Blood lead levels of children and its trend in China

Developmental effects of zebrafish (Danio rerio) embryos after exposure to glyphosate and lead mixtures

Natural aquatic environments have a heterogeneous composition; therefore, simultaneous exposure to multiple contaminants is relevant and more realistic when assessing exposure and toxicity. This study examines the combinatorial effects of two compounds found ubiquitously in drinking water across the United States: glyphosate and lead acetate. Zebrafish (Danio rerio) embryos were used as a model for investigating developmental delays following controlled exposures. Six different environmentally relevant exposure concentrations of glyphosate, ranging from 0.001 to 10 ppm, and lead acetate, ranging from 0.5 to 4 ppm, were applied first as single exposures and then as co-exposures. The sublethal endpoints of hatching and coagulation were quantified to determine potencies. Results indicate that higher concentrations of the individual chemicals correlate with later hatching with correlation coefficients of 0.71 and 0.40 for glyphosate and lead acetate respectively, while the co-exposure at lower concentrations induced earlier hatching with a correlation coefficient 0.74. In addition, increased levels of coagulation and glutathione reductase activity were observed following co-exposure, as compared to the individual exposures, suggesting potential toxicological interactions. These results support the need for further work assessing the combined potencies of aquatic contaminants rather than individual exposures.

Lead pollution-related health of children in China: Disparity, challenge, and policy

Lead (Pb) is a neurotoxic metal, and no level of lead exposure is safe for children. China has still experienced problems on child lead poisoning even though the Chinese government has phased out leaded gasoline since 2000. The underlying problem affecting the lead pollution-related health of children in China remains to be comprehensively investigated. It is found that although the significant decline of BLLs, as the Geometric Mean (GM), from 91.40 μg/L^GM in 2001 to 37.52 μg/L^GM in 2018 is observed, the average BLLs of children are still above 50 μg/L or more [average 59.70 (60.50-65.02, 95 % CI) μg/L^GM] after phasing out leaded gasoline since 2000 in China. Lead exposure causes 29.67 MID per 1000 children with a loss of 98.23 (59.40-146.21, 95 % CI) DALYs per 1000 in China, which is greater than the levels reported from the Western Pacific Region and other low- and middle-income countries. A significant correlation is observed between the number of child crimes (NoCCs) and the outcomes of long-term lead exposure for children in China. Although the disparities in BLLs in China are strongly influenced by unequal distributions of potential multi-lead related sources (soil lead, PM2.5 lead, dust lead), unbalance development of local industrialization and economies, as well as incorrect health care for younger children, the notable emissions from coal combustion (CC) and non-ferrous metals (NMS) exploitation dominate the crucial sources of low-level lead exposure to children after phasing out leaded gasoline in China currently. Faced with the unequal and disparate distribution of BLLs in China, the big bottleneck is to decrease the BLLs exertions of 36-45 μg/L in the next few decades. The Chinese government needs to make more efforts on developing more strict guidelines, implementing more policy strategies on prevention and management of blood Pb poisoning, and monitoring the nationwide changes in children's BLLs continuously.

Potentially Harmful Elements Associated with Dust of Mosques: Pollution Status, Sources, and Human Health Risks

Potentially harmful elements (PHEs) associated with dust generated from anthropogenic sources can be transported into mosques and deposited on the filters of the air-conditioners (AC); thereby, children and adults are exposed to such PHEs while visiting mosques. Data dealing with the assessment of PHEs pollution and its human health risk in mosques dust in Saudi Arabia are scarce. Therefore, this work aims to examine the levels and pollution status of PHEs in AC filter dust (ACFD) of mosques and their associated human health risk in three Saudi cities: Jubail, Jeddah, and Dammam metropolitan. A similar concentration pattern of PHEs is observed in three cities' mosques with noticeably higher concentrations than both global crustal and local background values for Zn, Cu, Pb, As, and Cd only. Except for Fe, Al, and Mn, the highest PHEs concentrations were found in Jeddah (1407 mg/kg), followed by Dammam (1239 mg/kg) and Jubail (1103 mg/kg). High PHEs' concentrations were also recorded in mosques located near workshops and suburban areas compared to urban areas. Based on the spatial pattern, enrichment factor, geo-accumulation index, pollution load index, and ecological risk values, Jubail, Jeddah, and Dammam have shown moderate pollution levels of Cd, As, Pb, and Zn. On the other hand, Cu. Zn, Cu, Cr, Pb, Ni, As, and Cd had degrees of enrichment levels that varied from significantly enriched to extremely highly enriched in the ACFD of the three cities. Heavy pollution is found in Jubail, which posed a higher potential ecological risk than in Jeddah and Dammam. Cd presents the highest ecological risk factors (ER) in the three cities. Carcinogenic and non-carcinogenic risks for children and adults follow the order: Jeddah > Dammam > Jubail, and the ingestion pathway was the main route for exposure. Carcinogenic and con-carcinogenic risks in the mosques of the various studied cities were generally within the acceptable range.

Source apportionment based on lead isotope ratios: Could domestic dog's blood lead be used to identify the level and sources of lead pollution in children?

Domestic dogs have been proved to be used as "sentinel organisms" to monitor human lead exposure. However, whether dogs' blood can be used to identify the levels and pollution source of children's lead exposure still needs evidence. To evaluate the potential use of domestic dogs' blood lead as an indicator of lead exposure levels and pollution source of children, accompanying with potential environmental media samples, lead concentrations and isotope ratios (expressed as ²⁰⁷Pb/²⁰⁶Pb, ²⁰⁸Pb/²⁰⁶Pb) in blood were investigated and compared between children and dogs, who came from a Pb-Zn smelter area, a coal fired area and a control area without industrial activity. The results showed that there were significant correlations in blood lead levels (BLLs) between children and dogs in the study areas (p < 0.01). The lead isotope ratios (LIRs) in blood of children and dogs were disparate among the three areas, however, the LIRs of dogs were quite correlated with those of children in each area (p < 0.01). With the comparison of LIRs between potential pollution sources (slag, ore, coal, paint) and blood samples, the identified lead sources based on dogs' blood were found to be coincident with those based on children's blood. Ore smelting and coal combustion were the main sources of lead exposure for the dogs and children in the smelting area, and coal combustion was the predominant source for the children and dogs living in the coal burning area and control area. The results showed that dogs' BLLs might be used to estimate children's BLLs, and blood LIRs measurements of dogs' could be used as an alternative for identifying the sources of children's lead exposure. This study further provided relevant evidence for dogs to be sentinels exposed to human lead exposure and an alternative method for source apportionment of children's lead exposure.

Adsorptive removal of heavy metal anions from water by layered double hydroxide: A review

High-valence heavy metals with high ecotoxicity are generally found in water in the form of anions, and this increases heavy metal pollution intensity and treatment difficulty. Recent studies have pointed to the potential efficiency of layered double hydroxides (LDHs) to meet this challenge. In this review, we retrospectively research the development of LDHs using a Java application called CiteSpace. We describe the unique layer structure, highly adjustable chemical properties, and diverse synthesis methods of LDHs, all of which decide the effective adsorption of heavy metal anions by LDHs. Subsequently, we focus on discussing the adsorption mechanism of LDHs on heavy metal anions, as well as the current state of research and future directions for microscopic interaction mechanisms. For practical applications, it is critical to improve the adsorption selectivity and stability. We then recommend solutions to improve the adsorption selectivity and stability after identifying the influencing mechanism. Finally, we provide our perspectives on the future development of LDHs adsorption of heavy metal anions.

Effect of food processing method on heavy metals

The problem of high content of heavy metals in food has spread broadly over the world. The presented study suggests the minimization of heavy metal content in processed food due to different applied techniques such as the frying, boiling, steaming and sous-vide. Three main food products were chosen for investigation – Daucus carota subsp. Sativus (carrot), Solanum tuberosum (potato) and Allium cepa (onion). The concentration of heavy metals (Zn, Pb, Mn, Cd, Cu) was determined in samples investigated by atomic-absorption spectrometer. The health risk index (HRI) was calculated based on obtained data. In all investigated samples, high concentration of lead was identified among the heavy metals. The highest concentration of zinc, lead and manganese was determined in boiled Daucus carota subsp. Sativus, cadmium – in sous - vide Daucus carota subsp. Sativus, copper – in steamed Daucus carota subsp. Sativus. HRI values of cadmium for Solanum tuberosum samples were ranged from 6.8 to 7.1 and for lead are ranged between 3.4 and 4.9.

The Performance Comparison of Socioeconomic and Behavioural Factors as Predictors of Higher Blood Lead Levels of 0–6-Year-Old Chinese Children between 2004 and 2014

Childhood lead exposure is a commonly known risk factor affecting children’s health, and 10 governments have taken actions to reduce children’s lead exposure sources. Because lab testing for children’s blood lead levels (BLLs) was not popularized easily, socioeconomic and behavioural factors have been usually used as predictors of screening methods. Along with the overall decreasing trend of children’s BLLs, the lead-exposure-potential-predicting ability of such factors might be limited or changed over time. Our study aims to compare the predicting ability of multiple factors, including the living environment, economic disparity and personal behaviour differences between 2004 and 2014. With potential predicting factors identified, it could provide direction in identifying individual children facing high-risk lead exposure in the unit of clinics or communities of China. The study was first conducted in 12 cities in China in 2004 and then repeated in 2014 in the same 12 cities with the same method. In total, 27,972 children aged under 7 years were included in this study. With confounding factors adjusted, the child’s age, the family’s socioeconomic status and the child’s personal hygiene habit, especially biting toys, continued to be important predictors of higher blood lead levels among Chinese children. The sex of the child was no longer a predictor. Factors such as the father’s occupational contact with lead, residence near the main road and taking traditional Chinese medicine had the potential to be new predictors.

Uneven development of the lead industry leads to regional differences in blood lead levels of children

Children's exposure to lead is a global health problem, especially in low- and middle-income countries. However, research on the relationship between children's blood lead levels (BLLs) and the development of the lead industry is still limited. This study examined whether children's BLLs were associated with the development of lead industry in different regions. Using survey data on the BLLs of children living in 250 prefectures in China with corresponding data on their economic factors and lead industries, we explored the regional variation of children's BLLs using statistical methods. The results show that the level of economic development in leaded areas was associated with inequity in children's BLLs and met the environmental Kuznets hypothesis. In areas without lead industries, there was little correlation between the level of economic development and the BLLs of children and thus the environmental Kuznets hypothesis was not supported. Lead mines, lead smelting and chemical companies are major sources of blood lead in children living in leaded areas. This study demonstrated the success of control policies for lead-acid battery manufacturers in promoting the prevention and control of childhood lead poisoning in China. China should consciously support the improvement of children's BLLs in undeveloped areas with lead industries through national financing and policies to avoid the continuous effects of the regional inequality problem of high children's BLLs.

Characteristics, distribution, and children exposure assessment of 13 metals in household dust in China: A big data pilot study

To explore the pollution characteristics of metals in household dust in China and their exposure to children, this study searched peer-reviewed papers published during 1980-2020 and analyzed 30 eligible papers screened under the per-decided strategy. We evaluated the sample-weighted concentration (SWC) of each metal, explored the sources of metals, and presented the quantitative description of spatial-temporary characteristics and children exposure to 13 metals with multi-route under a general living scenario. The results showed the concentrations of 13 metals with a range of 0.89-29 090.19 mg/kg. The SWC of Cd in household dust from rural areas was 3.29 times of that from urban areas, while the SWC of Ni from urban areas was 3.71 times of that from rural areas. The results showed that four principal components were extracted, and the cumulative contribution rate reached 79.127%. The exposure dose of 13 metals to children aged 2-3 years was presented with the highest by ingestion. Metals such as Fe, Zn, and Mn posed inevitable health risk to children with high exposure. Countermeasures should be carried out to minimize the children exposure to metals in household dust urgently, such as the establishment of environmental health standard for household dust.

Exposure to heavy metals and red blood cell parameters in children: A systematic review of observational studies

BACKGROUND

Mechanistic studies show that heavy metals interfere with the hematopoietic system by inhibiting key enzymes, which could lead to anemia. However, the link between children's exposure and red blood cell (RBC) parameters has been inconsistent. We aimed to summarize evidence on human studies exploring the association between exposure to lead, mercury, cadmium, arsenic, and chromium VI and RBC parameters in children.

METHODS

Following the PRISMA guidelines, we searched PubMed, Scopus, and Web of Science databases for studies published between January 2010 and April 2022. Eligible papers included human observational studies that directly assessed exposure (internal dose) to the heavy metals under study and RBC parameters in participants aged ≤ 18 years. We excluded studies using hospital-based samples. Study quality was assessed using the National Institutes of Health's Quality Assessment Tools for Cohort and Cross-Sectional Studies. We synthesized the evidence using vote counting based on the direction of the relationship.

RESULTS

Out of 6,652 retrieved papers, we included a total of 38 (33 assessing lead, four mercury, two cadmium, and two arsenic; chromium VI was not assessed in any included paper). More than half of the studies were conducted in Asia. We found evidence of a positive relationship between lead concentration and hemoglobin (proportion of studies reporting negative relationships = 0.750; 95% Confidence Interval (CI) 0.583, 0.874) and mean corpuscular hemoglobin (0.875; 95% CI 0.546, 0.986), and a positive relationship with red cell distribution width (0.000; 95%CI 0.000, 0.379). When considering only good-quality studies (24% of the Pb studies), only the relationship with hemoglobin levels remained (0.875; 95% CI: 0.546, 0.986).

CONCLUSION

We found evidence of a negative relationship between lead concentration and hemoglobin and mean corpuscular hemoglobin and of a positive relationship with red cell distribution width in children. We also identified a need to conduct more studies in European countries. Future studies should use standardized practices and make efforts to increase study quality, namely by conducting comprehensive longitudinal studies. Our findings support the need to take further actions to limit heavy metal exposure during childhood.

Evaluation of potential ecological risks in potential toxic elements contaminated agricultural soils: Correlations between soil contamination and polymetallic mining activity

Extensive mineral exploitation activities in history have aggravated potential toxic elements (PTEs) contamination in agricultural soils in China. Comprehensive ecological risk assessment is of great significance to orientate the restoration of contaminated soils, especially for those with high background values and multiple sources. The study area is located in the major rice producing area of China. Historically, there was a silver mine and a lead-zinc mine in the area, which were successively closed during the investigation. The intensive mining activities caused serious PTEs pollution in the agricultural soils around the mining area. In this study, five PTEs (As, Cd, Cr, Hg and Pb) selected to assessed the potential of geoaccumulation index in assessing agricultural soil potential risk assessment by identifying ecological risk sources. 315 of soil samples collected in 2009, 2014, 2018 were comprehensively analyzed by single pollution index evaluation (single factor index, geoaccumulation index), comprehensive evaluation (Nemerow index, potential ecological risk index) and trend analysis. Single factor index analysis showed that geoaccumulation index considered the impact of natural diagenesis of background values and human activities on the environment, ensuring high evaluation accuracy comparing to other methods used in typical complex agricultural soils. The modified potential ecological risk index revealed that the high background area did not represent high risk area, which was consistent with the implementation effect of governance measures. This study can provide important insights for policymakers and environmental engineers to quantitatively recognize the soil pollution and the effectiveness of governance based on applicable and reasonable evaluation methods.

Association of multi-metals exposure with intelligence quotient score of children: A prospective cohort study

BACKGROUND

Associations between most single metals and children's intelligence quotient (IQ) scores have been evaluated in previous studies. However, associations between multi-metal exposures and children's IQ scores have not been analyzed.

OBJECTIVES

To assess the joint effects of lead (Pb), manganese (Mn), antimony (Sb), tin (Sn) and titanium (Ti) co-exposure on children's IQ scores.

METHODS

A prospective cohort study was conducted in Shimen and Huayuan, Hunan Province, China. Urine metals levels were measured by inductively coupled plasma mass spectrometry (ICP-MS) at baseline. Children's IQ scores were repeatedly measured at baseline and follow-up following the method of Raven's Standard Progressive Matrices (SPM) and standardized as z scores. We fitted linear regression models and Bayesian kernel machine regression (BKMR) models to investigate the associations of metal levels with children's IQ scores after adjusting for covariates.

RESULTS

A total of 633 participants aged 7-10 years completed the survey. Urinary Pb (β = -0.028, P = 0.022) and urinary Ti (β = -0.0003, P = 0.001) were inversely associated with children's IQ scores. The BKMR analyses revealed significant negative overall effects of the five metals on children's IQ scores when all the metals were above their median levels, while significant positive associations were shown when all the metal concentrations were below their median levels. The model also showed negative trends of Sn and Ti on children's IQ. Furthermore, Ti and Sn had a synergistic relationship, with a decline in IQ score when Sn exposure was relatively high. The urinary Sn concentration was significantly higher but the urinary Ti concentration was significantly lower in participants from the Shimen area than in those from the Huayuan area. Decreasing trends of the overall effects were observed in both the Shimen and Huayuan areas.

CONCLUSION

Our findings revealed that multi-metal exposures caused a decline in children's IQ scores according to traditional linear regression models and the BKMR model. Our results provide some evidence of the association between multi-metal exposure and children's IQ. Meanwhile, interactions between multi-metal exposures on children's IQ should be given more attention.

Characterization and exposure assessment of household fine particulate matter pollution in China

Household fine particulate matter (PM_2.5 ) pollution greatly impacts residents' health. To explore the current national situation of household PM_2.5 pollution in China, a study was conducted based on literature published from 1998 to 2018. After extracting data from the literature in conformity with the requirements, the nationwide household-weighted mean concentration of household PM_2.5 (HPL) was calculated. Subgroup analyses of spatial, geographic, and temporal differences were also done. The estimated overall HPL in China was 132.2 ± 117.7 μg/m³ . HPL in the rural area (164.3 ± 104.5 μg/m³ ) was higher than that in the urban area (123.9 ± 122.3 μg/m³ ). For HPLs of indoor sampling sites, the kitchen was the highest, followed by the bedroom and living room. There were significant differences of geographic distributions. The HPLs in the South were higher than the North in four seasons. The inhaled dose of household PM_2.5 among school-age children differed from provinces with the highest dose up to 5.9 μg/(kg·d). Countermeasures should be carried out to reduce indoor pollution and safeguard health urgently.

Metal(loid) exposure on children from a historical metallurgical site

The data obtained in this study represent a comprehensive assessment of human exposure to metal(loids) enriched in the environment, derived from metallurgical activities in Cedral, a town in North-Central Mexico. A multi-elemental analysis (As, Cd, Cr, Cu, Fe, Mn and Sb) shows high metal(loid) content in environmental media (tailings samples, dust samples and particulate matter < 2.5 µm collected in the urban area). Blood samples from school-age children were collected and analyzed to determine exposure levels. The assessment of the data obtained from this study shows that Sb and Cd are highly enriched elements in the environment of Cedral; their respective levels in the blood samples analyzed are 10.9 and 11.3 times higher than their pediatric reference levels. The statistical analysis indicates a strong relationship between metal(loid)s in blood samples and both dust and PM_2.5 samples, which reveal that ingestion and inhalation could represent important exposure routes for metal(loid) intake. Continuous monitoring in the area is paramount to assess the health impact posed by the different routes of exposure. It is also important to implement health education programs to decrease the population's exposure to metal(loid)s and to design urgent remediation measures, to be implemented as soon as possible.

Heavy Metals in Indoor Dust Across China: Occurrence, Sources and Health Risk Assessment

In this study, the occurrence of heavy metals including cadmium (Cd), chromium (Cr), copper (Cu), lead (Pb), and zinc (Zn) was investigated in indoor dust samples collected from 33 urban and rural areas in 11 provinces, China. The concentrations of the selected heavy metals were determined by an inductively coupled plasma mass spectrometry. The mean concentrations of Zn (166 mg kg^-1), Pb (40.7 mg kg^-1), Cr (19.8 mg kg^-1), Cu (16.9 mg kg^-1), and Cd (2.29 mg kg^-1) in indoor dust are in low or moderate levels compared with other countries or regions. Cd was significantly enriched with the highest enrichment factor of 23.7, followed by Zn, Pb, Cu, and Cr, which were all lower than 3. The concentrations of Pb from Northern China (61.4 mg kg^-1) were significantly higher than those from Southern China (8.88 mg kg^-1). The concentrations of heavy metals in indoor dusts from rural areas were higher than those from urban areas except for Cu. The multivariate analysis of variance revealed that wall cover, fuel types, and air conditioning were dominant factors influencing the levels of heavy metals in indoor dust. Principal component analysis showed that outdoor dust and wall paint were main factors for the high concentrations of Cd, Pb, and Cr, accounting for 40.6% of the total contribution; traffic sources contributed to the high levels of Cu and Zn explained 20.6% of the total variance. The hazard indexes of selected heavy metals were less than 1 and carcinogenic risk value of Cr were between 1.01 × 10^-6 and 1 × 10^-4, indicating minor noncarcinogenic and carcinogenic risks from heavy metals in indoor dust for residents in China. Pb contributed 72.0% and 86.9% to the sum of noncarcinogenic risk values of selected heavy metals for adults and children, respectively. The carcinogenic risk value of Cr was approximately 13-fold higher than that of Cd for both adults and children. Children endured higher risks from heavy metals in indoor dust compared with adults.

Blood Lead, Systemic Inflammation, and Blood Pressure: Exploring Associations and Mediation Effects in Workers Exposed to Lead

Relationships of lead exposure with blood pressure and blood lead with inflammation have been previously established yet, but the conclusions are still controversial. The objective of our study was to investigate the role of systemic inflammation in the relationships between blood lead concentration and blood pressure. We quantified the levels of blood lead and white blood cell count in 505 lead-exposed workers with 842 observations. Associations between blood lead, white blood cell count, and blood pressure were evaluated by using linear mixed models. We further performed mediation analysis to investigate the role of white blood cell count in the associations between blood lead concentration and blood pressure. We observed that each 1% increase of blood lead levels was significantly positively associated with a 0.9%, 1.7%, and 1.1% increases in systolic blood pressure, white blood cell count, and blood platelet count, respectively. Also, we found that the levels of white blood cell count were positively correlated with diastolic blood pressure and systolic blood pressure in a dose-response manner. Mediation analysis showed that the levels of white blood cell significantly mediated the associations between concentration of blood lead and systolic blood pressure. Collectively, our findings suggest that blood lead was positively associated with systolic blood pressure and that systemic inflammation might play a key role in this association.

Blood lead levels of Chinese children from 1991 to 2020: Based on Monte Carlo simulation

Chinese children have been exposed to high level of lead due to polluted air, dust, contaminated foods and water, etc. In this research, we investigated published blood lead levels (BLLs) reflecting 1,057,832 Chinese children aged at 0-12 and teenagers aged at 13-18 in the past 30 years (1991-2020). The data mining and estimation were performed innovatively by Monte Carlo simulation to remedy the skewed distribution-induced bias. The temporal trend of Chinese children's BLLs showed an obvious decrease in the past decades from 88.74 μg/L (Geometric SD = 4.09) during 1991-1995 to 27.32 μg/L (Geometric SD = 4.18) during 2016-2020. This study also indicated that children's BLLs of Yunnan, Guizhou, Shanxi were at relatively high levels and most provinces showed a downward trend. Chinese boys aged at 1-18 years old had higher BLLs (GM: 44.03 μg/L) compared to girls (GM: 41.32 μg/L) (p < 0.001). At different age groups, Chinese children's BLLs were 42.04 μg/L (1-3 years old), 52.88 μg/L (4-6 years old), 50.49 μg/L (7 and above years old), respectively. Although the BLLs of Chinese children exhibited a continuous declined trend in the past 30 years, it was still higher than that in developed countries, which indicated that more efforts are needed in children's BLLs control.

Regional characteristics of children's blood lead levels in China: A systematic synthesis of national and subnational population data

The blood lead levels (BLLs) of children in China remain notably high in many areas. We aimed to summarise the relevant regional characteristics, identifying problematic areas and the causes of lead pollution. We searched the databases of PubMed, China National Knowledge Infrastructure (CNKI), and Wanfang Data, systematically reviewing 219 articles published from January 2010 to September 2020. In doing so, we assessed the BLLs noted in 220 prefectures across China. Data were organised using Geographic Information Systems (GIS) mapping. Out of a total of 629,627 children sampled, we found that the average blood lead level (BLL) of children included in our study is 50.61 ± 13.63 μg/L, which slightly exceeds the 50.00 μg/L US standard. Within the sample, 8.75% had BLLs higher than 100.00 μg/L. Children living in Liaoning, Hebei, Shanxi, Jiangxi, Anhui, Fujian, Guizhou, Yunnan, and Guangxi had notably high BLLs, at more than 60.00 μg/L. A total of 112 municipalities had an average children's BLL above 50.00 μg/L. Furthermore, Chenzhou, Linfen, Yuncheng, and Hechi had the highest children's BLLs, with average values above 100.00 μg/L. The leading contributors to lead pollution are lead mining, lead recovery and the smelting industry. Nonetheless, the lead-acid battery industry needs more attention. Although data suggest that BLLs are decreasing in China, many areas still have high BLLs that need to be monitored. Moreover, national standards must improve to decrease acceptable BLL thresholds for children.

Association of blood lead levels with preeclampsia: A cohort study in China

BACKGROUND

Preeclampsia is the main cause of maternal and perinatal death, especially in developing countries. Multiple studies suggest that blood lead levels in pregnancy are a risk factor for preeclampsia, even with low levels of blood lead. But less knows the dose-effect relationship of preeclampsia in low blood lead levels.

OBJECTIVES

This study aims to assess the association between blood lead levels and preeclampsia and to explore its dose-effect relationship between low blood lead levels and preeclampsia.

METHODS

The retrospective cohort study was consecutively conducted in a comprehensive tertiary hospital in Foshan city of Guangdong Province, China, from August 1, 2019, to November 30, 2019. Blood lead levels were measured in maternal whole blood in 12-27 (+6) weeks of pregnancy, using atomic absorption spectrometer. Preeclampsia diagnosis was ascertained from the electronic medical records system. The risk of preeclampsia was estimated by multivariable logical regression analysis, and a two-stage linear regression model was established to find out the dose-effect.

RESULTS

A total of 2174 people were included in this study, and 59 (2.7%) women developed preeclampsia. The dose-effect analysis revealed a non-linear association between blood lead levels and the risk of preeclampsia, with a cut-off point at 4.2 μg/dl. When blood lead levels were over 4.2 μg/dl, the risk of preeclampsia increased significantly with an increase in blood lead levels (OR = 2.05, 95%CI: 1.50, 2.81). In the multivariate regression models, per 1 μg/dl increment in blood lead levels was associated with 43% higher risk of developing preeclampsia (OR = 1.43,95%CI:1.17,1.74). Moreover, the association between blood lead levels and preeclampsia was stable in different subgroups.

CONCLUSIONS

Low levels of lead exposure had a dose-effect relationship of preeclampsia, with a cut-off point at 4.2 μg/dl. Blood lead levels had a non-linear association with preeclampsia. When the blood lead levels were higher than 4.2 μg/dl, the risk of preeclampsia increases by 105% for every 1 μg/dl increase in blood lead levels.

Bioaccumulation and changes of trace metals over the last two decades in marine organisms from Guangdong coastal regions, South China

Trace metal (Cr, Ni, Cu, Zn, Cd and Pb) exposures, distribution and bioaccumulation were investigated in marine organisms from Guangdong coastal regions, South China. The results showed that all of the selected metals were observed in marine organisms with a predomination of Cu and Zn. The metal exposure levels exhibited obvious variations between species with the decreasing order of crab>shellfish>shrimp>fish. The higher metals enrichment seen in shellfish and crab species primarily attributed to their living habits and the higher sediment background values of trace metals. Endpoint bioaccumulation factor (BAF_fd) was used to characterize the bioaccumulation potentials of marine organisms to trace metals, of which Cu and Zn were the most accumulated elements. The exposure of trace metals in the cultured organisms was far lower than those in wild marine organisms, which is probably due to the effect of growth dilution. Comparisons with previous studies demonstrated that the concentration profiles of most trace metals declined over the last one to two decades, except Cu, that increased indistinctively.

Adverse health effects of lead exposure on physical growth, erythrocyte parameters and school performances for school-aged children in eastern China

We conducted a cross-sectional study with 395 completely matched student samples enrolled from a public primary school in Nanjing of eastern China, including questionnaires, blood samples, growth indexes and school performances, all of which were used for the analysis of variance (ANOVA) and general linear model (GLM). The results showed that factors, such as gender, age, parents' education, residential passive smoking and picky eaters, had significant impacts on the blood lead levels (BPbs). As for the linear and non-linear dose-response relationship between BPbs and erythrocyte parameters, we found a positive association between BPbs and red blood cell count (RBC count) and mean corpuscular hemoglobin concentration (MCHC) but a negative association between BPbs and hemoglobin (HGB), hematocrit (HCT), mean corpuscular volume (MCV) and mean corpuscular hemoglobin (MCH). When BPbs increased by 10 μg/L, the RBC count increased by 0.18 × 10¹²/L, while HGB and HCT decreased by 1.19 g/L and 0.41% for boys, respectively. As for girls, corresponding increases in RBC count was 0.05 × 10¹²/L, while HGB and HCT decreased by 0.82 g/L and 0.23%. Meanwhile, for both boys and girls, MCHC increased by 2.55 g/L, while MCV and MCH levels decreased by 0.41 fL and 0.12 pg each. Furthermore, a remarkable adverse effect (p < 0.05) was observed on children's school performances as a result of increased BPbs. As BPbs increased by 10 μg/L, children's scores for Chinese, Math and English decreased by 0.42 points, 0.39 points and 0.87 points, respectively. In summary, our study indicated that lead exposure can have adverse health effects on children's erythrocyte parameters, BMI, and school performances.

Identifying the sources and spatial patterns of potentially toxic trace elements (PTEs) in Shanghai suburb soils using global and local regression models

Destructive development of suburban areas in some metropolises has exposed suburban soils to high risk of potentially toxic trace elements (PTEs) enrichment, which also threatens human and ecosystem health. This study investigated the pollution status, sources and spatial patterns of four PTEs (Pb, Cd, Cr and As) in 1805 soil samples collected from the suburbs of Shanghai in 2015. Nineteen potential sources, including: 6 soil property factors, 10 proximity factors and 3 topography factors, were selected to help explain the PTEs aggregation using logistic regression models from global and local perspectives. The statistical results of PTEs concentration revealed that Cd showed the highest pollution risk in local soils, which was followed by As. Soil property was the primary factor affecting the PTEs (except Cr) enrichment, both identified by global models and local models. The local model particularly emphasized the significant correlation between soil property and PTEs in most parts of the outer suburbs and southeastern inner suburbs. Some proximity factors such as distance to district center and water were negatively correlated with Cd pollution and some topography factors such as elevation and slope were closely related to As pollution. It is worth noting that in the coastal areas, especially Chongming Island, there were obvious PTEs depositions in the soil near the estuary. This study helps to identify the sources of anthropogenic contamination and geogenic enrichment of the four PTEs and their spatial patterns, playing an essential role in formulating regional environmental policies for coastal cities.

Quantificational exposure, sources, and health risks posed by heavy metals in indoor and outdoor household dust in a typical smelting area in China

Contamination of metals in household dust remains a concern for human health. However, few studies to date have been conducted on the contribution of both indoor and outdoor environments to the health risks posed by metals. This study was carried out to assess the potential health risks from both indoor and outdoor household dust and the respective contribution to the health risks for children. The results showed that household dusts were heavily polluted by metal(loid)s, which were up to 30 times higher than the relative background level, and were attributed to smelting activity. However, there are other pollution sources in indoor environments, since the I/O ratio values of Pb, Cd, and As were significantly higher than 1. HI values of Pb and As exceeded the threshold of (1) and accounted for approximately 60% and 24% to the HIt, respectively. The HIts of Zn, Cr, Mn, Hg, and Cu were mainly attributable to indoor dust exposure, particularly for Hg (73.44%), indicating non-carcinogenic health risks could be attributed more to the indoor dust exposure. This study highlights the potential risks of metal contamination in household environment, particularly indoor environment, on the health of children who live in the vicinity of smelting activity.

Toxicity, migration and transformation characteristics of lead in soil-plant system: Effect of lead species

Lead (Pb) is a typical hazardous element of high concern in species characteristics involving toxicity, migration and transformation. A greenhouse experiment was conducted using Solanum nigrum L. grown in soils treated by divalent (Pb²⁺), tetravalent (Pb⁴⁺), trimethyl (TML) and triethyl (TEL) lead for 60 days. Results of physio-biochemical parameters indicated Pb toxicity was ranked as TEL > TML > Pb²⁺ > Pb⁴⁺ in a dose-dependent manner, and the correlation levels of organic species were higher than inorganic species. S. nigrum L. adopted phytostabilization strategy through fixing Pb in roots and restricting its transfer to shoots. More phytotoxic Pb was absorbed from soils treated by Pb²⁺ than Pb⁴⁺ as well as TEL than TML. In soils, inorganic Pb species were mainly present in residues while organic Pb species in Fe/Mn oxide and exchangeable fractions. Although most of Pb species in plant existed in the low-bioavailable extractions of 1 M NaCl and 2% HAC, the water-soluble Pb extracted by d-H₂O and 80 % ethanol were increased to a large extent under high-level exposure. The occurrence of reduction and (de)alkylation were considered as the major pathways in the biotransformation of Pb species. This study will conduce to the ecological risk management for Pb-contaminated soils.

Characterizing pollution indices and children health risk assessment of potentially toxic metal(oid)s in school dust of Lahore, Pakistan

Toxic metal pollution is a renowned environmental concern, especially to sensitive environments like school classrooms and their association with children's health. The study was planned to determine the pollution characteristics of 13 potentially toxic metal (oid)s (PTMs) and their associated children's health risk assessment from school dust samples of considerably three land-use types (residential, roadside, and industrial areas) of Lahore, Pakistan. Geo-accumulation (I_geo), pollution (PI), integrated pollution (IPI) and pollution load (PLI) indexes were used to determine the PTMs contamination and USEPA health risk assessment models were employed to assess the health risks in children. The mean concentrations of Cd, Cr, Cu, Ni, Pb, and Zn for three land-use types were found much higher than the permissible limits. Results of pollution indices revealed that school dust was strongly contaminated with Cd, Pb, and Zn whilst moderately contaminated with Cr and Cu. Moreover, the health risk assessment models revealed no significant non-cancerous risks in children with predominantly highest hazardous index (HI) of Cr in industrial (4.61E-01) and Pb in both roadside (4.30E-01) and residential (2.26E-01) area schools. According to cumulative HI of all PTMs and exposure routes, the land-use areas were in descending order as industrial > roadside > residential. The calculations of hazardous quotient (HQ) showed ingestion was the leading pathway of PTMs exposure through school dust. For carcinogenic health risk (CR), the most prominent PTM was Cr with values of 1.53E-06 in industrial area schools, found close to the tolerable range (1.0E-06). Hence, school dust of Lahore prominently contaminated with eminent PTMs triggering slight health risks predominantly by ingestion exposure to children.

Blood lead levels among Chinese children: The shifting influence of industry, traffic, and e-waste over three decades

In China, data relating to the historic prevalence of childhood lead poisoning suggest its pervasiveness. This review analysed published epidemiological data on blood lead levels (BLLs) of 735,271 Chinese children aged 0-6 between 1987 and 2017. Among these children, the geometric mean (GM) BLL was 95.1 μg/L (geometric SD = 1.62), and 24.1% suffered lead poisoning (BLL ≥ 100 μg/L). Importantly, there was a temporal decrease in the GM BLL value, from 182.9 μg/L in 1987-1991 to 42.4 μg/L in 2012-2017. However, a rebound was seen in the most recent two years (2016 and 2017). Moreover, the GM BLL among Chinese children has not fallen as low as U.S. children. This indicates that either (1) leaded petrol or lead based-paint exposure sources have not been adequately controlled in China, or (2) other pollution sources, such as industry, traffic, and e-waste, are impacting Chinese children. Drivers behind spatio-temporal variations were explored to provide scientific evidence regarding the prevention of childhood lead poisoning. We found that BLLs among children in the central and eastern areas of China have dropped lower than those in the western area, and that the GM BLL of children living in rural areas now exceeds children in urban areas. These reversals may be associated with the industrial decentralization policy of the late 1980s, when many heavily polluting industries and manufacturers moved away from cities on the east coast. It was discovered that the BLLs of children living in areas associated with mining have remained high (GM BLL = 155.0 μg/L for 2007-2017), and that the lead poisoning rate (LPR) has become exceptionally high in areas associated with e-waste. Finally, the review offers a data comparison with other countries, an overview of potentially influencing factors and sources, as well as some suggested prevention strategies to reduce childhood lead exposure.

Contemporary blood lead levels of children aged 0-84 months in China: A national cross-sectional study

Despite the global abundance of studies on children's lead (Pb) exposure, the magnitude of Pb exposure among children across China remains unclear, especially for rural areas. In 2000, Pb was removed from petrol, marking a change in the sources of Pb exposure in China. To better understand children's Pb exposure and inform potential approaches to exposure reduction, we conducted a national blood Pb survey of 31,373 children (0-84 months old) from May 2013 to March 2015, using a multi-stage and multi-strata sampling method. Blood lead levels (BLLs) were tested using graphite furnace atomic absorption spectrometry with a detection limit of 1 µg/L. The results show that Chinese children had a contemporary geometric mean (GM) BLL of 26.7 μg/L, with 8.6% of BLLs exceeding 50 µg/L. Boys had higher BLLs (GM 27.2 μg/L) compared to girls (GM: 25.9 μg/L) (p < 0.001). Children at the age of 0-36 months had a lower PbB (GM 25.7 μg/L) level compared with those aged 36-84 months (GM 27.9 μg/L) (p < 0.001). When taking into account sociodemographic factors, a multivariate logistic regression analysis shows that the odds ratios (OR) of having a BLL of 27 µg/dL (i.e., median BLL of this study) or higher were 1.88 (95% CI: 1.76, 2.02) and 1.35 (95% CI: 1.22, 1.49) for homes using coal and biomass fuels, respectively, compared to those using gas or electricity. Meanwhile, children in homes close to roads were more likely to have BLLs exceeding 27 µg/dL (OR: 1.11, 95% CI: 1.03, 1.20). In China, rural children had higher BLLs compared to urban children. As a result of pediatric exposure to Pb, there were approximately 144 million and 36 million IQ points lost for rural children and urban children, respectively, revealing a disparity of Pb exposure between rural and urban areas in China. Cleaner domestic fuels and improved cooking/heating equipment will reduce contemporary Pb exposure in rural areas. In addition, the association between contemporary BLLs and distance away from roads further suggests that resuspension of legacy soil/dust Pb should not be neglected in future remediation programs and household interventions. As a large scale survey, this study provides evidence for revising the reference value of BLL, improving the guideline for clinical and public health management, and implementing interventions to prevent adverse health outcomes associated with low-level Pb exposure in children.

Risk Assessment and Implications of Schoolchildren Exposure to Classroom Heavy Metals Particles in Jeddah, Saudi Arabia

Classrooms Air Conditioner Filter (CACF) particles represent all of the exposed particles that have migrated to the interior environment. This study was conducted to assess the heavy metals contamination in CACF particles from Jeddah primary schools located in urban, suburban and residential areas; and to evaluate their health risks of children exposure (non-carcinogenic and carcinogenic). Heavy metals levels in CACF particles of schools were in the following order: urban schools > suburban schools > residential schools. Fe, Mn and Zn were the dominant species. Geo-accumulation index (I_geo), contamination factor (CF) and pollution load index (PLI) values indicated that the contamination levels was in the following order Cd > Pb > Zn > As > Cu > Ni > Mn > Cr > Co >V > Fe. School CACF particles was moderately contaminated with As and Zn and moderately to heavily contaminated with Pb and Cd. Enrichment factors (EFs) indicated that Zn, Cd, Pb, As and Cu in CACF particles were severe enriched. The hazard quotient (HQs) and hazards index (HI) values for heavy metals were lower than the acceptable level of one. As, Pb, Cr and Mn were exhibited high non-cancer effects for children. The lifetime cancer risk (LCR) and total lifetime cancer risk (TLCR), HQs and HI values for the different exposure pathways of heavy metals decreased in the following order: ingestion > dermal contact > inhalation. Carcinogenic and non-carcinogenic risk rank order of schools were urban schools > suburban schools > residential schools. The LCR and TLCR of heavy metals was in the following order: Co > Ni >Cr > Cd > As > Pb. The ingestion lifetime cancer risk (LCR_ing) and TLCR values from exposure to Ni and Cr in urban and suburban schools, Cd in urban schools, and Co in all Jeddah schools only exceed the acceptable range (1 × 10⁻⁶–1 × 10⁻⁴) Only LCR_ing and TLCR values from exposure to ∑ carcinogens exceed the acceptable level.

Regional characteristics of dietary lead intake in the Chinese population

Lead is known as a potent toxicant to human health and there is currently an issue with lead contamination of food in China. This study analysed the regional characteristics of dietary lead intake of the Chinese population and used this to assess the health risks for each region due to the presence of lead in different foods. Data of dietary lead intake was used from the 4th and 5th Chinese Total Diet Studies (CTDS) covering 12 to 20 provinces. Over 200 kinds of food samples were divided and analysed. Results showed that lead consumption varies from region to region, with some, such as Heibei, being at higher risk and consuming larger amounts, and others, such as Shanxi, being at lower risk. It was found that the spatial correlation between lead intake from meats and vegetables was 0.545. The strong association between meats and vegetables shows that lead contamination has a large effect on fresh foods. The food groups with the highest contribution to lead intake were cereals and vegetables, while the food categories with the lowest contribution were dairy products, sugar, and alcohol. The main food group contributing to lead intake in different regions was found to be cereals in Hebei, vegetables in Heilongjiang and Ningxia, and meats in Sichuan and Hunan. The food products contributing the most to lead intake were found to be kelp and nori in many provinces and other notable foods included processed and preserved soybean, meat, and fungus products. These results allow policy makers to better target their efforts when working on the issue of lead contamination, focusing on areas of high contamination, and to advise consumers to adjust their diets to avoid high risk foods as this issue is being resolved.

Analysis of disease profile, and medical burden by lead exposure from hospital information systems in China

BACKGROUND

Though lead (Pb)-gasoline has been banned for decades in China, Pb continues to be a vital risk factor for various diseases. Traditional studies, without large sample size, were unable to identify explicitly the associations among Pb, its disease profile, and the related medical burden. This study was designed to investigate: 1) current status of blood Pb levels; 2) Pb-associated disease profile, medical burden, as well as impact factors.

METHODS

Research subjects were patients who visited military hospitals and were required to test their blood Pb levels by doctors between 2013 and 2017. The large sample size and area coverage may, to a large extent, reveal the characteristics of Pb exposure in the whole Chinese population. Information of patients' electronic medical records was extracted using Structured Query Language (SQL) in Oracle database. The spatial, temporal, and population distribution of their blood Pb levels were tested, to illustrate the association of Pb exposure with diseases' profile, and medical burden. Non-parametric tests were applied to compare the differences of Pb levels among various groups.

RESULTS

The blood Pb concentration showed a positively skewed distribution by Kolmogorov-Smirnov test (D = 0.147, p < 0.01). The blood Pb concentration of Chinese patients was 28.36 μg/L, with the lowest blood Pb levels, 4.71 μg/L, found in patients from Guangxi Zhuang Autonomous Region, and the highest, 50 μg/L, in Yunnan province. Han Chinese patients' Pb levels were significantly lower than other minorities groups (z-score = - 38.54, p < 0.01). Average medical cost for Pb poisoning was about 6888 CNY for Chinese patients. Pb levels of patients with malignant neoplasm of lung, 45.34 μg/L, were far higher than malignant neoplasm of other respiratory, and intrathoracic organs, 24.00 μg/L (z-score = - 2.79, p < 0.01).

CONCLUSIONS

This study reported current status of blood Pb levels for patients who once visited military hospitals, partially representing the whole Chinese population. The result shows that Pb poisoning is still imposing marked economic burdens on patients under Pb exposure. Association of Pb with lung cancer may open up new areas for Pb-induced toxicology. The research strategy may advance toxicological studies in the aspect of medical data mining.

Anthropogenic atmospheric toxic metals emission inventory and its spatial characteristics in Guangdong province, China

Atmospheric toxic metals (TMs) may cause adverse effects on the environment and human health due to their bioavailability and toxicity. High-resolution TMs emission inventory is important input data for assessing human exposure risks, especially synergistic toxicity of multiple toxic metals. By using the latest city- and enterprise-level environment statistical data, an emission inventory of five TMs (Hg, As, Pb, Cd, Cr) in Guangdong province for the year of 2014 was developed using a bottom-up approach. The total emissions of Hg, As, Pb, Cd and Cr in Guangdong were estimated as 17.70, 32.59, 411.34, 13.13, and 84.16 t, respectively. Major emission sources for each TM were different. Hg emissions were dominated by coal combustion (33%), fluorescent lamp (18%) and cement (17%). 78% of Hg emissions were in the form of Hg⁰, 19% of Hg²⁺, and only 3% of Hg^p due to strict particulate matter control policies. Coal combustion (48%), nonferrous metal smelting (25%) and iron and steel industry (24%) were the major sources of As. Pb emissions primarily came from battery production (42%), iron and steel industry (21%) and gasoline combustion (17%). Cd and Cr emissions were dominated by nonferrous metal smelting (71%) and iron and steel industry (82%), respectively. Most of these TMs were emitted in the non-Pearl River Delta region, where the newly-built iron and steel industry, nonferrous metal smelting and cement production factories were intense. The uncertainties in the five TM emissions were high, due much to high uncertainties in TM emission factors and limited activity data. Thus, to improve the accuracy of these estimates, we recommend more field tests of TM emissions, especially for the industrial process sector. This study provides scientific support for formulating robust TMs control policies to alleviate the high risk of TMs exposure in Guangdong.

Changes of Atmospheric and Blood Concentrations of Lead and Cadmium in the General Population of South Korea from 2008 to 2017

We measured changes in atmospheric and blood levels of lead and cadmium in the South Korean general population during the past decade. Blood data of 16,873 adults were taken from the Korean National Health and Nutrition Examination Survey (KNHANES, 2008-2017). Atmospheric data were taken from 66 air quality monitoring sites in 16 different regions in South Korea. From 2008 to 2017, the geometric mean (GM) blood lead level decreased from 2.37 to 1.46 μg/dL (38.4% decrease), and the atmospheric lead concentration decreased by 61.0% in the overall population. During this time, the GM blood cadmium level decreased from 0.88 to 0.72 μg/L (18.2% decrease), and the atmospheric cadmium concentration decreased by 63.6%. Multiple linear regression analysis indicated that a half reduction in air lead was associated with a 0.09 μg/dL decrease in blood lead (95% CI: 0.03 to 0.15) in a subgroup of the metropolitan city population. However, a half reduction in air cadmium had no significant effect on blood cadmium. Multiple linear regression analyses indicated that the decrease in blood lead level over 10 years in Korea was related to the decrease in atmospheric lead concentration. However, the decrease in blood cadmium level during this time was not significantly associated with the decrease in atmospheric cadmium concentration. Our findings suggest that inhalation is a major source of lead exposure, but not of cadmium exposure. Ingestion of dietary cadmium presumably has a stronger impact on blood cadmium levels.

Dietary Lead Exposure and Associated Health Risks in Guangzhou, China

Lead exposure is associated with a wide range of adverse effects on human health. The principal exposure route in the general population is through the diet. In this study, we estimate the dietary lead intake and associated health risks among the residents of Guangzhou, China. Data on lead concentrations were derived from the food safety risk monitoring system, which included 6339 samples from 27 food categories collected in 2014–2017. Food consumption data were taken from a 2011 dietary survey of 2960 Guangzhou residents from 998 households. Dietary lead intake was estimated by age group (3–6, 7–17, 18–59, and ≥60 years), and relevant health risks were assessed using the margin of exposure (MOE) method. The mean and 95th percentiles (P95) of dietary lead intake were respectively 0.7466 and 2.4525 μg/kg body weight per day for preschool children aged 3–6 years; 0.4739 and 1.5522 μg/kg bw/day for school children aged 7–17 years; 0.3759 and 1.1832 μg/kg bw/day for adults aged 18–59 years; and 0.4031 and 1.3589 μg/kg bw/day for adults aged ≥60 years. The MOE value was less than 1 for preschool children at the mean exposure level and for all age groups at the P95 exposure level. Rice and its products, leafy vegetables, and wheat flour and its products were found to be the primary food sources of lead exposure. Our findings suggest that the health risk from dietary lead exposure is low for Guangzhou residents overall, but that young children and consumers of certain foods may be at increased risk. Continued efforts are needed to reduce the dietary lead exposure in Guangzhou.

Elevated lead levels from e-waste exposure are linked to sensory integration difficulties in preschool children

Exposure to lead is associated with adverse effects on neurodevelopment. However, studies of the effects of lead on sensory integration are few. The purpose of this research is to investigate the effect of lead exposure on child sensory integration by correlating the blood lead levels of children with sensory processing measures. A total of 574 children, from 3 to 6 years of age, 358 from an electronic waste (e-waste) recycling town named Guiyu, and 216 from Haojiang, a nearby town with no e-waste recycling activity, were recruited in this study. The median blood lead level in Guiyu children was 4.88 μg/dL, higher than the 3.47 μg/dL blood lead level in Haojiang children (P <  0.001). 47.2% of Guiyu children had blood lead levels exceeding 5 μg/dL. The median concentration of serum cortisol, an HPA-axis biomarker, in Guiyu children was significantly lower than in Haojiang, and was negatively correlated with blood lead levels. All subscale scores and the total score of the Sensory Processing Measure (Hong Kong Chinese version, SPM-HKC) in Guiyu children were higher than Haojiang children, indicating greater difficulties, especially for touch, body awareness, balance and motion, and total sensory systems. Sensory processing scores were positively correlated with blood lead, except for touch, which was negatively correlated with serum cortisol levels. Simultaneously, all subscale scores and the total SPM-HKC scores for children with high blood lead levels (blood lead > 5 μg/dL) were higher than those in the low blood lead level group (blood lead < 5 μg/dL), especially for hearing, touch, body awareness, balance and motion, and total sensory systems. Our findings suggest that lead exposure in e-waste recycling areas may result in a decrease in serum cortisol levels and an increase in child sensory integration difficulties. Cortisol may be involved in touch-related sensory integration difficulties.

Forecasting model to assess the potential of secondary lead production from lead acid battery scrap

Lead acid battery (LAB) scrap management is an important issue both environmentally and economically. The recovery of lead from battery scrap leads to a reduction in negative impacts of lead mining, as well as making the battery production cycle environmentally friendly. This work aims to propose a forecasting model for lead generation from LAB scrap based on time series modeling that uses data regarding after-market of batteries and new batteries produced for new cars. In order to illustrate the applicability of the new proposal, the model was applied to the Brazilian case. The main results show that at least 1% of LAB scrap from light vehicles have unknown or improper destinations; the efficiency of the recycling process in Brazil is still low, resulting in lead losses close to 4.5%; the lack of a sectorial agreement between the official battery market and the government concerning the reverse logistics of LAB scrap leads to a lack of precise data on the amount of LAB scrap generated and its final destination. Moreover, the economic importance of lead recycling and logistics of the secondary market are also discussed, with a focus on the dangers of illegal recycling.

A meta-analysis of blood lead levels in India and the attributable burden of disease

Multiple studies in India have found elevated blood lead levels (BLLs) in target populations. However the data have not yet been evaluated to understand population-wide exposure levels. We used arithmetic mean blood lead data published from 2010 to 2018 on Indian populations to calculate the average BLLs for multiple subgroups. We then calculated the attributable disease burden in IQ decrement and Disability Adjusted Life Years (DALYs). Our Pubmed search yielded 1066 articles. Of these, 31 studies representing the BLLs of 5472 people in 9 states met our study criteria. Evaluating these, we found a mean BLL of 6.86 μg/dL (95% CI: 4.38-9.35) in children and 7.52 μg/dL (95% CI: 5.28-9.76) in non-occupationally exposed adults. We calculated that these exposures resulted in 4.9 million DALYs (95% CI: 3.9-5.6) in the states we evaluated. Population-wide BLLs in India remain elevated despite regulatory action to eliminate leaded petrol, the most significant historical source. The estimated attributable disease burden is larger than previously calculated, particularly with regard to associated intellectual disability outcomes in children. Larger population-wide BLL studies are required to inform future calculations. Policy responses need to be developed to mitigate the worst exposures.

Urban street dust bound 24 potentially toxic metal/metalloids (PTMs) from Xining valley-city, NW China: Spatial occurrences, sources and health risks

Street dusts (SDs) were a significant tracer to understand the pollution status of potentially toxic metal/metalloids (PTMs) in local environment. In this study, a total of 157 SDs were collected in the valley-city of Xining, NW China, with the objective to systematically investigate the spatial occurrences, sources and health risk status of 24 PTMs bound in SDs. The basic datasets of pH and size-fractions showed that the SDs with PTMs were more alkaline and dominated with the coarse particle sizes between PM10-50, respectively. Results of concentration levels and spatial status of 24 PTMs processed with multi-statistical tools well established the sources identification in monitored local areas. It was suggested that the principal elements, Al, Fe, Si, K, Ca, Na, Mg, coupled with the trace elements Bi, Ga, Nb, Ni, Rb, Sr, Th, U, Y, Zr, As, Mn, Ti, V, Ce and La would be possiblely predominated by geogenic source or nature material, whereas contamination of Ba, Cu, Pb and Zn was clearly related to traffic-related sources. Peculiar associations among Cr and Co were possiblely enriched in SDs very close to the alloy industries. However, Sb and Sn differed from other observed PTMs, which appeared to derive predominantly from the coal combustion other than sources of electronic and mechanical industries. Compared to the integrated potential ecological risk index (PERI) of all PTMs with considerable contamination level and ecological risk, the single PTM of Sb posed very high risk. Calculated Hazard Index (HI) suggested ingestion as the most important exposure pathway for the majority of PTMs in children and adults, and no significant health risks of non-carcinogenic to children and adults were found except Cr (2.78) exposured to children. However, the evaluated cancerous risk was in the acceptable range both to children and adults except for the case of Cr exposure to adults (1.55E-06) compared to other PTMs. Although the carcinogenic risk was found no significant level, the maps of spatial carcinogenic risks above the threshold for children and adults were observed in some local monitoring areas, which should be attention and not to be always ignored.

Blood concentrations of lead, cadmium, mercury and their association with biomarkers of DNA oxidative damage in preschool children living in an e-waste recycling area

Reactive oxygen species (ROS)-induced DNA damage occurs in heavy metal exposure, but the simultaneous effect on DNA repair is unknown. We investigated the influence of co-exposure of lead (Pb), cadmium (Cd), and mercury (Hg) on 8-hydroxydeoxyguanosine (8-OHdG) and human repair enzyme 8-oxoguanine DNA glycosylase (hOGG1) mRNA levels in exposed children to evaluate the imbalance of DNA damage and repair. Children within the age range of 3-6 years from a primitive electronic waste (e-waste) recycling town were chosen as participants to represent a heavy metal-exposed population. 8-OHdG in the children's urine was assessed for heavy metal-induced oxidative effects, and the hOGG1 mRNA level in their blood represented the DNA repair ability of the children. Among the children surveyed, 88.14% (104/118) had a blood Pb level >5 μg/dL, 22.03% (26/118) had a blood Cd level >1 μg/dL, and 62.11% (59/95) had a blood Hg level >10 μg/dL. Having an e-waste workshop near the house was a risk factor contributing to high blood Pb (r _s  = 0.273, p < 0.01), while Cd and Hg exposure could have come from other contaminant sources. Preschool children of fathers who had a college or university education had significantly lower 8-OHdG levels (median 242.76 ng/g creatinine, range 154.62-407.79 ng/g creatinine) than did children of fathers who had less education (p = 0.035). However, we did not observe a significant difference in the mRNA expression levels of hOGG1 between the different variables. Compared with children having low lead exposure (quartile 1), the children with high Pb exposure (quartiles 2, 3, and 4) had significantly higher 8-OHdG levels (β _Q2 = 0.362, 95% CI 0.111-0.542; β _Q3 = 0.347, 95% CI 0.103-0.531; β _Q4 = 0.314, 95% CI 0.087-0.557). Associations between blood Hg levels and 8-OHdG were less apparent. Compared with low levels of blood Hg (quartile 1), elevated blood Hg levels (quartile 2) were associated with higher 8-OHdG levels (β _Q2 = 0.236, 95% CI 0.039-0.406). Compared with children having low lead exposure (quartile 1), the children with high Pb exposure (quartiles 2, 3, and 4) had significantly higher 8-OHdG levels.

Association between blood lead level and blood pressure: An occupational population-based study in Jiangsu province, China

Studies about the association between lead exposure and the elevation of blood pressure and risk of hypertension are varied, while available data on blood lead levels (BLL) in workers with lead-exposure are scarce. This research aimed to evaluate associations between BLL and blood pressure in an occupational population-based study in Jiangsu province, China. We enrolled 21,688 workers in this study. Information on socioeconomic and occupational background was obtained with face-to-face interviews. BLL, systolic blood pressure (SBP) and diastolic blood pressure (DBP) were measured, and hypertension status was confirmed. We found that workers in mini-factories had the highest average BLL (20.3 μg/dL; 95% CI, 19.0-21.6 μg/dL) for overall participants. The employees in private factories had higher BLL (9.6 μg/dL; 95% CI, 9.5-9.8 μg/dL). However, BLL was much lower (4.0 μg/dL; 95%CI, 3.7-4.2 μg/dL) in state-owned factories. Participants working in the electrical machinery and equipment manufacturing industry had higher BLL (9.1 μg/dL; 95% CI, 9.0-9.3μg/dL). Compared to those workers with ≤ 4.6 μg/dL BLL, workers with > 17.5 μg/dL BLL presented 1.34 mmHg and 0.70 mmHg average difference in SBP and DBP, respectively. The adjusted OR for hypertension was 1.11 (95%CI, 1.08-1.15) compared to the workers with > 17.5 μg/dL BLL and to those with ≤ 4.6 μg/dL BLL. In summary, we found that BLL was positively associated with SBP and DBP and with the morbidity of hypertension in occupational populations with a high concentration of lead exposure. It is important to formulate new standards of blood lead levels to screen for elevated lead exposure. In addition, a series of new systems of risk assessment should be established to further reduce and prevent lead exposure.

Dose-response relationship between blood lead levels and hematological parameters in children from central China

BACKGROUND

Lead is a heavy metal that can affect the human hematological system. However, reports are limited on the dose-response relationship between blood lead levels (BLLs) and hematological parameters in children. This study aimed to explore the dose-response relationship between BLLs and hematological measurements among children in China.

METHODS

A cross-sectional design was used. A total of 743 children aged 5-8 years were recruited from two counties in central China. The BLLs and blood levels of iron, zinc, and calcium were determined, and hematological parameters were measured.

RESULTS

All hematological measurements and BLLs were logarithm-transformed to ensure a normal distribution. The geometric mean of the BLLs of all children was 82.4 μg/L. Forty-one percent of the children had BLLs ≥ 100 μg/L. The lead-poisoning percentages of the children were significantly associated with gender, age, district of residence, and environmental lead exposure level. Multivariate linear regression analyses showed no significant linear correlation between BLL and each hematological parameter among the children with BLLs ≥ 100 μg/L. The analyses also revealed a small increase in red blood cell count (RBC) with increasing BLLs in the BLLs < 100 μg/L group (β = 0.03, P =  0.048). A negative association was noted between BLLs and blood platelet (PLT) count in the children with BLLs < 100 μg/L (β = -0.90, P < 0.001). Logistic regression analyses showed that BLLs were significantly associated with decreased hemoglobin (Hb) levels, RBC counts, PLT counts and mean corpuscular hemoglobin (MCH) after adjusting for potential confounders. Such analyses also revealed a dose-response relationship between the BLLs and hematological parameters (Hb level, RBC count, and PLT count). The children with BLLs ≥ 100 μg/L were 2.72, 2.51, and 3.76 times more likely to achieve decreased RBC counts, Hb levels and PLT counts, respectively, compared to those with BLLs < 100 μg/L. Compared with children with BLLs < 100 μg/L, those with BLLs ≥ 100 μg/L were 3.16 and 4.38 times more likely to show decreased Hb levels and PLT counts respectively in the high-level lead-exposure group and 4.33 times more likely to achieve a decreased PLT count in the low-level lead-exposure group. The individuals with BLLs of the highest quartile were 3.65, 5.87, and 29.23 times more likely to exhibit decreased Hb levels, RBC counts, and PLT counts, respectively, than the children with BLLs of the lowest quartile.

CONCLUSION

Our findings suggested a negative association between BLLs and hematological indicators (Hb level, RBC count, PLT count and MCH). A strong negative, non-linear dose-response relationship was also showed between BLLs and hematological parameters (Hb level, RBC count, and PLT count).

Blood lead levels of children in urban and suburban areas in China (1997-2015): Temporal and spatial variations and influencing factors

Blood lead (Pb) poisoning is a worldwide heath problem, especially in developing countries. As the largest developing country in the world, China faces severe health challenges, in particular the threat of blood Pb poisoning. In this study, the temporal trend of Chinese children's blood lead levels (BLLs) and blood lead poisoning incidence (BLPI) (percentage of BLL>100μg/L) and its influencing factors were investigated. We collected articles on children's BLLs published from 1997 to 2017 with sampling time from 1997 to 2015 by searching the databases of VIP Medical Information System (VMIS), China National Knowledge Infrastructure (CNKI) and Wanfang Data. After a rigorous investigation, 259 articles with eligible inclusion criteria were reviewed. Meanwhile, the data of Pb concentrations in the soil of 23 cities and the annual mean PM10 (particulate matter<10μm) concentrations of 24 provincial cities were collected. The temporal trend of children's BLLs and BLPIs could be divided into three stages: upward trend from 1997 to 2000, downward trend from 2001 to 2013, and upward trend from 2014 to 2015. The decline of BLLs from 2001 was primarily due to the phasing out of leaded gasoline since 2000 in China, while the descending air quality could explain the upward trend of BLLs in the period from 2014 to 2015. The correlation and regression analysis indicated that soil and air were two major pathways of Pb exposure for children in China. Although a noticeable decrease has been shown, the Chinese children's BLLs were still significantly higher than the levels of developed countries. We highly recommended that the critical value of blood Pb poisoning should be lowered to 50μg/L in China. Guidelines on the prevention and management of blood Pb poisoning are needed in China.

Environmental factors associated with blood lead among newcomer women from South and East Asia in the Greater Toronto Area

BACKGROUND

Newcomers bring with them histories of environmental exposure in their home countries and may have different sources of lead (Pb) exposure compared to other residents of their adopted country.

AIMS

To describe past and current factors associated with Pb exposure and blood Pb among South and East Asian newcomer women of reproductive age in the Greater Toronto Area (GTA), Ontario, Canada.

METHODS

In collaboration with public health units and community organizations a community-based research model was utilized by recruiting peer researchers to assist in all aspects of the study. Blood samples were taken and phone interviews were conducted. Canadian Health Measures Survey (CHMS) cycles 1, 2, and 3 data was used to contextualize the distribution blood Pb levels. Multiple regression was applied to log-transformed blood lead measurements, using a hierarchical model building process.

RESULTS

In total, 211 participants were recruited from Bangladesh, China, India, Pakistan and Sri Lanka. The distribution of the blood Pb varied by country of origin, and higher blood Pb values were found above 75th percentile compared to the CHMS. Distal factors significantly influencing blood Pb concentrations related to life history, such as duration of stay in Canada (RR=0.91; 95% CI 0.86-0.97), living near agricultural fields (RR=0.78; 95% CI 0.62-0.93), and country of origin. Proximal factors with significant contribution were use of cosmetics, traditional remedies, and smoking cigarettes.

RECOMMENDATIONS

Different past and current exposures may be important in various newcomer populations, informing international stakeholders, public health agencies, and primary care practitioners to adapt health education and exposure reduction programs to consider pre- and post-migration factors.

Use of a Survey to Assess the Environmental Exposure and Family Perception to Lead in Children (<6 Years) in Four Valley Cities, Northwestern China

With the growth of industry, the extensive use of lead, and urban expansion in Northwestern Valley Cities (NVC) China, there is probable reason for presuming an increasing risk of lead exposure. However, little is known about the lead exposure of children less than 6 years old in NVC. As a first investigation, this study uses a survey to systematically determine the influences of various risk factors within the family environment, parents' background, children's behavior, mother's behavior during pregnancy, and parental perception about children's blood lead (CBL). A total of 596 families were recruited from the general population in Urumqi, Lanzhou, Xining and Yan'an. Parents, and their children (<6 years old), were asked about the environment and behaviors which could possibly relate with lead exposure. The results indicated that in the typical NVC of China, children's environment and behavior, parents' education level, and mother's pregnancy behavior, were associated with potential CBL. It was noted that not all parents in NVC China recognized the importance of children's lead exposure. Therefore, children's health care and medical screening campaigns need to be designed to improve family's fundamental knowledge of lead hazards, associated health effects, and prevention in the NVC of China.

An Emission-Free Vacuum Chlorinating Process for Simultaneous Sulfur Fixation and Lead Recovery from Spent Lead-Acid Batteries

Spent lead-acid battery recycling by using conventional technologies is usually accompanied by releases of lead-containing wastewater as well as emissions of sulfur oxides and lead particulates that may potentially cause secondary pollution. This study developed a vacuum chlorinating process for simultaneous sulfur fixation and high-purity lead chloride (PbCl₂) recovery from spent lead paste by using calcium chloride (CaCl₂) and silicon dioxide (SiO₂) as reagents. The process train includes pretreatment, simultaneous PbCl₂ production and sulfur fixation, and PbCl₂ volatilization. The pretreatment eliminated chlorine emission from direct chlorinating reaction of PbO₂ in the initial S-paste (PbSO₄/PbO₂/PbO/Pb). During the subsequent PbCl₂ production and sulfur fixation step, lead compounds in the P-paste (PbSO₄/PbO) was converted to volatile PbCl₂, and sulfur was simultaneously fixed to the solid residues in the form of CaSO₄ to eliminate the emission of sulfur oxides. The final step, PbCl₂ volatilization under vacuum, is a physical phase-transformation process of ionic crystals, following a zeroth-order kinetic model. A cost estimate indicates a profit of USD $ 8.50/kg PbCl₂. This process offers a novel green lead recovery alternative for spent lead-acid batteries with environmental and economic benefits.

Blood Lead Levels and Risk Factors for Lead Exposure in a Pediatric Population in Ho Chi Minh City, Vietnam

Although lead recycling activities are a known risk factor for elevated blood levels in South East Asia, little is known regarding the prevalence of and risk factors for elevated blood lead levels (BLL) among the general pediatric population in Vietnam. This study is a cross-sectional evaluation of 311 children from Children’s Hospital #2 in Ho Chi Minh City, Vietnam. Capillary blood lead testing was performed using the LeadCare II. Mean BLLs were 4.97 μg/dL (Standard Deviation (SD) 5.50), with 7% of the participants having levels greater than 10 μg/dL. Living in Bing Duong province (OR 2.7, 95% CI 1.4–5.6.1) or the Dong Nai province (OR 2.3, 95% CI 1.0–5.1) and having an age greater than 12 months (OR 6.0, 95% CI 3.1–11.8) were associated with higher BLLs. The prevalence of elevated BLLs in Vietnam is consistent with other SE Asian countries. Mean BLLs in Ho Chi Minh City are markedly less than those seen in a separate study of children living near lead recycling activities. Additional evaluation is necessary to better detail potential risk factors if screening is to be implemented within Vietnam.

Sources, symptoms and characteristics of childhood lead poisoning: experience from a lead specialty clinic in China

OBJECTIVES

This study explored the sources of lead exposure, identified patients' geographic distribution and evaluated the symptoms of children with elevated blood lead levels (BLLs) referred to a pediatric lead specialty clinic in China.

MATERIAL AND METHODS

Data were collected from 515 consecutive outpatients attending the Pediatric Lead Poisoning Clinic in Xinhua Hospital, Shanghai, China, between 2011 and 2016, referred for BLLs ≥5 μg/dL. Atomic absorption spectrometry was used to measure venous BLLs.

RESULTS

The mean ± standard deviation age of the patients was 4.1 ± 3.2 years. Their BLLs ranged from 5 to 126 μg/dL. The geometric mean and median BLLs were 24 and 26 μg/dL, respectively. Two hundred and twenty-two children (43.1%) were exposed to industrial lead pollution-mainly from Zhejiang, Jiangsu, Hunan, Henan and Anhui provinces; whereas, 41.4% (213 cases) were induced by folk medicines used widely throughout China. Other nonindustrial sources of lead exposure included lead-containing tinfoil and tin pots. Household lead paint was a rare source. Most patients exhibited nonspecific symptoms, such as hyperactivity, attention difficulty, aggressiveness, constipation and anorexia.

CONCLUSIONS

Industrial pollution and folk medicines are important sources of lead exposure in China. Childhood lead poisoning may be difficult to diagnose clinically as symptoms are nonspecific. Thus, blood lead screening may be necessary to identify children at high risk of exposure. Education to raise the awareness of potential sources of exposure resulting in their elimination would be expected to decrease the incidence of children with elevated BLLs.

Trace metals and magnetic particles in PM2.5: Magnetic identification and its implications

Magnetic measurement was combined with geochemical analysis to investigate the trace metal pollution of PM_2.5. The study was carried out in Nanjing, China, where the average PM_2.5 concentrations in summer and winter in 2013–2014 were 66.37 and 96.92 μg/m³, respectively. The dominant magnetic mineral in PM_2.5 had a low-coercivity pseudo-single domain and consisted of magnetite and hematite. Iron-oxide magnetic particles comprised spherical as well as angular particles. Stable Pb isotopic ratio determinations showed that Pb in summer samples derived from coal emissions while the main sources of winter samples were smelting industry and coal emissions. The magnetic properties of the particles correlated strongly with trace metals derived from anthropogenic activities, such as industrial emission, coal combustion, and traffic vehicle activities, but poorly with those derived from natural sources. In the multiple linear regression analysis, Cr and Fe had higher correlation coefficients (training R > 0.7) in contrast to the low training R of As, Cd, Ni, Sr, and Ti (<0.5) determined using the PM_2.5 concentrations and magnetic parameter values as the decision variables. Our results support the use of environmental magnetism determinations as a simple and fast method to assess trace metals in urban particulate matter.