Gender Differences in Blood Lead and Hemoglobin Levels in Andean Adults with Chronic Lead Exposure

Abstract

A field study of the prevalence of lead (Pb) intoxication was conducted in 158 adults (67 men and 91 women) living at 2,500-2,800 meters in Ecuadorian Andean villages with high Pb contamination from local small-scale Pb-glazing cottage industries. Venous blood samples showed mean blood lead (PbB) levels of 34.5 μg/dL (SD 22.2) for men and 27.0 μg/dL (SD 18.4) for women; this difference was significant (t-test, p = 0.022; Mann-Whitney U, p = 0.044). An ANOVA showed no significant main effect for gender (F = 0.118, p = 0.782) or age (F = 2.479, p = 0.117), and no significant gender-by-age interaction (F = 0.273, p = 0.602). In the Pb-glazing study group, 39% of the men had PbB levels ≥40 μg/dL, while 41 % of the women had PbB levels ≥ 30 μg/elL (the WHO health-based biological limits). A reference group of 39 adults (24 men and 15 women) had a mean PbB level of 5.9 μg/dL (SD 2.8; range: 1.8–16.8), significantly different from that of the 158 subjects in the study group (t-test, p < 0.0001). The difference in mean PbB levels of men (6.8 μg/dL) and women (4.7 μg/dL) in the reference group was significant (t-test, p = 0.026; Mann-Whitney U, p = 0.019). The mean altitude-corrected hemoglobin levels in the study group were lower than normal, 11.3 g/dL for men and 10.9 g/dL for women.     

Re-emergence of Lead Poisoning from Contaminated Flour in a West Bank Palestinian Village

Abstract

Although contaminated flour was first described as an important source of endemic lead poisoning in the Middle East almost 20 years ago, the use of lead in community flour mills has not been eliminated and continues to represent a significant environmental risk. The authors describe an outbreak of lead poisoning in a West Bank Palestinian family and draw attention to this unusual but important source of lead exposure. All 13 members of the family (two children and 11 adults), were found to have lead poisoning following hospitalization for “gastroenteritis,” headache, joint pain, weight loss, and vision difficulties. Seven females had low hemoglobin levels. Blood lead concentrations ranged from 42 to 84 μg/dL. Household flour samples obtained from a stone mill, previously closed because of lead contamination, contained 2,000 ppm lead. Flour from traditional stone mills reinforced with lead joints remains a potential source for lead poisoning.     

Editorial: The Bhopal Gas Disaster: It's Not Too Late for Sound Epidemiology

In Russia, hair, rather than blood, is usually used as a substrate for screening children for lead poisoning. We attempted to gauge the accuracy of this method by comparing these two methods. The evaluation was done in Saratov, Russia. We collected hair and blood samples from 189 children who attended 11 kindergartens. Their mean blood lead concentration was 9.8 μmlg/dl (range = 3.1–35.7 μmlg/dl), and their mean hair lead concentration was 7.2 μmlg/g (range = 1.0–7.2 μmlg/g [i.e., 1.0 being the lowest detectable limit]). Hair lead concentration as a screening method had 57% sensitivity and resulted in 18% of the children being classified as false-negatives. We conclude, therefore, that measuring hair lead concentration is not an adequate method with which to screen children for lead poisoning.     

Low-Level Lead Exposure and Blood Lead Levels in Children: A Cross-Sectional Survey

The authors studied 53 girls (44.5%) and 66 (55.5%) boys in Karachi, Pakistan, to determine their blood lead levels. The association between blood lead levels/water lead levels and the possible risk factors and symptoms associated with lead toxicity was explored. The mean lead level for the entire group was 7.9 μg/dl (standard deviation = 4.5 μg/dl). Thirty (25.2%) of the children had lead levels that exceeded 10 μg/dl; 12 (10.0%) of these had lead levels that exceeded 15 μg/dl. Thirteen (20.9%) of the children under the age of 6 yr (n = 62) had lead levels greater than 10 μg/dl, and 6 (9.6%) had levels in excess of 15 μg/dl. The authors found no association (p > .05) between high lead levels in water and blood lead levels in children. Mean blood lead levels were highest in the group of children exposed to various risk factors for lead absorption (e.g., exposure to paint, remodeling, and renovation; use of lead utensils; pica). There was a significant association between a history of exposure to paint/renovation activities and a history of pica. High blood lead levels in the children in Karachi stress the urgency for actions that control lead pollution. Screening programs should be instituted by the state. Individuals must become aware of lead's toxicity, and they must avoid substances that contain lead.     

广州市某医疗机构体检儿童血铅水平调查

[目的]调查广州市0～14岁儿童血铅水平,为防治儿童铅中毒提供科学依据。[方法]收集2010年1月至2011年6月在广东省中医院就诊的0～14岁儿童1517名血铅资料,按照年龄划分为3组：〈3岁、3～7岁及〉7岁儿童组。采用原子吸收光谱法测定血铅含量。[结果]0～14岁儿童血铅均值为57.05μg/L;血铅≥100μg/L者39例,占调查人数的2.57%。不同年龄组间儿童血铅水平差异有统计学意义（P〈0.05）;3～14岁年龄段男童血铅水平明显高于女童（P〈0.05）。[结论]本次调查儿童血铅水平及铅中毒率较低。但铅对儿童健康的潜在风险不能忽视,应加强儿童铅中毒防治健康教育。     

Impact of lead transport on children's blood and environmental lead levels

Introduction: A lead monitoring project was established in 1996 to monitor the environmental and health effects of lead being transported through a remote town in tarpaulin‐covered trucks. Methods: Dust samples from sites on the transport route were collected at 3–6 monthly intervals between 1996 and 1999. Annual blood lead testing clinics, offering voluntary testing to children, were conducted from 1997 to 1999. Results: Of the 55 dust samples analysed, only nine contained particles of lead concentrate and these were present at very low levels. During the project 167 children were tested. The geometic mean of blood lead levels in 1997, 1998 and 1999 were 4.5 μg/dL, 5.0 μg/dL and 5.1 μg/dL, respectively (all within the normal range). Residence on the transport route was not associated with higher lead levels (P > 0.05). Conclusions: Lead transport was not associated with any detectable environmental contamination or increase in children's blood lead levels.     

Paternal Occupational Lead Exposure and Pregnancy Outcome

Abstract

Self-reported reproductive histories of male employees of a lead-zinc smelter were related to pre-conception measures of lead exposure to examine associations between paternal occupational lead exposure and adverse pregnancy outcome The participants reported 2,021 pregnancies which resulted in 1,684 normal live births, 12 stillbirths, 30, birth defects, 203 spontaneous abortions, and 92 “other” outcomes. Birth defects and stillbirths were combined for the analysis. The risk of a stillbirth or birth defect was elevated for pre-conception employment in a high-lead-exposure compared with a low-lead exposure job (odds ratio = 2.7, 95,% confidence interval = 0.7, 9.6). A similar risk was found for pre-conception blood lead levels of 25–39 μg/dL and ≥40μg/dL when compared With blood lead)level of <25μg/dL(OR = 2.9,95% CI = 0.6, 13.3 and OR = 2.5,95% CI = 0.5,11.6, respecdvely). No association was found between pre-conception lead exposure and spontaneous abortion. A relatively low response rate to the questiollnaire and potentially erroneous reporting of reproductive outcome by male workers are limitations of the study.     

Lead poisoning among young children in Russia: concurrent evaluation of childhood lead exposure in Ekaterinburg,Krasnouralsk, and Volgograd

The Gore-Chernomyrdin Commission encouraged a binational collaboration to evaluate pediatric lead poisoning in Russia. The study evaluated children in three Russian cities: Krasnouralsk, a small city with minimal traffic centered around a copper smelter; and Ekaterinburg and Volgograd, both of which are large cities with multiple factories and heavy vehicular traffic. This project was the first international use of portable blood lead analysis instruments. In each city, at least 90% of children attending selected neighborhood kindergartens participated. We selected kindergartens on the basis of their proximity to industrial areas and major traffic corridors. We obtained capillary blood samples and analyzed for lead content and hemoglobin (Hgb) levels in the field, and collected environmental samples (i.e., indoor dust, tap water, play area soil, and interior and exterior paint) and analyzed for each participating school and in the homes of about 10% of the children who had elevated blood lead levels (BLLs; greater than or equal to 10 microg/dL). We calculated all age-, sex-, and city-specific geometric means using generalized estimating equations to account for covariance within kindergartens, and used multivariate logistic regression models to identify variables predictive of elevated BLLs. Overall, 23% of study children had elevated BLLs and 2% were anemic, defined as Hgb < 11 g/dL. Krasnouralsk had the highest geometric mean BLL (10.7 microg/dL), the highest percentage of children (60%) with elevated BLLs, and the highest percentage of anemic children (4%). All soil samples in Krasnouralsk had detectable lead levels. Volgograd was the only city that had paint samples with elevated lead levels. We found apparent city-specific differences in the percentages of children with elevated BLLs. Lead-contaminated soil and dust, which can result from lead-based automotive fuel and from lead-related industrial emissions, appear to be the most important routes of lead exposure of those evaluated in this study. Elevated lead levels found in paint samples from Volgograd may indicate old undercoats of lead-based paint that could represent a regionally rather than nationally important source of exposure.     

Lead poisoning among construction workers renovating a previously deleaded bridge

This study evaluated lead poisoning among construction workers renovating a previously deleaded bridge. Twelve of 44 tested workers had blood leads exceeding 20 μg/dL. One was 50 μg/dL and two exceeded 40 μg/dL. Following medical intervention, blood leads dropped significantly, while ZPPs did not. Renovation released lead that had been inaccessible during deleading. Workers did not use engineering controls or respirators, change clothes, wash hands, or shower. Intervention included a lead-compliance program with provisions for exposure evaluation, training, hygiene, and engineering controls. Construction contractors and workers need to be aware that deleading of bridges and other structures may not remove lead from inaccessible locations. In particular, owners of these structures should specify provisions for anticipating and controlling this hazard in contracts. Am. J. Ind. Med. 31:319–323, 1997. © 1997 Wiley-Liss, Inc.     

2007-2008年青岛市李沧区部分0～5岁儿童血铅水平调查

[目的]了解李沧区0～5岁儿童血铅水平。[方法]对2007年5月至2008年6月在青岛市李沧区妇幼保健所查体的1178名0～5岁儿童血铅检测结果进行分析。[结果]检测1178名儿童,血铅为7～211μg／L,平均47．08μg／L,≥100μg／L者78例,铅中毒检出率为6．62％。血铅均值（μg／L）,男童为48．48,女童为45．42（P〈0．01）;入园儿童为50．53,散居儿童为43．09（P〈0．01）;郊区、城区、工业区儿童分别为41.54、43．36、54．64（P〈0．01）;不同年龄儿童的差异有统计学意义（P〈0．05）。铅中毒检出率,男童为8．16％,女童为4．81％（P〈0．05）;入园组为8．72％,散居组为3．31％（P〈0．05）;郊区、城区、工业区儿童分别为3．49％、5．97％、10．26％（P〈0．01）;不同年龄的差异有统计学意义（P〈0．05）。[结论]李沧区0～5岁儿童血铅水平和铅中毒率处于青岛市一般水平,随着年龄的增长而增高。     

Lead assay in blood of occupationally and non‐occupationally exposed donors

Ninety‐seven blood samples of occupationally and non‐occupationally exposed Nigerians were analysed by trichloro acetic acid precipitation (TCA) method. The values of lead in the samples range from ≤ 10.5–55.0 μg/100 ml. The mean blood levels for the occupationally exposed group vary between 28.5 ± 17.3 (SD), μg/100 ml, and 35.5 ± 15 (SD), μg/100 ml. The mean values for the non‐occupationally exposed group range from ≤ 10.5–16.3 ± 8.8 (SD) μg/100 ml. Blood lead levels are low in non‐occupationally exposed group and values are generally lower than the quoted threshold values. The lead levels are higher in blood of exposed group and most of the values exceed the quoted threshold values although lower than critical lead value that could cause poisoning. The mean blood levels in painters, drivers and motor mechanics are 30.4 ug/100 ml, 37–39 μg/100 ml and 36.7 μ.g/100 ml, respectively. The lead levels obtained in this study are consistent with low industrialization in Nigeria and with the small car population in relation with vast size of the country.     

Community blood lead survey with emphasis on preschool children following lead dust pollution in Esperance, Western Australia

Objective: To assess the impact of airborne lead dust on blood lead levels in residents of Esperance, a regional Western Australian town, with particular reference to preschool children. Methods: Following identification of significant airborne lead contamination, residents were notified that a blood lead clinic was available to all, with testing of preschool children encouraged. About 40% (333 children) of the preschool group and about 20% of the remaining population were tested. The main measures were blood lead levels, prevalence of elevated results and comparisons to other Western Australian surveys. Results: In preschoolers, 2.1% (seven children) had blood lead levels exceeding the current 10 μg/dL level of concern. This was not significantly different to two previous community‐based surveys elsewhere in Western Australia. However, at a lower cut‐off of 5 μg/dL, the prevalence of elevated lead levels was 24.6%, significantly higher than children tested in a previous Western Australian survey. The prevalence of blood lead levels of 10 μg/dL or greater in adults was 1.3% (26 adults), not significantly different from a previous Western Australian survey. Conclusions: The prevalence of preschool children with blood lead levels exceeding the current level of concern was not significantly increased. However, the increased prevalence of children with lead levels at or above 5 μg/dL demonstrates exposure to lead dust pollution. Implications: This episode of lead dust contamination highlights the need for strict adherence to environmental controls and effective monitoring processes to ensure the prevention of future events.     

Relationship Between Blood Lead Levels and Hematological Indices in Pregnant Women

Several studies have revealed a negative association between blood lead levels and hematological impairment. In this cross-sectional study, we examined the relationship between blood lead levels and hematological indices in 292 pregnant women from Durango, Mexico. Apparently healthy pregnant women, aged 14–41 years and at 3–41 weeks of gestation, were recruited between June 2007 and May 2008. Blood lead and hematological indices were measured. The mean blood lead was 2.79 ± 2.16 μg/dL, and lead levels ≥5 μg/dL were detected in 25 women (8.6%). Hemoglobin, hematocrit, and red blood cells count were significantly higher in pregnant women with a blood lead concentration of ≥5 μg/dL than the group with lower blood lead levels (p < .05). Mean corpuscular volume and mean corpuscular hemoglobin were not significantly related to lead levels. Hemoglobin and hematocrit showed a non-significant positive correlation with blood lead, but the correlation between red blood cell count and blood lead levels was statistically significant (r = 0.185, p = .002). The findings suggest that a positive association between blood lead and some hematological indices may occur at relatively low blood lead concentration (mean < 5 μg/dL).     

洛阳市儿童发铅水平的测定与分析

目的分析洛阳市区7岁以下儿童头发中的铅含量。方法发样0.4克经硝酸-高氯酸(10∶1)硝化后双硫腙分光光度法测定铅含量。结果76份发样的铅含量均值为13.2μg/g,其中3岁以下儿童的发铅含量较低。结论发铅水平的测定对儿童铅接触情况的判断有一定的指导意义。     

Lead poisoning from Ayurvedic treatment: a further case

Purpose:We report a case of a 30 years old Indian sailor with microcytic anemia (Hb 9.9), persistent abdominal pain, emesis, dark stool, hyperchromic urine, latent jaundice and asthenia. Lead intoxication was confirmed (blood lead value of 102 µg/dL). The patient assumed Ayurvedic medicines in the previous months. Ayurveda is an ancient form of Indian traditional popular medicine aiming to re-establish health and body function through herbal preparations, heavy metals are often added. Our purpose was to treat the patient and to establish the source of poisoning.Methods:After testing blood and urine lead concentration of other 3 crew members and analyzing over than 150 products used on the ship professional exposure was excluded. We analyzed the two Ayurvedic drugs assumed by the patient with an Inductively Coupled Plasma Mass Spectrometry. The patient underwent three chelation cycles with Calcium Disodium Ethylenediaminetetraacetic acid (EDTA) while monitoring blood and urinary lead levels.Results:The final blood lead level at discharge, after three chelation cycles, was 36.27 µg/dL. One of the two drugs contained extremely high concentrations of lead and mercury. The three different mixtures of this preparation showed lead concentrations of 12,638.54 mg/kg (Sample 2A), 23,043.02 mg/kg (Sample 2B), 21,352.97 mg/kg (Sample 2C); these levels are much higher than the highest values reported in literature for the indian soil (32 mg/kg).Conclusions:This case and similar cases raise the safety alert on complementary and alternative medicines; Ayurvedic medicine users should be carefully informed about potential risks and signs of poisoning.     

平顶山市3~6岁儿童铅中毒调查及影响因素分析

目的:了解该市学前儿童血铅水平和铅中毒流行情况及影响因素。方法:对铅防门诊和部分幼儿园的市区3~6岁学前儿童抽样检测血铅,并进行问卷调查与统计分析。结果:共检测1018例儿童,其中门诊病例220例,幼儿园798例。血铅均值81.3±30.1μg/L,铅中毒率31.0%,门诊铅中毒(47.3%)流行率高于幼儿园(26.6%),P<0.05。影响因素中,儿童挑食、家中使用燃煤灶具和学校及家庭周围高铅环境污染对铅中毒流行率有明显影响,P<0.05。结论:该市学前儿童铅中毒的流行率处中等水平,低于河南省的郑州、新乡、洛阳等地。环境污染是引起儿童铅中毒的主要因素,偏食对铅中毒也有影响。     

南京市学龄前儿童血铅血镉检测

目的了解南京市区儿童血铅血镉水平及其分布特征。方法 BH2100型钨舟原子吸收光谱仪对南京市6个主城区幼儿园1258例儿童进行血铅、血镉测定,按年龄、性别及地区情况进行比较分析。结果南京市儿童血铅平均水平为(70.93±15.79)μg/L,其中100μg/L者占114例(9.1%)血镉水平为0.61±0.47μg/L;地区间(交通繁忙地-下关区)和年龄间差异有统计学意义(P0.05)。结论南京市儿童的血铅水平应引起重视,学龄前儿童血镉水平正常,应继续加强铅、镉中毒危害的宣传教育,预防儿童铅、镉中毒的发生。     

Declining blood lead levels in Victorian children

Abstract: To investigate the distribution of blood lead levels in a sample of Victorian children, and to compare current levels with those from a similar survey in 1979, blood was tested for lead in 252 children (123 under five years) attending Royal Children's Hospital as outpatients and having venepuncture blood samples for medical reasons. Blood lead levels were determined by graphite furnace atomic absorption spectrophotometer. The mean blood lead level was 0.26 μmol/L (5.4 μg/dL). In the under-five age group, the mean was 0.28 μmol/L (5.7 μg/dL). Only 1.6 per cent of this group exceeded the National Health and Medical Research Council action level of 0.72 μmol/L (15 μg/dL). Levels in this age group have declined significantly since 1979, when the mean was 0.54 μmol/L (11.1 μg/dL) and 12.9 per cent exceeded 0.72 μmol/L (15 μg/dL). Average blood lead levels have halved since 1979, with likely contributing factors being reduced exposure from lead in diet, reduced access to lead in paint and reduced lead in ambient air. Children with elevated levels had identifiable risk factors such as pica or exposure to lead-based paint, suggesting the need for ongoing public health action to prevent exposure in these groups.     

Lead Levels in Blood Bank Blood

Although blood bank blood is usually screened for dangerous pathogens, the presence of toxic metals in blood has received little attention. Population blood lead levels have been declining in the United States, but occasional high outliers in blood lead concentration can be found–even when mean levels of blood lead are low. We sampled 999 consecutive blood bank bags from the King/Drew Medical Center, used between December 1999 and February 2000. The geometric mean blood lead level was 1.0 μg/dl (0.048 μmol/l), but 0.5% of the samples had lead levels that exceeded 10 μg/d1, and 2 samples had lead levels that exceeded 30 μg/dl. The 2 samples with the highest lead levels could have presented an additional risk to infants if they were used for blood replacement. Therefore, even in countries with generally low population blood lead levels, blood bank blood should be screened for lead concentration prior to use with infants.     

Blood Lead in Children and Its Determinants in Nagpur,India

Abstract

In a community-based cross-sectional study of 297 children aged 6 months to 6 years in an Indian city, the authors assessed the prevalence of elevated (≥ 10 μg/dL) blood lead (PbB) levels, their risk factors, and the lead contents in potential environmental sources. Mean PbB was 18.4 μg/dL ± 16.5. The prevalence of elevated PbB was. 67%. Anticipated risk factors for elevated PbB were living in houses painted with lead., based paint, odds ratio (OR) 6.42 (1.75, 23.6; p = 0.005), recent exposures to lead-based paint, OR 2.61 (1.07, 6.66; p = 0.03), and the use of the eye cosmetic “surma,” OR 2.63 (1.24, 5.56; p = 0.01). Unanticipated results were effect of upper caste as a risk factor, OR (adjusted) 1.85 (95% CI = 0.96, 3.57; p = 0.06), and the lack of effect of traffic, parental occupational exposure, or nutritional status. Analysis of various environmental sources such as paint, pencils, crayons, and clay, revealed high lead levels. These results demonstrate the existence of a major environmental health problem in Indian children, with risk factors that differ from those in other countries.