Children's Lead Levels Research Articles

Low blood lead levels and attention-deficit hyperactivity disorder in children: a systematic review and meta-analysis.

Attention-deficit hyperactivity disorder (ADHD) of children is one of the most common neurodevelopmental diseases; the etiology remains unclear. We reviewed and meta-analyzed case-control studies to assess the effects of blood lead levels in children on ADHD symptoms. Relevant studies were identified by searching electronic databases. A meta-analysis was performed using the fixed model of Review Manager 5.3 software. Seven relevant studies were identified. The case groups exhibited significant increases in ADHD symptoms [mean difference (MD), 0.59; 95% confidence interval (CI), 0.50-0.68; p<0.0001]. Subgroup assessment showed that even children with blood lead levels <3μg/dL exhibited significant increases in ADHD symptoms (MD, 0.47; 95% CI, 0.39-0.56; p<0.0001). Subgroup assessment also showed that children aged 5-12years exhibited more significant increases in ADHD symptoms (MD, 1.35; 95% CI, 0.28-2.41; p<0.0001) than children aged >12years. Our findings suggest that low blood lead levels may be associated with ADHD symptoms in children. However, caution is needed when interpreting the results because among-study heterogeneity was in play. Primary interventions should focus on children with low blood lead levels.

Elevated Blood Lead Levels in Children Associated with Living near Mining Waste Sites in Guerrero/Mexico

Blood lead levels (BLL) in children are associated with lead in soil and represent a major public health problem; however, there are few reports of lead contamination related to mining waste sites in Mexico. Therefore, we conducted a cross-sectional study in the State of Guerrero to identify the association between proximity of residence to mining site waste and BLL in children. The impact of the different variables related to BLL were analyzed with logistic regression. Geometric mean BLL was 13.6 μg/dL, 15.9 μg/dL in communities proximal to waste sites and 5.5 μg/dL in a distant control community. Children living in communities near the mining waste have higher BLL that children living in communities far away from the waste. Our results are similar to studies in other countries and indicate that mining waste sites remain an active source of BLL contamination that affect children’s health.

Four phases of the Flint Water Crisis: Evidence from blood lead levels in children

The Flint Water Crisis (FWC) is divisible into four phases of child water-lead exposure risk: Phase A) before the switch in water source to the Flint River (our baseline); Phase B) after the switch in water source, but before boil water advisories; Phase C) after boil water advisories, but before the switch back to the baseline water source of the Detroit Water and Sewerage Department (DWSD); and Phase D) after the switch back to DWSD. The objective of this work is to estimate water-lead attributable movements in child blood lead levels (BLLs) that correspond with the four phases in the FWC. With over 21,000 geo-referenced and time-stamped blood lead samples from children in Genesee County drawn from January 01, 2013 to July 19, 2016, we develop a series of quasi-experimental models to identify the causal effect of water-lead exposure on child BLLs in Flint. We find that the switch in water source (transitioning from phase A to B) caused mean BLLs to increase by about 0.5μg/dL, and increased the likelihood of a child presenting with a BLL ≥ 5μg/dL by a factor of 1.91–3.50, implying an additional 561 children exceeding 5μg/dL. We conservatively estimate cohort social costs (through lost earnings alone) of this increase in water-lead exposed children at $65 million, contrasted with expected annual savings of $2 million from switching water source. On the switch from Phase B to C, we find BLLs decreased about 50% from their initial rise following boil water advisories and subsequent water avoidance behaviors by households. Finally, the return to the baseline source water (Phase D) returned child BLLs to pre-FWC levels further implicating water-lead exposure as a causal source of child BLLs throughout the FWC.

Faulty lead tests worry U.S. regulators

Certain tests used to measure blood lead levels in children and pregnant women are inaccurate and may underestimate true concentrations, the Food & Drug Administration and the Centers for Disease C...

Lead Poisoning Surveillance: A Collaborative Effort between Epidemiology and WIC

IntroductionThere is no safe level of lead in the body, and elevated lead inchildren can lead to decreased Intelligence Quotients (IQ) andbehavioral problems. The American Academy of Pediatricsrecommends lead testing of children with a positive risk assessment.Children who live in low socioeconomic areas may be at higher riskfor lead exposure. As recent events have shown, having an elevatedlead poisoning surveillance system can be critical to ensure that thereis not a community-wide lead exposure. To reach the children thatmay not have been screened by a primary care physician, on March1, 2016 the Sedgwick County Health Department Women, Infants,and Children (WIC) program began offering lead screenings to allchildren in the WIC program and their mothers. Per Centers forDisease Control and Prevention (CDC) guidelines, the SedgwickCounty Health Department Epidemiology program (Epi) investigatesanyone who has an elevated blood lead test (5μg/dL or greater).There are two types of lead tests – screening (capillary finger stick)and confirmatory (venous blood draw).MethodsSedgwick County WIC clients are offered screening lead testingat their WIC appointments. Education to reduce lead exposure isprovided at the time the test is performed. The filter papers used in thistesting are sent to the Kansas Health and Environmental Laboratories(KHEL) for analysis, and the results are reported to Epi. Epi reportsthe lead testing results to WIC, who track the results in their patientcharts. Epi receives KHEL results of &lt;5μg/dL via fax and resultsof &gt;= 5μg/dL via electronic laboratory reporting in the EpiTraxdisease investigation software maintained by the Kansas Departmentof Health and Environment. Epi notifies any WIC clients with results&gt;= 5μg/dL, while WIC staff notify all other clients about their results.Education is provided to the client a second time by Epi staff and/ora WIC nurse or dietician. For clients with elevated blood lead tests,Epi interviews the case or guardian using an enhanced blood leadexposure questionnaire which asks about potential lead exposures,both in the home and at other locations (work, hobbies, etc.). If only ascreening test was performed, Epi recommends confirmatory testing.WIC lead testing program measures, including types of exposuresidentified, are monitored over time using data obtained from EpiTrax.ResultsBetween March 1 and July 21, of the 2,150 WIC clients offeredlead testing, 89% self-reported never having received a lead testpreviously. Of the 1,427 clients with WIC lead screening results,seven cases of elevated blood lead were identified. Of the seven, fivedid not have a previous elevated lead test in EpiTrax. The averagescreening test result was 8.6μg/dL (range 6.8 to 13.4). The averageage of the cases was 2 years (range 1-4). Of the seven cases, two(29%) were confirmed as 10.0 and 11.0μg/dL through venous testingat their primary care provider’s office. The remaining five cases havenot received confirmatory testing. One of the three cases interviewedreported that their babysitter lived in an old home, which could bethe source of lead exposure. While interviewing a child’s guardianabout an elevated 2016 test (7.9μg/dL), Epi discussed a previous2015 elevated lead test (6.0μg/dL) of which the client’s guardianwas unaware.ConclusionsThe ease of access to lead testing in the Sedgwick County WICprogram and the joint effort between WIC and Epi to implement anenhanced lead poisoning surveillance system identified six childrenwith elevated lead levels whose guardians did not know they hadelevated lead levels. This new surveillance program educates WICparents about lead, determines the lead levels in children for guardianknowledge (low level) and further follow-up (elevated level), andidentifies lead exposures of WIC children with elevated lead tests.

Iron and Zinc Supplementation Does Not Impact Urinary Arsenic Excretion in Mexican School Children

To examine the role of iron and zinc in arsenic excretion and metabolism in children. An analysis of urinary arsenic (UAs) concentrations from a double-blind randomized trial originally testing the efficacy of iron and zinc for lowering blood lead levels in children. A 2 × 2 factorial design was used, with children randomized individually, stratified by sex and classroom, to receive 30?mg ferrous fumarate (n?=?148), 30?mg zinc oxide (n?=?144), iron and zinc together (n?=?148), or placebo (n?=?151). Of the 602 children enrolled, 527 completed the 6-month treatment, and 485 had both baseline and final UAs values. The baseline total UAs concentration ranged from 3.2 to 215.9?µg/L. At baseline, children in the highest tertile of serum ferritin concentration had higher excretion of dimethylarsinic acid (DMA; 1.93?±?0.86%; P?<?.05), but lower excretion of monomethylarsonic acid (-0.91?±?0.39%; P?<?.05), compared with children in the lowest tertile. In an intention-to-treat analysis, iron had no effect on arsenic methylation or UAs excretion, but children receiving zinc had lower %DMA in urine (-1.7?±?0.8; P?<?.05). Iron and zinc status are not related to arsenic metabolism in children, and supplementation with these minerals has limited application in lowering arsenic concentrations. ClinicalTrials.gov: NCT02346188.

Childhood Blood Lead Levels in Children Aged

This report provides data concerning childhood blood lead levels (BLLs) in the United States during 2009-2014. These data were collected and compiled from raw data extracts sent by state and local health departments to CDC's Childhood Blood Lead Surveillance (CBLS) system. These raw data extracts have been de-identified and coded into a format specifically for childhood blood lead reporting. The numbers of children aged <5 years for 2014 are reported with newly confirmed BLLs ≥10 µg/dL by month (Table 1) and geographic location (Table 2). The incidence of BLLs ≥10 µg/dL is reported by age group for 2009-2014 (Table 3). The numbers of children aged <5 years are reported by the prevalence of BLLs 5-9 µg/dL by age group and sample type during 2009-2014 (Tables 4 and 5). For the period 2009-2014, the numbers of children newly confirmed with BLLs ≥70 µg/dL are summarized (Figure 1) as well as the percentage of children with BLLs ≥5 µg/dL (Figure 2).

Blood Lead Levels in Children of Southwest Iran, Aged 2-6 Years and Associated Factors.

Lead is one of the toxic metals that can cause several complications in children. This study was conducted to determine Blood Lead Levels (BLLs) in healthy children and its association with individual and environmental factors. This descriptive-analytical study was conducted on 262 healthy children aged 2-6 years in Shahrekord, Southwest Iran in 2013. After taking serum samples from the children, the checklists of effective environmental factors on lead toxicity were completed after interviewing the parents. BLLs were determined by ICP-MS. Data were analysed by descriptive and analytical statistics (chi-square and ANOVA) in SPSS 16. BLLs ranged 0.4-52.8 (mean: 6.9±7.9) ng/ml. BLL was significantly associated with father's education level, house colour damage, canned food use and soil eating (p<0.05), but not with age, gender, economic status, proximity to factory and kohl use (p>0.05). BLL can cause serious health risks for children in Shahrekord and is associated with certain risk factors. It is necessary to screen for these risk factors.

Association of Lead Levels and Cerebral Palsy.

Background: Cerebral palsy is a common motor disability in childhood. Raised lead levels affect cognition. Children with cerebral palsy may have raised lead levels, further impairing their residual cognitive motor and behavioral abilities. Environmental exposure and abnormal eating habits may lead to increased lead levels. Aims and Objectives: To measure blood lead levels in children with cerebral palsy and compare them with healthy neurologically normal children. To correlate blood lead levels with environmental factors. Material and Methods: Design: Prospective case-control study. Setting: Tertiary care hospital. Participants: Cases comprised 34 children with cerebral palsy, and controls comprised 34 neurologically normal, age- and sex-matched children. Methods: Clinical and demographic details were recorded as per proforma. Detailed environmental history was recorded to know the source of exposure to lead. These children were investigated and treated as per protocol. Venous blood was collected in ethylenediaminetetraacetic acid vials for analysis of blood lead levels. Lead levels were estimated by Schimadzu Flame AA-6800 (atomic absorption spectrophotometer). Data were analyzed using SPSS version 17. P < .05 was taken as significant. Results: Mean blood lead levels were 9.20 ± 8.31 µg/dL in cerebral palsy cases and 2.89 ± 3.04 µg/dL in their controls (P < .001). Among children with cerebral palsy, 19 (55.88%) children had blood lead levels ≥5 µg/dL. Lead levels in children with pica were 12.33 ± 10.02 µg/dL in comparison to children with no history of pica, 6.70 ± 4.60 µg/dL (P = .029). No correlation was found between hemoglobin and blood lead levels in cases and controls. Conclusion: In our study, blood lead levels are raised in children with cerebral palsy. However, further studies are required to show effects of raised levels in these children.

The effect of illegal lead processing on blood lead levels in children living in the mining area

Backgraund/Aim. The northern part of Kosovo was one of the largest lead and zinc production industries in Europe. Special attention has been paid to the landfill sites of these metals remained after past industrial activities. The inhabitants of Roma camps in this area are collecting led waste they process by crushing and melting in their shacks in primitively organized working environments. Because of all the aforementioned it was necessary to examine the concentration of blood lead level (BLL) in the children aged less than 6 years inhabiting this area, especially taking care of blood analysis of children living in Roma camps. Methods. The study was conducted in the municipality of Leposavic, Province Kosovo and Metohija, Serbia. Totally 78 subjects participated in the study. All the subjects were divided into two groups: the group I consisting of 42 children who lived in the Romas camp, and the group II with 36 children from a city kindergarten. Based on the mathematical model WRPLOT we found out that both groups of patients were in the low risk zone for industrial contamination exposure. Blood analysis was done according to the protocol provided by ESA Lead Care. Results. The average age of participants in the study was 4.60 ? 1.63 years. The mean BBL in the children from the group 1 was 19.11 ?g/dL and from the group 2 4.87 ?g/dL. There was a statistically significant difference in the mean values of BBL between the groups (U = 39, p &lt; 0.001). All of the children from the group 1 had BBL greater than 5 ?g/dL in comparison to 38.9% of the children from the group 2 (?2 = 35.75, p &lt; 0.001). Conclusion. Although both groups were located outside the zone of direct spread of pollution, the results indicate high concentrations of lead in blood of all the examined children. The concentration was higher in the children who lived in the area in which illegal processing of lead waste took place.

Household interventions for preventing domestic lead exposure in children.

Household interventions for preventing domestic lead exposure in children.

Blood Lead Levels in Children Aged

This report provides data concerning childhood blood lead levels (BLLs) in the United States during 2007-2013. These data were collected and compiled from raw data extracts sent by state and local health departments to CDC's Childhood Blood Lead Surveillance (CBLS) system. These raw data extracts have been de-identified and coded into a format specifically for childhood lead reporting. The numbers of children aged <5 years reported to CDC for 2013 with newly confirmed BLLs ≥10 µg/dL are provided in tabular form by month (Table 1) and geographic location (Table 2). The incidence of BLLs ≥10 µg/dL is reported by age group for 2007-2013 (Table 3). The numbers of children aged <5 years with BLLs 5-9µg/dL for 2013 are reported (Table 4). For the period 2007-2013, the numbers of children newly confirmed with BLLs ≥70 µg/dL are summarized (Figure 1) as well as the percentage of children with BLLs ≥5 µg/dL (Figure 2). This report is a part of the Summary of Notifiable Noninfectious Conditions and Disease Outbreaks - United States, which encompasses various surveillance years but is being published in 2016 (1). The Summary of Notifiable Noninfectious Conditions and Disease Outbreaks appears in the same volume of MMWR as the annual Summary of Notifiable Infectious Diseases (2).

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

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

Reducing blood lead levels in children exposed to electronic waste recycling in Montevideo

Reducing blood lead levels in children exposed to electronic waste recycling in Montevideo

Seasons and neighborhoods of high lead toxicity in New York City: The feral pigeon as a bioindicator

Human-induced rapid environmental change has created a global pandemic of neurobehavioral disorders in which industrial compounds like lead are the root cause. We assessed the feral pigeon (Columba livia) as a lead bioindicator in New York City. We collected blood lead level records from 825 visibly ill or abnormally behaving pigeons from various NYC neighborhoods between 2010 and 2015. We found that blood lead levels were significantly higher during the summer, an effect reported in children. Pigeon blood lead levels were not significantly different between years or among neighborhoods. However, blood lead levels per neighborhood in Manhattan were positively correlated with mean rates of lead in children identified by the NYC Department of Health and Mental Hygiene as having elevated blood lead levels (>10 μg/dl). We provide support for the use of the feral pigeon as a bioindicator of environmental lead contamination for the first time in the U.S. and for the first time anywhere in association with rates of elevated blood lead levels in children. This information has the potential to enable measures to assess, strategize, and potentially circumvent the negative impacts of lead and other environmental contaminants on human and wildlife communities.

Environmental and socioeconomic factors contributing to elevated blood lead levels in children from an industrial area of Upper Silesia.

The present study concentrated on a cross-sectional analysis of recent exposure to lead (Pb) and the socioeconomic factors behind increased Pb exposure in Polish children. Lead is one of the most widespread toxic heavy metals in the industrial region of Upper Silesia (Poland). Elevated blood Pb levels in children continue to be a matter of serious concern. The present study involved 4882 children from the Upper Silesia region, aged from 3 yr to 18 yr, over the calendar years 1999 to 2013. The concentration of Pb in blood was determined in each child. The children's parents were asked to answer survey questions about the child's environmental exposure to Pb as well as the socioeconomic condition of the family. Factors that correspond with increased exposure to Pb included: lower level of education of parents, unemployment, parents' occupational Pb exposure, poor socioeconomic status of the family, smoking at home, living on the ground floor of buildings, consumption of locally grown vegetables and fruits, longer outdoor playing periods in a polluted environment, and male gender. Environmental exposure to Pb is the most important factor behind chronic poisoning of children in Upper Silesia. The most important socioeconomic factor associated with concentrations of Pb in children's blood is a lower level of education of a child's mother and father. Environ Toxicol Chem 2016;35:2597-2603. © 2016 SETAC.

Lead toxicity and genetics in Flint, MI

Lead toxicity and genetics in Flint, MI

Blood Lead Levels in Young Children: US, 2009-2015

To evaluate trends in blood lead levels in children <6years of age, this Quest Diagnostics Health Trends report builds on previously reported National Health and Nutrition Examination Survey data with a much larger national group and adds more detail and novel assessments. This report describes the results from a 6-year retrospective study (May 2009-April 2015) based on >5 million blood lead level results (including >3.8 million venous results) from children <6years old living in all 50 states and the District of Columbia. We evaluated yearly changes and examined demographic categories including sex, pre-1950s housing construction, poverty income ratios (PIRs), Medicaid enrollment status, and geographic regions. Among children <6years old, 3.0% exhibited blood lead levels ≥5.0μg/dL (high). There were significant differences in high blood lead levels based on sex, pre-1950s housing construction quintiles, and PIR<1.25 and PIR>5 (all P<.01). Health and Human Services regions, states, and 3-digit ZIP code areas exhibited drastically different frequencies of high blood lead levels and blood lead levels ≥10.0μg/dL (very high). Generally, levels declined over time for all groups. Examination of more than 5 million venous blood lead level results in children younger than 6years old allowed for a robust, detailed analysis of blood lead level group results by geography and other criteria that are prohibited with the narrower National Health and Nutrition Examination Survey database. Progress in reducing the burden of lead toxicity is a public health success story that is incomplete with some identified factors posing larger, ongoing challenges.

Investigation and Evaluation of Children's Blood Lead Levels around a Lead Battery Factory and Influencing Factors.

Lead pollution incidents have occurred frequently in mainland China, which has caused many lead poisoning incidents. This paper took a battery recycling factory as the subject, and focused on measuring the blood lead levels of environmental samples and all the children living around the factory, and analyzed the relationship between them. We collected blood samples from the surrounding residential area, as well as soil, water, vegetables. The atomic absorption method was applied to measure the lead content in these samples. The basic information of the generation procedure, operation type, habit and personal protect equipment was collected by an occupational hygiene investigation. Blood lead levels in 43.12% of the subjects exceeded 100 μg/L. The 50th and the 95th percentiles were 89 μg/L and 232 μg/L for blood lead levels in children, respectively, and the geometric mean was 94 μg/L. Children were stratified into groups by age, gender, parents’ occupation, distance and direction from the recycling plant. The difference of blood lead levels between groups was significant (p < 0.05). Four risk factors for elevated blood lead levels were found by logistic regression analysis, including younger age, male, shorter distance from the recycling plant, and parents with at least one working in the recycling plant. The rate of excess lead concentration in water was 6.25%, 6.06% in soil and 44.44% in leaf vegetables, which were all higher than the Chinese environment standards. The shorter the distance to the factory, the higher the value of BLL and lead levels in vegetable and environment samples. The lead level in the environmental samples was higher downwind of the recycling plant.

Association of blood lead levels in children 0-72 months with living in Mid-Appalachia: a semi-ecologic study

Lead exposure in children remains a significant public health issue, although many advances have been made. The Mid-Appalachia area (Kentucky, New York, Ohio, Pennsylvania, and West Virginia) is 89-91% rural with a population density of 16-21 people/km2 (41-54 people/mi2). Mid-Appalachia has significant health disparities including concerns for the consequences of greater lead exposure to children due to mining and industrial footprints, and existing older housing. The purpose of this study is to compare the reported blood lead levels of screened children, aged 0-72 months in Mid-Appalachia, to the children in the USA in general. Data from the Centers for Disease Control and Prevention and from the US Census Bureau were analyzed in a semi-ecological study. The blood lead level of 5 μg/dL was compared between children in Mid-Appalachia and the US housing units built before 1950; US housing units built before 1940 were also compared. The number of children with blood lead levels of 5 μg/dL was significantly greater in Mid-Appalachia than nationally (7.75% vs 5.79%, respectively; p<0.0001). The number of homes built before 1950 (p<0.0001) and built before 1940 (p<0.0001) was significantly greater in Mid-Appalachia than nationally. Blood lead levels in children are higher in Mid-Appalachia than nationally and there is an ecological relationship with the number of homes built before 1950 and before 1940.