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Collado-López S, Burns KF, Smith SN, Kordas K, Desai G. Association between breakfast skipping and blood levels of lead and cadmium in children and adolescents aged 6-17 years: Results from the National Health and Nutrition Examination Survey 2013-2018. J Trace Elem Med Biol 2024; 84:127468. [PMID: 38728997 DOI: 10.1016/j.jtemb.2024.127468] [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] [Received: 01/13/2024] [Revised: 04/27/2024] [Accepted: 04/30/2024] [Indexed: 05/12/2024]
Abstract
INTRODUCTION Previous research suggests that fasting increases lead absorption in the gastrointestinal tract, and that regularly eating meals may reduce blood lead. However, there is insufficient evidence linking breakfast status and blood-metal levels in children. We assessed the cross-sectional association between breakfast consumption status and children and adolescent's blood levels of lead and cadmium. We also explored blood hemoglobin, serum ferritin, and age group as potential effect modifiers of these associations. METHODS This analysis included children and adolescents aged 6-17 years who participated in the National Health and Nutrition Examination Survey (NHANES) cycles 2013-2018 with complete data on breakfast consumption status (consumers vs. skippers), blood metals, and covariates (N=3722). Blood metal variables were log-transformed. Crude and covariate-adjusted, survey-weighted linear regression models were conducted for each blood metal outcome. Potential effect modification was explored using stratification. RESULTS Overall fewer participants reported skipping breakfast (n=719) than eating breakfast (n=3003). Mean (SE) concentrations of blood lead and cadmium (µg/L) were 0.63 (0.01) µg/dL and 0.13 (0.00) µg/L, respectively. Children and adolescents who skipped breakfast were more likely to be female (51.2%), older (mean 12.2 years, SE = 0.1), have a higher body mass index (mean 22.8 kg/m2, SE = 0.2), and a lower income-poverty ratio (mean 1.7, SE = 0.1) than breakfast consumers. No associations between breakfast consumption and any of the blood metals were found. When stratified by age (≤ 10, 11-13, and 14-17 years), children aged 11-13 years who consumed breakfast had lower log-transformed blood lead levels [β = -0.14 µg/L; 95% CI: (-0.25, -0.03)] compared to children of the same age who skipped breakfast. CONCLUSION Children 11-13 years-old who were breakfast consumers had lower blood lead levels compared to children of the same age who skipped breakfast. Our results support that encouraging breakfast consumption among school-age children may contribute to lower blood lead levels.
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Affiliation(s)
- Sonia Collado-López
- Center for Nutrition and Health Research, Instituto Nacional de Salud Pública, Cuernavaca, Morelos 62100, Mexico
| | - Kaelyn F Burns
- Department of Epidemiology and Environmental Health, University at Buffalo, Buffalo, NY 14214, USA.
| | - Samantha N Smith
- Department of Epidemiology and Environmental Health, University at Buffalo, Buffalo, NY 14214, USA
| | - Katarzyna Kordas
- Department of Epidemiology and Environmental Health, University at Buffalo, Buffalo, NY 14214, USA
| | - Gauri Desai
- Department of Epidemiology and Environmental Health, University at Buffalo, Buffalo, NY 14214, USA
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Mohammed LM, Karami M, Mehrabi Y, Hashemi SS, Farhang Dehghan S, Rafiee M, Baiee H. Exploring Blood Lead Level Determinants in Refinery Workers: A Cross-Sectional Study. Cureus 2024; 16:e63330. [PMID: 39070385 PMCID: PMC11283583 DOI: 10.7759/cureus.63330] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/27/2024] [Indexed: 07/30/2024] Open
Abstract
BACKGROUND Occupational lead exposure poses a significant risk to workers in industrial settings, especially in petroleum refineries. The study aimed to examine the prevalence and determinants of high blood lead concentrations among refinery workers in Kirkuk, Iraq. It has also been aimed to provide evidence-based approaches to identify associated risk factors. METHODS A cross-sectional study was conducted among 187 workers from three departments (transportation, storage, and production) in a petroleum refinery from August 2023 to April 2024. Blood lead levels (BLLs) were measured using graphite furnace atomic absorption spectroscopy (GFAAS) (Agilent, Santa Clara, CA). The elevated BLLs were defined as lead levels in blood samples greater than 10 µg/dL. Data on demographic characteristics, such as occupations, smoking habits, and drinking milk, were collected using a researcher-developed information sheet. Statistical analyses included the Kruskal-Wallis test and Pearson Chi-Square test, and logistic regression was used to address the determinants of elevated BLLs. The corresponding associations were reported using odds ratios (OR) and adjusted OR (AOR) along with 95% confidence intervals (CIs). RESULTS Eighty-five percent of the workers had high BLLs, with a median BLL of 17.11 µg/dL. The findings revealed that workers employed in outdoor settings had 4.25 times higher AOR (95% CI: 1.24-14.48) of experiencing high BLLs compared to those working indoors, after adjusting for other factors. This was especially true for workers who spent nine to 16 hours outdoors. Additionally, age and smoking were also found to be associated with an increased risk of high BLLs. On the other hand, the analysis indicated that drinking milk had a protective effect against high BLLs. CONCLUSION The high prevalence of elevated BLLs among refinery workers in Kirkuk underscores the urgency for immediate interventions. Regular monitoring of BLLs, improved training, dietary adjustments (e.g., consuming calcium and phosphate-rich milk, which can help lower BLLs), and smoking cessation programs are recommended to reduce lead exposure and safeguard workers' health. Furthermore, the results suggest that drinking milk could potentially reduce BLLs among petroleum refinery workers. Additional research is necessary to evaluate the effectiveness of these interventions and to continue monitoring exposure levels.
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Affiliation(s)
- Luay M Mohammed
- Department of Epidemiology, School of Public Health and Safety, Shahid Beheshti University of Medical Sciences, Tehran, IRN
| | - Manoochehr Karami
- Department of Epidemiology, School of Public Health and Safety, Shahid Beheshti University of Medical Sciences, Tehran, IRN
- Environmental and Occupational Hazards Control Research Center, Research Institute for Health Sciences and Environment, Shahid Beheshti University of Medical Sciences, Tehran, IRN
| | - Yadollah Mehrabi
- Department of Epidemiology, School of Public Health and Safety, Shahid Beheshti University of Medical Sciences, Tehran, IRN
| | - Seyed S Hashemi
- Department of Epidemiology, School of Public Health and Safety, Shahid Beheshti University of Medical Sciences, Tehran, IRN
| | - Somayeh Farhang Dehghan
- Environmental and Occupational Hazards Control Research Center, Research Institute for Health Sciences and Environment, Shahid Beheshti University of Medical Sciences, Tehran, IRN
| | - Mohammed Rafiee
- Department of Environmental Health Engineering, School of Public Health and Safety, Shahid Beheshti University of Medical Sciences, Tehran, IRN
| | - Hasan Baiee
- Department of Public Health and Community Medicine, Hilla University College, Babylon, IRQ
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Chaurasia P, McClean SI, Mahdi AA, Yogarajah P, Ansari JA, Kunwar S, Ahmad MK. Automated lead toxicity prediction using computational modelling framework. Health Inf Sci Syst 2023; 11:56. [PMID: 38028960 PMCID: PMC10661678 DOI: 10.1007/s13755-023-00257-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/07/2022] [Accepted: 10/21/2023] [Indexed: 12/01/2023] Open
Abstract
Background Lead, an environmental toxicant, accounts for 0.6% of the global burden of disease, with the highest burden in developing countries. Lead poisoning is very much preventable with adequate and timely action. Therefore, it is important to identify factors that contribute to maternal BLL and minimise them to reduce the transfer to the foetus. Literacy and awareness related to its impact are low and the clinical establishment for biological monitoring of blood lead level (BLL) is low, costly, and time-consuming. A significant contribution to an infant's BLL load is caused by maternal lead transfer during pregnancy. This acts as the first pathway to the infant's lead exposure. The social and demographic information that includes lifestyle and environmental factors are key to maternal lead exposure. Results We propose a novel approach to build a computational model framework that can predict lead toxicity levels in maternal blood using a set of sociodemographic features. To illustrate our proposed approach, maternal data comprising socio-demographic features and blood samples from the pregnant woman is collected, analysed, and modelled. The computational model is built that learns from the maternal data and then predicts lead level in a pregnant woman using a set of questionnaires that relate to the maternal's social and demographic information as the first point of testing. The range of features identified in the built models can estimate the underlying function and provide an understanding of the toxicity level. Following feature selection methods, the 12-feature set obtained from the Boruta algorithm gave better prediction results (kNN = 76.84%, DT = 74.70%, and NN = 73.99%). Conclusion The built prediction model can be beneficial in improving the point of care and hence reducing the cost and the risk involved. It is envisaged that in future, the proposed methodology will become a part of a screening process to assist healthcare experts at the point of evaluating the lead toxicity level in pregnant women. Women screened positive could be given a range of facilities including preliminary counselling to being referred to the health centre for further diagnosis. Steps could be taken to reduce maternal lead exposure; hence, it could also be possible to mitigate the infant's lead exposure by reducing transfer from the pregnant woman.
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Affiliation(s)
- Priyanka Chaurasia
- School of Computing, Engineering & Intelligent Systems, Ulster University, Derry, Londonderry, BT487JL UK
| | - Sally I. McClean
- School of Computing, Ulster University, Co. Antrim, Newtownabbey, BT370QB UK
| | - Abbas Ali Mahdi
- Department of Biochemistry, King George’s Medical University, Lucknow, Uttar Pradesh 226003 India
| | - Pratheepan Yogarajah
- School of Computing, Engineering & Intelligent Systems, Ulster University, Derry, Londonderry, BT487JL UK
| | - Jamal Akhtar Ansari
- Department of Biochemistry, King George’s Medical University, Lucknow, Uttar Pradesh 226003 India
| | - Shipra Kunwar
- Department of Obstetrics & Gynecology, Faculty of Medicine, Era University, Lucknow, Uttar Pradesh 226003 India
| | - Mohammad Kaleem Ahmad
- Department of Biochemistry, King George’s Medical University, Lucknow, Uttar Pradesh 226003 India
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Kordas K, Cantoral A, Desai G, Halabicky O, Signes-Pastor AJ, Tellez-Rojo MM, Peterson KE, Karagas MR. Dietary Exposure to Toxic Elements and the Health of Young Children: Methodological Considerations and Data Needs. J Nutr 2022; 152:2572-2581. [PMID: 36774123 PMCID: PMC10157815 DOI: 10.1093/jn/nxac185] [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] [Received: 04/04/2022] [Revised: 08/03/2022] [Accepted: 08/15/2022] [Indexed: 12/16/2022] Open
Abstract
Concerns have been raised regarding toxic-element (arsenic, cadmium, lead, and mercury) contamination of commercially available infant foods around the world. Young children are vulnerable to the effects of toxic elements, based on higher absorption levels and potentially poorer detoxification capacities. Toxic-element exposures in early life exact high societal costs, but it is unclear how much dietary exposure to these elements contributes to adverse health outcomes. Well-designed epidemiological studies conducted in different geographical and socioeconomic contexts need to estimate dietary toxicant exposure in young children and to determine whether causal links exist between toxicants in children's diets and health outcomes. This commentary outlines the methodological considerations and data needs to advance such research.
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Affiliation(s)
- Katarzyna Kordas
- Department of Epidemiology and Environmental Health, University at Buffalo, Buffalo NY, USA.
| | | | - Gauri Desai
- Department of Epidemiology and Environmental Health, University at Buffalo, Buffalo NY, USA
| | - Olivia Halabicky
- Department of Nutritional Sciences, University of Michigan, Ann Arbor, MI, USA
| | - Antonio J Signes-Pastor
- Unidad de Epidemiología de la Nutrición, Universidad Miguel Hernández, Alicante, Spain; Centro de Investigación Biomédica en Red de Epidemiología y Salud Pública (CIBERESP), Instituto de Salud Carlos III (ISCIII), Madrid, Spain; Instituto de Investigación Sanitaria y Biomédica de Alicante (ISABIAL), Alicante, Spain
| | - Martha M Tellez-Rojo
- Center for Nutrition and Health Research, Instituto Nacional de Salud Pública, Cuernavaca, Morelos, Mexico
| | - Karen E Peterson
- Department of Nutritional Sciences, University of Michigan, Ann Arbor, MI, USA; Department of Environmental Health Sciences, University of Michigan, Ann Arbor, MI, USA
| | - Margaret R Karagas
- Department of Epidemiology, Geisel School of Medicine at Dartmouth, Hanover, NH, USA
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Bramwell L, Morton J, Harding AH, Lin N, Entwistle J. Determinants of blood and saliva lead concentrations in adult gardeners on urban agricultural sites. ENVIRONMENTAL GEOCHEMISTRY AND HEALTH 2022; 44:3493-3513. [PMID: 34622415 PMCID: PMC9522656 DOI: 10.1007/s10653-021-01095-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 04/19/2021] [Accepted: 09/03/2021] [Indexed: 06/13/2023]
Abstract
Soil Pb concentrations at urban agriculture sites (UAS) commonly exceed recommended safe levels. There is a lack of evidence regarding uptake of Pb by gardeners using such sites for food crops. Our study aimed to elucidate whether gardening in soil with raised Pb levels results in Pb body burdens of concern to health, and to assess confounding factors influencing Pb body burden. Our cross-sectional case study measured Pb in saliva and blood of UAS gardeners (n = 43), soil and produce samples from their UAS, and home tap water. Blood and saliva Pb concentrations were compared with those from non-UAS gardener controls (n = 29). A health risk threshold of 5 µg dL-1 blood Pb level (BLL) was selected in keeping with international guidance. Detailed surveys investigated individuals' anthropometrics and potential Pb exposures from diet, and historic and everyday activities. Saliva was not found to be a suitable biomarker of adult Pb exposure in this context. Predictors of higher BLLs were being older, being male and eating more root vegetables and shrub fruit. Eating more green vegetables predicted a lower BLL, suggesting a protective effect against Pb uptake. UAS gardeners' BLLs (geometric mean 1.53; range 0.6-4.1 µg dL-1) were not significantly higher (p = 0.39) than the control group (geometric mean 1.43; range 0.7-2.9 µg dL-1). All BLLs were below 5 µg dL-1 except one resulting from occupational exposure. Having paired the UAS gardeners with closely matched controls, we found Pb in UAS soils (with range 62-1300 mg kg-1from common urban sources) unlikely to pose an additional risk to adult health compared to their neighbours who did not access UAS. As such, other Pb sources may be the dominant factor controlling BLL.
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Affiliation(s)
- Lindsay Bramwell
- Population Health Sciences Institute, Newcastle University, Newcastle upon Tyne, NE2 4AX Tyne and Wear UK
- Present Address: Department of Geography and Environmental Sciences, Northumbria University, Ellison Building, Newcastle Upon Tyne, NE1 8ST Tyne and Wear UK
| | - Jackie Morton
- Health and Safety Executive Science and Research Centre, Buxton, SK17 9JN Derbyshire UK
| | - Anne-Helen Harding
- Health and Safety Executive Science and Research Centre, Buxton, SK17 9JN Derbyshire UK
| | - Nan Lin
- Department of Mathematics, Physics and Electrical Engineering, Northumbria University, Ellison Building, Newcastle Upon Tyne, NE1 8ST Tyne and Wear UK
| | - Jane Entwistle
- Present Address: Department of Geography and Environmental Sciences, Northumbria University, Ellison Building, Newcastle Upon Tyne, NE1 8ST Tyne and Wear UK
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Miller JG, Buthmann JL, Gotlib IH. Hippocampal volume indexes neurobiological sensitivity to the effect of pollution burden on telomere length in adolescents. New Dir Child Adolesc Dev 2022; 2022:155-172. [PMID: 35738556 DOI: 10.1002/cad.20471] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/09/2023]
Abstract
Exposure to environmental pollutants has been associated with cellular aging in children and adolescents. Individuals may vary, however, in their sensitivity or vulnerability to the effects of environmental pollutants. Larger hippocampal volume has emerged as a potential index of increased sensitivity to social contexts. In exploratory analyses (N = 214), we extend work in this area by providing evidence that larger hippocampal volume in early adolescence reflects increased sensitivity to the effect of neighborhood pollution burden on telomere length (standardized β = -0.40, 95% CI[-0.65, -0.15]). In contrast, smaller hippocampal volume appears to buffer this association (standardized β = 0.02). In youth with larger hippocampal volume, pollution burden was indirectly associated with shorter telomere length approximately 2 years later through shorter telomere length at baseline (indirect standardized β = -0.25, 95% CI[-0.40, 0.10]). For these youth, living in high or low pollution-burdened neighborhoods may predispose them to develop shorter or longer telomeres, respectively, later in adolescence.
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Affiliation(s)
- Jonas G Miller
- Department of Psychology, Stanford University, Stanford, California, USA
| | - Jessica L Buthmann
- Department of Psychology, Stanford University, Stanford, California, USA
| | - Ian H Gotlib
- Department of Psychology, Stanford University, Stanford, California, USA
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Cheng XJ, Li GB, Zhang SS, Liu Y, Dong YC, Xue-Ning-Li. Factors associated with blood lead levels in children in Shenyang, China: a cross-sectional study. BMC Pediatr 2022; 22:122. [PMID: 35272651 PMCID: PMC8908648 DOI: 10.1186/s12887-022-03182-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/19/2021] [Accepted: 03/01/2022] [Indexed: 12/02/2022] Open
Abstract
Background Although blood lead levels (BLLs) in children are gradually decreasing, low-concentration lead exposure can still exert adverse effects. We studied the factors that affect BLLs in children in Shenyang, China. Methods We conducted a cross-sectional study by administering structured questionnaires on family demographics and food intake. The concentrations of lead in venous blood were determined by graphite furnace atomic absorption spectrometry. Results A total of 273 children aged 1–6 years were enrolled. The geometric mean (geometric standard deviation) of BLLs was 24.94 (12.70) μg/L in boys and 23.75 (11.34) μg/L in girls. The prevalence of BLLs of ≥35 μg/L was 22.7% and was mainly observed in children aged under 3 years. Often hand washing before meals was protective against BLLs ≥20 μg/L (adjusted OR: 0.427, 95%CI: 0.238–0.767, p = 0.004). Consumption of puffed grains and eggs had an adjusted OR (95%CI) for BLLs ≥20 μg/L of 1.714 (1.012–2.901) (p = 0.045) and 1.787 (1.000–3.192) (p = 0.050), respectively. Conclusions BLLs of children in Shenyang are still higher than in developed countries. Consumption of puffed grains and eggs is associated with higher BLLs. Often hand washing before meals may be protective against high BLLs.
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Affiliation(s)
- Xiao-Jun Cheng
- Department of Pediatrics, The Fourth Affiliated Hospital of China Medical University, Shenyang, Liaoning, People's Republic of China
| | - Guang-Bo Li
- Department of Child and Adolescent Health, School of Public Health, China Medical University, Shenyang, Liaoning, People's Republic of China
| | - Shuang-Shuang Zhang
- Department of Pediatrics, The Fourth Affiliated Hospital of China Medical University, Shenyang, Liaoning, People's Republic of China
| | - Ying Liu
- Department of Pediatrics, The Fourth Affiliated Hospital of China Medical University, Shenyang, Liaoning, People's Republic of China
| | - Yi-Chen Dong
- Department of Pediatrics, The Fourth Affiliated Hospital of China Medical University, Shenyang, Liaoning, People's Republic of China
| | - Xue-Ning-Li
- Department of Pediatrics, The Fourth Affiliated Hospital of China Medical University, Shenyang, Liaoning, People's Republic of China.
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Branz M, Harris JK, Haslam M. An Observational Study of the Association Between Exposure to Vacant Building Demolitions and Elevated Blood Lead Levels in Children Under Six in St Louis City. JOURNAL OF PUBLIC HEALTH MANAGEMENT AND PRACTICE 2022; 28:E446-E455. [PMID: 34475370 DOI: 10.1097/phh.0000000000001416] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Abstract
CONTEXT St Louis City has been demolishing vacant buildings at an increasing rate. Demolition can cause lead dust spread, and childhood lead exposure can have negative effects on cognition, growth, and development. Previous studies show an association between exposure to multiple demolitions and elevated blood lead levels (EBLLs) in children, but St Louis City does not monitor the effects of demolitions on children's blood lead levels. OBJECTIVES The purpose of this study was to measure the association between exposure to demolitions and EBLLs in children younger than 6 years in St Louis City from 2017 to 2020. DESIGN/SETTING/PARTICIPANTS We analyzed blood lead testing data for children 0 to 72 months of age (n = 22 192) and proximity to demolitions. Exposure was the presence of demolitions within 400 ft of a child's address in the 33 days before their first lead test. MAIN OUTCOME MEASURE We used logistic regression to test the association between proximity to demolition and EBLLs (≥5 µg/dL). RESULTS The percentage of children living in proximity to 1 or more demolitions was slightly higher among those with EBLLs (n = 21; 1.3%) than among those without EBLLs (n = 250; 1.2%). However, after adjusting for age, sex, year home was built, season, neighborhood socioeconomic percentile, and neighborhood racial composition, the odds of EBLLs were not significantly different for children exposed to 1 or more demolitions (OR = 0.82; 95% CI, 0.5-1.25) compared with exposed to zero demolitions. CONCLUSIONS Although this study found no association between exposure to demolitions and EBLLs, results should be interpreted with caution, given numerous limitations. Given the consequences of childhood lead exposure, it is recommended that St Louis City conduct a similar analysis on demolitions conducted after 2020 using systematically collected demolition dates. Targeted testing or soil and air monitoring could also be informative.
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Affiliation(s)
- Mikayla Branz
- Brown School, Washington University in St Louis, St Louis, Missouri (Ms Branz and Dr Harris); and City of St Louis Department of Health, St Louis, Missouri (Mr Haslam)
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Liu X, Taylor MP, Aelion CM, Dong C. Novel Application of Machine Learning Algorithms and Model-Agnostic Methods to Identify Factors Influencing Childhood Blood Lead Levels. ENVIRONMENTAL SCIENCE & TECHNOLOGY 2021; 55:13387-13399. [PMID: 34546733 DOI: 10.1021/acs.est.1c01097] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/14/2023]
Abstract
Blood lead (Pb) poisoning remains a global concern, particularly for children in their early developmental years. Broken Hill is Australia's oldest operating silver-zinc-lead mine. In this study, we utilized recent advances in machine learning to assess multiple algorithms and identify the most optimal model for predicting childhood blood Pb levels (BLL) using Broken Hill children's (<5 years of age) data (n = 23,749) from 1991 to 2015, combined with demographic, socio-economic, and environmental influencing factors. We applied model-agnostic methods to interpret the most optimal model, investigating different environmental and human factors influencing childhood BLL. Algorithm assessment showed that stacked ensemble, a method for automatically and optimally combining multiple prediction algorithms, enhanced predictive performance by 1.1% with respect to mean absolute error (p < 0.01) and 2.6% for root-mean-squared error (p < 0.01) compared to the best performing constituent algorithm (random forest). By interpreting the model, the following information was acquired: children had higher BLL if they resided within 1.0 km to the central mine area or 1.37 km to the railroad; year of testing had the greatest interactive strength with all other factors; BLL increased faster in Aboriginal than in non-Aboriginal children at 9-10 and 12-18 months of age. This "stacked ensemble + model-agnostic interpretation" framework achieved both prediction accuracy and model interpretability, identifying previously unconnected variables associated with elevated childhood BLL, offering a marked advantage over previous works. Thus, this approach has a clear value and potential for application to other environmental health issues.
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Affiliation(s)
- Xiaochi Liu
- School of Information Engineering, China University of Geosciences, Beijing 100083, China
- Earth and Environmental Sciences, Faculty of Science and Engineering, Macquarie University, Sydney 2109, New South Wales, Australia
| | - Mark P Taylor
- Earth and Environmental Sciences, Faculty of Science and Engineering, Macquarie University, Sydney 2109, New South Wales, Australia
| | - C Marjorie Aelion
- Department of Environmental Health Sciences, School of Public Health & Health Sciences, University of Massachusetts, Amherst 01003, Massachusetts, United States
| | - Chenyin Dong
- State Environmental Protection Key Laboratory of Environmental Pollution Health Risk Assessment, South China Institute of Environmental Sciences, Ministry of Ecology and Environment, Guangzhou 510655, China
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Environment in Children's Health: A New Challenge for Risk Assessment. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph181910445. [PMID: 34639744 PMCID: PMC8507725 DOI: 10.3390/ijerph181910445] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 08/31/2021] [Revised: 09/27/2021] [Accepted: 10/01/2021] [Indexed: 11/17/2022]
Abstract
In the last few years, many studies have focused on the effects of environmental contaminant exposure during the prenatal period or infancy as predictors of health outcomes in the future. In these time windows, due to their rapid growth, and physiologic and metabolic development, we can observe a higher vulnerability to the effects of environment, with respect to adulthood. The evidence of possible influences, partly mediated by epigenetic mechanisms, involve neurobehavioral responses and immune, endocrine, and respiratory systems, acting directly on the child or indirectly when mediated by placental transfer or breast feeding. In particular, due to a greater intake of air, food, and fluids relative to body weight, crawling behaviors and short stature, the risk of excessive exposure is greater in children. However, data on the long-term implications of early exposures are scarce. Additionally, so that physicians and institutions for child care and assistance of pregnant women can take actions to counteract the effects of chemical pollution (i.e., by educational opportunities), a risk assessment perspective that responds to the biocomplexity of the human being is needed. The present paper provides an overview of physiologic and behavioral characteristics during the perinatal period and in childhood, suggesting in a more integrated way, the need of a new risk-assessment approach to managing chronic disease in pediatric patients.
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Chen J, Wang N, Yuan Y, Zhang W, Xia F, Chen B, Dong R, Lu Y. Blood lead, nutrient intake, and renal function among type 2 diabetic patients. ENVIRONMENTAL SCIENCE AND POLLUTION RESEARCH INTERNATIONAL 2021; 28:49063-49073. [PMID: 33939087 DOI: 10.1007/s11356-021-13623-0] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/30/2021] [Accepted: 03/18/2021] [Indexed: 06/12/2023]
Abstract
Lead (Pb) exposure has been reported to have nephrotoxicity. However, such an effect has not been well investigated in type 2 diabetes (T2D) patients, especially when taking into account the nutrition status of the patients. Therefore, we explore the association between blood lead levels (BLLs), dietary intake of nutrients, and impaired renal function among patients with T2D. We measured BLLs and biochemical parameters of renal injury in 780 patients. Dietary nutrients intake was assessed by a food frequency questionnaire in 420 of 780 participants. We found high BLLs were significantly associated with certain parameters of renal injury, and dietary intake of specific nutrients (mainly micronutrients) was associated with reduced BLLs at high percentile distribution of concentration. BLLs were also found to have moderation effects on the association between specific dietary nutrients and specific renal function parameters.
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Affiliation(s)
- JingSi Chen
- Department of Nutrition and Food Hygiene, School of Public Health, Soochow University, Suzhou, China
- Key Laboratory of Public Health Safety of Ministry of Education, Collaborative Innovation Center of Social Risks Governance in Health, School of Public Health, Fudan University, Shanghai, 200032, China
| | - NingJian Wang
- Institute and Department of Endocrinology and Metabolism, Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, 200011, China
| | - Yaqun Yuan
- Key Laboratory of Public Health Safety of Ministry of Education, Collaborative Innovation Center of Social Risks Governance in Health, School of Public Health, Fudan University, Shanghai, 200032, China
| | - Wen Zhang
- Institute and Department of Endocrinology and Metabolism, Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, 200011, China
| | - FangZhen Xia
- Institute and Department of Endocrinology and Metabolism, Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, 200011, China
| | - Bo Chen
- Key Laboratory of Public Health Safety of Ministry of Education, Collaborative Innovation Center of Social Risks Governance in Health, School of Public Health, Fudan University, Shanghai, 200032, China
| | - RuiHua Dong
- Key Laboratory of Public Health Safety of Ministry of Education, Collaborative Innovation Center of Social Risks Governance in Health, School of Public Health, Fudan University, Shanghai, 200032, China.
| | - YingLi Lu
- Institute and Department of Endocrinology and Metabolism, Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, 200011, China.
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Desai G, Anzman-Frasca S, Vernarelli JA, Ravenscroft J, Yang J, Burstein G, Kordas K. Examining Links Between Diet and Lead Exposure in Young Children: 2009 to 2014 National Health and Nutrition Examination Survey. Acad Pediatr 2021; 21:471-479. [PMID: 32562770 DOI: 10.1016/j.acap.2020.06.009] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/24/2019] [Revised: 06/03/2020] [Accepted: 06/11/2020] [Indexed: 11/18/2022]
Abstract
OBJECTIVE Despite recommendations to consume iron-, calcium-, and vitamin C-rich foods for managing blood lead levels (BLLs), limited evidence exists on how specific foods affect children's BLLs. Using data from 12- to 36-month olds (n = 992) from the 2009 to 2014 National Health and Nutrition Examination Survey, we assessed how foods rich in these nutrients associate with BLLs, and with potential inadvertent exposures to cadmium and mercury. METHODS Food intake was assessed from one 24-hour dietary recall. Foods were categorized into 10 energy-adjusted groups, with intake categorized as none (reference) and tertiles. BLLs were natural log-transformed. Linear regressions tested associations between food groups and BLLs. Logistic regressions were conducted for blood cadmium and mercury. RESULTS Median (5%, 95% range) BLLs were 1.01 (0.39, 3.21) µg/dL. Majority of food groups (7 of 10) showed little association with BLLs. Compared to no intake, cereal (tertile 3: β [95% confidence interval] = -0.22 [-0.41, -0.02]) and milk (Ptrend < 0.002; nonsignificant tertiles) consumption was associated with lower BLLs. Meat (tertile 2: 0.23 [0.01, 0.45]) and fruit drink (tertile 2: 0.20 [0.03, 0.38]; tertile 3: 0.25 [0.02, 0.49]) intake was associated with higher BLLs. Fruit drink consumption was associated with lower likelihood of having blood cadmium >0.11 µg/dL (tertile 3: odds ratio: 0.05 [0.01, 0.36]). No associations were observed with blood mercury. CONCLUSIONS Among young children, consumption of iron-, calcium-, and vitamin C-rich foods showed weak or no association with BLLs. Few associations were observed for blood cadmium or mercury. Food-based approaches to BLL management may have limited utility when exposure is low.
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Affiliation(s)
- Gauri Desai
- Department of Epidemiology and Environmental Health, School of Public Health and Health Professions, The State University of New York (SUNY) at Buffalo (G Desai and K Kordas).
| | - Stephanie Anzman-Frasca
- Department of Pediatrics, Jacobs School of Medicine and Biomedical Sciences, and Center for Ingestive Behavior Research, The State University of New York (SUNY) at Buffalo (S Anzman-Frasca)
| | | | - Julia Ravenscroft
- Department of Anthropology, University of Kentucky (J Ravenscroft), Lexington, Ky
| | - Janet Yang
- Department of Communication, The State University of New York (SUNY) at Buffalo (J Yang)
| | - Gale Burstein
- Erie County Department of Health (G Burstein), Buffalo, NY; Department of Pediatrics, Jacobs School of Medicine and Biomedical Sciences, The State University of New York (SUNY) at Buffalo (G Burstein)
| | - Katarzyna Kordas
- Department of Epidemiology and Environmental Health, School of Public Health and Health Professions, The State University of New York (SUNY) at Buffalo (G Desai and K Kordas)
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Donangelo CM, Kerr BT, Queirolo EI, Vahter M, Peregalli F, Mañay N, Kordas K. Lead exposure and indices of height and weight in Uruguayan urban school children, considering co-exposure to cadmium and arsenic, sex, iron status and dairy intake. ENVIRONMENTAL RESEARCH 2021; 195:110799. [PMID: 33508259 PMCID: PMC10916356 DOI: 10.1016/j.envres.2021.110799] [Citation(s) in RCA: 13] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/06/2020] [Revised: 01/15/2021] [Accepted: 01/21/2021] [Indexed: 05/18/2023]
Abstract
Child growth depends on complex factors including diet, nutritional status, socioeconomic, and sanitary conditions, and exposure to environmental chemicals. Lead exposure is known to impair growth in young children but effects in school-age children are less clear. The effects of co-exposure to low-level lead and other toxic metals on child growth are not well understood. We examined cross-sectional associations of blood lead (BLL) with growth indices (Z scores of body mass index for age, BAZ, and height for age, HAZ) in Uruguayan urban school children (n = 259; ~7 y). Potential differences in these associations in children with lower vs. higher urinary inorganic arsenic metabolites (U-As), urinary cadmium (U-Cd), sex (42% girls), iron deficiency (ID, 39% children), or intake of dairy foods below recommended levels were examined. BLL was measured using AAS, U-As using HPLC-HGICP-MS, and U-Cd using ICP-MS. Dietary information was obtained by two 24-h recalls completed by caregivers. Children's linear growth was within age and sex-appropriate reference values. Overweight (BAZ > 1 2 SD) was found in 20.1%, and obesity (BAZ > 2 SD) in 18.5%, of children. Ranges (5th, 95th percentile) of biomarker concentrations were: BLL, 0.8-7.8 μg/dL; U-Cd, 0.01-0.2 μg/L, and U-As, 4.0-27.3 μg/L. BLL was inversely associated with HAZ ([95% CI]: 0.10 [-0.17, -0.03]) in covariate-adjusted models. Although this association was slightly more pronounced in girls, children without ID, and children with lower U-As, there was little evidence of effect modification due to overlapping CIs in stratified models. BLLs were not associated with BAZ, except for a suggestion of a negative relationship in girls (-0.10 [-0.23, 0.02]) but not boys [0.001 [-0.11, 0.12]). Our findings indicate that exposure to low levels of lead was associated with lower HAZ in apparently normally growing urban school children. Larger future studies should help elucidate if these associations persist over time and across populations.
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Affiliation(s)
| | - Brendan T Kerr
- Department of Epidemiology and Environmental Health, University at Buffalo, Buffalo, NY, USA
| | - Elena I Queirolo
- Departmento de Neurocognición, Centro de Investigación Mullin, Universidad Católica Del Uruguay, Montevideo, Uruguay
| | - Marie Vahter
- Department of Environmental Medicine, Karolinska Institutet, Solna, Sweden
| | - Fabiana Peregalli
- Departmento de Neurocognición, Centro de Investigación Mullin, Universidad Católica Del Uruguay, Montevideo, Uruguay
| | - Nelly Mañay
- Departmento de Toxicología, Facultad de Química, Universidad de La República, Montevideo, Uruguay
| | - Katarzyna Kordas
- Department of Epidemiology and Environmental Health, University at Buffalo, Buffalo, NY, USA.
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Gatzke-Kopp LM, Warkentien S, Willoughby M, Fowler C, Folch DC, Blair C. Proximity to sources of airborne lead is associated with reductions in Children's executive function in the first four years of life. Health Place 2021; 68:102517. [PMID: 33540187 DOI: 10.1016/j.healthplace.2021.102517] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/15/2020] [Revised: 01/07/2021] [Accepted: 01/18/2021] [Indexed: 12/19/2022]
Abstract
Although policies to remove lead from gasoline have resulted in a substantial reduction in airborne lead, multiple industries are known to generate lead that is released in the air. The present study examines the extent to which residential proximity to a documented source of airborne lead is associated with intellectual and executive function in children. Data were available for n = 849 children from the Family Life Project. Geolocation for children's residences between birth and 36 months were referenced against the Environmental Protection Agency's Risk Screening Environmental Indicators (RSEI) database, which estimates exposure for each ½ mile grid in the contiguous United States. Instrumental variable models were employed to estimate causal associations between exposure and cognitive outcomes measured at 36, 48, and 60 months, using census-documented density of manufacturing employment as the instrument. Models of continuous lead dosage indicated small negative effects for both child IQ and executive function (EF). These results indicate that RSEI estimates of airborne lead exposure are meaningfully associated with decrements in cognitive development.
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Affiliation(s)
- Lisa M Gatzke-Kopp
- Department of Human Development and Family Studies, The Pennsylvania State University, University Park, PA, 16802, USA.
| | - Siri Warkentien
- Education and Workforce Development, RTI International, Washington, DC, 20005, USA
| | - Michael Willoughby
- Education and Workforce Development, RTI International, Research Triangle Park, NC, 27709, USA
| | - Chris Fowler
- Department of Geography, The Pennsylvania State University, University Park, PA, 16802, USA
| | - David C Folch
- Department of Geography, Planning, and Recreation, Northern Arizona University, Flagstaff, AZ, 86001, USA
| | - Clancy Blair
- Department of Population Health, New York University Grossman School of Medicine, New York, NY, 10016, USA
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15
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Gleason KM, Valeri L, Shankar AH, Obrycki JF, Ibne Hasan MOS, Mostofa G, Quamruzzaman Q, Wright RO, Christiani DC, Bellinger DC, Mazumdar M. Stunting and lead: using causal mediation analysis to better understand how environmental lead exposure affects cognitive outcomes in children. J Neurodev Disord 2020; 12:39. [PMID: 33327931 PMCID: PMC7745460 DOI: 10.1186/s11689-020-09346-x] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/06/2020] [Accepted: 11/18/2020] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Many children in Bangladesh experience poor nutritional status and environmental lead exposure, both of which are associated with lower scores on neurodevelopmental assessments. Recent studies have suggested that part of lead's adverse effects on neurodevelopment are caused in part by lead's effect on growth. New statistical methods are now available to evaluate potential causal pathways in observational studies. This study used a novel statistical method to test the hypothesis that stunting, a measure of linear growth related to poor nutrition, is a mediator and/or an effect modifier of the lead exposure's adverse effect on cognitive development. METHODS Participants were 734 children from a longitudinal birth cohort established in rural Bangladesh to study the health effects of prenatal and early childhood environmental metal exposures. Lead exposure was estimated using umbilical cord blood samples obtained at birth and blood obtained via venipuncture at age 20-40 months. Stunting was determined using the World Health Organization's standards. Neurodevelopment was assessed at age 20-40 months years using the Bayley Scales of Infant and Toddler Development, Third Edition (BSID-III). We evaluated the effect of lead on stunting and whether the effect of lead on cognitive scores is modified by stunting status in multivariable regression analyses. We then conducted a novel 4-way mediation analysis that allows for exposure-mediator interaction to assess how much of the effect of lead on cognitive scores is explained by the pathway through stunting (mediation) and how much is explained by the interaction between lead and stunt (effect modification). RESULTS Stunting was not a mediator of the effect of lead in our analyses. Results suggested effect modification by stunting. In an area of Bangladesh with lower lead exposures (median umbilical cord blood lead concentration, 1.7 μg/dL), stunting modified the relationship between prenatal blood lead concentrations and cognitive score at age 2-3 years. A 1-unit increase in natural log cord blood lead concentration in the presence of stunting was associated with a 2.1-unit decrease in cognitive scores (β = - 2.10, SE = 0.71, P = 0.003). This interaction was not found in a second study site where lead exposures were higher (median umbilical cord blood lead concentration, 6.1 μg/dL, β = - 0.45, SE = 0.49, P = 0.360). CONCLUSIONS We used a novel method of mediation analysis to test whether stunting mediated the adverse effect of prenatal lead exposure on cognitive outcomes in Bangladesh. While we did not find that stunting acted as mediator of lead's effect on cognitive development, we found significant effect modification by stunting. Our results suggest that children with stunting are more vulnerable to the adverse effects of low-level lead exposure.
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Affiliation(s)
- Kelsey M Gleason
- Department of Medicine, Robert Larner M.D. College of Medicine, Burlington, VT, USA
| | - Linda Valeri
- Department of Biostatistics, Columbia Mailman School of Public Health, New York, NY, USA
| | - Anuraj H Shankar
- Department of Nutrition, Harvard T.H. Chan School of Public Health, Boston, MA, USA
| | - John F Obrycki
- Department of Neurology, Boston Children's Hospital, 300 Longwood Avenue, Boston, MA, 02115, USA
| | | | | | | | - Robert O Wright
- Department of Preventive Medicine, Icahn School of Medicine at Mt. Sinai, New York, NY, USA
- Department of Environmental Medicine and Public Health, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - David C Christiani
- Department of Environmental Health, Harvard T.H. Chan School of Public Health, Boston, MA, USA
| | - David C Bellinger
- Department of Neurology, Boston Children's Hospital, 300 Longwood Avenue, Boston, MA, 02115, USA
- Department of Environmental Health, Harvard T.H. Chan School of Public Health, Boston, MA, USA
| | - Maitreyi Mazumdar
- Department of Neurology, Boston Children's Hospital, 300 Longwood Avenue, Boston, MA, 02115, USA.
- Department of Environmental Health, Harvard T.H. Chan School of Public Health, Boston, MA, USA.
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16
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Mayfield KE, Hession SL, Weatherspoon L, Hoerr SL. A Cross-Sectional Analysis Exploring Differences between Food Availability, Food Price, Food Quality and Store Size and Store Location in Flint Michigan. JOURNAL OF HUNGER & ENVIRONMENTAL NUTRITION 2020. [DOI: 10.1080/19320248.2019.1693469] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
Affiliation(s)
- Kellie E. Mayfield
- Department of Nutrition, Georgia State University, Atlanta, Georgia, USA
| | - Sarah L. Hession
- Center for Statistical Training & Consulting, Michigan State University, East Lansing, Michigan, USA
| | - Lorraine Weatherspoon
- Department of Food Science and Human Nutrition, Michigan State University, East Lansing, Michigan, USA
| | - Sharon L. Hoerr
- Department of Food Science and Human Nutrition, Michigan State University, East Lansing, Michigan, USA
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17
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Trentacosta CJ, Mulligan DJ. New directions in understanding the role of environmental contaminants in child development: Four themes. New Dir Child Adolesc Dev 2020; 2020:39-51. [PMID: 32920950 PMCID: PMC8189654 DOI: 10.1002/cad.20363] [Citation(s) in RCA: 14] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/24/2022]
Abstract
Environmental contaminants, which include several heavy metals, persistent organic pollutants, and other harmful chemicals, impair several domains of child development. This article describes four themes from recent research on the impact of environmental contaminants on child development. The first theme, disparities in exposure, focuses on how marginalized communities are disproportionately exposed to harmful environmental contaminants. The second theme, complexity of exposures, encapsulates recent emphases on timing of exposures and mixtures of multiple exposures. The third theme, mechanisms that link exposures to outcomes, focuses on processes that elucidate how contaminants impact outcomes. The fourth theme, mitigating risks associated with exposures, sheds light on potential protective factors that could ameliorate many of the harmful effects of contaminant exposures. Developmental scientists are well positioned to contribute to interdisciplinary research that addresses these themes, which could foster additional conceptual and empirical innovations and inform policies and practices to mitigate risks and improve children's well-being.
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18
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Gump BB, Hruska B, Parsons PJ, Palmer CD, MacKenzie JA, Bendinskas K, Brann L. Dietary contributions to increased background lead, mercury, and cadmium in 9-11 Year old children: Accounting for racial differences. ENVIRONMENTAL RESEARCH 2020; 185:109308. [PMID: 32222635 PMCID: PMC7898456 DOI: 10.1016/j.envres.2020.109308] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/12/2019] [Revised: 02/24/2020] [Accepted: 02/24/2020] [Indexed: 05/22/2023]
Abstract
BACKGROUND Initial interest in the adverse consequences of exposure to lead (Pb), mercury (Hg), and cadmium (Cd) focused on relatively high exposures through environmental or occupational sources; however, recent evidence suggests even low-level background exposure to non-essential metals might be detrimental, particularly for children's health and development. One potentially important source of increased background levels of non-essential toxic metals is diet. OBJECTIVES We considered whether differences in diet are associated with levels of non-essential metals in blood and whether racial differences in metals are mediated by dietary differences. METHODS We assessed blood levels of Pb, Hg, and Cd in a sample of 9-11 year-old children (N = 295) comprised of 42% European Americans (EAs), 58% African American (AAs), and 47% female. Diet was assessed using 24-h dietary recalls during phone interviews administered to parents on two consecutive days (Friday and Saturday). The Healthy Eating Index-2105 (HEI-2015) was calculated to assess diet quality. RESULTS The current study identified significant dietary sources of non-essential metal exposure - namely total fruit for Pb, total protein for Hg, and greens and beans for Cd. Moreover, AAs were found to have significantly higher blood levels of Pb and Hg than EAs and these racial differences were significantly mediated by these dietary differences. DISCUSSION This study is one of very few to consider total diet in children and exposure to the non-essential metals Pb, Hg, and Cd, and the first to demonstrate that racial differences in increased background blood levels of non-essential toxic metals can be accounted for by racial differences in diet. Given regional differences in food consumption patterns and specific farm and store sources for the foods, the generalizability of the current findings has yet to be determined; however, commonly consumed foods appear to be a significant source of low-level non-essential metals.
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Affiliation(s)
- Brooks B Gump
- Department of Public Health, Food Studies, and Nutrition, Syracuse University, United States.
| | - Bryce Hruska
- Department of Public Health, Food Studies, and Nutrition, Syracuse University, United States
| | - Patrick J Parsons
- Laboratory of Inorganic and Nuclear Chemistry, Wadsworth Center, New York State Department of Health, United States; Department of Environmental Health Sciences, School of Public Health, The University at Albany, United States
| | - Christopher D Palmer
- Laboratory of Inorganic and Nuclear Chemistry, Wadsworth Center, New York State Department of Health, United States; Department of Environmental Health Sciences, School of Public Health, The University at Albany, United States
| | - James A MacKenzie
- Department of Biological Sciences, State University of New York College at Oswego, United States
| | - Kestutis Bendinskas
- Department of Chemistry, State University of New York College at Oswego, United States
| | - Lynn Brann
- Department of Public Health, Food Studies, and Nutrition, Syracuse University, United States
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19
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Bah HAF, Bandeira MJ, Gomes-Junior EA, Anjos ALS, Rodrigues YJM, Dos Santos NR, Martinez VO, Rocha RBMA, Costa RG, Adorno EV, Menezes-Filho JA. Environmental exposure to lead and hematological parameters in Afro-Brazilian children living near artisanal glazed pottery workshops. JOURNAL OF ENVIRONMENTAL SCIENCE AND HEALTH. PART A, TOXIC/HAZARDOUS SUBSTANCES & ENVIRONMENTAL ENGINEERING 2020; 55:964-974. [PMID: 32400283 DOI: 10.1080/10934529.2020.1761738] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/04/2019] [Revised: 04/22/2020] [Accepted: 04/23/2020] [Indexed: 06/11/2023]
Abstract
This study aimed to evaluate the exposure to environmental lead (Pb) of children from a traditional community of African descent in Brazil and the effects on hematological parameters. Children (n = 75) aged 5.5-13 years from the exposed areas classified as low (LEx) and moderately (MEx) exposed were compared with children (n = 75) of a control group (CG). Dust Pb loading rates (RtPbs) at children's homes were measured. Peripheral venous blood samples were collected to assess Pb biomarkers of exposure and effects. All Pb determinations were performed by graphite furnace atomic absorption spectrometry. The median (IQR) of RtPb, PbB level, and ALA-D activity were 65 (25-137) μgPb/m2/30 days, 1.0 (0.1-2.8) μg/dL, and 71 (55-86) U/L, respectively. Spearman correlation evidenced the relationship of PbB with RtPb (rho = 0.368, P < 0.001) and ALA-D activity (rho = -0.587; P ˂ 0.001). After adjusting for exposure degree and child's age, a decline of 7.4 U/L in ALA-D activity was associated with a 10-fold increase in PbB. The prevalence ratio of elevated PbB (>5 μg/dL) in LEx and MEx areas were 1.5 and 3.7, respectively. Indoor dust exposure, living near pottery workshops and the secondary exposure were the main determinants of elevated PbB levels, which were associated with hematological effects.
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Affiliation(s)
- Homegnon A F Bah
- Laboratory of Toxicology, College of Pharmacy, Federal University of Bahia, Salvador, Brazil
- Graduate Program in Pharmacy, College of Pharmacy, Federal University of Bahia, Salvador, Brazil
| | - Matheus J Bandeira
- Laboratory of Toxicology, College of Pharmacy, Federal University of Bahia, Salvador, Brazil
- Graduate Program in Pharmacy, College of Pharmacy, Federal University of Bahia, Salvador, Brazil
| | - Erival A Gomes-Junior
- Laboratory of Toxicology, College of Pharmacy, Federal University of Bahia, Salvador, Brazil
- Graduate Program in Food Science, College of Pharmacy, Federal University of Bahia, Salvador, Brazil
| | - Ana Laura S Anjos
- Laboratory of Toxicology, College of Pharmacy, Federal University of Bahia, Salvador, Brazil
| | - Ynayara J M Rodrigues
- Graduate Program in Food Science, College of Pharmacy, Federal University of Bahia, Salvador, Brazil
| | - Nathália R Dos Santos
- Laboratory of Toxicology, College of Pharmacy, Federal University of Bahia, Salvador, Brazil
- Graduate Program in Pharmacy, College of Pharmacy, Federal University of Bahia, Salvador, Brazil
| | - Victor O Martinez
- Graduate Program in Pharmacy, College of Pharmacy, Federal University of Bahia, Salvador, Brazil
| | - Rômula B M A Rocha
- Graduate Program in Pharmacy, College of Pharmacy, Federal University of Bahia, Salvador, Brazil
| | - Renata G Costa
- Graduate Program in Food Science, College of Pharmacy, Federal University of Bahia, Salvador, Brazil
| | - Elisângela V Adorno
- Graduate Program in Pharmacy, College of Pharmacy, Federal University of Bahia, Salvador, Brazil
| | - José A Menezes-Filho
- Laboratory of Toxicology, College of Pharmacy, Federal University of Bahia, Salvador, Brazil
- Graduate Program in Pharmacy, College of Pharmacy, Federal University of Bahia, Salvador, Brazil
- Graduate Program in Food Science, College of Pharmacy, Federal University of Bahia, Salvador, Brazil
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20
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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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21
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Wani AL, Ansari MO, Ahmad MF, Parveen N, Siddique HR, Shadab GGHA. Influence of zinc levels on the toxic manifestations of lead exposure among the occupationally exposed workers. ENVIRONMENTAL SCIENCE AND POLLUTION RESEARCH INTERNATIONAL 2019; 26:33541-33554. [PMID: 31583521 DOI: 10.1007/s11356-019-06443-w] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/21/2019] [Accepted: 09/05/2019] [Indexed: 06/10/2023]
Abstract
Lead and zinc are usually found at the same occupational places and occur as co-contaminants. Effects of lead toxicity are detrimental on human health as it is probable carcinogen and impairs normal growth and development. On the other hand, zinc is an important nutritional element, the deficiency of which causes debilitating effects on growth and development. The purpose of this study was to examine the possible association of blood lead and zinc levels and any influence of zinc over DNA damage, blood cell membrane aberration and oxidative stress among lead and zinc co-exposed workers. Atomic absorption spectroscopy was used for lead and zinc measurement and comet assay for DNA damage assessment. Haematological aberrations were studied using light and electron microscopy (LM and EM) followed by electron density X-ray spectroscopy (EDS) and elemental mapping. Occupational exposure was observed to cause significant elevation in blood lead levels among workers. This elevation in lead levels and associated DNA damage among workers was significantly high in comparison to controls. Further light and electron micrographs of red blood cells revealed significant morphological alterations associated with increased lead ions in workers. It was clear from SEM-based elemental maps and EDS graphs that elevated lead levels were associated with low levels of zinc. The results suggest that lead absorption is highly influenced due to zinc levels in body which has an impact over DNA damage, blood cell aberration and oxidative stress caused by lead exposure. Efforts are going on to understand the role of other trace metals on lead toxicity in order to develop a sustainably nutrition-based therapeutic intervention. Graphical abstract.
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Affiliation(s)
- Ab Latif Wani
- Cytogenetics and Molecular Toxicological Laboratory, Section of Genetics, Department of Zoology, Faculty of Life Sciences, Aligarh Muslim University, Aligarh, Uttar Pradesh, 202002, India
| | - Mohd Owais Ansari
- Cytogenetics and Molecular Toxicological Laboratory, Section of Genetics, Department of Zoology, Faculty of Life Sciences, Aligarh Muslim University, Aligarh, Uttar Pradesh, 202002, India
| | - Md Fahim Ahmad
- Cytogenetics and Molecular Toxicological Laboratory, Section of Genetics, Department of Zoology, Faculty of Life Sciences, Aligarh Muslim University, Aligarh, Uttar Pradesh, 202002, India
| | - Nuzhat Parveen
- Cytogenetics and Molecular Toxicological Laboratory, Section of Genetics, Department of Zoology, Faculty of Life Sciences, Aligarh Muslim University, Aligarh, Uttar Pradesh, 202002, India
| | - Hifzur R Siddique
- Molecular Cancer Genetics & Translational Research Lab, Section of Genetics, Department of Zoology, Aligarh Muslim University, Aligarh, Uttar Pradesh, 202002, India
| | - G G Hammad Ahmad Shadab
- Cytogenetics and Molecular Toxicological Laboratory, Section of Genetics, Department of Zoology, Faculty of Life Sciences, Aligarh Muslim University, Aligarh, Uttar Pradesh, 202002, India.
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22
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Screening for Elevated Blood Lead Levels and Related Risk Factors among Thai Children Residing in a Fishing Community. TOXICS 2019; 7:toxics7040054. [PMID: 31614792 PMCID: PMC6958338 DOI: 10.3390/toxics7040054] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 08/17/2019] [Revised: 09/25/2019] [Accepted: 10/08/2019] [Indexed: 01/07/2023]
Abstract
The present study explored environmental and behavioral factors associated with elevated blood lead (Pb) levels in 311 children (151 girls and 160 boys), aged 3–7 years, who lived in a coastal fishing community of the Pakpoon Municipality, Nakhon Si Thammarat, Thailand. The geometric mean for blood Pb was 2.81 µg/dL, ranging between 0.03 and 26.40 µg/dL. The percentage of high blood Pb levels, defined as blood Pb ≥ 5 µg/dL, was 10.0% in boys and 13.9% in girls. Parental occupation in producing fishing nets with lead weights was associated with a marked increase in the prevalence odds ratio (POR) for high blood Pb (POR 17.54, 95%; CI: 7.093, 43.390; p < 0.001), while milk consumption was associated with 61% reduction in the POR for high blood Pb (POR 0.393, 95%; CI: 0.166, 0.931; p = 0.034). High blood Pb was associated with an increased risk for abnormal growth (POR 2.042, 95%; CI: 0.999, 4.174; p = 0.050). In contrast, milk consumption was associated with a 43% reduction in POR for abnormal growth (POR 0.573, 95%; CI: 0.337, 0.976; p = 0.040). After adjustment for age, the mean (standard error of mean, SE) values for blood Pb were 6.22 (0.50) μg/dL in boys and 6.72 (0.49) μg/dL in girls of parents with an occupation in making fishing nets with lead weights. These mean blood Pb values were respectively 2.3 and 2.5 times higher than similarly aged boys and girls of parents with other occupations. These data are essential for setting surveillance and programmes to prevent toxic Pb exposure, especially in children of coastal fishing communities in southern Thailand.
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Landes FC, Inauen J, Ponce‐Canchihuamán J, Markowski K, Ellis TK, van Geen A. Does Involving Parents in Soil Sampling Identify Causes of Child Exposure to Lead? A Case Study of Community Engagement in Mining-Impacted Towns in Peru. GEOHEALTH 2019; 3:218-236. [PMID: 32159043 PMCID: PMC7007120 DOI: 10.1029/2019gh000200] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/30/2019] [Revised: 07/11/2019] [Accepted: 07/15/2019] [Indexed: 05/05/2023]
Abstract
Over a million people in Peru may be exposed to lead (Pb) due to past or present mining-related activities; however, neither soil Pb nor blood Pb are routinely monitored throughout the country. Because little is known about Pb contamination in smaller mining-impacted towns, soil Pb was mapped in four such towns with a portable X-ray fluorescence analyzer in 2015. The roadside mapping delineated hotspots of highly contaminated soil (1,000-6,000 mg/kg Pb) in two of the towns. The local health department, provided with a LeadCare II analyzer, then measured blood-Pb levels >5 in 65% and >10 μg/dL in 15% of children (n = 200) up to 6 years of age in these same four communities. There were no clear relations between child blood-Pb levels and Pb levels in soil samples collected inside (n = 50) or outside the home (n = 50). Increased child blood Pb was associated with decreased level of cleanliness of parent clothing (n = 136) and shoes (n = 138), linking a possible behavioral factor for transferring contaminated soil and dust to children. In order to explore individual exposure and variations in soil Pb, 10 parents of children with blood Pb >10 μg/dL and 10 parents of children with blood Pb <5 μg/dL were invited to collect soil samples in areas where their children play and screen it for Pb using a color-based field procedure. Importantly, parents identified a new hotspot of Pb contamination that had been missed by the previous portable X-ray fluorescence soil mapping. The findings highlight the feasibility and value of involving families impacted by environmental contamination to identify and reduce environmental health risk.
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Affiliation(s)
- Franziska C. Landes
- Lamont‐Doherty Earth ObservatoryColumbia UniversityPalisadesNYUSA
- Department of Earth and Environmental SciencesColumbia UniversityNew YorkNYUSA
| | | | - Johny Ponce‐Canchihuamán
- Center for Research in Environmental HealthLimaPeru
- Facultad de Salud Publica y AdministracionUniversidad Peruana Cayetano HerediaLimaPeru
| | - Kathie Markowski
- Lamont‐Doherty Earth ObservatoryColumbia UniversityPalisadesNYUSA
| | - Tyler K. Ellis
- Lamont‐Doherty Earth ObservatoryColumbia UniversityPalisadesNYUSA
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Li T, Zhang S, Tan Z, Dai Y. Potential dietary factors for reducing lead burden of Chinese preschool children. ENVIRONMENTAL SCIENCE AND POLLUTION RESEARCH INTERNATIONAL 2019; 26:22922-22928. [PMID: 31177414 DOI: 10.1007/s11356-019-05527-x] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/29/2018] [Accepted: 05/21/2019] [Indexed: 06/09/2023]
Abstract
Dietary approaches to treat children's low lead exposure are implemented routinely in China, while evidence for the effect could not be provided until now. The aim of this study was to examine the relationship between diets including nutrition supplementation and blood lead level of preschool children of China. In total, 17,859 preschool children from 14 cities were recruited, and their social-demography, living environment, and dietary intakes were collected, and capillary blood sample was tested for lead concentration. The average blood lead concentration was 34.5 μg/L, and after adjusting children's social-demography factors, the consumption of milk or dairy production, fruits, and calcium supplementation had negative dose-response relationships with blood lead level. Conversely, intake of iron-rich food and supplementation was not associated. Further studies are needed to prove the causal relationships.
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Affiliation(s)
- Tao Li
- Capital Institute of Pediatrics, Beijing, 100020, China
| | | | - Zangwen Tan
- Capital Institute of Pediatrics, Beijing, 100020, China
| | - Yaohua Dai
- Capital Institute of Pediatrics, Beijing, 100020, China.
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25
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Fruit and Vegetable Prescriptions for Pediatric Patients Living in Flint, Michigan: A Cross-Sectional Study of Food Security and Dietary Patterns at Baseline. Nutrients 2019; 11:nu11061423. [PMID: 31242555 PMCID: PMC6627167 DOI: 10.3390/nu11061423] [Citation(s) in RCA: 20] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/01/2019] [Revised: 06/18/2019] [Accepted: 06/19/2019] [Indexed: 01/31/2023] Open
Abstract
Though fruit and vegetable consumption is essential for disease prevention and health maintenance, intake among children fails to meet dietary recommendations. Limited access to and the affordability of fresh produce, particularly among low-income youth, are barriers to adequate intake. To address these challenges, researchers and pediatricians in Flint, Michigan, expanded a successful fruit and vegetable prescription program that provides one $15 prescription for fresh fruits and vegetables to every child at every office visit. Vendors include the downtown farmers' market and a local mobile market. This study describes baseline characteristics, dietary patterns, food access, and food security among 261 caregiver-child dyads enrolled August 2018-March 2019. The child-reported mean daily intake of vegetables (0.72 cups ± 0.77), dairy products (1.33 cups ± 1.22), and whole grains (0.51 ounces ± 0.49) were well below recommendations. Furthermore, 53% of children and 49% of caregivers who completed the food security module indicated low or very low food security. However, there were no statistically significant differences in the child consumption of fruits and vegetables between households that reported high versus low food security (p > 0.05). Results validate and raise deep concerns about poor dietary patterns and food insecurity issues facing Flint children, many of whom continue to battle with an ongoing drinking water crisis. Additional poverty-mitigating efforts, such as fruit and vegetable prescription programs, are necessary to address these gaps.
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Taylor CM, Doerner R, Northstone K, Kordas K. Dietary Patterns Are Not Consistently Associated with Variability in Blood Lead Concentrations in Pregnant British Women. J Nutr 2019; 149:1027-1036. [PMID: 31149708 PMCID: PMC6543203 DOI: 10.1093/jn/nxz023] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/14/2018] [Revised: 12/13/2018] [Accepted: 01/30/2019] [Indexed: 11/14/2022] Open
Abstract
BACKGROUND During pregnancy lead crosses the placenta freely and can have adverse effects on the fetus, with the potential for lifelong impact on the child. Identification of dietary patterns and food groups in relation to measures of lead status could provide a more useful alternative to nutrient-specific advice to minimize fetal lead exposure. OBJECTIVES The aim of this study was to evaluate whether dietary patterns and food groups are associated with blood lead concentration (B-Pb) in pregnancy. DESIGN Whole blood samples were collected at a median of 11 wk gestation (IQR 9-13 wk) from women enrolled in the Avon Longitudinal Study of Parents and Children birth cohort study, and analyzed for lead. Dietary pattern scores were derived from principal components analysis of a food-frequency questionnaire (32 wk gestation). Associations of dietary pattern scores (quartiles), and of food groups (frequency of consumption), with the likelihood of B-Pb ≥5 µg/dL identified with adjusted logistic regression (n = 2167 complete cases). RESULTS There was a negative association between the "confectionery" dietary pattern and the likelihood of B-Pb ≥5 µg/dL (OR: 0.62; 95% CI: 0.41, 0.94) in an adjusted model. There were no associations with other dietary patterns. There was a positive association between the food group "all leafy green and green vegetables" and the likelihood of B-Pb ≥5 µg/dL (OR 1.45; 95% CI: 1.04, 2.01). Conversely, the food group "cakes and biscuits" was negatively associated (OR 0.63; 95% CI: 0.43, 0.93). After multiple imputation, there was a positive association of the "healthy" diet pattern and no association of the "confectionery" pattern. CONCLUSIONS We found limited evidence of an association between women's typical diet and B-Pb during pregnancy. Our findings do not indicate need to revise dietary guidance for pregnant women, who are advised to adopt a healthy diet in pregnancy, with a variety of foods consumed in moderation.
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Affiliation(s)
- Caroline M Taylor
- Centre for Academic Child Health, Bristol Medical School, University of Bristol, UK
| | - Rita Doerner
- Bristol Medical School, University of Bristol, UK
| | | | - Katarzyna Kordas
- Epidemiology and Environmental Health, School of Public Health and Health Professions, University at Buffalo, Buffalo, NY
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Gulson B, Mizon K, Taylor A, Wu M. Dietary zinc, calcium and nickel are associated with lower childhood blood lead levels. ENVIRONMENTAL RESEARCH 2019; 168:439-444. [PMID: 30390566 DOI: 10.1016/j.envres.2018.10.029] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/30/2018] [Revised: 10/25/2018] [Accepted: 10/25/2018] [Indexed: 05/22/2023]
Abstract
The potential mitigation of elevated blood lead (PbB) levels with nutrient intake remains debatable. A comprehensive review by Kordas (2017) concluded that careful examination of the links between nutrition (nutritional status, nutrients, diet) and lead (Pb) exposure revealed limited and tenuous evidence. We have measured 20 elements including calcium (Ca), chromium (Cr), copper (Cu), iron (Fe), magnesium (Mg), manganese (Mn), nickel (Ni), zinc (Zn), and Pb from 6-day duplicate diets of 108 young children over a 5-year period and expressed these as intakes per body weight. Bivariate analyses showed a weak positive association between the Pb content in the diets of the participants and the level of Pb in their blood, as might be expected. Weak, but negative, associations occurred between the other elements in the diet and PbB. The associations for Ca, Mg, Ni and Zn were statistically significant for both subject-based (between subjects) and within-subject effects: that is, as the levels of elements in diet increased, the PbB level decreased. The largest percentage of variance of PbB in the context of the bivariate model accounted for was 4.23% for Zn, followed by Ca (3.91%) and Fe (2.20%). Supplementary analyses indicated that the between- and within-subject effects did not vary with the age at which participants entered the study, or with the levels of elements at their first measurement. A multivariable analysis using Weighted Quantile Sum Regressions showed that a weighted composite comprised of all the dietary elements had a significant association with PbB when adjusted for Pb in the diet and other covariates and also when adjusted for Pb in house dust; the latter was found to have the strongest association with PbB in earlier analyses. The highest weights were for Ca (0.29), Ni (0.27) and Zn (0.22); these results are generally consistent with those from the mixed model analyses.
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Affiliation(s)
- Brian Gulson
- Department of Environmental Sciences, Macquarie University, Sydney, NSW 2109, Australia; CSIRO, Energy, Sydney, Australia.
| | - Karen Mizon
- Department of Environmental Sciences, Macquarie University, Sydney, NSW 2109, Australia
| | - Alan Taylor
- Department of Psychology, Macquarie University, Sydney, Australia
| | - Michael Wu
- UBO Services Australia, Sydney, NSW, Australia
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Bjørklund G, Dadar M, Chirumbolo S, Aaseth J. High Content of Lead Is Associated with the Softness of Drinking Water and Raised Cardiovascular Morbidity: A Review. Biol Trace Elem Res 2018; 186:384-394. [PMID: 29656350 DOI: 10.1007/s12011-018-1336-8] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/02/2018] [Accepted: 04/04/2018] [Indexed: 10/17/2022]
Abstract
Daily ingestion of lead (Pb), even through piped drinking water, has long time been an important issue of concern, attracting for decades research in environmental science and toxicology, and again comes to prominence because of recent high-profile cases of exposure of populations in several countries to Pb-contaminated water. Numerous studies have reported an association between Pb in water and the risk of cardiovascular pathologies. Low levels of magnesium and calcium, i.e., low degree of hardness of the drinking water, may accentuate Pb leaching from water pipes and furthermore increase Pb absorption. This review evaluates the evidence for an association between Pb exposure from drinking water and cardiovascular end points in human populations.
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Affiliation(s)
- Geir Bjørklund
- Council for Nutritional and Environmental Medicine, Toften 24, 8610, Mo i Rana, Norway.
| | - Maryam Dadar
- Razi Vaccine and Serum Research Institute, Agricultural Research, Education and Extension Organization (AREEO), Karaj, Iran
| | - Salvatore Chirumbolo
- Department of Neurological and Movement Sciences, University of Verona, Verona, Italy
| | - Jan Aaseth
- Faculty of Public Health, Inland Norway University of Applied Sciences, Elverum, Norway
- Department of Research, Innlandet Hospital Trust, Brumunddal, Norway
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Ravenscroft J, Roy A, Queirolo EI, Mañay N, Martínez G, Peregalli F, Kordas K. Drinking water lead, iron and zinc concentrations as predictors of blood lead levels and urinary lead excretion in school children from Montevideo, Uruguay. CHEMOSPHERE 2018; 212:694-704. [PMID: 30176551 DOI: 10.1016/j.chemosphere.2018.07.154] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/05/2018] [Revised: 06/13/2018] [Accepted: 07/25/2018] [Indexed: 06/08/2023]
Abstract
The global burden of water-based lead (Pb) exposure on children is largely unknown; however, the importance of water sources as a path of Pb exposure is receiving increased attention due to recent prominent exposure events related to corroded plumbing infrastructure in the US. This study investigated the contribution of Pb in household drinking and cooking water to Pb levels in blood (PbB) and urine (PbU) within 353 early school-aged children from Montevideo, Uruguay. Additionally, the analysis considered the child's iron status and the water content of iron (WFe) and zinc (WZn) in relation to water Pb and blood/urine Pb concentrations. Lead concentrations for both PbB and PbU were fairly low (M ± SD: 4.2 ± 2.1 μg/dL; Median [5%, 95%]: 1.9 [0.6, 5.1 μg/L, respectively]); however 21% of the sample had a PbB >5 μg/dL but ≤ 10 μg/dL. Overall, there was little evidence of an association between water metal concentrations and children's PbB/PbU. However, when the sample was stratified by children's iron status, WPb was positively related to PbU, but negatively related to PbB in iron-replete children, even after adjusting for WFe and WZn. In iron-deficient children, there was no elevation in PbU with increasing WPb. In this sample of children with low Pb levels, there were no overwhelming relationships between WPb and either PbB or PbU, however, there was some evidence that iron-replete status promotes excretion of WPb.
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Affiliation(s)
- Julia Ravenscroft
- Epidemiology and Environmental Health, University at Buffalo, Buffalo, NY 14214, USA.
| | - Aditi Roy
- Department of Pediatrics, Vanderbilt University Medical Center, Nashville, TN 37232, USA
| | - Elena I Queirolo
- Center for Research, Catholic University of Uruguay, Montevideo, Uruguay
| | - Nelly Mañay
- Toxicology Area, Faculty of Chemistry, University of the Republic of Uruguay, Montevideo, Uruguay
| | - Gabriela Martínez
- Toxicology Area, Faculty of Chemistry, University of the Republic of Uruguay, Montevideo, Uruguay
| | - Fabiana Peregalli
- Center for Research, Catholic University of Uruguay, Montevideo, Uruguay
| | - Katarzyna Kordas
- Epidemiology and Environmental Health, University at Buffalo, Buffalo, NY 14214, USA
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Kordas K, Burganowski R, Roy A, Peregalli F, Baccino V, Barcia E, Mangieri S, Ocampo V, Mañay N, Martínez G, Vahter M, Queirolo EI. Nutritional status and diet as predictors of children's lead concentrations in blood and urine. ENVIRONMENT INTERNATIONAL 2018; 111:43-51. [PMID: 29172090 PMCID: PMC5915341 DOI: 10.1016/j.envint.2017.11.013] [Citation(s) in RCA: 53] [Impact Index Per Article: 8.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/17/2017] [Revised: 10/17/2017] [Accepted: 11/17/2017] [Indexed: 05/05/2023]
Abstract
Lead exposure remains an important public health problem. Contaminated foods may act as a source of lead exposure, while certain nutrients may reduce lead absorption. We examined the cross-sectional associations of dietary patterns and the intake of several nutrients and foods with blood (Pb-B) and urinary (Pb-U) lead concentrations in children (5-8y) from Montevideo, Uruguay. From two 24-hour recalls completed by caregivers, we derived the mean daily intake of select nutrients and food groups (dairy, milk, fruit, root vegetables, foods rich in heme and non-heme iron), as well as "nutrient dense" and "processed" food patterns. Pb-B (n=315) was measured using atomic absorption spectrometry; Pb-U (n=321) using ICP-MS. Pb-U was adjusted for specific gravity and log-transformed to approximate a normal distribution. Iron deficiency (ID) and dietary variables were tested as predictors of Pb-B and log-Pb-U in covariate-adjusted regressions. Median [5%, 95%] Pb-B and Pb-U were 3.8 [0.8-7.8] μg/dL and 1.9 [0.6-5.1] μg/L, respectively; ~25% of Pb-B above current U.S. CDC reference concentration of 5μg/dL. ID was associated with 0.75μg/dL higher Pb-B, compared to non-ID (p<0.05). Consumption of root vegetables was not associated with Pb-B or log-Pb-U. Higher scores on the nutrient-dense pattern were related with higher Pb-Bs, possibly due to consumption of green leafy vegetables. Dietary intake of iron or iron-rich foods was not associated with biomarkers of lead. Conversely, children consuming more calcium, dairy, milk and yogurt had lower Pb-B and log-Pb-U. Our findings appear consistent with existing recommendations on including calcium-rich, but not iron- or vitamin-C-rich foods in the diets of lead-exposed children, especially where the consumption of these foods is low.
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Affiliation(s)
- Katarzyna Kordas
- Epidemiology and Environmental Health, University at Buffalo, Buffalo, NY, United States.
| | - Rachael Burganowski
- Epidemiology and Environmental Health, University at Buffalo, Buffalo, NY, United States
| | - Aditi Roy
- Department of Pediatrics, Vanderbilt University Medical Center, Nashville, TN, United States
| | - Fabiana Peregalli
- Centre for Research, Catholic University of Uruguay, Montevideo, Uruguay; Department of Gastroenterology, Hepatology and Nutrition, Pereira Rossell Hospital, Montevideo, Uruguay
| | - Valentina Baccino
- Centre for Research, Catholic University of Uruguay, Montevideo, Uruguay
| | - Elizabeth Barcia
- Centre for Research, Catholic University of Uruguay, Montevideo, Uruguay
| | - Soledad Mangieri
- Centre for Research, Catholic University of Uruguay, Montevideo, Uruguay
| | - Virginia Ocampo
- Centre for Research, Catholic University of Uruguay, Montevideo, Uruguay
| | - Nelly Mañay
- Toxicology Area, Faculty of Chemistry, University of the Republic of Uruguay, Montevideo, Uruguay
| | - Gabriela Martínez
- Toxicology Area, Faculty of Chemistry, University of the Republic of Uruguay, Montevideo, Uruguay
| | - Marie Vahter
- Institute of Environmental Health, Karolinska Institutet, Stockholm, Sweden
| | - Elena I Queirolo
- Centre for Research, Catholic University of Uruguay, Montevideo, Uruguay
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Green D, Sullivan M, Cooper N, Dean A, Marquez C. A Pilot Study of Children's Blood Lead Levels in Mount Isa, Queensland. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2017; 14:E1567. [PMID: 29236077 PMCID: PMC5750985 DOI: 10.3390/ijerph14121567] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 11/21/2017] [Revised: 12/06/2017] [Accepted: 12/08/2017] [Indexed: 12/03/2022]
Abstract
Mount Isa, Queensland, is one of three Australian cities with significant lead emissions due to nonferrous mining and smelting. Unlike the two other cities with lead mines or smelters, Mount Isa currently has no system of annual, systematic, community-wide blood lead level testing; and testing rates among Indigenous children are low. In previous screenings, this group of children has been shown to have higher average blood lead levels than non-Indigenous children. The first aim of this study was to assess whether parents and children would participate in less invasive, rapid point-of-care capillary testing. The second aim was to measure blood lead levels among a range of children that roughly reflected the percentage of the Indigenous/non-Indigenous population. This pilot study is based on a convenience sample of children between the ages of 12 and 83 months who were recruited to participate by staff at a Children and Family Centre. Over three half-days, 30 children were tested using capillary blood samples and the LeadCare II Point-of-Care testing system. Rapid point-of-care capillary testing was well tolerated by the children. Of 30 children tested, 40% (n = 12) had blood lead levels ≥5 µg/dL and 10% had levels ≥10 µg/dL. The highest blood lead level measured was 17.3 µg/dL. The percentage of children with blood lead levels ≥5 µg/dL was higher among Indigenous children compared to non-Indigenous (64.2% compared to 18.8%) as was the geometric mean level (6.5 (95% CI, 4.7, 9.2) versus 2.4 (95% CI, 1.8, 3.1)), a statistically significant difference. Though based on a small convenience sample, this study identified 12 children (40%) of the sample with blood lead levels ≥5 µg/dL. Due to historical and ongoing heavy metal emissions from mining and smelting in Mount Isa, we recommend a multi-component program of universal blood lead level testing, culturally appropriate follow-up and intervention for children who are identified with blood lead levels ≥5 µg/dL. We further recommend focused outreach and assistance to the Indigenous community, and further control of emissions and remediation of existing environmental lead contamination in children's play and residential areas.
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Affiliation(s)
- Donna Green
- Climate Change Research Centre, University of New South Wales, Kensington, Sydney, NSW 2052, Australia.
- The ARC Centre of Excellence for Climate Systems Science, University of New South Wales, Kensington, Sydney, NSW 2052, Australia.
| | - Marianne Sullivan
- Department of Public Health, William Paterson University, Wayne, NJ 07470, USA.
| | - Nathan Cooper
- Climate Change Research Centre, University of New South Wales, Kensington, Sydney, NSW 2052, Australia.
- The ARC Centre of Excellence for Climate Systems Science, University of New South Wales, Kensington, Sydney, NSW 2052, Australia.
| | - Annika Dean
- Climate Change Research Centre, University of New South Wales, Kensington, Sydney, NSW 2052, Australia.
| | - Cielo Marquez
- Sonic HealthPlus Super Clinic, Ryan Road, Mount Isa, QLD 4825, Australia.
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32
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Schmidt CW. After the Screening: What Happens Next for Children with Elevated Blood Lead? ENVIRONMENTAL HEALTH PERSPECTIVES 2017; 125:102001. [PMID: 29068317 PMCID: PMC5933304 DOI: 10.1289/ehp2482] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 07/06/2017] [Accepted: 07/06/2017] [Indexed: 06/07/2023]
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Mayfield KE, Carolan M, Weatherspoon L, Chung KR, Hoerr SM. African American Women's Perceptions on Access to Food and Water in Flint, Michigan. JOURNAL OF NUTRITION EDUCATION AND BEHAVIOR 2017; 49:519-524.e1. [PMID: 28601169 DOI: 10.1016/j.jneb.2017.04.002] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/17/2016] [Revised: 04/11/2017] [Accepted: 04/12/2017] [Indexed: 06/07/2023]
Abstract
OBJECTIVE To explore the perceptions of food access by African American women in Flint, MI. METHODS Using womanist theory, in which African American women's experiential knowledge centered the analysis, 8 focus groups were conducted during fall/spring, 2014-2015. Seventeen mothers aged 21-50 years with children aged <18 years and 13 women aged >60 years comprised the groups. RESULTS The high cost of water, poor availability of healthy foods in inner-city stores, and limited transportation were barriers to accessing healthy food. Conversely, receiving food from food giveaways, friends, and family, as well as access to transportation facilitated food access. These women also reported discriminatory experiences and diet-related health concerns. Participants were keenly aware of available free community resources and gender, racial, and income barriers to accessing them. CONCLUSION AND IMPLICATIONS Understanding these barriers and facilitators provides information to aid local food policy assistance decisions and inform community-based interventions, especially given the lead contamination of water and the purported importance of a healthy diet to sequester lead.
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Affiliation(s)
| | - Marsha Carolan
- Department of Human Development and Family Studies, Michigan State University, East Lansing, MI
| | - Lorraine Weatherspoon
- Department of Food Science and Human Nutrition, Michigan State University, East Lansing, MI
| | - Kimberly R Chung
- Department of Community Sustainability, Michigan State University, East Lansing, MI
| | - Sharon M Hoerr
- Department of Food Science and Human Nutrition, Michigan State University, East Lansing, MI
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