher compared to those of children of similar age groups in the United States, suggesting that Pb contamination may be more ubiquitous in the Mbare flats area, potentially predisposing these children to impaired development.

Comparison of Blood Lead Levels in Children and Adolescents with and without Functional Abdominal Pain.

Functional abdominal pain is a health concern with chronic abdominal discomfort without clear etiology. Several etiologic factors are raised in this regard, one related to environmental factors. This study aimed to compare blood lead levels between children and adolescents with and without functional abdominal pain. This case-control study was performed in 2019-2020 in Isfahan, Iran. The sample size was calculated as 70 cases and an equal number of controls. Cases were children and adolescents with functional gastrointestinal disorder (FGID), and controls were grouped age- and sex-matched. Controls were randomly selected from those referred for routine health screening. Both groups obtained blood lead, iron, and calcium levels. All participants completed the FFQ Food Consumption and Environmental Pollutants Questionnaire. Participants were 139 children (68 cases and 71 controls). The mean (SD) age was 9.40 (3.91) years in the FGID group and 8.79 (3.46) years in the controls (P = 0.330). The mean (SD) blood lead level was not significantly different between the FGID group and the controls (3.98 ± 2.56 vs 3.81 ± 1.96 μg/dl, respectively, P = 0.670). We found that 55.3% of children with high lead levels had FGID, while 44.4% of children with lower lead levels had FGID, but the difference was not statistically significant (P = 0.33). We found that the lead level was higher in patients with FGID than in the controls; however, this difference was not significantly different. This might be because of elevated lead levels in both groups. Future ecological studies with a large sample size are necessary in this regard.

Relationship Between Primary Language Spoken at Home and Blood Lead Levels in Children from Northeast Ohio, United States: A Retrospective Cohort Study.

To estimate the prevalence and incidence of blood lead levels (BLL) ≥ 5 and ≥ 3.5µg/dl and assess their association with primary language spoken at home in Northeast Ohio, U.S. children, a retrospective cohort study was conducted among 19,753 children aged < 6years. Primary language spoken at home was used to define children fromresettled refugee families (RRFs) and non-RRFs. The overall BLL ≥ 5 and ≥ 3.5µg/dl prevalence were 3.22 and 6.10%, and incidence rateswere 2.25 and 3.64 cases per 100 person-years, respectively. Compared to children from non-RRFschildren from RRFs were 3.62-times [95% confidence interval (CI): 1.84, 7.13] as likely to have BLL ≥ 5µg/dl prevalence, and 6.72-times [95% CI 2.60, 17.40] as likely to have BLL ≥ 5µg/dl incidence during the follow-up period. The higher prevalence and incidence of BLL acquired in the United States among children from RRFs warrant further research to identify specific environmental and sociocultural lead sources for these children.

Community Health Services and Blood Lead Reduction in Children

Objectives: To assess the effect of multidisciplinary community health services on reducing blood lead in children. Material and methods: Retrospective observational study, before-after type. The information of an intervention program in the “Mi Peru” district was analyzed. The population consisted of 1,191 children of both genders who had results of blood lead level and who were evaluated during 2016 and 2017. The sample consisted of 187 children with blood lead levels ≥10 μg/dL. Community health services had three components: comprehensive multidisciplinary care, health education and house calls. Results: The blood lead level at the start of the intervention, 88.5% (n=139) belonged to category II and 11.5% (n=18) belonged to category III. At the end of the intervention, 66.9% (n=105) resulted in category I, the proportion of lead levels belonging to categories II and III was reduced to 29.9% (n=47) and 3.2% (n=5) respectively. In relation to the blood lead level at the beginning of the intervention and at the end of the intervention, the initial mean of 13.96 μg/dL was reduced to 8.96 μg/dL and the median from 12.40 μg/dL to 8.20 μg/dL (p<0.001). Conclusions: Community health services reduced blood lead levels in children with elevated blood lead levels. It is suggested to promote and strengthen the comprehensive house calls and health education about the risks of lead exposure.

Association of lead exposure with stunting and underweight among children aged 3-5 years in China

Objective: To evaluate the association of lead exposure with stunting and underweight among children aged 3-5 years in China. Methods: Data was collected from China National Human Biomonitoring (CNHBM) between January 2017 and December 2018. A total of 3 554 children aged 3-5 years were included. Demographic characteristic, lifestyle and nutritional status were collected through questionnaires. Height and weight were measured by standardized method. Stunting and underweight status were determined by calculating height for age Z-score and weight for age Z-score. Blood and urine samples were collected to detect the concentrations of blood lead, urinary lead and urinary creatinine. Children were stratified into 4 groups (Q1 to Q4) by quartiles of blood lead level and corrected urinary lead level, respectively. Complex sampling logistic regression models were applied to evaluate the association of the blood lead level, urinary lead level with stunting and underweight. Results: Among 3 554 children, the age was (4.09±1.06) years, of which 1 779 (80.64%) were female and 1 948 (55.84%) were urban residents. The prevalence of stunting and wasting was 7.34% and 2.96%, respectively. The M (Q1, Q3) for blood lead levels and urinary lead levels in children was 17.49 (12.80, 24.71) μg/L, 1.20 (0.61, 2.14) μg/g Cr, respectively. After adjusting for confounding factors, compared with the lowest blood lead concentration group Q1, the risk of stunting gradually increased in the Q3 and Q4 group (Ptrend=0.010), with OR (95%CI) values of 1.40 (0.80-2.46) and 1.80 (1.07-3.04), respectively. Compared with the lowest urinary lead concentration group Q1, the risk of stunting still increased in the Q3 and Q4 group (Ptrend=0.012), with OR (95%CI) values of 1.69 (1.01-2.84) and 1.79 (1.05-3.06), respectively. The correlation between the lead exposure and underweight was not statistically significant (P>0.05). Conclusion: Lead exposure is positively associated with the risk of stunting among children aged 3-5 years in China.

Delta-Aminolevulinic acid dehydratase enzyme activity and susceptibility to lead toxicity in Uganda’s urban children

Background: Rapid industrialization, urbanization, and population explosion in sub-Saharan Africa escalate environmental lead levels and subsequently blood lead levels in children. Its levels in one’s environment account for their blood lead levels. One’s susceptibility to lead toxicity is governed by nutrition status, age and genetics. This study aimed at expounding susceptibility to lead toxicity by relating blood lead levels, delta-aminolevulinic acid dehydratase (ALAD) enzyme activity, and genetic variations of proteins that code for ALAD in urban children of Uganda. Methods: A total of 198 blood samples were spectrophotometrically analysed for blood lead levels (BLL), hemoglobin (Hb) levels, and ALAD enzyme activity before DNA extraction, polymerase chain reaction, and restriction fragment length digestion for ALAD polymorphism. Results: Up to 99.5% of the total samples analyzed coded for ALAD1 allele compared to 0.05% that coded for ALAD2. There was a significant relationship between BLL, Hb status and ALAD enzyme activity in the three isozymes (ALAD1-1, ALAD1-2 and ALAD2-2) in strength of ALAD1-1 (r = 0.42, p -value = 0.02) ˂ ALAD1-2 (r = 0.62, p -value = ˂ 0.001) ˂ ALAD2-2 (r = 0.67, p -value = ˂ 0.001). Conclusions: Majority of children in Uganda code for the ALAD1 allele, which is important for blood lead ions hoarding during lead toxicity. Hoarding of blood lead not only delays exposure effects but also accumulates its levels in deposit tissues and this poses adverse effects later in their lives

Cardiovascular Mortality and Leaded Aviation Fuel: Evidence from Piston-Engine Air Traffic in North Carolina

Leaded fuel used by piston-engine aircraft is the largest source of airborne lead emissions in the United States. Previous studies have found higher blood lead levels in children living near airports where leaded aviation fuel is used. However, little is known about the health effects on adults. This study is the first to examine the association between exposure to aircraft operations that use leaded aviation fuel and adult cardiovascular mortality. We estimated the association between annual piston-engine air traffic and cardiovascular mortality among adults age 65 and older near 40 North Carolina airports during 2000 to 2017. We used several strategies to minimize the potential for bias due to omitted variables and confounding from other health hazards at airports, including coarsened exact matching, location-specific intercepts, and adjustment for jet-engine and other air traffic that does not use leaded fuel. Our findings are mixed but suggestive of adverse effects. We found higher rates of cardiovascular mortality within a few kilometers downwind of single- and multi-runway airports, though these results are not always statistically significant. We also found significantly higher cardiovascular mortality rates within a few kilometers and downwind of single-runway airports in years with more piston-engine air traffic. We did not consistently find a statistically significant association between cardiovascular mortality rates and piston-engine air traffic near multi-runway airports, where there was greater uncertainty in our measure of the distance between populations and aviation exposures. These results suggest that (i) reducing lead emissions from aviation could yield health benefits for adults, and (ii) more refined data are needed to obtain more precise estimates of these benefits. Subject Areas: Toxic Substances, Health, Epidemiology, Air Pollution, Ambient Air Quality. JEL codes: Q53, I18.

Factors associated with blood lead levels in children in Shenyang, China: a cross-sectional study

BackgroundAlthough blood lead levels (BLLs) in children are gradually decreasing, low-concentration lead exposure can still exert adverse effects. We studied the factors that affect BLLs in children in Shenyang, China.MethodsWe conducted a cross-sectional study by administering structured questionnaires on family demographics and food intake. The concentrations of lead in venous blood were determined by graphite furnace atomic absorption spectrometry.ResultsA total of 273 children aged 1–6 years were enrolled. The geometric mean (geometric standard deviation) of BLLs was 24.94 (12.70) μg/L in boys and 23.75 (11.34) μg/L in girls. The prevalence of BLLs of ≥35 μg/L was 22.7% and was mainly observed in children aged under 3 years. Often hand washing before meals was protective against BLLs ≥20 μg/L (adjusted OR: 0.427, 95%CI: 0.238–0.767, p = 0.004). Consumption of puffed grains and eggs had an adjusted OR (95%CI) for BLLs ≥20 μg/L of 1.714 (1.012–2.901) (p = 0.045) and 1.787 (1.000–3.192) (p = 0.050), respectively.ConclusionsBLLs of children in Shenyang are still higher than in developed countries. Consumption of puffed grains and eggs is associated with higher BLLs. Often hand washing before meals may be protective against high BLLs.

Spatial Analysis and Lead-Risk Assessment of Philadelphia, USA.

Childhood lead poisoning is an issue that continues to plague major U.S. cities. Despite efforts by the Philadelphia Department of Public Health to curtail systemic childhood lead poisoning, children continue to be identified with elevated blood lead levels. The persistence of elevated blood lead levels in children is concerning because lead poisoning has been linked to decreases in academic achievement and IQ, with associated repercussions for entire communities. This paper reports the results of an analysis of the spatial distribution of houses with lead paint (i.e., pre‐1978), demolitions, and occurrence of historic smelters, in West and North Philadelphia, relative to elevated blood lead level data, to determine which lead sources act as primary lead‐risk factors. The presence of lead paint in homes and the number of demolitions of older properties were found to have the highest correlations to elevated blood lead levels for children in Philadelphia. Using lead‐risk factors including lead paint, housing code violations, demolitions, and owner‐occupied housing units, a lead‐risk assessment was performed at the census tract level to identify future soil sampling sites and high‐risk neighborhoods in Philadelphia. These sites of high risk for lead exposure, and in particular the census tracts 175 and 172, should be prioritized for lead poisoning prevention initiatives.