Elevated blood lead levels in a riverside population in the Brazilian Amazon

Lead (Pb) is recognized as one of the most toxic metals. Sources of Pb exposure have been widely documented in North America, and the removal of Pb additives from gasoline was reflected in a dramatic lowering of blood Pb concentration. In Latin America, the removal of Pb from gasoline resulted in decreased exposure, but Pb levels in many areas remain high due to occupational and environmental sources of exposure. While many of the Pb sources have been identified (mining, industries, battery recycling, lead-based paint, ceramics), new ones occasionally crop up. Here we report on blood Pb (B-Pb) levels in remote riverside communities of the Brazilian Amazon. Blood Pb (B-Pb) levels were determined in 448 persons from 12 villages of the Lower Tapajós River Basin, Pará, Brazil. Socio-demographic and dietary information, as well as occupational, residential and medical history was collected using an interview-administered questionnaire. B-Pb, measured by ICP-MS, showed elevated concentrations. Mean B-Pb was 13.1 μg/dL±8.5, median B-Pb was 11.2 μg/dL and ranged from 0.59 to 48.3 μg/dL. Men had higher B-Pb compared to women (median: 15.3 μg/dL vs 7.9 μg/dL respectively). B-Pb increased with age for women, while it decreased for men. For both genders, B-Pb decreased with education. There were significant differences between villages. Exploratory analyses, using linear partition models, showed that for men B-Pb was lower among those who were involved in cattle-raising, and higher among those who hunted, farmed and fished. The distribution profile of B-Pb directed us towards artisanal transformation of manioc to flour (farinha), which requires heating in a large metal pan, with stirring primarily done by young men. In the village with the highest B-Pb, analysis of Pb concentrations (dry weight) of manioc (prior to transformation) and farinha (following transformation) from 6 houses showed a tenfold increase in Pb concentration (mean: 0.017±0.016 to 0.19±0.10 μg/g). This was confirmed in one of these villages where we sampled manioc paste (just before roasting) and the roasted farinha (0.05 μg/g vs 0.20 μg/g). While there may be other sources (ammunition, sinkers for fishing nets), the high concentrations in farinha, a dietary staple, assuredly makes an important contribution. Further action needs to reduce Pb sources in this region.     

High blood lead levels in recreational indoor-shooters

Introduction  Recreational shooting in indoor firing ranges is very popular in Germany. Lead-containing ammunition is still in use. Therefore we checked the blood lead levels (BLL) from 129 subjects doing several types of shooting disciplines. Methods  In total, BLLs of 129 shooters (nine female) from 11 different shooting ranges with a mean age of 49 years were measured. The blood samples were taken after the volunteers had given written informed consent. Determination of lead was carried out by graphite furnace atomic absorption (GF-AAS) under strict internal and external quality control schemes. Results  While individuals shooting only with airguns (n = 20) showed a median BLL of 33 μg/l (range 18–127 μg/l), those who were also users of .22 lr weapons (n = 15) turned out to have a median of 87 μg/l (range 14–172 μg/l). Shooters of .22 lr and large calibre handguns (9 mm or larger) (n = 51) had median 107 μg/l (range 27–375 μg/l) and those only using large calibre handguns (n = 32) had median 100 μg/l (range 28–326 μg/l). The IPSC-group (n = 11) had the highest median with 192 μg/l (range 32–521 μg/l). Conclusion  Our results show clearly that many shooters have high blood levels; some of them are still exceeding threshold limit values (TLVs) for lead exposed workers. Especially for younger women there is a high potential risk if they become pregnant. So there is a clear need for improving the situation whether by use of lead-free ammunition or by better ventilation systems.     

Correlation between maternal and cord blood lead levels

Whole blood lead levels were estimated by atomic absorption analysis in 226 blood samples from 113 mothers of 23 different nationalities. Samples were collected before delivery, and from cord blood from their respective neonates. The concentrations of blood lead were within the expected range of occupationally unexposed populations. Mean maternal blood lead levels were 0.72 0.10 mumol/l (14.9 2.14 mug/dl), range 0.32-1.34 mumol/l (6.6-27.8 mug/dl) and mean cord blood levels were 0.64 0.12 mumol/l (range 0.29-1.46 mumol/l). Sixteen percent of the mothers and nearly 10% cord blood samples were found to have blood lead level greater than 0.97 mumol/l (20 mug/dl). Very high levels, in excess of 1.21 mumol/l (25 mug/dl), were detected in 3.5% of mothers as compared to 2.6% of cord blood samples. Out of 113 infants, 65 (58%) were males with a mean cord blood lead level of 0.63 mumol/l and 48 (42%) were females with a mean level of 0.66 muol/l. The lowest maternal blood lead levels 0.68 mumol/l were observed in ages 20 to 25 years old, and lowest cord blood levels 0.58 mumol/l were seen in maternal age of less than 20 years old. On the other hand, the highest maternal and cord blood lead levels (0.82 and 0.75 mumol/l, respectively) were observed in maternal ages of greater than 35 years old. The results show a direct correlation of blood lead level between mothers and umbilical cord as seen in the linear regression distribution curve.     

Occurrence and determinants of increases in blood lead levels in children shortly after lead hazard control activities

This study is an examination of the effect of lead hazard control strategies on children's blood lead levels immediately after an intervention was conducted as part of the US Department of Housing and Urban Development's Lead-Based Paint Hazard Control Grant Program. Fourteen state and local government grantees participated in the evaluation. The findings indicated an overall average reduction in the blood lead levels of 869 children soon after the implementation of lead hazard controls. However, 9.3% of these children (n = 81) had blood lead increases of 5 microg/dL or more. Data routinely collected as part of the evaluation, as well as additional information supplied by the individual programs, were used to determine potential reasons for these observed increases in blood lead. A logistic regression analysis indicated that three principal factors were associated with the blood lead increases: the number of exterior deteriorations present in the child's home (prior to intervention), the educational level of the female parent or guardian of the child, and the child's age. The statistical analysis did not find evidence that children living in households that either did not relocate or relocated for less than the full work period were significantly more likely to have a blood lead increase equal to or greater than 5 microg/dL than children living in households that fully relocated. Statistical analyses also did not reveal any single interior strategy to be more or less likely than others to be associated with a blood lead increase of 5 microg/dL or more.     

杭州市3528例儿童血铅水平调查

目的:了解杭州市10岁以下儿童血铅水平及高血铅检出率。方法:用原子吸收光谱分析法对3 528例儿童进行血铅含量测定,比较不同性别和年龄组之间的差异。结果:3 528例儿童血铅平均值为24.91μg/L,其中>100μg/L有37例,占1.04%;不同性别儿童间血铅水平几何均值差异有统讲学意义,而高血铅检出率差异无统计学意义;不同年龄儿童的血铅水平几何均值差异无统计学意义,高血铅检出率有统计学差异。结论:杭州市儿童血铅水平较低,但铅中毒情况依然存在,应采取进一步措施减少儿童铅接触。     

十堰市2～6岁集居儿童血铅现状分析

目的 了解十堰市城区2～6岁集居儿童血铅水平现状并分析其影响因素.方法 血铅采用石墨炉原子吸收光谱法测定,并对儿童家长进行问卷调查.结果 2 431名集居儿童的血铅平均值为0.487 μmol/L,其中,1 092名儿童血铅≥0.48 μmol/L.结论 目前十堰市城区集居儿童平均血铅水平与铅中毒率较高,应采取措施控制诱发因素.     

上海市推广使用无铅汽油对儿童血铅水平影响的追踪调查

目的　研究推广使用无铅汽油前后儿童血铅水平的动态变化规律。方法　 1997年 8～9月间 ,在上海市 5个区县 30所托幼机构 196 9名 1～ 6岁儿童进行了血铅水平抽样调查 ,然后于1998年 4～ 6月及 1999年 8～ 9月对相应人群进行血铅水平两次追踪调查。调查采用末梢血纸片法血铅测定方法。结果　上海市儿童血铅水平几何均数在推广无铅汽油前为 83μg/L ,推广无铅汽油后的 1998年为 80 μg/L ,1999年为 76 μg/L ,与前一年相比血铅水平的变化均有显著意义 (t值分别为2 .2 190、4 .4 5 76 ,P值分别小于 0 .0 5和 0 .0 1) ;超过目前国际公认的儿童铅中毒诊断标准 (10 0 μg/L)的比例也由使用无铅汽油前的 37.8%下降到 1999年的 2 4 .8% ,差异有非常显著性 (u =8.82 4 7,P <0 .0 1)。儿童血铅水平几何均数下降幅度徐汇区为 10 μg/L、静安区 11μg/L、杨浦区 6 μg/L、嘉定区4 μg/L、崇明县 2 μg/L。 结论　推广使用无铅汽油可降低儿童的血铅水平。     

Liver transplantation for end-stage alcoholic liver disease: a single-center experience from mainland China

There has been a gradual increase in the number of patients with end-stage alcoholic liver disease (ALD) undergoing liver transplantation (LT) in mainland China. However, few studies have focused on the post-transplant outcomes of this population. The aim of this study was to evaluate the efficacy of LT in patients with ALD, mainly focusing on survival rates, complications, and alcohol recidivism. The results were retrospectively analyzed from 20 patients, who underwent LT for ALD from December 2003 to September 2007 at Liver Transplant Center of Third Affiliated Hospital of Sun Yat-sen University. The 1-, 2-, and 3-year survival rates of the ALD group and non-ALD group were 90.0, 80.0, 80.0% and 90.3, 84.7, 79.8%, respectively. There was no significant difference in 1-, 2-, and 3-year survival rates between these two groups (P = .909). No significant difference was observed in complications such as pulmonary infection (50.0 vs. 31.9%, P = .137), biliary complications (15.0 vs. 27.4%, P = .297), hepatic arterial complications (10.0 vs. 6.9%, P = .641), and rejection (15.0 vs. 8.1%, P = .394) after LT between the ALD group and non-ALD group. There was only one person who resumed mild, intermittent drinking after LT. End-stage ALD is a good indication for LT, with similar results in non-ALD patients. The major cause of death in ALD patients after LT was infectious complications. More attention is needed for the prophylaxis of infectious complications after LT.     

The effect of lead-based paint hazard remediation on blood lead levels of lead poisoned children in New York City

Despite the widespread use of lead paint hazard control for children with lead poisoning, few controlled studies that estimate the effect of such control on children's blood lead levels have been published. This retrospective follow-up study examined the effects of lead hazard remediation and its timing on the blood lead levels of lead-poisoned children. From the New York City child blood lead registry, 221 children were selected who had an initial blood lead level of 20-44 micro g/dL between 1 July 1994 and 31 December 1996; were 6 months to 6 years of age; had a report of a follow-up blood lead test between 10 and 14 months after the initial test; had a lead-based paint hazard identified in the primary dwelling unit prior to the 10- to 14-month follow-up blood lead test; had resided or spent time at only one address with an identified lead-based paint hazard; and were not chelated. The decline in geometric mean blood lead levels from baseline to 10-14 months later was compared for children whose homes were remediated and whose homes were not remediated during the follow-up period. Regardless of remediation, geometric mean blood lead levels declined significantly from 24.3 micro g/dL at the initial diagnosis to 12.3 micro g/dL at the 10- to 14-month follow-up blood lead test (P<0.01). Among the 146 children whose homes were remediated the geometric mean blood lead levels declined 53% compared to 41% among the 75 children whose homes were not remediated by the follow-up blood lead test, a remediation effect of approximately 20% (P<0.01). After adjusting for potential confounders, the remediation effect was 11%, although it was no longer significant. Race was the only factor that appeared to confound the relationship: Black children had higher follow-up blood lead levels even after controlling for other factors, including the natural logarithm of the initial blood lead level. The effect of remediation appeared to be stronger for younger (10 to <36 months old) than for older (36 to 72 months old) children (P=0.06). While children in homes with earlier remediation (within less than 3 months) appeared to have greater declines in blood lead levels at the follow-up test than children in homes with later remediation (after 3 or more months), this trend was not significant when controlling for confounding factors. The findings of this study suggest that early identification of lead-poisoned children and timely investigation and abatement of hazards contribute to reducing blood lead levels. However, the apparent effect is modest and further research is needed to systematically test and improve the effectiveness of lead hazard controls.     

Status of children's blood lead levels in Pakistan: implications for research and policy

OBJECTIVES: Data on blood lead levels, sources of lead and health effects were reviewed among children in Pakistan. METHODS: A systematic review was conducted of published studies found through PubMed, an index of Pakistani medical journals PakMediNet and unpublished reports from governmental and non-governmental agencies in Pakistan. RESULTS: With the exception of a few studies that had adequate sample sizes and population-based samples, most studies were small and used convenience sampling methods to select study subjects. Overall, blood lead levels declined from 38 microg/dl in 1989 to 15 microg/dl in 2002. The major sources of lead that directly or indirectly resulted in lead exposure of children included: leaded petrol; father's occupation in lead-based industry; leaded paint; traditional cosmetics; and remedies. Apart from leaded petrol, there was no information regarding the level of lead in other sources such as paints and the household environment. Very little information was available regarding the adverse health effects of lead among children. CONCLUSION: The phasing out of leaded petrol was a commendable mitigation measure undertaken in July 2001 in Pakistan. A comprehensive assessment is now needed urgently to explore other sources of lead contributing to adverse health effects, and to plan intervention options with the ultimate goal of reducing the burden of disease due to lead exposure.     

0~15岁儿童血铅水平调查

目的:了解天津市0~15岁儿童血铅水平。方法:采用严格质量控制的流行病学研究方法,于2000年7月~2003年7月对天津市8836例0~15岁儿童进行血铅水平测定。结果:8836名儿童血铅均值为83·86μg/L。其中血铅≥100μg/L者2097例,占23·73%,男童高于女童,有显著性差异(P<0·001)。结论:铅中毒已经对儿童健康造成了潜在的危害,所以要采取措施,查找铅污染源,预防铅中毒。     

Blood lead levels in children, China

To evaluate Chinese children's blood lead levels (BLLs) and identify its distribution features, we collected articles on children's BLLs published from 1994 to March 2004 using the Chinese Biomedical Disc and reviewed 32 articles eligible for the following criteria: (1) BLLs measured by Graphite Furnace Atomic Absorption Spectroscopy or Inductively Coupled Plasma-Mass Spectrometry; (2) strict quality control; (3) no lead pollution sources in the areas where the screened subjects live; and (4) sample size bigger than 100. We found that mean BLLs of Chinese children was 92.9 microg/L (37.2-254.2 microg/L), and 33.8% (9.6-80.5%) of the subjects had BLLs higher than 100 microg/L. Nine of the 27 provinces or cities reported had average BLLs 100 microg/L. Boys' BLL was 96.4 microg/L, significantly higher than girls' 89.4 microg/L (P<0.001). BLLs of children 6 years increased with age. The mean BLLs of children living in industrial and urban areas were significantly higher than those of children in suburbs and rural areas. Our results suggested that children's BLLs in China are higher than those of their counterparts in other countries due to its heavy lead pollution. Therefore, this is of great public health importance.     

Smoking habits and levels of lead and cadmium in blood in urban women

Summary In 222 Dutch urban women lead (PbB)- and cadmium (CdB)-levels in blood were measured and related to smoking habits. PbB ranged from 40 ppb to 240 ppb and CdB rangedfrom 0.2 ppb to 4.4 ppb. Smokers had slightly higher PbB-levels and distinctly higher CdB-levels.     

兰州市新生儿血铅含量测定及其相关因素探讨

对１０３ 例新生儿（ 随机抽样） 进行耳垂微量血铅含量的测定。采用石墨炉原子吸收光谱法取外周血０－１ ｍｌ 进行检测，以多元逐步回归分析法进行统计学处理。结果表明：血铅均值为８３－５μｇ／ Ｌ，异常检出率２４－２７ ％ ；早产儿、低体重儿及有窒息史的小儿，其血铅水平大多增高；母亲血铅、文化程度、职业以及某些环境因素与新生儿血铅水平有相关性。本市区新生儿血铅平均值为８３－５μｇ／ Ｌ，远高于其他省、市，≥１００μｇ／ Ｌ者所占比例为２４－２７ ％ 。防治铅中毒应从健康教育、环境干预和临床防治着手     

职业性铅暴露工人血铅和血尿酸的相关性分析

目的 研究职业性铅作业工人血铅和尿酸的变化,探讨血铅浓度变化和血尿酸指标之间的关系.方法 车间空气中铅烟的短时间接触浓度用原子吸收火焰法检测.选择一般情况可比的非铅作业工人作为对照,根据接触铅的浓度是否超过职业限值将263名铅接触工人分为职业限值内组及超职业限值组.分析不同血铅水平和血尿酸指标的变化.结果 (1)车间空气中铅烟的时间加权平均容许浓度(PC-TWA)达0.13 mg/m3,超标率为68.61％; (2)接铅超职业限值组血铅浓度达(3.16±0.03) μmol/L、尿酸为(528±109.48) μmol/L,均显著高于对照组(P＜0.05); (3)血铅浓度的变化和尿酸异常率存在一致的变化趋势.结论 职业性铅接触引起血铅浓度升高和血尿酸升高,且血铅浓度越高,血尿酸升高程度越大.     

Isotopic evidence of the persistent dominance of blood lead concentrations by previous gasoline lead emissions in Yerevan, Armenia

Recent (1999) blood lead (PbB) isotopic compositions (n=17) of males and females in Yerevan, Armenia, indicate that previous emissions of leaded gasoline still dominate the populace's PbB concentrations 2 years after the country's apparent de facto elimination of leaded gasoline in Armenia. The range of PbB isotopic compositions overlaps those of air and near-road surface soils in Yerevan, and the averages of those isotopic compositions in blood (208Pb/207Pb=2.442; 206Pb/207Pb=1.158) and near-road soils (208Pb/207Pb=2.442; 206Pb/207Pb=1.157) are indistinguishable. Using a proxy for historic leaded-gasoline emissions in Armenia, these analyses suggest that leaded gasoline was, is, and will continue to be via the resuspension of lead-bound soils contaminated by previous depositions from leaded-gasoline emissions, a relatively important source of industrial lead in both Yerevan's atmosphere and its populace. However, the level of lead contamination in the Armenian populace, based on the PbB geometric mean of 4.0microg/dL (n=49) measured in this initial survey, appears to be much lower than recently proposed by the Armenian Ministry of Nature Protection.     

Rodent models of alcoholic liver disease: Of mice and men

Alcoholic liver disease (ALD) is a major cause of acute and chronic liver disease worldwide. The progressive nature of ALD is well described; however, the complex interactions under which these pathologies evolve remain to be fully elucidated. Clinically there are no clear biomarkers or universally accepted, effective treatment strategies for ALD. Experimental models of ALD are an important component in identifying underlying mechanisms of alcohol-induced injury to develop better diagnostic markers, predictors of disease progression, and therapeutic targets to manage, halt, or reverse disease progression. Rodents remain the most accessible model for studying ALD pathology. Effective rodent models must mimic the natural history of ALD while allowing examination of complex interactions between multiple hepatic, and non-hepatic, cell types in the setting of altered metabolic or oxidative/nitrosative stress, inflammatory responses, and sensitivity to cytotoxic stress. Additionally, mode and duration of alcohol delivery influence hepatic response and present unique challenges in understanding disease pathology. This review provides an overview of rodent models of ALD, their strengths and weaknesses relative to human disease states, and provides insight of the potential to develop novel rodent models to simulate the course of human ALD.     

Surveillance of elevated blood lead levels in children in Torreon, Coahuila, Mexico, 1998-2010

Introduction

Because children exposed to lead have a very high health risk, surveillance and prevention programs are very important to avoid short- and long-term health effects.

Objectives

To describe the trend for the blood lead levels over a 12-year period in environmentally exposed children and to document the actions implemented to reduce the blood lead levels.

Materials and methods

We performed a retrospective cohort study of children aged 0–15 years who were enrolled in the Coahuila Health Secretary's Childhood Blood Lead Level Surveillance program. This database includes children from the city of Torreon, Coahuila, Mexico, where the biggest smelter in Latin America is located.

Results

A total of 151,322 observations were analyzed in the study. The percentage of samples with elevated blood lead levels decreased from 84.9% to 10.4% during 1998–2010, and the decrease was greater in girls than in boys.

Conclusion

According to the results of our study, the majority of strategies and activities to decrease blood lead levels in an environmentally exposed population should be focused on children aged 0–5 years, on the home environment, on preventing fugitive emissions from smelters and other sources and on the proper disposal and confinement of industrial residues.