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Lu Y, Chandan AK, Mehta S, Kushwaha M, Kumar A, Ali M, Srivastava A, Ghosh AK, Bose-O'Reilly S, Nambiar L, Kass D. Assessment of prevalence of elevated blood lead levels and risk factors among children and pregnant women in Bihar, India. ENVIRONMENTAL RESEARCH 2024:119528. [PMID: 38960355 DOI: 10.1016/j.envres.2024.119528] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/27/2024] [Revised: 06/09/2024] [Accepted: 06/30/2024] [Indexed: 07/05/2024]
Abstract
BACKGROUND While modeled estimates and studies in contaminated areas indicate high lead exposure among children in Bihar, India, local data on lead exposure in the child population is limited. OBJECTIVES To characterize lead exposure, and assess potential sources of lead exposure among a state-representative sample of children and their pregnant mothers residing in Bihar. METHODS Blood samples were collected from 697 children under five and 55 pregnant women from eight districts in Bihar. Blood lead levels were determined using capillary blood and a portable lead analyzer. Household demographics, home environment, behavior, and nutrition information were collected through computer-assisted personal interviews with primary caregivers. Logistic regression was used to assess associations between potential risk factors and elevated blood lead levels. RESULTS More than 90% of children and 80% of pregnant women reported blood lead levels ≥ 5 μg/dL. Living near a lead-related industry and pica behavior of eating soil were significantly associated with increased odds of having elevated blood lead levels. Additional risk factors for having a blood level ≥5 μg/dL included the use of skin lightening cream (aOR = 5.11, 95%CI: 1.62, 16.16) and the use of eyeliners (aOR = 2.81, 95%CI: 1.14, 6.93). Having blood lead levels ≥ 10 μg/dL was also significantly associated with the household member who had an occupation or hobby involving the use of lead (aOR = 1.75, 95%CI: 1.13, 2.72). DISCUSSION Elevated blood lead levels were prevalent among children and pregnant women in Bihar, indicating the urgent need for a comprehensive lead poisoning prevention strategy.
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Affiliation(s)
- Yi Lu
- Vital Strategies, New York, New York, USA
| | | | - Sumi Mehta
- Vital Strategies, New York, New York, USA
| | | | - Arun Kumar
- Mahavir Cancer Sansthan & Research Centre, Patna, Bihar, India
| | - Mohammad Ali
- Mahavir Cancer Sansthan & Research Centre, Patna, Bihar, India
| | | | | | - Stephan Bose-O'Reilly
- Pure Earth, New York, New York, USA; Institute and Clinic for Occupational, Social and Environmental Medicine, University Hospital, LMU Munich, Munich, Germany
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2
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Wen Z, Zheng D, Wu J, Tian H, Yang Q, Chen L, Ji Z, Chen Y, Li Z. Integral trends in research of lead exposure and child health from 2012 to 2022: a bibliometric analysis. ENVIRONMENTAL SCIENCE AND POLLUTION RESEARCH INTERNATIONAL 2024; 31:9251-9271. [PMID: 38191730 DOI: 10.1007/s11356-023-31744-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/14/2023] [Accepted: 12/22/2023] [Indexed: 01/10/2024]
Abstract
Lead poisoning in children is a non-negligible and ongoing threat to children's health and optimal development worldwide. There is no sufficient scientometric analysis available on this subject, though. Aiming to uncover the research development, hotspots, and possible future orientation, we performed a scientometric analysis of related publications from 2012 to 2022. Initial information was accessed using the "Analysis Results" and "Create Citation Report" sections of the Web of Science core collection database, which were utilized to find original publications in this field of research. Biblioshiny and VOSviewer software were applied to further analyze and visualize the data. The research addressed a range of topics, including yearly publications, highly cited articles, co-cited references, journals, authors, nations, organizations, and keywords. A total of 883 articles were retrieved. From 2018 to 2021, the annual publication output was abundant and peaked in 2019. Among 111 countries, the USA obtained the highest number of documents issued, total citations, and total link strength. Meanwhile, most of the top 15 institutions, including the top four, are located in the USA. Further, we spotted greater scopes with development potential, including enhancing records to lessen exposure to harmful risks, improving methods for observing lead sources, and elucidating the gradient link between lead poisoning symptoms and concentrations. We anticipate that our research will assist researchers in summarizing previous research and providing perspectives for workable prospective study topics.
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Affiliation(s)
- Zhuolin Wen
- Department of Thyroid, Breast and Hernia Surgery, General Surgery, The Second Affiliated Hospital of Shantou University Medical College, No. 69 North Dongxia Road, Shantou, Guangdong, 515041, People's Republic of China
| | - Daitian Zheng
- Department of Thyroid, Breast and Hernia Surgery, General Surgery, The Second Affiliated Hospital of Shantou University Medical College, No. 69 North Dongxia Road, Shantou, Guangdong, 515041, People's Republic of China
| | - Jinyao Wu
- Department of Thyroid, Breast and Hernia Surgery, General Surgery, The Second Affiliated Hospital of Shantou University Medical College, No. 69 North Dongxia Road, Shantou, Guangdong, 515041, People's Republic of China
| | - Huiting Tian
- Department of Thyroid, Breast and Hernia Surgery, General Surgery, The Second Affiliated Hospital of Shantou University Medical College, No. 69 North Dongxia Road, Shantou, Guangdong, 515041, People's Republic of China
| | - Qiuping Yang
- Department of Thyroid, Breast and Hernia Surgery, General Surgery, The Second Affiliated Hospital of Shantou University Medical College, No. 69 North Dongxia Road, Shantou, Guangdong, 515041, People's Republic of China
| | - Lingzhi Chen
- Department of Thyroid, Breast and Hernia Surgery, General Surgery, The Second Affiliated Hospital of Shantou University Medical College, No. 69 North Dongxia Road, Shantou, Guangdong, 515041, People's Republic of China
| | - Zeqi Ji
- Department of Thyroid, Breast and Hernia Surgery, General Surgery, The Second Affiliated Hospital of Shantou University Medical College, No. 69 North Dongxia Road, Shantou, Guangdong, 515041, People's Republic of China
| | - Yexi Chen
- Department of Thyroid, Breast and Hernia Surgery, General Surgery, The Second Affiliated Hospital of Shantou University Medical College, No. 69 North Dongxia Road, Shantou, Guangdong, 515041, People's Republic of China
| | - Zhiyang Li
- Department of Thyroid, Breast and Hernia Surgery, General Surgery, The Second Affiliated Hospital of Shantou University Medical College, No. 69 North Dongxia Road, Shantou, Guangdong, 515041, People's Republic of China.
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3
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Tan SW, Cohen SG, Wilson MA, Johnson TP, Ivers JA. Lead Poisoning From Home-Prepared Indian Spices in 3 Families. Clin Pediatr (Phila) 2023; 62:824-829. [PMID: 36660959 DOI: 10.1177/00099228221150158] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/21/2023]
Abstract
Spice consumption, along with other environmental factors, can contribute to pediatric lead poisoning. Although public health efforts have increased awareness of contamination of spices, false assumptions regarding the safety of home-prepared spices have emerged. Here, we present the clinical features, family beliefs, and environmental toxicology of 3 spice-associated pediatric lead poisoning cases.
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Affiliation(s)
- Shirlee W Tan
- Department of Public Health - Seattle & King County, Seattle, WA, USA
| | - Sharon G Cohen
- Department of Public Health - Seattle & King County, Seattle, WA, USA
| | - Matt A Wilson
- Department of Public Health - Seattle & King County, Seattle, WA, USA
| | - Tory P Johnson
- Section of Infections of the Nervous System, National Institute of Neurological Disorders and Stroke, National Institutes of Health, Bethesda, MD, USA
| | - Jessica A Ivers
- Department of Pediatrics, Polyclinic, Seattle, WA, USA
- University of Washington, Seattle, WA, USA
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4
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Imagawa M, Rushing M, Carter A, Schott R, Berman JD. Using blood lead concentrations of wildlife sentinels to identify environmental risk factors of lead exposure for public health and wildlife rehabilitation efforts. ECOTOXICOLOGY (LONDON, ENGLAND) 2023; 32:357-369. [PMID: 36964298 DOI: 10.1007/s10646-023-02642-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 03/03/2023] [Indexed: 06/18/2023]
Abstract
Lead poisoning remains a persistent health issue for both humans and wildlife, despite strides to reduce lead contamination in the environment. Using Geographic Information Systems (GIS), this study explores the associations between blood lead levels (BLLs) in wildlife sentinels and possible built environment lead exposure risk factors in the Minneapolis-Saint Paul, Minnesota urban area. Results show a high-level of heterogeneity in animal BLLs (n = 472) across our urban environment and suggest that each kilometer increase in road density is associated with a 17.07% (95% CI: 1.48%, 35.05%) increase in BLL in our study species of Virginia opossums and Eastern gray squirrels, and a 14.28% (95% CI: 1.16%, 29.09%) increase in BLL of rock pigeons. For squirrels and opossums, we see an additional 5.72% (95% CI: 0.59%, 10.85%) increased risk of BLL for every 1000 people per square-mile. The relationship between animal sentinels and environmental hazards can give us an insight into the potential lead exposure risks for humans. The use of wildlife sentinel data to explore environmental risk factors supports a One Health approach to better address public health questions and aid in wildlife rehabilitation related to residual lead poisoning from ambient environmental exposures.
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Affiliation(s)
- Mito Imagawa
- University of Minnesota School of Public Health, Division of Environmental Health Sciences, Minneapolis, MN, USA
| | - Marcus Rushing
- University of Minnesota School of Public Health, Occupational and Environmental Medicine, Minneapolis, MN, USA
| | | | - Renee Schott
- Wildlife Rehabilitation Center, Roseville, MN, USA
| | - Jesse D Berman
- University of Minnesota School of Public Health, Division of Environmental Health Sciences, Minneapolis, MN, USA.
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Shi X, Wang Y, Deng X, Wu W, Hua W, Zhou Z, Xin K, Tang L, Ning Z. Excellent capture of Pb(II) and Cu(II) by hierarchical nanoadsorbent Fe 3O 4@SiO 2@PAA-SO 3H: A combined experimental and theoretical study. CHEMOSPHERE 2022; 309:136791. [PMID: 36220425 DOI: 10.1016/j.chemosphere.2022.136791] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/24/2022] [Revised: 09/13/2022] [Accepted: 10/04/2022] [Indexed: 06/16/2023]
Abstract
A novel magnetic nanoadsorbent (Fe3O4@SiO2@PAA-SO3H) was synthesized by grafting acrylic acid and sulfonic group to Fe3O4@SiO2 using a facile cross-link technology. The adsorbent presented water-stability and biocompatibility in wastewater, which exhibited high-selectivity capture for Pb(II) and Cu(II) of 182.5 mg/g and 250.7 mg/g, respectively, at pH 6.0. Furthermore, the adsorption-desorption processes show that nanoadsorbent still retains high uptake capacity after 6 cycles, revealing structural stability and advanced recycling. Effects from other ions existed weak interference in removal of Pb(II) and Cu(II). Meanwhile, the mechanism was further analyzed from both electrostatic potential (ESP) and average local ionization energy (ALIE) based on the density functional theory (DFT). The results indicate that interaction among nanoadsorbent and heavy metal ions is bridged by oxygen active sites. As the Fe3O4@SiO2@PAA-SO3H adsorbent is a hierarchical, highly water-dispersible and biocompatible adsorbent, it is a potential new treatment option for wastewater.
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Affiliation(s)
- Xin Shi
- School of Chemistry Science and Engineering, Yunnan University, Kunming, 650091, Yunnan Province, PR China
| | - Yue Wang
- School of Chemistry Science and Engineering, Yunnan University, Kunming, 650091, Yunnan Province, PR China
| | - Xianhong Deng
- School of Chemistry Science and Engineering, Yunnan University, Kunming, 650091, Yunnan Province, PR China
| | - Wenbin Wu
- School of Chemistry Science and Engineering, Yunnan University, Kunming, 650091, Yunnan Province, PR China
| | - Wenting Hua
- School of Chemistry Science and Engineering, Yunnan University, Kunming, 650091, Yunnan Province, PR China
| | - Ziqin Zhou
- School of Chemistry Science and Engineering, Yunnan University, Kunming, 650091, Yunnan Province, PR China
| | - Kai Xin
- School of Chemistry Science and Engineering, Yunnan University, Kunming, 650091, Yunnan Province, PR China
| | - Lihong Tang
- School of Chemistry Science and Engineering, Yunnan University, Kunming, 650091, Yunnan Province, PR China.
| | - Zhiyuan Ning
- School of Chemistry Science and Engineering, Yunnan University, Kunming, 650091, Yunnan Province, PR China.
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Jenkins D, Grossman D, Slusky D, Danagoulian S. Blood Lead Testing in Flint Before and After Water Contamination. Pediatrics 2022; 150:189898. [PMID: 36325806 DOI: 10.1542/peds.2022-056541] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 09/21/2022] [Indexed: 11/05/2022] Open
Abstract
OBJECTIVE Lead is a neurotoxicant that negatively affects health. Reducing lead exposure and early detection among children are important public health goals. Our objective with this study was to determine if the September 2015 lead advisory in Flint, Michigan affected lead testing among children when possible exposure was widely publicized. METHOD This study included 206 001 children born in Michigan from 2013 to 2015 and enrolled in Medicaid, using 2013 to 2017 claims data to determine if and at what age an individual received a lead test. Difference-in-differences regression models were used to compare the receipt of lead tests among children in Flint with other cities in Michigan before and after September 2015, when a lead advisory was issued for the city warning about potential exposure to lead in publicly supplied water. RESULTS Before the lead advisory, approximately 50% of children in Flint received a lead test by 12 months of age and nearly 75% received a lead test by 24 months of age. After the September 2015 advisory, the receipt of lead tests among children in Flint increased 10 percentage points by 12 months compared with other cities. Effects by 10-month cohorts, as of 2016, revealed a 20-percentage-point increase for children in Flint compared with other cities. CONCLUSIONS Despite a highly publicized lead advisory, children in Flint enrolled in Medicaid received lead tests earlier, but the proportion of Medicaid-eligible children who were tested did not change. This suggests that increasing lead testing is a difficult policy goal to achieve and, therefore, supports recent efforts focusing on primary prevention to reduce lead exposure.
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8
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Johnson KM, Specht AJ, Hart JM, Salahuddin S, Erlinger AL, Hacker MR, Woolf AD, Hauptman M, Karumanchi SA, O'Brien K, Wylie BJ. Risk-Factor Based Lead Screening and Correlation with Blood Lead Levels in Pregnancy. Matern Child Health J 2022; 26:185-192. [PMID: 35020085 PMCID: PMC8826746 DOI: 10.1007/s10995-021-03325-x] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/24/2021] [Indexed: 01/14/2023]
Abstract
OBJECTIVES Lead exposure has devastating neurologic consequences for children and may begin in utero. The American College of Obstetricians and Gynecologists recommends prenatal lead screening using a risk factor-based approach rather than universal blood testing. The clinical utility of this approach has not been studied. We evaluated a risk-factor based questionnaire to detect elevated blood lead levels in pregnancy. METHODS We performed a secondary analysis of a cohort of parturients enrolled to evaluate the association of lead with hypertensive disorders of pregnancy. We included participants in this analysis if they had a singleton pregnancy ≥ 34 weeks' gestation with blood lead levels recorded. Participants completed a lead risk factor survey modified for pregnancy. We defined elevated blood lead as ≥ 2 μg/dL, as this was the clinically reportable level. RESULTS Of 102 participants enrolled in the cohort, 92 had blood lead measured as part of the study. The vast majority (78%) had 1 or more risk factor for elevated lead using the questionnaire yet none had clinical blood lead testing during routine visits. Only two participants (2.2%) had elevated blood lead levels. The questionnaire had high sensitivity but poor specificity for predicting detectable lead levels (sensitivity 100%, specificity 22%). CONCLUSIONS FOR PRACTICE Prenatal risk-factor based lead screening appears underutilized in practice and does not adequately discriminate between those with and without elevated blood levels. Given the complexity of the risk factor-based approach and underutilization, the benefit and cost-effectiveness of universal lead testing should be further explored.
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Affiliation(s)
- Katherine M Johnson
- Department of Obstetrics and Gynecology, Beth Israel Deaconess Medical Center, 330 Brookline Avenue, Boston, MA, 02215, USA.
- Department of Obstetrics, Gynecology, and Reproductive Biology, Harvard Medical School, 25 Shattuck St, Boston, MA, 02115, USA.
- Department of Obstetrics and Gynecology, University of Massachusetts Medical School/University of Massachusetts Memorial Medical Center, 119 Belmont Street, Worcester, MA, 01605, USA.
| | - Aaron J Specht
- Harvard T. H. Chan School of Public Health, Boston, MA, 02215, USA
| | - Jessica M Hart
- Department of Obstetrics and Gynecology, Beth Israel Deaconess Medical Center, 330 Brookline Avenue, Boston, MA, 02215, USA
- Department of Obstetrics, Gynecology, and Reproductive Biology, Harvard Medical School, 25 Shattuck St, Boston, MA, 02115, USA
| | - Saira Salahuddin
- Department of Obstetrics, Gynecology, and Reproductive Biology, Harvard Medical School, 25 Shattuck St, Boston, MA, 02115, USA
- Center for Vascular Biology Research, Beth Israel Deaconess Medical Center/Harvard Medical School, 99 Brookline Avenue, RN 359, Boston, MA, 02215, USA
| | - Adrienne L Erlinger
- Department of Obstetrics and Gynecology, Beth Israel Deaconess Medical Center, 330 Brookline Avenue, Boston, MA, 02215, USA
| | - Michele R Hacker
- Department of Obstetrics and Gynecology, Beth Israel Deaconess Medical Center, 330 Brookline Avenue, Boston, MA, 02215, USA
- Department of Obstetrics, Gynecology, and Reproductive Biology, Harvard Medical School, 25 Shattuck St, Boston, MA, 02115, USA
- Harvard T. H. Chan School of Public Health, Boston, MA, 02215, USA
| | - Alan D Woolf
- Pediatric Environmental Health Center, Division of General Pediatrics, Boston Children's Hospital, 300 Longwood Ave, Boston, MA, USA
- Region 1 Pediatric Environmental Health Specialty Unit, Boston, MA, USA
- Department of Pediatrics, Harvard Medical School, Boston, MA, USA
| | - Marissa Hauptman
- Pediatric Environmental Health Center, Division of General Pediatrics, Boston Children's Hospital, 300 Longwood Ave, Boston, MA, USA
- Region 1 Pediatric Environmental Health Specialty Unit, Boston, MA, USA
- Department of Pediatrics, Harvard Medical School, Boston, MA, USA
| | - S Ananth Karumanchi
- Center for Vascular Biology Research, Beth Israel Deaconess Medical Center/Harvard Medical School, 99 Brookline Avenue, RN 359, Boston, MA, 02215, USA
- Department of Medicine, Cedars-Sinai Medical Center, 8700 Beverly Blvd, Los Angeles, CA, 90048, USA
| | - Karen O'Brien
- Department of Obstetrics and Gynecology, Beth Israel Deaconess Medical Center, 330 Brookline Avenue, Boston, MA, 02215, USA
- Department of Obstetrics, Gynecology, and Reproductive Biology, Harvard Medical School, 25 Shattuck St, Boston, MA, 02115, USA
| | - Blair J Wylie
- Department of Obstetrics and Gynecology, Beth Israel Deaconess Medical Center, 330 Brookline Avenue, Boston, MA, 02215, USA
- Department of Obstetrics, Gynecology, and Reproductive Biology, Harvard Medical School, 25 Shattuck St, Boston, MA, 02115, USA
- Region 1 Pediatric Environmental Health Specialty Unit, Boston, MA, USA
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Neuwirth L, Okeke E, El Idrissi A. Developmental Pb 2+-Exposure induces cardiovascular pathologies in adult male rats. HEART AND MIND 2022. [DOI: 10.4103/hm.hm_73_21] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
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Marshall AT, McConnell R, Lanphear BP, Thompson WK, Herting MM, Sowell ER. Risk of lead exposure, subcortical brain structure, and cognition in a large cohort of 9- to 10-year-old children. PLoS One 2021; 16:e0258469. [PMID: 34648580 PMCID: PMC8516269 DOI: 10.1371/journal.pone.0258469] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/30/2020] [Accepted: 09/26/2021] [Indexed: 02/03/2023] Open
Abstract
BACKGROUND Lead, a toxic metal, affects cognitive development at the lowest measurable concentrations found in children, but little is known about its direct impact on brain development. Recently, we reported widespread decreases in cortical surface area and volume with increased risks of lead exposure, primarily in children of low-income families. METHODS AND FINDINGS We examined associations of neighborhood-level risk of lead exposure with cognitive test performance and subcortical brain volumes. We also examined whether subcortical structure mediated associations between lead risk and cognitive performance. Our analyses employed a cross-sectional analysis of baseline data from the observational Adolescent Brain Cognitive Development (ABCD) Study. The multi-center ABCD Study used school-based enrollment to recruit a demographically diverse cohort of almost 11,900 9- and 10-year-old children from an initial 22 study sites. The analyzed sample included data from 8,524 typically developing child participants and their parents or caregivers. The primary outcomes and measures were subcortical brain structure, cognitive performance using the National Institutes of Health Toolbox, and geocoded risk of lead exposure. Children who lived in neighborhoods with greater risks of environmental lead exposure exhibited smaller volumes of the mid-anterior (partial correlation coefficient [rp] = -0.040), central (rp = -0.038), and mid-posterior corpus callosum (rp = -0.035). Smaller volumes of these three callosal regions were associated with poorer performance on cognitive tests measuring language and processing speed. The association of lead exposure risk with cognitive performance was partially mediated through callosal volume, particularly the mid-posterior corpus callosum. In contrast, neighborhood-level indicators of disadvantage were not associated with smaller volumes of these brain structures. CONCLUSIONS Environmental factors related to the risk of lead exposure may be associated with certain aspects of cognitive functioning via diminished subcortical brain structure, including the anterior splenium (i.e., mid-posterior corpus callosum).
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Affiliation(s)
- Andrew T. Marshall
- Children’s Hospital Los Angeles, and the Department of Pediatrics, University of Southern California, Los Angeles, California, United States of America
| | - Rob McConnell
- Department of Population and Public Health Sciences, University of Southern California, Los Angeles, California, United States of America
| | - Bruce P. Lanphear
- Faculty of Health Sciences, Simon Fraser University, Vancouver, British Columbia, Canada
| | - Wesley K. Thompson
- Department of Biostatistics, Department of Family Medicine and Public Health, University of California, San Diego, San Diego, California, United States of America
| | - Megan M. Herting
- Department of Population and Public Health Sciences, University of Southern California, Los Angeles, California, United States of America
| | - Elizabeth R. Sowell
- Children’s Hospital Los Angeles, and the Department of Pediatrics, University of Southern California, Los Angeles, California, United States of America
- * E-mail:
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Boyle J, Yeter D, Aschner M, Wheeler DC. Estimated IQ points and lifetime earnings lost to early childhood blood lead levels in the United States. THE SCIENCE OF THE TOTAL ENVIRONMENT 2021; 778:146307. [PMID: 34030355 DOI: 10.1016/j.scitotenv.2021.146307] [Citation(s) in RCA: 13] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/12/2021] [Revised: 03/01/2021] [Accepted: 03/02/2021] [Indexed: 06/12/2023]
Abstract
There is no safe detectable level of lead (Pb) in the blood of children. Blood lead levels (BLLs) at ages 6-24 months ≥2 μg/dL result in lost grade school intelligence quotient (IQ) points at ages 5-10 years. Black children continue to have the highest BLLs in the United States. Therefore, we examined currently undetermined racial/ethnic disparities in anticipated IQ points and associated lifetime earnings lost to early childhood blood lead. We conducted secondary analysis of infants with blood lead (in μg/dL) measured at ages 12-24 months by the cross-sectional National Health and Nutrition Examination Survey (NHANES) during 1999 to 2010. Nationally-representative estimates were produced using weighted simulation model. A total of 1241 infants were included from the NHANES sample (52% male; mean [SD] age, 18.5 [3.5] months; 25% Black [non-Hispanic], 42% Hispanic [any race], 5% Other/Multiracial, and 29% White [non-Hispanic]) after excluding 811 without BLL determinations. For national outcomes, Black infants experienced approximately 46-55% greater average estimated loss of grade school IQ points from blood lead than Hispanic or White infants (-1.78 IQ points vs. -1.15 and -1.21 respectively) with similar disparities in costs to expected lifetime earnings (-$47,116 USD vs. -$30,393 and -$32,356 respectively). Our estimated nationwide costs of IQ points lost to BLLs during this 12-year period totaled $554 billion ($46.2 billion/year), in which blood lead <5 μg/dL accounted for 74% of this total burden. We report two aspects of the substantial national costs attributable to lead exposure in just the second year of life alone, which disproportionately impact predominately African-American Black infants from continuing legacies of environmental racism in lead exposure. Our findings underscore the remarkably high costs from recognized hazards of blood lead even at the lowest levels and the importance of primary prevention regarding childhood lead exposure.
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Affiliation(s)
- Joseph Boyle
- Department of Biostatistics, Virginia Commonwealth University, Richmond, VA 23284, USA
| | - Deniz Yeter
- School of Nursing, University of Kansas Medical Center, Kansas City, KS 66160, USA
| | - Michael Aschner
- Department of Molecular Pharmacology, Albert Einstein College of Medicine, Bronx, NY 10461, USA
| | - David C Wheeler
- Department of Biostatistics, Virginia Commonwealth University, Richmond, VA 23284, USA.
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Nazari M, Amini A, Eden NT, Duke MC, Cheng C, Hill MR. Highly-Efficient Sulfonated UiO-66(Zr) Optical Fiber for Rapid Detection of Trace Levels of Pb 2. Int J Mol Sci 2021; 22:ijms22116053. [PMID: 34205199 PMCID: PMC8200020 DOI: 10.3390/ijms22116053] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/05/2021] [Revised: 05/27/2021] [Accepted: 05/28/2021] [Indexed: 11/16/2022] Open
Abstract
Lead detection for biological environments, aqueous resources, and medicinal compounds, rely mainly on either utilizing bulky lab equipment such as ICP-OES or ready-made sensors, which are based on colorimetry with some limitations including selectivity and low interference. Remote, rapid and efficient detection of heavy metals in aqueous solutions at ppm and sub-ppm levels have faced significant challenges that requires novel compounds with such ability. Here, a UiO-66(Zr) metal-organic framework (MOF) functionalized with SO3H group (SO3H-UiO-66(Zr)) is deposited on the end-face of an optical fiber to detect lead cations (Pb2+) in water at 25.2, 43.5 and 64.0 ppm levels. The SO3H-UiO-66(Zr) system provides a Fabry–Perot sensor by which the lead ions are detected rapidly (milliseconds) at 25.2 ppm aqueous solution reflecting in the wavelength shifts in interference spectrum. The proposed removal mechanism is based on the adsorption of [Pb(OH2)6]2+ in water on SO3H-UiO-66(Zr) due to a strong affinity between functionalized MOF and lead. This is the first work that advances a multi-purpose optical fiber-coated functional MOF as an on-site remote chemical sensor for rapid detection of lead cations at extremely low concentrations in an aqueous system.
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Affiliation(s)
- Marziyeh Nazari
- Mathematics and Physics Department, School of Engineering, Australian College of Kuwait, Safat 13015, Kuwait;
- Institute for Sustainable Industries and Livable Cities (ISILC), Victoria University, Melbourne, VIC 8001, Australia;
| | - Abbas Amini
- Mechanical Engineering Department, School of Engineering, Australian College of Kuwait, Safat 13015, Kuwait
- Center for Infrastructure Engineering, Western Sydney University, Penrith, NSW 2751, Australia
- Correspondence:
| | - Nathan T. Eden
- Department of Chemical Engineering, Monash University, Clayton, VIC 3800, Australia; (N.T.E.); (M.R.H.)
| | - Mikel C. Duke
- Institute for Sustainable Industries and Livable Cities (ISILC), Victoria University, Melbourne, VIC 8001, Australia;
| | - Chun Cheng
- Department of Materials Science and Engineering, Southern University of Science and Technology (SUSTech), Shenzhen 518055, China;
| | - Matthew R. Hill
- Department of Chemical Engineering, Monash University, Clayton, VIC 3800, Australia; (N.T.E.); (M.R.H.)
- CSIRO Manufacturing, Clayton, VIC 3168, Australia
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Hillyer M, Matiz LA, Robbins-Milne L, Friedman S. Who to Test? A Retrospective Study of Lead Testing in High-Risk Children. Clin Pediatr (Phila) 2021; 60:267-272. [PMID: 33840266 DOI: 10.1177/00099228211008286] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
BACKGROUND Nearly all pediatric patients in our setting meet high-risk criteria for lead exposure based on screening recommendations and guidelines. Implementation of screening and testing has been inconsistent. OBJECTIVE To assess the utility and efficacy of performing universal lead testing between ages 1 and 5 at an urban academic pediatric practice. METHODS Retrospective review of patients with routine lead testing between 2010 and 2015. Key variables included demographics, serum lead level, and behavioral diagnoses. RESULTS A total of 6597 serum lead levels from 3274 patients were reviewed. Forty-seven samples (0.7%) from 24 patients (0.7%) were elevated. Of the 24 patients with elevated lead, 75% were identified at age 1 or 2. Sixty-seven percent of patients with first elevated lead level at age 3 or older had a diagnosis of developmental delay. CONCLUSION Routine testing of high-risk patients yielded minimal specificity in identifying elevated lead levels, especially in patients older than 3 years and without developmental delay.
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Affiliation(s)
- Margot Hillyer
- NewYork-Presbyterian/Columbia University Medical Center, New York, NY, USA
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McElroy KG, Iobst SE, DeVance-Wilson C, Ludeman E, Barr E. Systematic Review and Meta-Analysis of the Effect of Nutrients on Blood Lead Levels in Pregnancy. J Obstet Gynecol Neonatal Nurs 2020; 49:243-253. [PMID: 32259512 DOI: 10.1016/j.jogn.2020.02.004] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 02/01/2020] [Indexed: 11/18/2022] Open
Abstract
OBJECTIVE To synthesize experimental and nonexperimental research on the relationship between nutrients and blood lead levels in pregnant women. We also performed a meta-analysis on a subgroup of studies on calcium and blood lead levels. DATA SOURCES PubMed, Embase, and CINAHL databases were searched in July 2019. STUDY SELECTION We included articles published in English in any year that reported the results of experimental or observational studies on the effect of nutrients on blood lead levels in pregnancy. DATA EXTRACTION Three nurse reviewers extracted data and appraised the studies using tools from the Joanna Briggs Institute. DATA SYNTHESIS AND META-ANALYSIS We included 28 studies from 16 countries. Study authors examined 14 distinct nutrients, with calcium being the most frequent. The metaregression included nine analyses of the effect of calcium on blood lead levels and showed a small but significant inverse relationship. The quality of evidence for the effect of calcium on lead levels was high. Eleven analyses were related to the effect of iron on blood lead levels. The quality of evidence was high, and we found mostly negative associations between iron intake and blood lead levels. The quality of evidence for the remaining nutrients was moderate, with few significant findings. CONCLUSION Targeted nutritional interventions may be beneficial for pregnant women with current lead exposure or a history of elevated lead levels, particularly those with calcium- or iron-deficient diets. More rigorously designed studies are needed in this area.
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Yeter D, Banks EC, Aschner M. Disparity in Risk Factor Severity for Early Childhood Blood Lead among Predominantly African-American Black Children: The 1999 to 2010 US NHANES. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2020; 17:ijerph17051552. [PMID: 32121216 PMCID: PMC7084658 DOI: 10.3390/ijerph17051552] [Citation(s) in RCA: 27] [Impact Index Per Article: 6.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 12/28/2019] [Revised: 02/23/2020] [Accepted: 02/24/2020] [Indexed: 11/16/2022]
Abstract
There is no safe detectable level of lead (Pb) in the blood of young children. In the United States, predominantly African-American Black children are exposed to more Pb and present with the highest mean blood lead levels (BLLs). However, racial disparity has not been fully examined within risk factors for early childhood Pb exposure. Therefore, we conducted secondary analysis of blood Pb determinations for 2841 US children at ages 1–5 years with citizenship examined by the cross-sectional 1999 to 2010 National Health and Nutrition Examination Survey (NHANES). The primary measures were racial disparities for continuous BLLs or an elevated BLL (EBLL) ≥5 µg/dL in selected risk factors between non-Hispanic Black children (n = 608) and both non-Hispanic White (n = 1208) or Hispanic (n = 1025) children. Selected risk factors included indoor household smoking, low income or poverty, older housing built before 1978 or 1950, low primary guardian education <12th grade/general education diploma (GED), or younger age between 1 and 3 years. Data were analyzed using a regression model corrected for risk factors and other confounding variables. Overall, Black children had an adjusted +0.83 µg/dL blood Pb (95% CI 0.65 to 1.00, p < 0.001) and a 2.8 times higher odds of having an EBLL ≥5 µg/dL (95% CI 1.9 to 3.9, p < 0.001). When stratified by risk factor group, Black children had an adjusted 0.73 to 1.41 µg/dL more blood Pb (p < 0.001 respectively) and a 1.8 to 5.6 times higher odds of having an EBLL ≥5 µg/dL (p ≤ 0.05 respectively) for every selected risk factor that was tested. For Black children nationwide, one in four residing in pre-1950 housing and one in six living in poverty presented with an EBLL ≥5 µg/dL. In conclusion, significant nationwide racial disparity in blood Pb outcomes persist for predominantly African-American Black children even after correcting for risk factors and other variables. This racial disparity further persists within housing, socio-economic, and age-related risk factors of blood Pb outcomes that are much more severe for Black children.
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Affiliation(s)
- Deniz Yeter
- Independent Researcher, Kansas City, KS 66104, USA
- Correspondence:
| | | | - Michael Aschner
- Department of Molecular Pharmacology, Albert Einstein College of Medicine, Bronx, NY 10461, USA;
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Ettinger AS, Egan KB, Homa DM, Brown MJ. Blood Lead Levels in U.S. Women of Childbearing Age, 1976-2016. ENVIRONMENTAL HEALTH PERSPECTIVES 2020; 128:17012. [PMID: 31944143 DOI: 10.1289/ehp5926] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/24/2023]
Abstract
BACKGROUND Lead can adversely affect maternal and child health across a wide range of exposures; developing fetuses and breastfeeding infants may be particularly vulnerable. We describe the distribution of blood lead levels (BLLs) in U.S. women of childbearing age and associations with sociodemographic, reproductive, smoking, and housing characteristics over a 40-y period. METHODS Data from the National Health and Nutrition Examination Survey (NHANES) II, NHANES III Phase I and Phase II, and 1999-2016 continuous NHANES were used to describe the distribution of BLLs (given in micrograms per deciliter; 1μg/dL=0.0483μmol/L) in U.S. women 15-49 years of age between 1976 and 2016. For all women with valid BLLs (n=22,408), geometric mean (GM) BLLs and estimated prevalence of BLLs ≥5μg/dL were calculated overall and by selected demographic characteristics. For NHANES II, estimated prevalence of BLLs ≥10 and ≥20μg/dL were also calculated. RESULTS The most recent GM BLLs (2007-2010 and 2011-2016, respectively) were 0.81μg/dL [95% confidence interval (CI): 0.79, 0.84] and 0.61μg/dL (95% CI: 0.59, 0.64). In comparison, GM BLLs in earlier periods (1976-1980, 1988-1991, and 1991-1994) were 10.37μg/dL (95% CI: 9.95, 10.79), 1.85μg/dL (95% CI: 1.75, 1.94), and 1.53μg/dL (95% CI: 1.45, 1.60), respectively. In 2011-2016, 0.7% of women of childbearing age had BLLs ≥5μg/dL, and higher BLLs were associated with older age, other race/ethnicity, birthplace outside the United States, four or more live births, exposure to secondhand tobacco smoke, and ever pregnant or not currently pregnant. DISCUSSION Lead exposure in U.S. women of childbearing age is generally low and has substantially decreased over this 40-y period. However, based on these estimates, there are still at least 500,000 U.S. women being exposed to lead at levels that may harm developing fetuses or breastfeeding infants. Identifying high-risk women who are or intend to become pregnant remains an important public health issue. https://doi.org/10.1289/EHP5925.
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Affiliation(s)
- Adrienne S Ettinger
- Lead Poisoning Prevention and Environmental Health Tracking Branch, Division of Environmental Health Science and Practice, National Center for Environmental Health, Centers for Disease Control and Prevention, Atlanta, Georgia, USA
| | - Kathryn B Egan
- Lead Poisoning Prevention and Environmental Health Tracking Branch, Division of Environmental Health Science and Practice, National Center for Environmental Health, Centers for Disease Control and Prevention, Atlanta, Georgia, USA
| | - David M Homa
- Office on Smoking and Health, National Center for Chronic Disease Prevention and Health Promotion, Centers for Disease Control and Prevention, Atlanta, Georgia, USA
| | - Mary Jean Brown
- Department of Social and Behavioral Sciences, Harvard T.H. Chan School of Public Health, Boston, Massachusetts, USA
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Ettinger AS, Egan KB, Homa DM, Brown MJ. Blood Lead Levels in U.S. Women of Childbearing Age, 1976-2016. ENVIRONMENTAL HEALTH PERSPECTIVES 2020; 128:17012. [PMID: 31944143 PMCID: PMC7015629 DOI: 10.1289/ehp5925] [Citation(s) in RCA: 30] [Impact Index Per Article: 7.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/22/2019] [Revised: 11/05/2019] [Accepted: 12/03/2019] [Indexed: 05/19/2023]
Abstract
BACKGROUND Lead can adversely affect maternal and child health across a wide range of exposures; developing fetuses and breastfeeding infants may be particularly vulnerable. We describe the distribution of blood lead levels (BLLs) in U.S. women of childbearing age and associations with sociodemographic, reproductive, smoking, and housing characteristics over a 40-y period. METHODS Data from the National Health and Nutrition Examination Survey (NHANES) II, NHANES III Phase I and Phase II, and 1999-2016 continuous NHANES were used to describe the distribution of BLLs (given in micrograms per deciliter; 1μg/dL=0.0483μmol/L) in U.S. women 15-49 years of age between 1976 and 2016. For all women with valid BLLs (n=22,408), geometric mean (GM) BLLs and estimated prevalence of BLLs ≥5μg/dL were calculated overall and by selected demographic characteristics. For NHANES II, estimated prevalence of BLLs ≥10 and ≥20μg/dL were also calculated. RESULTS The most recent GM BLLs (2007-2010 and 2011-2016, respectively) were 0.81μg/dL [95% confidence interval (CI): 0.79, 0.84] and 0.61μg/dL (95% CI: 0.59, 0.64). In comparison, GM BLLs in earlier periods (1976-1980, 1988-1991, and 1991-1994) were 10.37μg/dL (95% CI: 9.95, 10.79), 1.85μg/dL (95% CI: 1.75, 1.94), and 1.53μg/dL (95% CI: 1.45, 1.60), respectively. In 2011-2016, 0.7% of women of childbearing age had BLLs ≥5μg/dL, and higher BLLs were associated with older age, other race/ethnicity, birthplace outside the United States, four or more live births, exposure to secondhand tobacco smoke, and ever pregnant or not currently pregnant. DISCUSSION Lead exposure in U.S. women of childbearing age is generally low and has substantially decreased over this 40-y period. However, based on these estimates, there are still at least 500,000 U.S. women being exposed to lead at levels that may harm developing fetuses or breastfeeding infants. Identifying high-risk women who are or intend to become pregnant remains an important public health issue. https://doi.org/10.1289/EHP5925.
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Affiliation(s)
- Adrienne S. Ettinger
- Lead Poisoning Prevention and Environmental Health Tracking Branch, Division of Environmental Health Science and Practice, National Center for Environmental Health, Centers for Disease Control and Prevention, Atlanta, Georgia, USA
| | - Kathryn B. Egan
- Lead Poisoning Prevention and Environmental Health Tracking Branch, Division of Environmental Health Science and Practice, National Center for Environmental Health, Centers for Disease Control and Prevention, Atlanta, Georgia, USA
| | - David M. Homa
- Office on Smoking and Health, National Center for Chronic Disease Prevention and Health Promotion, Centers for Disease Control and Prevention, Atlanta, Georgia, USA
| | - Mary Jean Brown
- Department of Social and Behavioral Sciences, Harvard T.H. Chan School of Public Health, Boston, Massachusetts, USA
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