Probabilistic estimates of prenatal lead exposure at 195 toxic hotspots in low- and middle-income countries

Chronic lead exposure and burden of cardiovascular disease during 1990-2019: a systematic analysis of the global burden of disease study

Background

Cardiovascular diseases (CVD) are the leading causes of death and disability worldwide. Lead exposure is an important risk factor for CVD. In our study, we aimed to estimate spatial and temporal trends in the burden of cardiovascular disease associated with chronic lead exposure.

Methods

The data collected for our study were obtained from Global Burden of Disease (GBD) study 2019 and analyzed by age, sex, cause, and location. To assess the temporal trends in burden of CVD attributable to chronic lead exposure over 30 years, we used Joinpoint regression analysis.

Results

In 2019, the number of lead exposure-attributable CVD deaths and disability-adjusted life-years (DALYs) were 0.85 and 17.73 million, 1.7 and 1.4 times more than those observed in 1990, respectively. However, the corresponding age-standardized rates (ASR) of death and DALY gradually decreased from 1990 to 2019, especially from 2013 to 2019. Over the last 30 years, among 21 GBD regions and 204 countries and territories, the High-income Asia Pacific and the Republic of Korea experienced the largest reductions in age-standardized DALY and death rates, while Central Asia and Afghanistan experienced the largest increases. Males and the elderly population suffered higher death rates and DALY burdens than females and the young population. Furthermore, we observed that higher socio-demographic index (SDI) regions demonstrated lower ASR of death and DALY rates. In 2019, the low and low-middle SDI regions, especially South Asia, exhibited the highest burden of CVD attributable to lead exposure.

Conclusion

Our study provides a thorough understanding of the burden of CVD attributable to chronic lead exposure. The findings confirm the significance of implementing lead mitigation strategies and increasing investment in CVD prevention and treatment. These measures are crucial in reducing the burden of CVD and promoting public health on a global scale.

Gastrointestinal Manifestations of Lead Poisoning: A Brief Report

Gastrointestinal (GI) manifestations of lead poisoning include abdominal pain, constipation, and diarrhea. Depending on the severity of a symptom, surgical consultation is required. The present study aimed to make a comparison between the mean blood lead levels of patients hospitalized for lead toxicity and the various Gl symptoms. A retrospective cross-sectional study was performed in 2020 at Khorshid Hospital, the main regional referral center for poisoned patients (Isfahan, Iran). A total of 82 patients aged ≥18 years who were hospitalized for lead poisoning during 2017-2018 were included in the study. Patients' information was extracted from hospital medical records, including demographic information, clinical manifestations, blood lead levels, and treatment outcome. The mean age of the patients was 48.18±11.9 years, 91.5% were men, and 62.2% suffered from multiple GI symptoms, with abdominal pain being predominant (31.7%). Blood lead levels in patients with multiple GI symptoms were higher than those with only one symptom (P=0.01). Surgical consultation was required in 14.6% of the patients. Multiple GI symptoms were the main predictive factor for blood lead levels above 70 mg/dL (P=0.03, Odds ratio=3.06, 95% CI=1.09-8.61). Given the prevalence of abdominal pain and its association with elevated blood lead levels, differential diagnosis of abdominal pain should include lead toxicity.

Estimating the burden of diseases attributable to lead exposure in the North Africa and Middle East region, 1990-2019: a systematic analysis for the Global Burden of Disease study 2019

BACKGROUND

Lead exposure (LE) and its attributable deaths and disability-adjusted life years (DALYs) have declined in the recent decade; however, it remains one of the leading public health concerns, particularly in regions with low socio-demographic index (SDI) such as the North Africa and Middle East (NAME) region. Hence, we aimed to describe the attributable burden of the LE in this region.

METHODS

Data on deaths, DALYs, years of life lost (YLLs), and years lived with disability (YLDs) attributable to LE in the NAME region and its 21 countries from 1990 to 2019 were extracted from the Global Burden of Disease (GBD) 2019 study.

RESULTS

In 2019, the age-standardized death and DALY rates attributable to LE were 23.4 (95% uncertainty interval: 15.1 to 33.3) and 489.3 (320.5 to 669.6) per 100,000 in the region, respectively, both of which were higher among men than women. The overall age-standardized death and DALY rates showed 27.7% and 36.8% decreases, respectively, between 1990 and 2019. In this period, Bahrain, the United Arab Emirates, and Turkey had the highest decreases in the age-standardized death and DALY rates, while Afghanistan, Egypt, and Yemen had the lowest ones. Countries within high SDI quintile had lower attributable burden to LE compared with the low SDI quintile. Cardiovascular diseases and chronic kidney diseases accounted for the 414.2 (258.6 to 580.6) and 28.7 (17.7 to 41.7) LE attributable DALYs per 100,000 in 2019, respectively. The attributable YLDs was 46.4 (20.7 to 82.1) per 100,000 in 2019, which shows a 25.7% reduction (-30.8 to -22.5%) over 1990-2019.

CONCLUSIONS

The overall LE and its attributed burden by cause have decreased in the region from 1990-2019. Nevertheless, the application of cost-effective and long-term programs for decreasing LE and its consequences in NAME is needed.

Reducing disease and death from Artisanal and Small-Scale Mining (ASM) - the urgent need for responsible mining in the context of growing global demand for minerals and metals for climate change mitigation

Artisanal and small-scale mining (ASM) takes place under extreme conditions with a lack of occupational health and safety. As the demand for metals is increasing due in part to their extensive use in 'green technologies' for climate change mitigation, the negative environmental and occupational consequences of mining practices are disproportionately felt in low- and middle-income countries. The Collegium Ramazzini statement on ASM presents updated information on its neglected health hazards that include multiple toxic hazards, most notably mercury, lead, cyanide, arsenic, cadmium, and cobalt, as well as physical hazards, most notably airborne dust and noise, and the high risk of infectious diseases. These hazards affect both miners and mining communities as working and living spaces are rarely separated. The impact on children and women is often severe, including hazardous exposures during the child-bearing age and pregnancies, and the risk of child labor. We suggest strategies for the mitigation of these hazards and classify those according to primordial, primary, secondary, and tertiary prevention. Further, we identify knowledge gaps and issue recommendations for international, national, and local governments, metal purchasers, and employers are given. With this statement, the Collegium Ramazzini calls for the extension of efforts to minimize all hazards that confront ASM miners and their families.

Global magnitude and temporal trends of idiopathic developmental intellectual disability attributable to lead exposure from 1990 to 2019: Results from Global Burden of Disease Study

As an important environmental pollutant, lead exposure can result in idiopathic developmental intellectual disability (IDII). However, the latest spatiotemporal patterns across the world are unclear. Therefore, in this study, the global burden of lead exposure-related IDII was assessed using the Global Burden of Disease (GBD) study (2019). The data were downloaded from the Institute for Health Metrics and Evaluation (IHME), and the estimated annual percentage change (EAPC) was calculated to assess the changing trend of the age-standardized disability-adjusted life-years (DALYs) rates (ASDR) of global IDII attributed to lead exposure. In 2019, the number of global DALYs of IDII attributed to lead exposure was 2.72 million, the corresponding ASDR was 35.70 per 100,000. The ASDR was highest in children and adolescents, and low- and middle-income countries. From 1990 to 2019, the global number of DALYs of IDII attributable to lead exposure increased by 7.89%, while the ASDR of IDII decreased by 19.19% [EAPC = -0.78, 95% confidence interval (CI): (-0.90, -0.66)]. The downward trends were seen in most GBD regions and countries, especially in high-income countries, but 11 countries presented an upward trend. Therefore, it is important to continue to improve primary mental healthcare globally, especially in low- and middle-income countries. Meanwhile, the implementation of effective strategies to reduce lead exposure should be continually strengthened.

Global Trends in Mortality and Burden of Stroke Attributable to Lead Exposure From 1990 to 2019

Background

Lead exposure is an important risk factor for stroke. However, the latest global spatiotemporal patterns of lead exposure-related stroke burden were unclear. In this study, we assessed this topic.

Methods

The data were obtained from the Global Burden of Disease Study (2019). The estimated annual percentage change (EAPC) was estimated to evaluate the temporal trends of the age-standardized mortality and disability-adjusted life years (DALYs) rates (ASMR and ASDR) of stroke attributable to lead exposure.

Results

In 2019, the numbers of global stroke deaths and DALYs attributable to lead exposure were 305.27 and 6738.78 thousand, respectively. The corresponding ASMR and ASDR were highest in males, the elderly population, low and middle-income countries, and the intracerebral hemorrhage subtype. From 1990 to 2019, the ASMR and ASDR of global stroke attributable to lead exposure decreased [ASMR: EAPC = −1.34, 95% confidence interval (CI): (−1.57, −1.10); ASDR: EAPC = −1.74, 95% CI: (−1.95, −1.52)], especially in females, the high-income countries, and the subarachnoid hemorrhage subtype.

Conclusion

This study emphasizes the importance of continued implementation of lead exposure prevention strategies and improved high-efficiency treatment and stroke acute health care, especially in low and middle-income countries.

Characteristics and Risk Assessment of Soil Polluted by Lead around Various Metal Mines in China

The contamination of soil by lead (Pb) is a serious and widespread problem in China, especially in mining areas. This paper summarized the available data regarding Pb-contaminated soils around various metal mines in China. Based on these data, the Pb concentration in the soil and its temporal and spatial changes were analyzed. Potential ecological hazards and adult lead models were also used to estimate ecological and health risks. The results indicated that the concentration of Pb was closely related with the type of mine. Compared with other types of mine, soil around lead-zinc (Pb-Zn) and tin (Sn) mines with high Pb contents in the metallic ores and high pollutant emission coefficient were more strongly polluted by Pb. The characteristic spatial and temporal variations of Pb pollution status in China were clarified, and the results showed that the concentration was high in the southern, southwestern, and central regions of China where many mining areas were located, and the mean value passed a turning point in 2012. Ecological risk assessments indicated that some areas around mines were at considerable to high risk, and the risk was relatively severe in Pb-Zn mining areas. According to the adult lead model, Pb-Zn mines had a greater impact on blood Pb concentration than the other types of mine.

A Biodegradable Secondary Battery and its Biodegradation Mechanism for Eco-Friendly Energy-Storage Systems

The production of rechargeable batteries is rapidly expanding, and there are going to be new challenges in the near future about how the potential environmental impact caused by the disposal of the large volume of the used batteries can be minimized. Herein, a novel strategy is proposed to address these concerns by applying biodegradable device technology. An eco-friendly and biodegradable sodium-ion secondary battery (SIB) is developed through extensive material screening followed by the synthesis of biodegradable electrodes and their seamless assembly with an unconventional biodegradable separator, electrolyte, and package. Each battery component decomposes in nature into non-toxic compounds or elements via hydrolysis and/or fungal degradation, with all of the biodegradation products naturally abundant and eco-friendly. Detailed biodegradation mechanisms and toxicity influence of each component on living organisms are determined. In addition, this new SIB delivers performance comparable to that of conventional non-degradable SIBs. The strategy and findings suggest a novel eco-friendly biodegradable paradigm for large-scale rechargeable battery systems.

Effect of industrial wastewater on wheat germination, growth, yield, nutrients and bioaccumulation of lead

Due to fresh water scarcity, farmers are using polluted water for irrigation. This research was conducted to study the bioaccumulation of Pb in wheat (Cv. Shafaq-2006). The experiment was comprised of seven treatments of lead i.e. 0–1,000 mg Pb/kg. The results revealed that lead severely reduces germination (− 30%), seedling fresh weight (− 74%), seedling dry weight (− 77%), vigor index (− 89%), tolerance index (− 84%), plant height (− 33%), number of leaves (− 41%), root fresh weight (− 50%), shoot fresh weight (− 62%), root dry weight (− 63%), shoot dry weight (− 71%), and root length (− 45%). The physiological parameters also respond negatively like stomatal conductance (− 82%), transpiration rate (− 72%) and photosynthetic rate (− 74%). Similarly, biochemical parameters also showed negative impacts, like carotenoids (− 41), total chlorophyll (− 43), chlorophyll a (− 42) and chlorophyll b (− 53). Yield parameters like the number of seed/plant, seed weight/plant, 1,000 seed weight and harvest index were reduced by 90%, 88%, 44% and 61%, respectively in T₆. In addition, protein contents (− 81%), phosphorous (− 60%) and potassium (− 55%) were highly effected in the highest lead concentration (T₆). Lead accumulation was extremely higher in seeds (119%) as compared to control plants. Lead bio-accumulation above threshold concentrations in crop parts is a serious human health concern.