Causes of lead toxicity in a Nigerian city.

BACKGROUND: Up to 70% of young Nigerian children have been reported to have blood lead concentrations > or =10 microg/dl. AIMS: To better elucidate risk factors for lead toxicity among Nigerian families with children at risk for lead toxicity. METHODS: Two geographic wards in Jos, Nigeria were selected for study, one previously reported to have a high mean blood lead level (37 (SD 13) microg/dl) and one with a lower mean blood lead level (17 (SD 10) microg/dl) in young children. Data pertaining to potential risk factors for lead exposure were collected from children and adults in 34 households. RESULTS: The mean (SD) blood lead concentration of 275 subjects, aged 3 weeks to 90 years, was 8.7 (5.7) microg/dl (range 1-34 microg/dl); 92 (34%) had concentrations > or =10 microg/dl. In multivariate analysis, an age of 5 years and under, flaking house paint, residence near a gasoline seller, male gender, increasing maternal and paternal education, and use of a lead ore eye cosmetic were independently associated with greater blood lead concentration. Vehicle ownership was associated with reduced lead concentration. Compared with the low-lead ward, residence in the high-lead ward remained significantly associated with greater lead values, indicating that additional factors likely contribute to lead exposure. CONCLUSION: Although the cause of increased lead levels in Jos appears to be multi-factorial, several remediable sources contribute to lead exposure in Nigeria.     

Blood lead levels and risk factors for lead toxicity in children from schools and an urban slum in Delhi

This cross-sectional study was conducted to estimate the mean blood lead levels (BLL) and prevalence of lead toxicity in a representative sample of schoolchildren and children residing in an urban slum. In addition, the association of potential environmental risk factors with elevated BLL was studied. Children aged 4-6 years were selected from schools of the South zone of Delhi (n = 125) and from an urban slum (n = 65). Risk factors were recorded using a pre-tested questionnaire and blood lead and zinc protoporphyrin (ZPP) levels were estimated. The mean BLL was 7.8 microg/dl (SD 3.9) and the proportion of children with blood lead > or = 10 microg/dl was 18.4 per cent. Distance of the residence or school from a main road appeared to be associated with higher blood lead concentrations, but these differences were not statistically significant. In our setting, vehicular pollution may be a major contributing factor in lead contamination of the environment.     

Hepatic toxicity of antituberculous drugs in children.

Three cases of children who developed hepatic toxicity of different degree while on antituberculous treatment with isoniazid and rifampicin are reported. The clinical picture is presented and the pathogenesis of the hepatic damage is discussed. The pathological findings in the liver are those of a drug induced hepatitis. The combined treatment of tuberculosis in children with isoniazid and rifampicin is potentially dangerous and should be reserved for cases in which resistance to other drugs has been demonstrated.     

Prevention of childhood lead poisoning

Although past national public health efforts have reduced lead exposure significantly, lead poisoning remains the most common environmental health problem affecting American children. Currently, lead exposure occurs predominantly through ingestion of lead-contaminated household dust and soil in older housing containing lead-based paint; exposure can be increased with housing deterioration or renovation. Environmental prevention efforts focus on improvement in risk assessment, development of housing-based standards for lead-based paint hazards, and safe and cost-effective lead hazard remediation techniques. Educational efforts address parental awareness of lead exposure pathways, hygiene, and housekeeping measures to prevent ingestion of dust and soil. Blood lead screening is recommended either universally at ages 1 and 2 years or in a targeted manner where local health departments can document a low prevalence of elevated blood lead levels. Nutritional interventions involve provision of regular meals containing adequate amounts of calcium and iron and supplementation for iron deficiency. Lead chelation should complement environmental, nutritional, and educational interventions, when indicated. Collaboration of multiple federal agencies in a new strategy to eliminate childhood lead poisoning should further prevention efforts.     

Maternal perceptions of lead poisoning in children with normal and elevated lead levels.

INTRODUCTION: The purpose of this study was to examine mothers' perceptions of the severity and susceptibility of their children to lead poisoning and to determine if a correlation existed between mothers' knowledge of lead poisoning and their children's blood lead levels. It was thought that mothers of children with lead poisoning (lead levels > or = 10 micrograms/dL) would score lower on a test of their perceptions and knowledge of lead poisoning than would mothers of children with normal lead levels (lead levels < or = 9 micrograms/dL). METHOD: A cross-sectional study comparing scores of a questionnaire completed by mothers whose children had elevated blood lead levels and mothers whose children had normal blood lead levels was conducted. RESULTS: No difference was found in the median test score between the 2 groups. For the correct responses on a question-by-question comparison, significant difference existed between groups; however, the percentage of correct responses was not always greater for the mothers of children with normal blood lead levels. DISCUSSION: Mothers' perceptions and knowledge of lead poisoning were not associated with their children's blood lead levels.     

Causes of lead toxicity in a Nigerian city

Background: Up to 70% of young Nigerian children have been reported to have blood lead concentrations ⩾10 µg/dl. Aims: To better elucidate risk factors for lead toxicity among Nigerian families with children at risk for lead toxicity. Methods: Two geographic wards in Jos, Nigeria were selected for study, one previously reported to have a high mean blood lead level (37 (SD 13) µg/dl) and one with a lower mean blood lead level (17 (SD 10) µg/dl) in young children. Data pertaining to potential risk factors for lead exposure were collected from children and adults in 34 households. Results: The mean (SD) blood lead concentration of 275 subjects, aged 3 weeks to 90 years, was 8.7 (5.7) µg/dl (range 1–34 µg/dl); 92 (34%) had concentrations ⩾10 µg/dl. In multivariate analysis, an age of 5 years and under, flaking house paint, residence near a gasoline seller, male gender, increasing maternal and paternal education, and use of a lead ore eye cosmetic were independently associated with greater blood lead concentration. Vehicle ownership was associated with reduced lead concentration. Compared with the low-lead ward, residence in the high-lead ward remained significantly associated with greater lead values, indicating that additional factors likely contribute to lead exposure. Conclusion: Although the cause of increased lead levels in Jos appears to be multi-factorial, several remediable sources contribute to lead exposure in Nigeria.     

School functioning of US children with asthma.

Data from the 1988 US National Health Interview Survey on Child Health, a nationally representative cross-sectional survey, were used to determine national estimates of school outcomes (grade failure, learning disabilities, and suspension/expulsion) and mean number of absences for children with asthma (CWA) compared to well children without current health conditions. Families indicated that 536 (4.9%) of the 10,362 survey children in grades 1 through 12 had had asthma in the previous 12 months. Families reported 18% of CWA vs 15% of well children had grade failure, 9% of CWA vs 5% of well children had learning disabilities, and 5% of CWA vs 6% of well children had been expelled or suspended. Children with asthma averaged 7.6 school days absent compared with 2.5 days for the well group. Multiple logistic regression was used to compare the odds of grade failure, learning disabilities, and suspension/expulsion among CWA and well children, overall and stratified by income. Similar methods were used to assess the role of health status among asthmatic children. After adjustment for demographic factors, CWA had similar risks of grade failure and suspension/expulsion, but 1.7 times the risk of learning disability compared with well children. Also, among families with incomes below $20,000, CWA had twice the odds of grade failure compared with well children. For asthmatic children, reported health status was an important predictor of learning disability. Ten percent of CWA were reported to be in fair-poor health. After adjustment for demographic factors, those in fair-poor health were twice as likely to have a reported learning disability compared with those in good-excellent health.(ABSTRACT TRUNCATED AT 250 WORDS)     

Theophylline toxicity in children

Sixty-five cases of theophylline toxicity in children were reviewed. Vomiting, tachycardia, and central nervous system excitation were the most common manifestations. Seizure activity occurred in four acutely intoxicated children whose serum theophylline concentrations were less than 70 micrograms/ml. Two patients experienced visual hallucinations in association with high serum theophylline levels. Dosing errors accounted for the majority of cases. Most instances of toxicity could have been avoided by more careful consideration of the patient's medication history and more diligent monitoring of serum theophylline concentrations.     

Acetaminophen toxicity in children

Acetaminophen is widely used in children, because its safety and efficacy are well established. Although the risk of developing toxic reactions to acetaminophen appears to be lower in children than in adults, such reactions occur in pediatric patients from intentional overdoses. Less frequently, acetaminophen toxicity is attributable to unintended inappropriate dosing or the failure to recognize children at increased risk in whom standard acetaminophen doses have been administered. Because the symptoms of acetaminophen intoxication are nonspecific, the diagnosis and treatment of acetaminophen intoxication are more likely to be delayed in unintentional cases of toxicity. This statement describes situations and conditions that may contribute to acetaminophen toxicity not associated with suicidal intentions.