Lead Toxicity in Children: An Unremitting Public Health Problem

Analyzing and Optimizing the Distribution of Blood Lead Level Testing for Children in New York City: A Data-Driven Approach

This study investigates blood lead level (BLL) rates and testing among children under 6 years of age across the 42 neighborhoods in New York City from 2005 to 2021. Despite a citywide general decline in BLL rates, disparities at the neighborhood level persist and are not addressed in the official reports, highlighting the need for this comprehensive analysis. In this paper, we analyze the current BLL testing distribution and cluster the neighborhoods using a k-medoids clustering algorithm. We propose an optimized approach that improves resource allocation efficiency by accounting for case incidences and neighborhood risk profiles using a grid search algorithm. Our findings demonstrate statistically significant improvements in case detection and enhanced fairness by focusing on under-served and high-risk groups. Additionally, we propose actionable recommendations to raise awareness among parents, including outreach at local daycare centers and kindergartens, among other venues.

Pediatric Lead Chelation Managed During Critical Medication Shortages: Case Report and Literature Review

Lead poisoning in children has the potential for devastating neurodevelopmental consequences. There is significant socioeconomic disparity in children with lead poisoning. Specific lead chelation regimens have been approved for children by the US Food and Drug Administration, however in the United States, there has been a recent national shortage of the primary therapy, edetate calcium disodium (CaNa2 EDTA). This case report presents a 23-month-old child with severe symptomatic lead poisoning during a national shortage of CaNa2 EDTA to highlight the need for advocacy regarding critical medication shortages, especially for antidote therapy. The infant's initial blood lead level was 364 mcg/dL and he received a continuous infusion of CaNa2 EDTA (1000 mg/m2/day), as well as dimercaprol (4 mg/kg intramuscularly every 4 hours). The supply of CaNa2 EDTA was exhausted on day 3 of therapy so he was transitioned to enteral succimer monotherapy. Initial parenteral therapy of 72 hours achieved a lead level of 72 mcg/dL; he then completed his enteral course of succimer along with environmental mitigation. However, elevated blood lead levels persisted and he subsequently required 3 more courses of enteral succimer, and he continues to have detectable blood lead levels 2 years after initial presentation. In the face of medication shortages including CaNa2 EDTA, and now also dimercaprol, clinicians must create and study alternative chelation therapy regimens for pediatric lead toxicity. Furthermore, public policy initiatives, including the development of a national supply stockpile of chelation agents, must be created in order to minimize supply chain disruption and ensure adequate and equitable antidote therapy for lead poisoning outbreaks.

A 'click' based fluorescent probe mimicking the IMPLICATION logic gate for Cu(II) and Pb(II) sensing: DFT and molecular docking studies

'Click' derived 1,2,3-triazole appended scaffolds are intriguing candidates for selective metal ion recognition because of their stereospecificity and efficiency. The presented report uses the 'click' approach to introduce a glyoxal bis-(2-hydroxyanil)-based chemosensor probe (GT) via the CuAAC pathway, which can selectively detect Cu(II) and Pb(II) ions, both of which are among the most hazardous and perturbing environmental pollutants. NMR spectroscopy, IR spectroscopy, and mass spectrometry (LCMS) were used to successfully characterize the synthesized probe. The discerning recognition behaviour of the probe for Cu(II) and Pb(II) ions was established through a chemosensing investigation using fluorescence and UV-vis spectroscopy, wherein the fluorescence spectral analysis demonstrated the probe to mimic the IMPLICATION logic gate. Furthermore, the metal-ligand interaction was also validated by 1H NMR and IR spectroscopy of the synthesized GT-metal complex, and UV-vis spectroscopy was also employed to analyze the effect of time and temperature on the capacity of the probe to bind with Cu(II) and Pb(II) ions. Furthermore, the sensor's atherosclerosis-inhibition potential was investigated in silico utilizing docking analysis with tribbles-1 protein, and a density functional theory (DFT) study enhanced the understanding of its structure using the B3LYP functional and the 6311G++(d,p) basis set.

Berberine Hydrochloride Improves Cognitive Function and Hippocampal Antioxidant Status in Subchronic and Chronic Lead Poisoning

OBJECTIVES

To determine the neuroprotective effects of berberine hydrochloride (BBR) against lead-induced injuries on the hippocampus of rats.

METHODS

Wistar rats were exposed orally to doses of 100 and 500 ppm lead acetate for 1 and 2 months to develop subchronic and chronic lead poisening models, respectively. For treatment, BBR (50 mg/kg daily) was injected intraperitoneally to rats poisoned with lead. At the end of the experiment, the spatial learning and memory of rats were assessed using the Morris water maze test. Hippocampal tissue changes were examined by hematoxylin and eosin staining. The activity of antioxidant enzymes catalase, superoxide dismutase, glutathione peroxidase, and malondialdehyde levels as parameters of oxidative stress and antioxidant status of the hippocampus were evaluated.

RESULTS

BBR reduced cognitive impairment in rats exposed to lead (P<0.05 or P<0.01). The resulting biochemical changes included a decrease in the activity of antioxidants and an increase in lipid peroxidation of the hippocampus of lead-exposed rats (P<0.05 or P<0.01), which were significantly modified by BBR (P<0.05). BBR also increased the density of healthy cells in the hippocampus of leadexposed rats (P<0.05). Significant changes in tissue morphology and biochemical factors of the hippocampus were observed in rats that received lead for 2 months (P<0.05). Most of these changes were insignificant in rats that received lead for 1 month.

CONCLUSION

BBR can improve oxidative tissue changes and hippocampal dysfunction in lead-exposed rats, which may be due to the strong antioxidant potential of BBR.

Environmental Racism and Child Health

Environmental racism poses a significant threat to child health. It is a major contributor to disproportionate exposure to environmental hazards that are linked to adverse health outcomes. This narrative review shows the profound impact that environmental racism poses to healthy child development through 3 examples. Historical redlining provides compelling evidence of how historical policies continue to influence neighborhoods' physical and social conditions. Exploring chemicals in beauty products reveals how anti-Black perceptions of beauty work to expose children of color to endocrine-disrupting chemicals. Finally, by exploring childhood lead exposure, we see how decades of inequitable implementation of lead exposure prevention policies contribute to persistent disparities in the United States today. Fixing these structural issues is complex and will require political will and investment. Yet, individual clinicians play an important role in their local communities in protecting children from the harms of environmental racism, through education, genuine collaboration with the community, and advocacy.

Metallopeptide nanoreservoirs for concurrent imaging and detoxification of lead (Pb) from human retinal pigment epithelial (hRPE1) cells

Inspired by natural metallopeptides, our work focuses on engineering self-assembling nanostructures of C2-symmetric metallopeptide conjugates (MPC) from a pyridine-bis-tripeptide bioprobe that uniquely detects lead (Pb2+) ions by emitting a fluorescence signal at 450 nm, which is further intensified in the presence of DAPI (λem = 458 nm), enhancing the bioimaging quality. This study enables precise lead quantification by modulating the ionic conformation and morphology. Experimental and theoretical insights elucidate the nanostructure formation mechanism, laying the groundwork for materials encapsulation and advancing lead detoxification. Our proof-of-principle experiment, demonstrating actin filament recovery in lead-treated cells, signifies therapeutic potential for intracellular lead aggregation and introduces novel avenues in biotechnological applications within biomaterials science.

Identifying and Responding to Lead in Drinking Water in a University Setting

Lead is an established neurotoxicant, and it has known associations with adverse neurodevelopmental and reproductive outcomes. Exposure to lead at any level is unsafe, and the United States (US) has enacted various federal and state legislations to regulate lead levels in drinking water in K-12 schools and childcare facilities; however, no regulations exist for higher education settings. Upon the discovery of lead in drinking water fixtures in the University of North Carolina at Chapel Hill (UNC-CH) campus, a cross-campus water testing network and sampling plan was developed and deployed. The campaign was based on the US Environmental Protection Agency's (EPA) 3Ts (Training, Testing, and Taking Action) guidance. The seven-month campaign involved 5954 tests on 3825 drinking water fixtures across 265 buildings. A total of 502 (8.43%) tests showed lead above the limit of detection (1 part per billion, ppb), which represented 422 (11.03%) fixtures. Fewer than 1.5% of the tests were above the EPA action level for public water systems (15 ppb). In conclusion, systematic testing of all the fixtures across campus was required to identify localized contamination, and each entity in the cross-campus network undertook necessary roles to generate a successful testing campaign. UNC-CH established preventative measures to test drinking water fixtures every three years, which provide a framework for other higher education institutions in responding to lead contamination.

Lead Levels in the Most Consumed Mexican Foods: First Monitoring Effort

Globally, there is growing concern over the presence of lead (Pb) in foods because it is a heavy metal with several toxic effects on human health. However, monitoring studies have not been conducted in Mexico. In this study, we estimated the concentrations of Pb in the most consumed foods and identified those that exceeded the maximum limits (MLs) for Pb in foods established by the International Standards. Based on the Mexican National Health and Nutrition Survey, 103 foods and beverages were selected and purchased in Mexico City retail stores and markets. Samples were analyzed twice using atomic absorption spectrophotometry. Values above the limit of quantification (0.0025 mg/kg) were considered to be detected. The percentage of detected values was 18%. The highest concentration was found in infant rice cereal (1.005 mg/kg), whole wheat bread (0.447 mg/kg), pre-cooked rice (0.276 mg/kg), black pepper (0.239 mg/kg), and turmeric (0.176 mg/kg). Among the foods with detected Pb, the levels in infant rice cereal, whole wheat bread, pre-cooked rice, and soy infant formula exceeded the MLs. The food groups with the highest percentages of exceeded MLs were baby foods (18%) and cereals (11%). Monitoring the concentration of contaminants in foods is essential for implementing food safety policies and protecting consumer health.

Lead induced genotoxicity and hepatotoxicity in zebrafish (Danio rerio) at environmentally relevant concentration: Nrf2-Keap1 regulated stress response and expression of biomarker genes

Genotoxic and hepatotoxic potentials of Pb at an environmentally relevant concentration (5 ppm) in zebrafish were investigated in the present study. Erythrocytic nuclear abnormality tests revealed the increased frequencies of abnormal erythrocytes after Pb exposure, indicating a strong genotoxic potential of Pb. Multiple stress-related parameters were further evaluated in liver, the major detoxifying organ. Pb caused increased production of ROS, which in turn caused severe oxidative stress. As a result, lipid peroxidation was increased, whereas reduced glutathione level and catalase activity was decreased. Alterations in liver histoarchitecture also served as evidence of Pb-induced hepatotoxicity. Pb-induced ROS stress triggered upregulation of Nrf2, Nqo1, Ho1; downregulation of Keap1, and altered mRNA expressions of Mn-sod, Cu/Zn-sod, gpx1, cyp1a, ucp2 suggesting involvement of Nrf2-Keap1-ARE signaling in cellular defence. Nrf2-keap1 is a sensitive biomarker of Pb-induced ROS stress. Overexpression of Hsp70 and other genes in hepatocytes might help cell survival under oxidative stress generation.

Effect of Environmental and Socioeconomic Factors on Increased Early Childhood Blood Lead Levels: A Case Study in Chicago

This study analyzes the prevalence of elevated blood lead levels (BLLs) in children across Chicagoland zip codes from 2019 to 2021, linking them to socioeconomic, environmental, and racial factors. Wilcoxon tests and generalized additive model (GAM) regressions identified economic hardship, reflected in per capita income and unemployment rates, as a significant contributor to increased lead poisoning (LP) rates. Additionally, LP rates correlate with the average age of buildings, particularly post the 1978 lead paint ban, illustrating policy impacts on health outcomes. The study further explores the novel area of land surface temperature (LST) effects on LP, finding that higher nighttime LST, indicative of urban heat island effects, correlates with increased LP. This finding gains additional significance in the context of anthropogenic climate change. When these factors are combined with the ongoing expansion of urban territories, a significant risk exists of escalating LP rates on a global scale. Racial disparity analysis revealed that Black and Hispanic/Latino populations face higher LP rates, primarily due to unemployment and older housing. The study underscores the necessity for targeted public health strategies to address these disparities, emphasizing the need for interventions that cater to the unique challenges of these at-risk communities.

Effectiveness of educational interventions for the prevention of lead poisoning in children: a systematic review

INTRODUCTION

Childhood exposure to lead has severe health consequences including long-term physical, behavioral, and learning problems. Lead poisoning often occurs in the home and persists as a form of environmental injustice, disparately impacting certain children based on factors such as socioeconomic status, immigration status, and race. Because abatement is costly, many prevention programs rely on educational interventions. We conducted a systematic review to assess the effectiveness of educational interventions on reducing blood lead levels (BLL) in children.

CONTENT

Following PRISMA-P guidelines, a librarian-guided search strategy incorporated database-specific subject headings and keywords related to lead poisoning and education, and encompassed four databases: Ovid MEDLINE, Scopus, Web of Science Core Collection and CINAHL. Two reviewers screened the results for those that met inclusion criteria (original research, study population of children under 18 years, inclusion of an educational intervention, outcome of BLL).

SUMMARY AND OUTLOOK

We screened the titles of 2,062 non-duplicate studies, the abstracts of 78 studies, and full texts of 23 articles, resulting in 17 articles that met eligibility criteria. Thirteen studies used multi-pronged interventions, which precluded comprehensive assessment of the effectiveness of the educational component. Interventions that had success in lowering BLL included some notable elements: longevity of intervention, consideration of culture and ethnicity; use of a community or home-based approach; and provision of supplies or assistance with cleaning. Of the four of studies that used solely educational interventions, three were successful in reducing BLL. Among the 12 studies that used a control group, six found their interventions to be successful in reducing BLL. This review found that educational interventions, either alone or as part of a multi-pronged approach, do not consistently reduce BLL in children. However, educational interventions may decrease severity of lead poisoning in children when more robust interventions are not feasible.

Integral trends in research of lead exposure and child health from 2012 to 2022: a bibliometric analysis

Lead poisoning in children is a non-negligible and ongoing threat to children's health and optimal development worldwide. There is no sufficient scientometric analysis available on this subject, though. Aiming to uncover the research development, hotspots, and possible future orientation, we performed a scientometric analysis of related publications from 2012 to 2022. Initial information was accessed using the "Analysis Results" and "Create Citation Report" sections of the Web of Science core collection database, which were utilized to find original publications in this field of research. Biblioshiny and VOSviewer software were applied to further analyze and visualize the data. The research addressed a range of topics, including yearly publications, highly cited articles, co-cited references, journals, authors, nations, organizations, and keywords. A total of 883 articles were retrieved. From 2018 to 2021, the annual publication output was abundant and peaked in 2019. Among 111 countries, the USA obtained the highest number of documents issued, total citations, and total link strength. Meanwhile, most of the top 15 institutions, including the top four, are located in the USA. Further, we spotted greater scopes with development potential, including enhancing records to lessen exposure to harmful risks, improving methods for observing lead sources, and elucidating the gradient link between lead poisoning symptoms and concentrations. We anticipate that our research will assist researchers in summarizing previous research and providing perspectives for workable prospective study topics.

A multi-city study of indoor air quality in green vs non-green low-income housing

OBJECTIVES

The condition of the home is a strong predictor of exposure to environmental contaminants, with low-income households being particularly vulnerable. Therefore, improving housing standards is a priority. Housing built to "green" standards, with improved building methods and materials, has been suggested to reduce contaminants. However, evidence is limited as to which contaminants are reduced. The Green Housing Study was conducted to address this issue. The study hypothesis was that housing built using green components has lower concentrations of environmental contaminants compared to conventional housing.

METHODS

A repeated-measures, 12-month cohort study was performed in three U.S. cities. Data were collected in the home at three time points throughout a year. The level of contaminants were estimated using air samples for particulate matter and black carbon, dust samples for aeroallergens and pesticides, and resident or study staff reporting evidence of mold. To investigate source(s) of PM2.5 and black carbon, multivariable models using stepwise variable selection were developed.

RESULTS

In adjusted generalized estimating equations (GEE) models, black carbon concentration (μg/m3) (β = -0.22, 95% CI = -0.38 to -0.06, p = 0.01), permethrin (OR = 0.28, 95% CI = 0.15-0.49, p < 0.0001), and reported mold (OR = 0.29, 95% CI = 0.13-0.68, p = 0.003) were significantly lower in green homes. Cockroach antigen was also lower in green homes (OR = 0.59, 95% CI = 0.33-1.08, p = 0.09), although not statistically significant. We found that 68% of PM2.5 was explained by dwelling type and smoking and 42% of black carbon was explained by venting while cooking and use of a gas stove.

CONCLUSIONS

This study provides quantitative data suggesting benefits of incorporating green building practices on the level of numerous environmental contaminants known to be associated with health. Occupant behavior, particularly smoking, is an important contributor to indoor air pollution.

Effect of lead exposure on histone modifications: A review

Lead at any levels can result in detrimental health effects affecting various organ systems. These systematic manifestations under Pb exposure and the underlying probable pathophysiological mechanisms have not been elucidated completely. With advancements in molecular research under Pb exposure, epigenetics is one of the emerging field that has opened many possibilities for appreciating the role of Pb exposure in modulating gene expression profiles. In terms of epigenetic alterations reported in Pb toxicity, DNA methylation, and microRNA alterations are extensively explored in both experimental and epidemiological studies, however, the understanding of histone modifications under Pb exposure is still in its infant stage limited to experimental models. In this review, we aim to present a synoptic view of histone modifications explored in relation to Pb exposure attempting to bring out this potential lacunae in research. The scarcity of studies associating histone modifications with Pb toxicity, and the paucity of their validation in human cohort further emphasizes the strong research potential of this field. We summarize the review by presenting our hypotheses regarding the involvement of these histone modification in various diseases modalities associated with Pb toxicity.

Characterization of bacterial diversity and capacity to remove lead of a consortium from mining soil

INTRODUCTION

At present, the presence of lead (Pb2+) continues to be a problem in water bodies due to its continuous use and high toxicity. The aim of this study was to investigate the bacterial diversity of a potential consortium used as a biosorbent for the removal of lead in an aqueous solution.

METHODS

The minimum inhibitory concentration and the mean lethal dose of the consortium were determined, and then the optimal variables of pH and temperature for the removal process were obtained. With the optimal conditions, the kinetic behavior was evaluated, and adjustments were made to different mathematical models. A Fourier transform infrared spectroscopy analysis was performed to determine the functional groups of the biomass participating in the removal process, and the diversity of the bacterial consortium was evaluated during Pb2+ removal by an Ion Torrent Personal Genome Machine System.

RESULTS

It was found that the intraparticle diffusion model was the one that described the adsorption kinetics showing a higher rate constant with a higher concentration of Pb2+, while the Langmuir model was that explained the isotherm at 35 °C, defining a maximum adsorption load for the consortium of 54 mg/g. In addition, it was found that Pb2+ modified the diversity and abundance of the bacterial consortium, detecting genera such as Pseudomonas, Enterobacter, Citrobacter, among others.

CONCLUSIONS

Thus, it can be concluded that the bacterial consortium from mining soil was a biosorbent with the ability to tolerate high concentrations of Pb2+ exposure. The population dynamics during adsorption showed enrichment of Proteobacteria phyla, with a wide range of bacterial families and genera capable of resisting and removing Pb2+ in solution.

Pseudomonas putida Metallothionein: Structural Analysis and Implications of Sustainable Heavy Metal Detoxification in Madinah

Heavy metals, specifically cadmium (Cd) and lead (Pb), contaminating water bodies of Madinah (Saudi Arabia), is a significant environmental concern that necessitates prompt action. Madinah is exposed to toxic metals from multiple sources, such as tobacco, fresh and canned foods, and industrial activities. This influx of toxic metals presents potential hazards to both human health and the surrounding environment. The aim of this study is to explore the viability of utilizing metallothionein from Pseudomonas putida (P. putida) as a method of bioremediation to mitigate the deleterious effects of pollution attributable to Pb and Cd. The use of various computational approaches, such as physicochemical assessments, structural modeling, molecular docking, and protein-protein interaction investigations, has enabled us to successfully identify the exceptional metal-binding properties that metallothionein displays in P. putida. The identification of specific amino acid residues, namely GLU30 and GLN21, is crucial in understanding their pivotal role in facilitating the coordination of lead and cadmium. In addition, post-translational modifications present opportunities for augmenting the capacity to bind metals, thereby creating possibilities for focused engineering. The intricate web of interactions among proteins serves to emphasize the protein's participation in essential cellular mechanisms, thereby emphasizing its potential contributions to detoxification pathways. The present study establishes a strong basis for forthcoming experimental inquiries, offering potential novel approaches in bioremediation to tackle the issue of heavy metal contamination. Metallothionein from P. putida presents a highly encouraging potential as a viable remedy for environmental remediation, as it is capable of proficiently alleviating the detrimental consequences related to heavy metal pollution.

Using Artificial Intelligence to Identify Sources and Pathways of Lead Exposure in Children

CONTEXT

Sources and pathways of lead exposure in young children have not been analyzed using new artificial intelligence methods.

OBJECTIVE

To collect environmental, behavioral, and other data on sources and pathways in 17 rural homes to predict at-risk households and to compare urban and rural indicators of exposure.

DESIGN

Cross-sectional pilot study.

SETTING

Knox County, Illinois, which has a high rate of childhood lead poisoning.

PARTICIPANTS

Rural families.

METHODS

Neural network and K-means statistical analysis.

MAIN OUTCOME MEASURE

Children's blood lead level.

RESULTS

Lead paint on doors, lead dust, residential property assessed tax, and median interior paint lead level were the most important predictors of children's blood lead level.

CONCLUSIONS

K-means analysis confirmed that settled house dust lead loadings, age of housing, concentration of lead in door paint, and geometric mean of interior lead paint samples were the most important predictors of lead in children's blood. However, assessed property tax also emerged as a new predictor. A sampling strategy that examines these variables can provide lead poisoning prevention professionals with an efficient and cost-effective means of identifying priority homes for lead remediation. The ability to preemptively target remediation efforts can help health, housing, and other agencies to remove lead hazards before children develop irreversible health effects and incur costs associated with lead in their blood.

Inorganic nutrients and heavy metals in some wild edible plants consumed by rural communities in Northern Uganda: Implications for human health

For centuries, wild edible plant species have sustained local communities across Africa by supplementing households' diets in seasons of food shortage. Wild edible plants contain inorganic nutrients, which are essential for the proper functioning of organisms. However, their nutritional contents have not been well researched and are generally poorly understood. This study aimed to quantify the levels of inorganic micro-and macronutrients as well as heavy metals (Mg, Ca, K, Fe, Zn, Cd, Hg and Pb) in selected wild edible plants traditionally consumed among the Acholi communities in northern Uganda, and associated health risks of consuming them. The leaves and young stems of 12 wild edible plants, viz: Acalypha rhomboidea, Asystacia gangetica, Crassocephalum sacrobasis, Crotalaria ochroleuca, Heterotis rotundifolia, Hibiscus cannabinus, Hibiscus sp., Hibiscus surattensis, Ipomoea eriocarpa, Maerua angolensis, Senna obtusifolia and Vigna membranacea were air-dried and crushed to powder. The powders were then macerated using aqua regia solution and analyzed in triplicates using the Atomic Absorption Spectrophotometry (AAS). The target hazard quotient (THQ) of Pb was calculated for non-carcinogenic health risks. Mg, Ca, K, Fe, Zn and Pb were detectable in all the wild edible plants sampled. All inorganic nutrients (mg/100gdw), were below the Recommended Daily Allowance (RDA); Mg (9.4 ± 0.19 to 10.4 ± 0.15), Ca (119 ± 5.82 to 1265 ± 14.9), Fe (3.29 ± 0.02 to 11.2 ± 0.09), Zn (0.52 ± 0.02 to 2.36 ± 0.03). Hg and Cd were below detectable limits in all the samples tested. The content of Pb (0.69 ± 0.11 to1.22 ± 0.07) was higher than the CODEX and EU limits of 0.1 ppm (0.001 mg/g) but was below the recommended threshold of 1. The health risk assessment revealed no potential hazards both in children and adults. However, there is a need to study the bioavailability of Pb when the vegetables are consumed due to factors such as indigestion and antinutritional compounds.

Physico-chemical characterization of indoor settled dust in Children's microenvironments in Ikeja and Ota, Nigeria

Indoor dust is a collection of particles identified as a major reservoir for several emerging indoor chemical pollutants. This study presents indoor dust particles' morphology and elemental composition in eight children's urban and semi-urban microenvironments (A-H) in Nigeria. Samples were collected using a Tesco vacuum cleaner and analyzed with scanning electron microscopy coupled with an energy-dispersive X-ray (SEM-EDX). The morphology results confirm the presence of alumino silicates, mineral particles and flakes, fly ash and soot, and soot aggregates deposited on alumino silicate particles in the sampled microenvironments. These particles may trigger serious health concerns that directly or indirectly affect the overall well-being of children. From the EDX analysis, the trend of elements (w/w %) in the dust particles across the sampled sites was silicon (386) > oxygen (174)> aluminium (114) > carbon (34.5) > iron (28.0) > calcium (16.7) > magnesium (14.2) > sodium (7.92) > potassium (7.58) > phosphorus (2.22) > lead (2.04) > manganese (1.17) > titanium (0.21). Lead (Pb), a toxic and carcinogenic heavy metal, was observed in locations A and B. This is a concern without a safe lead level because of the neurotoxicity effect on children. As a result, further research on the concentrations, bioavailability, and health risk assessment of heavy metals in these sampled locations is recommended. Furthermore, frequent vacuum cleaning, wet moping and adequate ventilation systems will significantly reduce the accumulation of indoor dust-bound metals.

Environmental exposure assessment of lead and cadmium in street vended foods sold in selected locations in Kenya

The preparation and handling practices, as well as raw materials for street food vending businesses, could be sources of toxic heavy metals in street vended foods (SVFs). The objective of this study was to assess the levels of lead (Pb) and cadmium (Cd) contamination in ready-to-eat SVFs sold in selected locations within Thika town, Kenya. A total of 199 samples consisting of cereal-based foods, sliced fruits, salads, groundnuts, tubers, fresh fruit juices, eggs, smokies, and sausages were randomly collected for analysis. The concentration of Pb and Cd in street vended foods (SVFs) was determined by atomic absorption spectrophotometry. The results indicated that at least one of the food sample types was contaminated with Pb. The level of Pb contamination in SVFs ranged between 0.271 ± 0.070 and 1.891 ± 0.130 mg/kg with groundnuts recording significantly (p < .0001) higher levels (1.891 mg/kg) than all other food samples. Cadmium contamination levels in the SVF samples ranged between 0.001 ± 0.001 and 0.010 ± 0.003 mg/kg. Significantly (p < .0001) high levels of Cd were observed in cereal-based foods (0.010 mg/kg) and fresh fruit juices (0.008 mg/kg). The Pb concentrations reported in this study are a food safety concern since they exceed the maximum recommended limits set by the Joint Food and Agriculture Organization (FAO)/World Health Organization (WHO) food standards program. There is therefore a need for the establishment and enforcement of policies to govern the street food vending businesses to reduce heavy metal contamination in the SVFs.

Surface Adsorption Mechanism between Lead(II,IV) and Nanomaghemite Studied on Polluted Water Samples Collected from the Peruvian Rivers Mantaro and Cumbaza

Real water remediation is an important issue that requires the development of novel adsorbents with remarkable adsorption properties, permitting reusability. In this work, the surface and adsorption properties of bare magnetic iron oxide nanoparticles were systematically studied, before and after the application of a maghemite nanoadsorbent in two real Peruvian effluents severely contaminated with Pb(II), Pb(IV), Fe(III), and others. We were able to describe the Fe and Pb adsorption mechanisms that occurred at the particle surface. ⁵⁷Fe Mössbauer and X-ray photoelectron spectroscopy results together with kinetic adsorption analyses gave evidence for two involved surface mechanisms: (i) surface deprotonation of maghemite nanoparticles (isoelectric point of pH = 2.3), forming Lewis sites bonding Pb complexes; and (ii) the formation of a thin inhomogeneous secondary layer of iron oxyhydroxide and adsorbed Pb compounds, as favored by surface physicochemical conditions. The magnetic nanoadsorbent enhanced the removal efficiency to values of ca. 96% and provided adsorptive properties with reusability due to the conserved morphological, structural, and magnetic properties. This makes it favorable for large-scale industrial applications.

Complexities in attributing lead contamination to specific sources in an industrial area of Philadelphia, PA

Globally, lead (Pb) contamination is one of the top ten chemical exposure issues affecting public health. The identification of specific Pb sources provides valuable information to determine assignment of liability for site cleanup, improve sampling plans and develop remedial strategies. This paper examines Pb concentrations and Pb isotopic data from samples collected at and near the site of a Pb paint production facility with a long operating history. Although high soil Pb concentrations were found at the site, Pb concentrations in surrounding neighborhoods did not simply decline with distance from the site. We evaluated soil concentrations and isotopic mixing lines to explore potential sources of Pb pollution. Three-isotope plots showed overlap of site samples and the surrounding neighborhood, consistent with pollution from the facility affecting offsite soils. A major challenge in separation of potential sources, however, is that the isotopic signatures of other potential Pb sources fall within the range of the soil data. The long operational site history, soil disturbances, the presence of nearby smelters, and other local and remote sources affect identification of lead sources. This analysis demonstrates that source attribution can be confounded by incomplete site and material sourcing information. An integrated approach that includes in-depth site characterization and an evaluation of historical activities (e.g., Pb ores used over time, amounts of Pb emitted by all area smelters, land use changes, and soil disturbances) is important for determining source attribution. This analysis provides insight into future site investigations where soil lead contamination has resulted from a long industrial history in an urban setting.

Luminescent Quantum Dots: Synthesis, Optical Properties, Bioimaging and Toxicity

Luminescent nanomaterials such as semiconductor nanocrystals (NCs) and quantum dots (QDs) attract much attention to optical detectors, LEDs, photovoltaics, displays, biosensing, and bioimaging. These materials include metal chalcogenide QDs and metal halide perovskite NCs. Since the introduction of cadmium chalcogenide QDs to biolabeling and bioimaging, various metal nanoparticles (NPs), atomically precise metal nanoclusters, carbon QDs, graphene QDs, silicon QDs, and other chalcogenide QDs have been infiltrating the nano-bio interface as imaging and therapeutic agents. Nanobioconjugates prepared from luminescent QDs form a new class of imaging probes for cellular and in vivo imaging with single-molecule, super-resolution, and 3D resolutions. Surface modified and bioconjugated core-only and core-shell QDs of metal chalcogenides (MX; M = Cd/Pb/Hg/Ag, and X = S/Se/Te,), binary metal chalcogenides (MInX₂; M = Cu/Ag, and X = S/Se/Te), indium compounds (InAs and InP), metal NPs (Ag, Au, and Pt), pure or mixed precision nanoclusters (Ag, Au, Pt), carbon nanomaterials (graphene QDs, graphene nanosheets, carbon NPs, and nanodiamond), silica NPs, silicon QDs, etc. have become prevalent in biosensing, bioimaging, and phototherapy. While heavy metal-based QDs are limited to in vitro bioanalysis or clinical testing due to their potential metal ion-induced toxicity, carbon (nanodiamond and graphene) and silicon QDs, gold and silica nanoparticles, and metal nanoclusters continue their in vivo voyage towards clinical imaging and therapeutic applications. This review summarizes the synthesis, chemical modifications, optical properties, and bioimaging applications of semiconductor QDs with particular references to metal chalcogenide QDs and bimetallic chalcogenide QDs. Also, this review highlights the toxicity and pharmacokinetics of QD bioconjugates.

Elevated lead exposure in Australian hunting dogs during a deer hunting season

There is growing recognition of the threat posed by toxic lead-based ammunition. One group of domestic animals known to be susceptible to harmful lead exposure via this route is hunting dogs. Scent-trailing dogs ('hounds') are used to hunt introduced sambar deer (Cervus unicolor) during a prescribed eight-month (April-November) annual hunting season, during which they are fed fresh venison, in Victoria, south-eastern Australia. We used this annual season as a natural experiment to undertake longitudinal sampling of dogs for lead exposure. Blood was collected from 27 dogs owned by four different deer hunters and comprising three different breeds just prior to the start of the hound hunting season (March 2022) and in the middle of the season (August 2022), and blood lead levels (BLLs) (μg/dL) were determined via inductively coupled plasma mass spectrometry (ICP-MS). Using Tobit regression, the expected BLLs across all dogs were significantly lower before the season (0.50 μg/dL, standard error [SE] = 0.32 μg/dL) than during the season (1.39 μg/dL, SE = 0.35 μg/dL) (p = 0.01). However, when the breed of dog was included in the analyses, this effect was only significant in beagles (P < 0.001), not bloodhounds (p = 0.73) or harriers (p = 0.43). For 32% of the dogs before the season, and 56% during the season, BLLs exceeded the established threshold concentration for developmental neurotoxicity in humans (1.2 μg/dL). Time since most recent venison feeding, sex of dog and owner were not associated with BLLs. The finding that BLLs more than doubled during the hunting season indicates that lead exposure is a risk in this context. These results expand the sphere of impact from environmental lead in Australia from wild animals and humans, to include some groups of domestic animals, a textbook example of a One Health issue.

Lead contamination in Australian game meat

Lead-based ammunition (gunshot and bullets) frequently leaves small lead fragments embedded in the meat of wild-shot game animals. Australia produces several commercial game meat products from wild animals harvested with lead-based ammunition and has a growing population of recreational hunters. However, no studies have previously investigated the frequency of lead fragments or lead concentrations in Australian game meat. We examined 133 Australian minced game meat items of four types for evidence of lead contamination. Samples were meat from kangaroos (Macropus and Osphranter spp.; n=36) and Bennett's wallabies (Notamacropus rufogriseus; n=28) sold for human consumption, and deer ('venison'; multiple spp.; n=32) and stubble quail (Coturnix pectoralis; n=37) harvested for private consumption by recreational hunters. All packages were studied by digital radiography to detect the presence of radio-dense fragments, assumed to be lead fragments from ammunition. Visible fragments were absent in commercially available kangaroo products, but were present in 4%, 28% and 35% of wallaby, venison and quail, respectively. Mean meat lead concentrations (mg/kg wet weight) were 0.01 ± 0.01 for kangaroo, 0.02 ± 0.01 for wallaby, 0.12 ± 0.07 for venison, and 1.76 ± 3.76 for quail. The Australian food standards threshold for livestock meat (0.1 mg/kg w.w.) was not exceeded by any kangaroo or wallaby products but was exceeded by 53% and 86% of venison and quail, respectively. Radiography only detected 35% of samples that were above the food safety threshold. While average lead concentrations in commercially available macropod (kangaroo and wallaby) meat were low, those in recreationally harvested game meat may pose health risks for hunters and associated consumers.

Nanomaterials for Fluorescence and Multimodal Bioimaging

Bioconjugated nanomaterials replace molecular probes in bioanalysis and bioimaging in vitro and in vivo. Nanoparticles of silica, metals, semiconductors, polymers, and supramolecular systems, conjugated with contrast agents and drugs for image-guided (MRI, fluorescence, PET, Raman, SPECT, photodynamic, photothermal, and photoacoustic) therapy infiltrate into preclinical and clinical settings. Small bioactive molecules like peptides, proteins, or DNA conjugated to the surfaces of drugs or probes help us to interface them with cells and tissues. Nevertheless, the toxicity and pharmacokinetics of nanodrugs, nanoprobes, and their components become the clinical barriers, underscoring the significance of developing biocompatible next-generation drugs and contrast agents. This account provides state-of-the-art advancements in the preparation and biological applications of bioconjugated nanomaterials and their molecular, cell, and in vivo applications. It focuses on the preparation, bioimaging, and bioanalytical applications of monomodal and multimodal nanoprobes composed of quantum dots, quantum clusters, iron oxide nanoparticles, and a few rare earth metal ion complexes.

Individual and Neighborhood Characteristics Associated With Confirmatory and Follow-up Blood Lead Testing Among Children With Elevated Blood Lead Levels

OBJECTIVES

The aim of this study was to assess the proportions and likelihood of children who receive confirmatory and follow-up blood lead testing within the recommended time frames after an initial capillary elevated blood lead level (EBLL) and confirmed EBLL, respectively, by individual and neighborhood-level sociodemographic characteristics.

DESIGN

We linked and used blood testing and sociodemographic characteristics data from a Pennsylvania birth cohort including children born between 2017 and 2018. Generalized linear mixed models were constructed to examine the associations between sociodemographic factors and having recommended confirmatory and follow-up testing.

SETTING

A population-based, retrospective cohort study.

PARTICIPANTS

In this birth cohort, children who underwent at least 1 BLL test were followed up to 24 months of age. Children with a first unconfirmed (n = 6259) and confirmed BLL (n = 4213) ≥ 5 μg/dL were included in the analysis.

MAIN OUTCOME MEASURE

Children had confirmatory and follow-up testing within the recommended time frames.

RESULTS

Of the children with unconfirmed and confirmed EBLLs, 3555 (56.8%) and 1298 (30.8%) received confirmatory and follow-up testing, respectively. The proportions of the 2 outcome measures were lower among children experiencing certain sociodemographic disadvantages. In the univariate analyses, lower initial BLLs, older age, non-Hispanic Blacks, lower maternal educational levels, maternal Medicaid, The Special Supplemental Nutrition Program for Women, Infants, and Children (WIC) enrollment, maternal smoking, and higher quartiles of neighborhood poverty and old housing were associated with lower odds of having confirmatory and follow-up testing. However, in multivariate models, children with lower initial BLLs, older age, maternal smoking, and non-Hispanic Blacks were significantly less likely to have confirmatory and follow-up testing.

CONCLUSIONS

There were deficiencies in having recommended confirmatory and follow-up blood lead testing among children, especially those with sociodemographic disadvantages. Public health agencies and stakeholders should finetune policies to improve follow-up testing in conjunction with primary and secondary preventions for early detection and reduction of lead exposure among targeted children at risk of lead poisoning.

The Impact of Long-Term Clinoptilolite Administration on the Concentration Profile of Metals in Rodent Organisms

Heavy metals are dangerous systemic toxicants that can induce multiple organ damage, primarily by inducing oxidative stress and mitochondrial damage. Clinoptilolite is a highly porous natural mineral with a magnificent capacity to eliminate metals from living organisms, mainly by ion-exchange and adsorption, thus providing detoxifying, antioxidant and anti-inflammatory medicinal effects. The in vivo efficiency and safety of the oral administration of clinoptilolite in its activated forms, tribomechanically activated zeolite (TMAZ) and Panaceo-Micro-Activated (PMA) zeolite, as well as the impact on the metallic biodistribution, was examined in healthy female rats. Concentration profiles of Al, As, Cd, Co, Pb, Ni and Sr were measured in rat blood, serum, femur, liver, kidney, small and large intestine, and brain using inductively coupled plasma mass spectrometry (ICP-MS) after a 12-week administration period. Our results point to a beneficial effect of clinoptilolite materials on the concentration profile of metals in female rats supplemented with the corresponding natural clinoptilolite materials, TMAZ and PMA zeolite. The observed decrease of measured toxicants in the kidney, femur, and small and large intestine after three months of oral intake occurred concomitantly with their most likely transient release into the bloodstream (serum) indicative of a detoxification process.

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

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

Associations among prenatal and postnatal arsenic, lead, and cadmium exposures and motor development in 3-year-old children: a longitudinal birth cohort study in Taiwan

Prenatal and postnatal exposures to heavy metals have been suggested to interfere with neurodevelopment, but the neurotoxicity of lead (Pb), arsenic (As), and cadmium (Cd) is still unclear. In this study, we aimed to assess the associations between the levels of As, Cd, and Pb and children's neurodevelopment. A total of 299 mother-infant pairs were recruited in this study and their meconium were collected. After three years, 53 children underwent the Bayley Scales of Infant and Toddler Development (Bayley-III) examinations and provided hair and fingernail specimens. The levels of As, Cd, and Pb in the meconium, hair, and fingernail were measured by inductively coupled plasma mass spectrometry; the median levels were the following: meconium, 42.7, 5.57, and 25.6 ng/g, respectively; hair, 0.19, 0.05, and 3.61 μg/g, respectively; and fingernail, 0.29, 0.04, and 0.84 μg/g, respectively. After adjusting for potential confounding factors, we found that the log-transformed levels of As in the hair samples was negatively associated with gross motor development (β =  - 0.032; 95% confidence interval: - 0.061 to - 0.004). We conclude that postnatal exposure to As is a crucial period for gross motor development in children, while the effects of Cd and Pb on neurodevelopment are less clear.

Hidden toxins: bathtubs as a potential source of lead exposure in children

Exposure to lead (Pb) remains a serious health concern for children in the United States, particularly those residing in deteriorating housing. While some sources of Pb such as deteriorating paint and lead waterworks are relatively well understood and widely known, other sources remain hidden. One potential hidden source is bathtubs. In this experiment, water resting in a leaded bathtub was tested over a course of 60 min to determine the extent of metal leaching from the tub to the water. Lead levels in the water increased from 6.8 μg/L at baseline to 13 μg/L after resting in the tub for 60 min. Further research is needed to understand if this is typical, the contributing factors, and clinical significance of this finding.

Invasive plants as biosorbents for environmental remediation: a review

Water contamination is an environmental burden for the next generations, calling for advanced methods such as adsorption to remove pollutants. For instance, unwanted biowaste and invasive plants can be converted into biosorbents for environmental remediation. This would partly solve the negative effects of invasive plants, estimated at 120 billion dollars in the USA. Here we review the distribution, impact, and use of invasive plants for water treatment, with emphasis on the preparation of biosorbents and removal of pollutants such as cadmium, lead, copper, zinc, nickel, mercury, chromate, synthetic dyes, and fossil fuels. Those biosorbents can remove 90-99% heavy metals from aqueous solutions. High adsorption capacities of 476.190 mg/g for synthetic dyes and 211 g/g for diesel oils have been observed. We also discuss the regeneration of these biosorbents.

Association between serum folate concentrations and blood lead levels in adolescents: A cross-sectional study

As a heavy metal, lead is a common toxic agent. Its accumulation in the body is harmful to physical health, particularly in children and adolescents. Studies have reported that folate may play a protective role in lead exposure. An association between serum folate concentrations (SFC) and blood lead levels (BLL) has been documented in adults, but studies in adolescents are limited. This study investigated the relationship between SFC and BLL in American adolescents. This cross-sectional study collected relevant data on both SFC and BLL of 5,195 adolescents in the NHANES database from 2007 to 2018. Multivariable linear regressions and smooth curve fittings were adopted to evaluate the correlation between BLL and SFC. After adjusting potential confounders, we found negative relationships between BLL and SFC [β = -0.0041 (-0.0063, -0.0019)], and the associations were significant in non-Hispanic Whites, Mexican Americans, and other races but not significant in non-Hispanic blacks (P = 0.139). Furthermore, the negative trends were significant in adolescents aged 16-19 years and females aged 12-15 years but insignificant in males aged 12-15 years (P = 0.172). Therefore, these findings provide a basis for future research on the mechanism of folate in regulating blood lead levels.

Childhood exposure to metal(loid)s in industrial and urban areas along the Persian Gulf using toenail tissue as a biomarker

Metal(loid)s (MLs) with natural or anthropogenic sources may cause adverse health effects in children. This study aimed to compare the childhood exposure to ΣMLs (essential, non-essential and toxic) in an industrial and an urban area in Southwest Iran using toenail tissue as a biomarker. The present study was carried out with school children in the age range of 7-12 years, who were living in an industrial area in the petrochemical and gas area (PGA) of the Central District of Asaluyeh County and in an urban area (UA) located in the Kaki District. A total of 270 boys and girls were recruited in January to April 2019. The ICP-MS was used for determination of the studied MLs. A multi-linear regression model was constructed to assess the effect of residence area on toenail ML levels. A significantly higher level of ΣMLs in toenail from the PGA was observed compared to the level in the UA (8.839 vs. 7.081 μg/g, β = -0.169 and p < 0.05). However, all of the 15 MLs studied were detected in the toenail samples from both study sites. Significant differences for the mean Cr (β = -0.563), Fe (β = -0.968), Mn (β = -0.501), Ni (β = -0.306), and Pb (β = -0.377) levels were found between toenail samples from the study areas (p < 0.05), with higher levels in the PGA. The results of this study suggest that children in industrial area are prone to a greater risk for ML exposures compared with those living in a non-industrial urban area.

Prevalence of specific micronutrient deficiencies in urban school going children of India aged between 6 and 16 years: study protocol for a multicentric cross-sectional study

INTRODUCTION

Childhood and adolescence are the period of rapid physical and cognitive growth and development, requiring adequate nutrition. Malnutrition in the form of undernutrition or micronutrient deficiency or overweight/obesity affects the health, cognition and educational achievement of this age group. The objective of this study is to assess the prevalence of calcium, iron, zinc, selenium, folate, vitamin A, 25 hydroxy vitamin D and vitamin B12 deficiencies in the serum and haemoglobin, ferritin and lead levels and its association with reported dietary intake and cognitive abilities, in urban school going children aged 6-16 years in 10 cities of India.

METHODS AND ANALYSIS

A multicentric cross-sectional study will be conducted to recruit 2400 participants (240 per site) across India. Participants will be selected using random sampling and will be categorised into age groups of 6-11 years and 12-16 years, with equal distribution. Data on socioeconomic status, anthropometric measures and 3-day dietary intake and cognitive performance will be collected. Blood samples will be collected for biochemical analysis of micronutrients. Findings will estimate the prevalence of micronutrient deficiencies and their association with dietary habits and cognitive functioning.

ETHICS AND DISSEMINATION

Study protocol has been reviewed and approved by institutional ethics committee of all 10 participating sites. Results will be shared and published in a peer-reviewed journal, so that the findings will be helpful for the stakeholders in planning nutritional interventions for targeted groups.

TRIAL REGISTRATION NUMBER

CTRI/2019/02/017783.

Exposure and health risk assessment from consumption of Pb contaminated water in Addis Ababa, Ethiopia

Exposure to lead (Pb) through drinking water has been linked to adverse health outcomes. Children are particularly susceptible. This study was designed to measure Pb contamination level in drinking water of the Ethiopian city Addis Ababa and assess the associated health risks. Eighty-eight fully-flushed drinking water samples were collected from all ten sub-cities of Addis Ababa. Pb concentration was measured using an Inductively Coupled Plasma Mass Spectrometer (ICP-MS). The chronic daily intake (CDI), the hazard quotient (HQ), and the cancer risk (CR) of Pb were determined to assess exposure levels and health effects. Blood lead level (B-Pb) for children was modelled using the integrated exposure uptake biokinetic model (IEUBK). The mean concentration of Pb in the drinking water was 17.8 μg/l, where >50% of the samples exceeded WHO's 10 μg/l guideline. Significant spatial variation of Pb was noticed among sub-cities. The mean CDI was 1.43 and 0.59 μg/kg/day for children and adults, respectively. The HQ showed that 8% of children and 2.3% of adults exceeded the safe limit. The predicted geometric mean of B-Pb ranged from 3.23 to 14.65 μg/dl. The risk of a child having a B-Pb level >5 μg/dl at the median water Pb concentration (10.5 μg/l) was estimated at 13.4%. Based on the 95^th percentile Pb concentration (75.1 μg/l), 89.6% of children would have B-Pb levels above the 5 μg/dl threshold. The estimated CR was found in the range of 1 × 10^-7 to 9.9 × 10^-5; hence cancer risks are not a concern. The study concluded that Addis Ababa's drinking water is likely to be a source of lead exposure where consumers at specific city locations are at risk of numerous non-cancer health effects. The impacts are expected to be severe in the Ethiopian context; hence further investigations and coordinated interventions are required.

Effects of Individual and Neighborhood Characteristics on Childhood Blood Lead Testing and Elevated Blood Lead Levels, A Pennsylvania Birth Cohort Analysis

BACKGROUND

Despite declining lead exposure among U.S. children, childhood blood lead level (BLL) undertesting and elevation remains a public health issue. This study explores the impacts of maternal, infant, and neighborhood characteristics on the receipt of lead testing and having elevated BLLs (EBLLs) among children under age two.

METHODS

Pennsylvania infants born in 2015 and 2016 were followed to 24 months. Birth certificate data were linked to 2015 through 2018 blood lead surveillance data and neighborhood data on household income, poverty, and the burden of houses built before 1970. Generalized linear mixed models were used to examine the individual and neighborhood characteristics independently and/or interactively affecting the likelihood of lead testing and of having EBLLs.

RESULTS

A total of 48.6% of children were tested for BLLs, and 2.6% of them had confirmed EBLLs. The likelihood of lead testing and of having EBLLs among non-Hispanic black children was respectively 7% and 18% higher than white children. Children born to mothers with the lowest educational attainment (<high school), with self-payment as a payment source for delivery, and without WIC enrollment were at higher risk of undertesting. Children living in neighborhoods of the lowest quartile of household income and the highest quartile of poverty and old housing were more likely to have EBLLs. Different neighborhood characteristics modified the associations between some individual factors (such as race/ethnicity, payment source for delivery, and WIC enrollment) and the odds of undertesting and of having EBLLs.

CONCLUSION

This cohort analysis provides more accurate estimates of lead screening rates and the percentages of EBLLs than cross-sectional analysis. Some maternal and infant demographics significantly impact the risk of undertesting and of having EBLLs, and some of the effects vary across different neighborhood characteristics. These findings can help lead prevention programs to target screening and treatment resources to children with specific characteristics.