[Decision tools for selecting industrial sites where a systematic blood lead screening should be implemented]

Identifying Sources of Lead Exposure for Children in the Republic of Georgia, with Lead Isotope Ratios

In the Republic of Georgia, a 2018 national survey estimated that more than 40% of children aged 2-7 years had a blood lead concentration (BLC) of more than 5 µg/dL. The objective of this study was to document the feasibility of employing lead isotope ratios (LIRs) to identify and rank the Pb (lead) exposure sources most relevant to children across Georgia. A cross-sectional survey between November 2019 and February 2020 of 36 children previously identified as having BLCs > 5 µg/dL from seven regions of Georgia involved the collection of blood and 528 environmental samples, a questionnaire on behaviours and potential exposures. The LIRs in blood and environmental samples were analysed in individual children and across the whole group to ascertain clustering. A fitted statistical mixed-effect model to LIR data first found that the blood samples clustered with spices, tea, and paint, then, further isotopically distinct from blood were sand, dust, and soil, and lastly, milk, toys, pens, flour, and water. Analysis of the LIRs provided an indication and ranking of the importance of Pb environmental sources as explanatory factors of BLCs across the group of children. The findings support the deployment of interventions aimed at managing the priority sources of exposure in this population.

Activities at risk of lead exposure and lead poisoning in children of travellers' families in charente, France

Background

-A study to assess lead exposure of traveller children aged from 9 months to 18 years old was conducted in Charente-France between 2017 and 2019.

Methods

A face-to-face questionnaire was administered to each participating family (N = 78). Blood samples were collected, and in case of lead poisoning, an environmental survey of soil, dust and water samples was also performed.

Results

-Among the 100 children, they were 39 girls and 61 boys. Among them, 40 suffered from lead poisoning (Blood Lead Level ≥50 μg/L). Being a boy aged between 11 and 14 years old, and participating in lead exposure at-risk activities were significantly associated with higher mean blood lead level.

Conclusion

-The high levels of lead detected advocate the reinforcement of lead poisoning screening for all children in the traveller population.

French children's exposure to metals via ingestion of indoor dust, outdoor playground dust and soil: contamination data

In addition to dietary exposure, children are exposed to metals via ingestion of soils and indoor dust, contaminated by natural or anthropogenic outdoor and indoor sources. The objective of this nationwide study was to assess metal contamination of soils and dust which young French children are exposed to. A sample of 484 children (6 months to 6 years) was constituted in order to obtain representative results for young French children. In each home indoor settled dust was sampled by a wipe in up to five rooms. Outdoor playgrounds were sampled with a soil sample ring (n=315) or with a wipe in case of hard surfaces (n=53). As, Cd, Cr, Cu, Mn, Pb, Sb, Sr, and V were measured because of their potential health concern due to soil and dust ingestion. The samples were digested with hydrochloric acid, and afterwards aqua regia in order to determine both leachable and total metal concentrations and loadings by mass spectrometry with a quadrupole ICP-MS. In indoor settled dust most (total) loadings were below the Limit of Quantification (LOQ), except for Pb and Sr, whose median loadings were respectively 9 and 10 μg/m². The 95th percentile of loadings were 2 μg/m² for As, <0.8 for Cd, 18 for Cr, 49 for Cu, <64 for Mn, 63 for Pb, 2 for Sb, 56 for Sr, and <8 for V. Median/95th percentile of loadings in settled dust on outdoor playgrounds were 2/16, <0.8/1.3, 17/53, 49/330, 99/424, 32/393, 2/13, 86/661 and 10/37 μg/m² for As, Cd, Cr, Cu, Mn, Pb, Sb, Sr, and V respectively. In outdoor playground soil median/95th percentile of concentrations (μg/g) were 8/26, <0.65/1, 25/52, <26/53,391/956, 27/254, 0.7/4, 54/295, 23/57 for As, Cd, Cr, Cu, Mn, Pb, Sb, Sr, and V respectively. These results are comparable with those observed in other countries. Because of their representative nature, we can assess children's exposures to these metals via soil and dust and the associated risks in urban and rural environments. Ratios of leachable/total concentrations and loadings, calculated on >LOQ measurements, differed among metals. To a lesser extent, they were also affected by type of matrix, with (except for Cd) a greater leachability of dust (especially indoor) compared to soils.

Effects of grinding and shaking on Cd, Pb and Zn distribution in anthropogenically impacted soils

The effects of grinding size and shaking process on the results of Cd (cadmium), Pb (lead) and Zn (zinc) distribution measurements three agricultural and three kitchen garden soils highly contaminated by past atmospheric fallout of two lead and zinc smelters in northern France were studied. The physico-chemical parameters and pseudo-total concentration of metals within these soils were determined. The fractionation of metals was performed in triplicate, using the procedure recommended by the Standards, Measurements and Testing program (SM&T), on each air-dried soil sample, ground to pass through 2-mm, 0.315-mm and 0.250-mm sieves and using a reciprocating or rotary shaker. The samples were analysed by flame or electrothermal absorption atomic spectrometry using a self-reversal background system. For both shaking processes, the grinding size had no effect on the fractionation of metals in contaminated agricultural soils. In contrast, using a reciprocating shaker, the fractionation of metals in the kitchen garden samples sieved at <2mm was so different that in the samples prepared to pass through the 0.315-mm and 0.250-mm sieves. Therefore changes (use of a 50 mL graduated polypropylene centrifuge tube, evaporation of the solution to a fixed volume in step 3 and the use of an automatic shaking heating bath) were made to the initial procedure and a rotary shaker was used to improve the suspension of the soil samples during extraction. For all grinding sizes, the fractionation of the three metals contained in the contaminated kitchen garden soil samples was successfully achieved. Nevertheless, some discrepancies from samples sieved at <2mm were obtained. On the other hand, it is worth noting that the effect of the type of shaker on the distribution of metal depended on the soil and the grinding size. From an analytical point of view, precision and trueness were improved after optimisation of the procedure for all sequential extraction procedure steps. The best results were obtained for samples sieved at <0.250 mm. Similar trends were obtained using the CRM BCR(®)-701 certified material. All the results showed that optimisation of the sequential extraction procedure could be adopted for the Cd-, Pb- and Zn-partitioning in contaminated kitchen garden soils with high-level anthropogenic sources.

Childhood lead exposure in France: benefit estimation and partial cost-benefit analysis of lead hazard control

BACKGROUND

Lead exposure remains a public health concern due to its serious adverse effects, such as cognitive and behavioral impairment: children younger than six years of age being the most vulnerable population. In Europe, the lead-related economic impacts have not been examined in detail. We estimate the annual costs in France due to childhood exposure and, through a cost benefit analysis (CBA), aim to assess the expected social and economic benefits of exposure abatement.

METHODS

Monetary benefits were assessed in terms of avoided national costs. We used results from a 2008 survey on blood-lead (B-Pb) concentrations in French children aged one to six years old. Given the absence of a threshold concentration being established, we performed a sensitivity analysis assuming different hypothetical threshold values for toxicity above 15 μg/L, 24 μg/L and 100 μg/L. Adverse health outcomes of lead exposure were translated into social burden and economic costs based on literature data from literature. Direct health benefits, social benefits and intangible avoided costs were included. Costs of pollutant exposure control were partially estimated in regard to homes lead-based paint decontamination, investments aiming at reducing industrial lead emissions and removal of all lead drinking water pipes.

RESULTS

The following overall annual benefits for the three hypothetical thresholds values in 2008 are: €22.72 billion, €10.72 billion and €0.44 billion, respectively. Costs from abatement ranged from €0.9 billion to 2.95 billion/year. Finally, from a partial CBA of lead control in soils and dust the estimates of total net benefits were € 3.78 billion, € 1.88 billion and €0.25 billion respectively for the three hypothesized B-Pb effect values.

CONCLUSIONS

Prevention of childhood lead exposure has a high social benefit, due to reduction of B-Pb concentrations to levels below 15 μg/L or 24 μg/L, respectively. Reducing only exposures above 100 μg/L B-Pb has little economic impact due to the small number of children who now exhibit such high exposure levels. Prudent public policies would help avoiding future medical interventions, limit the need for special education and increase future productivity, and hence lifetime income for children exposed to lead.

Performance of several decision support tools for determining the need for systematic screening of childhood lead poisoning around industrial sites

BACKGROUND

Living around industrial sites may expose young children to lead and cause elevated blood lead levels (BLLs). Systematic screening for childhood lead poisoning is necessarily invasive but may be appropriate, depending on children's exposure levels. Our objective was to assess the performance of several decision support tools for determining the need for systematic BLL screening in children around industrial sites.

METHOD

We used several exposure models to predict BLLs: the pharmacokinetic model IEUBK, the InVS dose model, and an empirical relation (Lewin, 1999) between soil concentrations and BLLs. We tested the BLLs (percentage of children with a BLL >100 micro g/l) that they predicted as well as threshold levels of soil pollution (200, 400, 500 ppm) for 71 situations for which the literature reports both environmental soil concentrations and BLLs in children aged 0-6 years. The tools' performance (sensitivity and specificity) was assessed by the rate of 'correct' (mass screening or not) decisions, judged retrospectively on the basis of measured BLLs, for different tolerated percentages of children with elevated BLLs.

RESULTS

Decision support systems based on soil pollution levels were not adequately protective. The IEUBK and (updated) InVS mechanistic exposure models were the most effective in this setting.

CONCLUSION

Exposure models may provide decision support if sufficient data about environmental contamination and dietary intake are available. Absolute performance measurement nonetheless remains difficult, in view of the limitations of the input data.