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.
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