Intellectual impairment and blood lead levels

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

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

Global decrease in blood lead concentrations due to the removal of leaded gasoline

Lead (Pb) is a chemical element with extreme toxicity that is classified as one of the ten chemicals of most significant concern to human health. The main problem involving Pb is its use as a fuel additive (tetraethyllead - TEL) at a global level, which raised the atmospheric Pb concentrations. It is estimated that between 80 and 90% of the atmospheric Pb in large cities came from the use of TEL, and as a consequence, it was also the main source responsible for human exposure to the element. Therefore, this work aimed to evaluate, through a systematic review, the blood concentrations of Pb in scientific articles published in the first two decades of the 2000s to compare the global and regional trends of each continent over time. Our data show the importance of removing TEL in decreasing human exposure to Pb worldwide. We observed exponentially decreasing blood Pb concentrations over the years after additive removal on all continents, resulting in a global trend which TEL's use was the major process governing human exposure worldwide. In addition, the results also showed that, despite the removal of Pb additives lowering levels of human blood Pb, the general population remains exposed to the element through exogenous and endogenous sources. The exhaust Pb particles were deposited into the environment in proportion to the traffic flows, and the legacy of Pb in the environment requires novel primary prevention remedy to curtail exposure.

Community-Engaged Assessment of Soil Lead Contamination in Atlanta Urban Growing Spaces

Urban agriculture is emerging as a method to improve food security and public health in cities across the United States. However, an increased risk of exposure to heavy metals and metalloids (HMM) exists through interaction with contaminated soil. Community-engaged research (CEnR) is one method that can promote the inclusion of all partners when studying exposures such as HMM in soil. Researchers and community gardeners co-designed this study to measure the concentrations of lead (Pb), using X-Ray Fluorescence (XRF) verified with Inductively Coupled Plasma-Mass Spectrometry (ICP-MS) in soils from 19 urban agricultural and residential sites in the Westside of Atlanta and three rural sites in Georgia. Seventeen other HMM were measured but not included in this study, because they did not pose risks to the community comparable to elevated Pb levels. Pb concentrations were compared to the Environmental Protection Agency (EPA)'s regional screening levels (RSLs) for residential soil and the University of Georgia (UGA) extension service's low-risk levels (LRLs) for agriculture. Soils from the majority of sites had levels below EPA RSLs for Pb, yet above the UGA LRL. However, soil Pb concentrations were three times higher than the EPA RSL on some sites that contained metal refining waste or slag. Our findings led to direct action by local and federal government agencies to initiate the cleanup of slag residue. Studies involving exposures to communities should engage those affected throughout the process for maximum impact.

Effect of the COVID-19 Global Pandemic on Illinois Children Tested for Blood Lead Level and Exposure

Objectives. To determine whether the number of children tested for lead exposure and the number of case rates increased (rate ratio [RR] > 1), decreased (RR < 1), or remained stable (RR = 1) during COVID-19 pandemic year 2020 compared with prepandemic year 2019. Methods. We analyzed more than 415 000 children's records reported to the Illinois Department of Public Health in 2019 and 2020 by demographic characteristics. The testing rate was the number of children tested yearly per population. The case rate was the proportion of children whose yearly tests showed a blood lead level of 5 or more micrograms per deciliter. RR was the 2020 case rate divided by the 2019 case rate. Results. In 2020, 19.6% of children were tested for lead compared with 25.5% in 2019. Testing decreased in 97% of counties. The 24% decreased testing in 2020 was notably in African Americans (36.4% decrease), high-risk zip codes (29.8% decrease), and rural counties (26.9% decrease). Case rates increased in rural counties, high-risk zip codes, Whites, and Hispanics. Conclusions. During pandemic year 2020, the number of children tested for lead decreased by 24%, and case rates increased in 51% of counties. Public Health Implications. Redesignation of high-risk zip codes is recommended to increase the testing of at-risk populations. (Am J Public Health. 2023;113(1):89-95. https://doi.org/10.2105/AJPH.2022.307109).

Effects of humic acid on Pb2+ adsorption onto polystyrene microplastics from spectroscopic analysis and site energy distribution analysis

Microplastics (MPs), act as vectors of heavy metal pollutants in the environment, is of practical significance to study the adsorption process and mechanism on heavy metals. In this study, polystyrene microplastics (PSMPs) were used as model MPs to study the adsorption of Pb²⁺ on PSMPs and the effects of humic acid (HA) on the adsorption process. The results showed that HA promoted the adsorption of Pb²⁺ on PSMPs, and the higher the concentration of HA, the greater the adsorption of Pb²⁺. With the increase of pH value and decrease of ionic strength, the adsorption capacity of PSMPs for Pb²⁺ increased. The scanning electron microscope equipped with the energy dispersive spectroscope (SEM–EDS), fourier transform-infrared spectra (FT-IR) and X-ray photoelectron spectroscopy (XPS) analysis showed that Pb²⁺ could be adsorbed directly onto PSMPs and also indirectly by HA. The higher K_SV values in the PSMPs-HA-Pb²⁺ system than PSMPs-HA system by fluorescence analysis of HA suggested that HA acted as a bridging role in the adsorption of Pb²⁺ on PSMPs. The site energy distribution analysis further revealed that HA increased the average site energy μ(E^*) and its standard deviation σ_e^* of PSMPs by introducing more adsorption sites, thus enhanced the adsorption affinity of PSMPs. This study provided more thoughts and insights into the adsorption behavior and mechanism of MPs for Pb²⁺ in aquatic environments.

Taurine-Derived Compounds Produce Anxiolytic Effects in Rats Following Developmental Lead Exposure

Lead (Pb2+) is a developmental neurotoxicant that disrupts the GABA-shift and subsequently causes alterations in the brain's excitation-to-inhibition (E/I) balance. Taurine is a well-established neuroprotective and inhibitory compound for regulating brain excitability. Since mechanistically taurine can facilitate neuronal inhibition through the GABA-AR, the present study examined the anxiolytic potential of taurine derivatives. Treatment groups consisted of the following developmental Pb2+-exposures: Control (0 ppm) and Perinatal (150 ppm or 1,000 ppm lead acetate in the drinking water). Rats were scheduled for behavioral tests between postnatal days (PND) 36-45 with random drug assignments to either saline, taurine, or taurine-derived compound (TD-101, TD-102, or TD-103) to assess the rats' responsivity to each drug in mitigating the developmental Pb2+-exposure and anxiety-like behaviors through the GABAergic system. Long-Evans hooded rats were assessed using an open field (OF) test for preliminary locomotor assessment. Twenty-four hours later, the same rats were exposed to the elevated plus maze (EPM) and were given an i.p. injection of 43 mg/Kg of the saline, taurine, or TD drugs 15 min prior to testing. Each rat was tested using the triple-blind random assignment method for each drug condition. The OF data revealed that Control female rats had increased locomotor activity over Control male rats, and the Pb2+-exposed males and females had increased locomotor activity when compared to the Control male and female rats. However, in the EPM, the Control female rats exhibited more anxiety-like behaviors over Control male rats, and the Pb2+-exposed male and female rats showed selective responsivity to TD drugs when compared to taurine. For Pb2+-exposed males, TD-101 showed consistent recovery of anxiety-like behaviors similar to that of taurine regardless of Pb2+ dose, whereas in Pb2+-exposed females TD-101 and TD-103 showed greater anxiolytic responses in the EPM. The results from the present psychopharmacological study suggests that taurine and its derivatives are interesting drug candidates to explore sex-specific mechanisms and actions of taurine and the associated GABAergic receptor properties by which these compounds alleviate anxiety as a potential behavioral pharmacotherapy for neurodevelopmental Pb2+ exposure.

Nail Samples of Children Living near Coal Ash Storage Facilities Suggest Fly Ash Exposure and Elevated Concentrations of Metal(loid)s

Children who live near coal-fired power plants are exposed to coal fly ash, which is stored in landfills and surface impoundments near residential communities. Fly ash has the potential to be released as fugitive dust. Using data collected from 263 children living within 10 miles of coal ash storage facilities in Jefferson and Bullitt Counties, Kentucky, USA, we quantified the elements found in nail samples. Furthermore, using principal component analysis (PCA), we investigated whether metal(loid)s that are predominately found in fly ash loaded together to indicate potential exposure to fly ash. Concentrations of several neurotoxic metal(loid)s, such as chromium, manganese, and zinc, were higher than concentrations reported in other studies of both healthy and environmentally exposed children. From PCA, it was determined that iron, aluminum, and silicon in fly ash were found to load together in the nails of children living near coal ash storage facilities. These metal(loid)s were also highly correlated with each other. Last, results of geospatial analyses partially validated our hypothesis that children's proximity to power plants was associated with elevated levels of concentrations of fly ash metal(loid)s in nails. Taken together, nail samples may be a powerful tool in detecting exposure to fly ash.

Effects of accumulated environmental, social and host exposures on early childhood educational outcomes

BACKGROUND

Persistent disparities in academic performance may result from a confluence of adverse exposures accruing disproportionately to specific subpopulations.

OBJECTIVE

Our overarching objective was to investigate how multiple exposures experienced over time affect early childhood educational outcomes. We were specifically interested in whether there were: racial/ethnic disparities in prevalence of adverse exposures; racial/ethnic disparities in associations observed between adverse exposures and early childhood educational outcomes; and interactions between exposures, suggesting that one exposure augments susceptibility to adverse effects of another exposure.

METHODS

We link geocoded North Carolina birth data for non-Hispanic white (NHW) and non-Hispanic black (NHB) children to blood lead surveillance data and 4th grade end-of-grade (EOG) standardized test scores (n = 65,151). We construct a local, spatial index of racial isolation (RI) of NHB at the block group level. We fit race-stratified multi-level models of reading and mathematics EOG scores regressed on birthweight percentile for gestational age, blood lead level, maternal smoking, economic disadvantage, and RI, adjusting for maternal- and child-level covariates and median household income.

RESULTS

There were marked racial/ethnic disparities in prevalence of adverse exposures. Specifically, NHB children were more likely than NHW children to be economically disadvantaged (80% vs. 40%), live in block groups with the highest quintile of RI (46% vs. 5%), have higher blood lead levels (4.6 vs. 3.7 μg/dL), and lower birthweight percentile for gestational age (mean: 39th percentile vs. 51st percentile). NHB children were less likely to have mothers who reported smoking during pregnancy (11% and 22%). We observed associations between key adverse exposures and reading and math EOG scores in 4th grade. Higher birthweight percentile for gestational age was associated with higher EOG scores, while economic disadvantage, maternal smoking, and elevated blood lead levels were associated with lower EOG scores. Associations observed for NHB and NHW children were generally not statistically different from one another, with the exception of neighborhood RI. NHB children residing in block groups in the highest RI quintile had reading and math scores 1.54 (0.74, 2.34) and 1.12 (0.38, 1.87) points lower, respectively, compared to those in the lowest RI quintile; statistically significant decrements in EOG scores associated with RI were not observed for NHW children. We did not find evidence of multiplicative interactions between exposures for NHB or NHW children.

DISCUSSION

Key adverse host, environmental, and social exposures accrue disproportionately to NHB children. Decrements in test scores associated with key adverse exposures were often but not always larger for NHB children, but were not significantly different from those estimated for NHW children. While we did not observe interactive effects, NHB children on average experience more deleterious combined exposures, resulting in larger decrements to test scores compared to NHW children.

Causes, Factors, and Control Measures of Opportunistic Premise Plumbing Pathogens—A Critical Review

This review critically analyses the chemical and physical parameters that influence the occurrence of opportunistic pathogens in the drinking water distribution system, specifically in premise plumbing. A comprehensive literature review reveals significant impacts of water age, disinfectant residual (type and concentration), temperature, pH, and pipe materials. Evidence suggests that there is substantial interplay between these parameters; however, the dynamics of such relationships is yet to be elucidated. There is a correlation between premise plumbing system characteristics, including those featuring water and energy conservation measures, and increased water quality issues and public health concerns. Other interconnected issues exacerbated by high water age, such as disinfectant decay and reduced corrosion control efficiency, deserve closer attention. Some common features and trends in the occurrence of opportunistic pathogens have been identified through a thorough analysis of the available literature. It is proposed that the efforts to reduce or eliminate their incidence might best focus on these common features.

Blood Lead Levels in U.S. Children Ages 1-11 Years, 1976-2016

BACKGROUND

Lead can adversely affect child health across a wide range of exposure levels. We describe the distribution of blood lead levels (BLLs) in U.S. children ages 1-11 y by selected sociodemographic and housing characteristics over a 40-y period.

METHODS

Data from the National Health and Nutrition Examination Survey (NHANES) II (1976-1980), NHANES III (Phase 1: 1988-1991 and Phase II: 1991-1994), and Continuous NHANES (1999-2016) were used to describe the distribution of BLLs (in micrograms per deciliter; 1 μ g / dL = 0.0483 μ mol / L ) in U.S. children ages 1-11 y from 1976 to 2016. For all children with valid BLLs (n = 27,122 ), geometric mean (GM) BLLs [95% confidence intervals (CI)] and estimated prevalence ≥ 5 μ g / dL (95% CI) were calculated overall and by selected characteristics, stratified by age group (1-5 y and 6-11 y).

RESULTS

The GM BLL in U.S. children ages 1-5 y declined from 15.2 μ g / dL (95% CI: 14.3, 16.1) in 1976-1980 to 0.83 μ g / dL (95% CI: 0.78, 0.88) in 2011-2016, representing a 94.5% decrease over time. For children ages 6-11 y, GM BLL declined from 12.7 μ g / dL (95% CI: 11.9, 13.4) in 1976-1980 to 0.60 μ g / dL (95% CI: 0.58, 0.63) in 2011-2016, representing a 95.3% decrease over time. Even so, for the most recent period (2011-2016), estimates indicate that approximately 385,775 children ages 1-11 y had BLLs greater than or equal to the CDC blood lead reference value of 5 μ g / dL . Higher GM BLLs were associated with non-Hispanic Black race/ethnicity, lower family income-to-poverty-ratio, and older housing age.

DISCUSSION

Overall, BLLs in U.S. children ages 1-11 y have decreased substantially over the past 40 y. Despite these notable declines in population exposures to lead over time, higher GM BLLs are consistently associated with risk factors such as race/ethnicity, poverty, and housing age that can be used to target blood lead screening efforts. https://doi.org/10.1289/EHP7932.

Evaluation of a portable XRF device for in vivo quantification of lead in bone among a US population

BACKGROUND

Lead (Pb) concentration in bone is a reliable biomarker for cumulative Pb exposure and studying associated health outcomes. However, the standard K-shell fluorescence (KXRF) bone Pb measurement technology has limitations in large-scale population studies.

OBJECTIVE

We compared measurements from a portable XRF device and a KXRF device.

METHODS

We measured bone Pb concentrations in vivo using portable XRF and KXRF, each measured at the mid-tibia bone in 71 people, 38-95 years of age (mean ± SD = 63 ± 11 years) living in or near three Indiana communities, US; 10 participants were occupationally exposed. We estimated the correlation between bone Pb concentrations measured by both devices. We also examined the extent to which the detection limit (DL) of the portable XRF was influenced by scan time and overlying soft tissue thickness. Finally, we quantified the associations of estimated bone Pb concentration with age and age with soft tissue thickness.

RESULTS

The mean bone Pb concentration measured via portable XRF was 12.3 ± 16.7 mg Pb/kg dry bone. The uncertainty of a 3-minute (N = 60) in vivo portable XRF measurement ranged from 1.8 to 6.3 mg/kg, in the context of soft tissue thickness ranging from 2 to 6 mm. This uncertainty was reduced by a factor of 1.4 with 5-minute measurements (N = 11). Bone Pb measurements via portable XRF and KXRF were significantly correlated: r = 0.48 for all participants, and r = 0.73 among participants with soft tissue thickness < 6 mm (72% of the sample). Bone Pb concentrations were higher among participants who were older or were occupationally exposed to Pb. Soft tissue thickness decreased with age.

CONCLUSION

With its ease of use, portability, and comparable sensitivity with conventional KXRF systems, the portable XRF could be a valuable tool for non-invasive quantification of bone Pb in vivo, especially for people with thinner soft tissue.

Childhood Lead Poisoning: A Perpetual Environmental Justice Issue?

As the amount of lead in the environment has significantly decreased with the removal of lead in gasoline and paint, the United States has made great strides in preventing lead poisoning or reducing levels of lead in young children's blood. Even so, lead exposure is not equal for all children-low-income and minority children continue to bear a disproportionate burden of exposure primarily through contact with deteriorating lead-based paint from older housing and potentially through drinking contaminated water resulting from failing leaded pipes, as evidenced by the recent events in Flint, Michigan. These facts suggest that childhood lead poisoning is an environmental justice issue worthy of public health consideration and action; "environmental justice" is focused on identifying and addressing disproportionately high and adverse effects of environmental hazards on low-income and minority communities. The question remains, however, as to whether addressing the quality-of-life "risk" factors associated with lead poisoning might eventually lead to reduction in exposure, as well as potentially resulting in adverse health effects. Utilizing an environmental justice framework and examining this issue through a multidimensional environmental justice lens, we contemplated the quality-of-life factors that may essentially predispose minority children and their families to lead poisoning. Specifically, we examined American Community Survey data (2012-2016) focused on comparing race/ethnicity with other sociodemographic variables known to be associated with risks for childhood lead poisoning. The results provide thought-provoking context for making progress toward eliminating lead poisoning as a major environmental justice concern.

Dietary contributions to increased background lead, mercury, and cadmium in 9-11 Year old children: Accounting for racial differences

BACKGROUND

Initial interest in the adverse consequences of exposure to lead (Pb), mercury (Hg), and cadmium (Cd) focused on relatively high exposures through environmental or occupational sources; however, recent evidence suggests even low-level background exposure to non-essential metals might be detrimental, particularly for children's health and development. One potentially important source of increased background levels of non-essential toxic metals is diet.

OBJECTIVES

We considered whether differences in diet are associated with levels of non-essential metals in blood and whether racial differences in metals are mediated by dietary differences.

METHODS

We assessed blood levels of Pb, Hg, and Cd in a sample of 9-11 year-old children (N = 295) comprised of 42% European Americans (EAs), 58% African American (AAs), and 47% female. Diet was assessed using 24-h dietary recalls during phone interviews administered to parents on two consecutive days (Friday and Saturday). The Healthy Eating Index-2105 (HEI-2015) was calculated to assess diet quality.

RESULTS

The current study identified significant dietary sources of non-essential metal exposure - namely total fruit for Pb, total protein for Hg, and greens and beans for Cd. Moreover, AAs were found to have significantly higher blood levels of Pb and Hg than EAs and these racial differences were significantly mediated by these dietary differences.

DISCUSSION

This study is one of very few to consider total diet in children and exposure to the non-essential metals Pb, Hg, and Cd, and the first to demonstrate that racial differences in increased background blood levels of non-essential toxic metals can be accounted for by racial differences in diet. Given regional differences in food consumption patterns and specific farm and store sources for the foods, the generalizability of the current findings has yet to be determined; however, commonly consumed foods appear to be a significant source of low-level non-essential metals.

Evaluation of Pb concentrations in selected vegetables and portable drinking water, and intelligent quotients of school children in Ishiagu-a Pb mining community: health risk assessment using predictive modelling

This study evaluates the concentrations of lead (Pb) in 6 selected vegetables and drinking water samples taken from an agricultural/mining town Ishiagu. This evaluation is important because these vegetables and water are major gateway of lead exposure through ingestion, especially children in the Pb mining environment. Pb at even very low concentrations has been shown to have adverse effect on developing brain and hence children's intellectual ability. The impact of lead-contaminated food/water intake on the cognitive function was focused on school children whose parents have lived in the Pb mining town for over 25 years before they were born. Non-invasive, "target risk quotient" (TRQ) methodology, based on the principle of predictive toxicology was adopted for our analysis. Samples of these vegetables harvested in July and August 2015, and water taken from homes at 4 different villages in Ishiagu town and neighbouring community Akaeze (control), were subjected to appropriate chemical treatment/digestion procedures and the concentrations of Pb determined using AA-700 Shimadzu model atomic absorption spectrophotometer. From 642 structured questionnaire administered to the teachers/children, the daily vegetable ingestion rates for each vegetable (mg/child/day) and estimated daily intakes (EDI) of lead were obtained. The results show that the concentrations of Pb in water samples and the 6 vegetables harvested from the lead mining town vary as distances increase from the mining sites while the total target hazard quotients (TTHQs) for the vegetable crops were greater than one (˃ 1). The cognitive functions of 160 school children (aged 6-8 years), sampled from 265 families based on their meeting the criteria for distances away from the mining site, were evaluated using Raven's Standard Progressive Matrices and psychometrics. The data generated were analysed using (SPSS) version 21.0 and results expressed as mean ± standard deviation of intelligent quotient (IQ). Students' t tests for independent samples were used to compare the IQ results for children in the lead mining area and non-mining area. A model based on predictive toxicology paradigm which can show a relationship between concentrations of lead in vegetables/water and cognitive function was developed. This model shows that there is a positive correlation between total lead concentrations in vegetables/water and children's cognitive function.

Does atmospheric processing produce toxic Pb-containing compounds? A case study in suburban Beijing by single particle mass spectrometry

A single particle aerosol mass spectrometry (SPAMS) was deployed to investigate the mixing state and chemical processing of Pb-rich particles in suburban Beijing. Based on a large dataset of mass spectra, Pb-rich particles were classified into Pb-O-Cl-N-S (55%), Pb-N (17%), Pb-N-S (15%), and Pb-EC (7%). Residual coal combustion, industrial activities, and meteorological conditions were identified as main factors regulating the variations of Pb-rich particles in the atmosphere. The highest abundance of the Pb-rich particles was observed during heating period (HP) primarily due to the increase in coal usage. Pb in Pb-O-Cl-N-S type was identified in forms of PbO, PbCl_2, and Pb(NO₃)₂. Dominantly presented in the form of Pb(NO₃)₂, Pb-N type represented the completely transformed Pb-rich particles from PbO/PbCl₂ by atmospheric processes. It is found that PbCl₂ and PbO could be transformed to Pb(NO₃)₂, highly dependent on the amount of NO₂ and RH. Significant enhancement of nitrate in Pb-O-Cl-N-S particles was observed when the RH was greater than 60%, emphasizing the importance of heterogeneous hydrolysis of N₂O₅ on the formation of Pb(NO₃)_2. Compared with non-carcinogenic PbCl₂/PbO and insoluble PbO, soluble and carcinogenic Pb(NO₃)₂ produced by atmospheric processes may significantly enhance negative effects of Pb-rich particles on human health and the ecosystem.

Trace elements in rice grain and agricultural soils: assessment of health risk of inhabitants near a former secondary lead smelter in Khulna, Bangladesh

Ingestion of food grain grown in metal-contaminated soils may cause serious effects on human health. This study assessed the concentrations of Pb, As, Cd and Zn in agricultural soils and in rice grains near a former secondary lead smelter in Khulna, Bangladesh. It analyzed 29 samples of surface soil and rice grain collected around 500 m of the smelter. Contamination factor (C_f), pollution load index and total hazard quotient (THQ) were calculated to determine ecological and human health risks. Cd was not detected in any of the samples. For the soil samples, medians of the concentrations of Pb, As and Zn were 109, 6.2 and 514 mg/kg, respectively. For the rice grain samples, medians of the concentrations of Pb, As and Zn were 4, 1.4 and 25 mg/kg fw, respectively. Medians of the concentrations of Pb and As in rice grain were higher compared to their maximum allowable limit (0.2 mg/kg), which indicate potential health risks to inhabitants near the Pb smelter. The mean values of C_f for Pb, As, and Zn were, respectively, 11.6, 2.1 and 7.4. For Pb, around 41% of the samples had C_f > 6 indicating very strong contamination. THQ values for Pb and As were greater than 1.0, which evinces the health hazards of these trace elements. Measures should be taken to prevent trace elements exposure from Pb smelter in the study area.

Environmental lead exposure is associated with neurocognitive dysfunction in children with chronic kidney disease

BACKGROUND

Environmental lead exposure is associated with cognitive impairment in healthy children, with deficits seen in intelligence quotient (IQ), attention, and behavior. Neurocognitive dysfunction is also a well-described complication among children with chronic kidney disease (CKD). The objective was to evaluate the association between blood lead levels (BLL) and performance on neurocognitive assessments in a cohort of children with CKD.

METHODS

Cross-sectional study of children with mild to moderate CKD from the Chronic Kidney Disease in Children (CKiD) multicenter prospective cohort study. The primary exposure was BLL. The primary outcome was performance on age-specific neurocognitive assessments evaluating IQ, executive functioning, attention, hyperactivity, and behavior. Multivariable linear regression was used to evaluate the association between BLL and neurocognitive performance, adjusted for key sociodemographic and clinical variables.

RESULTS

A total of 412 subjects were included with median age 15.4 years, median estimated GFR 39 mL/min/1.73², median BLL 1.2 mcg/dL, and median IQ score 99. In multivariable linear regression, higher BLL was associated with significantly lower IQ score (- 2.1 IQ points for every 1-mcg/dL increase in BLL, p = 0.029). Higher BLL was associated with worse scores on the Conners' Continuous Performance Test II Variability T-Score, a measure of inattention (+ 1.8 T-Score points for every 1-mcg/dL increase in BLL, p = 0.033).

CONCLUSIONS

Low-level lead exposure is associated with significantly lower IQ and more inattention in children with CKD, a population already at high risk for neurocognitive dysfunction. Universal screening for elevated BLL should be considered for all children with CKD at age 12-24 months.

Trends in Elevated Blood Lead Levels Using 5 and 10 µg/dL Levels of Concern Among Refugee Children Resettled in Massachusetts, 1998-2015

OBJECTIVES

Refugee children are known to have a high prevalence of elevated blood lead levels (EBLLs). We sought to determine trends in EBLLs among refugee children during an 18-year period and examine relationships between descriptive characteristics and EBLLs by using 10 µg/dL and 5 µg/dL levels of concern.

METHODS

We retrospectively evaluated refugee health screening data from Massachusetts for 1998 through 2015 for refugee children aged <7 years. We performed bivariate and multivariate analyses of variables including sex, age, region of origin, anemia, intestinal parasites, tuberculosis test results, and anthropometric measurements and used both 5 µg/dL and 10 µg/dL levels of concern for EBLLs.

RESULTS

Of 3421 eligible refugee children, 3054 (88.2%) were tested. Using 5 µg/dL and 10 µg/dL levels of concern, 1279 (41.9%) and 241 (7.9%) children, respectively, had EBLLs. Mean BLLs declined steadily from 7.58 µg/dL in 2004 to 4.03 µg/dL in 2015. African (adjusted odds ratio [aOR] = 2.49; 95% confidence interval [CI], 1.81-3.43), East Asian and Pacific (aOR = 1.98; 95% CI, 1.35-2.91), and South-Central Asian (aOR = 2.47; 95% CI, 1.53-4.01) regions of origin and anemia (aOR = 1.50; 95% CI, 1.14 -1.97) were significantly associated with BLLs ≥5 µg/dL.

CONCLUSIONS

The prevalence of EBLLs among refugees compared with US-born children is high. Because EBBLs increase the risk for neurocognitive impairment in children, public health professionals, policy makers, researchers, refugee resettlement staff members, and health care providers must remain vigilant in screening for lead poisoning and educating refugees about the hazards posed to young children by lead.

Long-term consequences of early postnatal lead exposure on hippocampal synaptic activity in adult mice

INTRODUCTION

Lead (Pb) exposure yielding blood lead levels (BLL) as low as 2 µg/dl in children is an international problem. More common in US low-income neighborhoods, childhood Pb exposure can cause behavioral and cognitive deficits, including working memory impairments, which can persist into adulthood. So far, studies characterized short-term effects of high Pb exposure on neuronal structure and function. However, long-term consequences of early chronic Pb exposure on neuronal activity are poorly documented.

METHODS

Here, we exposed male and female mice (PND [postnatal day] 0 to PND 28) to one of three Pb treatments: 0 ppm (sodium-treated water, control), 30 ppm (low dose), and 330 ppm (high dose) lead acetate. Once the male and female mice were 9-12 months old, extracellular field recordings on hippocampal slices were performed.

RESULTS

We show that at CA3 to CA1 synapses, synaptic transmission was decreased and neuronal fiber activity was increased in males exposed to lowest level Pb. In contrast, both synaptic transmission and neuronal fiber activity were increased in females exposed to high Pb. The ventral hippocampus-medial prefrontal cortex (vHPC-mPFC) synapses are crucial for working memory in rodents. The lowest level Pb decreased vHPC-mPFC synaptic transmission, whereas high Pb decreased short-term synaptic depression.

CONCLUSIONS

Overall, we show for the first time that early exposure to either high or lowest level Pb has long-term consequences on different synaptic properties of at least two hippocampal synapses. Such consequences of early Pb exposure might worsen the cognitive decline observed in aging men and women. Our results suggest that additional efforts should focus on the consequences of early Pb exposure especially in at-risk communities.

Potential ecological risk of metal pollution in lead smelter-contaminated agricultural soils in Khulna, Bangladesh

Lead smelters are important source of metal pollution. This study assessed ecological risks of three heavy metals (Pb, As, and Zn) in agricultural soils surrounding five Pb smelters from Khulna district in Bangladesh. A total of 81 surface soil samples collected within 500-m radius of the smelters were analyzed using an atomic absorption spectrophotometer (AAS). Concentrations of Pb, As, and Zn ranged within 6-3902, 1.8-9.6, and 45.4-563 mg/kg, respectively. About half of the Pb samples (~ 51%) exceeded soil quality standard target value (85 mg/kg), and the concentrations gradually decreased with horizontal distance from the smelter. The value of pollution index (PI) measured for Pb, As, and Zn varied respectively in the range of 0-195, 0.6-3.2, and 0.67-8.28, with mean values of 11.7, 1.9, and 3.92. The value of integrated pollution index (IPI) calculated for these metals remained between 0.58 and 66.2 with a mean of 5.7, and that designates ~ 96% of the sampled soils as moderately or highly contaminated. Potential ecological risk (PER) calculated for the metals indicate that all the samples were within low to moderate risk, and the descending order of PER of the metals was Pb > As > Zn.

Organophosphate Pesticide Metabolite Concentrations in Urine during Pregnancy and Offspring Nonverbal IQ at Age 6 Years

BACKGROUND

Susceptibility to organophosphate (OP) pesticide neurotoxicity may be greatest during the prenatal period; however, previous studies have produced mixed findings concerning in utero OP pesticide exposure and child cognition.

OBJECTIVES

Our objective was to determine whether maternal urinary concentrations of OP pesticide metabolites are inversely associated with child nonverbal IQ at 6 y of age and to examine potential effect measure modification by the PON1 gene.

METHODS

Data came from 708 mother–child pairs participating in the Generation R Study. Maternal urine concentrations of six dialkylphosphates (DAPs), collected at [Formula: see text], 18–25, and [Formula: see text] of gestation, were determined. Child nonverbal IQ was measured at 6 y of age using the Mosaics and Categories subtests from the Snijders-Oomen Nonverbal Intelligence Test-Revised. PON1 was determined in cord blood for 474 infants. Multiple linear regression models were fit to estimate the DAP-IQ associations and PON1 interactions.

RESULTS

Overall, associations between child nonverbal IQ and maternal DAP concentrations were small and imprecise, and these associations were inconsistent across urine sampling periods. Howover, for a 10-fold difference in total DAP concentration for the [Formula: see text] of gestation samples, adjusted child nonverbal IQ was 3.9 points lower (95% CI: [Formula: see text], [Formula: see text]). Heterogeneity in the DAP–IQ association by PON1 gene allele status was not observed ([Formula: see text]).

CONCLUSIONS

Consistent evidence of an association between higher maternal urinary DAP concentrations and lower child IQ scores at 6 y of age was not observed. There was some evidence for an inverse relation of child nonverbal IQ and late pregnancy urinary DAPs, but the estimated association was imprecise. https://doi.org/10.1289/EHP3024.

Drinking water lead, iron and zinc concentrations as predictors of blood lead levels and urinary lead excretion in school children from Montevideo, Uruguay

The global burden of water-based lead (Pb) exposure on children is largely unknown; however, the importance of water sources as a path of Pb exposure is receiving increased attention due to recent prominent exposure events related to corroded plumbing infrastructure in the US. This study investigated the contribution of Pb in household drinking and cooking water to Pb levels in blood (PbB) and urine (PbU) within 353 early school-aged children from Montevideo, Uruguay. Additionally, the analysis considered the child's iron status and the water content of iron (WFe) and zinc (WZn) in relation to water Pb and blood/urine Pb concentrations. Lead concentrations for both PbB and PbU were fairly low (M ± SD: 4.2 ± 2.1 μg/dL; Median [5%, 95%]: 1.9 [0.6, 5.1 μg/L, respectively]); however 21% of the sample had a PbB >5 μg/dL but ≤ 10 μg/dL. Overall, there was little evidence of an association between water metal concentrations and children's PbB/PbU. However, when the sample was stratified by children's iron status, WPb was positively related to PbU, but negatively related to PbB in iron-replete children, even after adjusting for WFe and WZn. In iron-deficient children, there was no elevation in PbU with increasing WPb. In this sample of children with low Pb levels, there were no overwhelming relationships between WPb and either PbB or PbU, however, there was some evidence that iron-replete status promotes excretion of WPb.

Elevated Blood Lead Levels in Infants and Children in Haiti, 2015

OBJECTIVE

Few studies have reported blood lead levels (BLLs) in Haitian children, despite the known presence of lead from environmental factors such as soil, water, leaded paint and gasoline, improperly discarded batteries, and earthquakes. We sought to determine the prevalence of elevated blood lead levels (EBLLs) among healthy Haitian children.

METHODS

We enrolled children aged 9 months to 6 years from 3 geographic areas in Haiti (coastal, urban, and mountain) from March 1 through June 30, 2015. We obtained anthropometric measurements, household income, potential sources of lead exposure, and fingerstick BLLs from 273 children at 6 churches in Haiti. We considered a BLL ≥5 μg/dL to be elevated.

RESULTS

Of 273 children enrolled in the study, 95 were from the coastal area, 78 from the urban area, and 100 from the mountain area. The median BLL was 5.8 μg/dL, with higher levels in the mountain area than in the other areas ( P < .001). BLLs were elevated in 180 (65.9%) children. The prevalence of EBLL was significantly higher in the mountain area (82 of 100, 82.0%; P < .001) than in the urban area (42 of 78, 53.8%) and the coastal area (56 of 95, 58.9%; P < .001). Twenty-eight (10.3%) children had EBLLs ≥10 μg/dL and 3 (1.1%) children had EBLLs ≥20 μg/dL. Exposure to improperly discarded batteries ( P = .006) and living in the mountain area ( P < .001) were significant risk factors for EBLLs.

CONCLUSIONS

More than half of Haitian children in our study had EBLLs. Public health interventions are warranted to protect children in Haiti against lead poisoning.

Sex-Dependent Effects of Developmental Lead Exposure on the Brain

The role of sex as an effect modifier of developmental lead (Pb) exposure has until recently received little attention. Lead exposure in early life can affect brain development with persisting influences on cognitive and behavioral functioning, as well as, elevated risks for developing a variety of diseases and disorders in later life. Although both sexes are affected by Pb exposure, the incidence, manifestation, and severity of outcomes appears to differ in males and females. Results from epidemiologic and animal studies indicate significant effect modification by sex, however, the results are not consistent across studies. Unfortunately, only a limited number of human epidemiological studies have included both sexes in independent outcome analyses limiting our ability to draw definitive conclusions regarding sex-differentiated outcomes. Additionally, due to various methodological differences across studies, there is still not a good mechanistic understanding of the molecular effects of lead on the brain and the factors that influence differential responses to Pb based on sex. In this review, focused on prenatal and postnatal Pb exposures in humans and animal models, we discuss current literature supporting sex differences in outcomes in response to Pb exposure and explore some of the ideas regarding potential molecular mechanisms that may contribute to sex-related differences in outcomes from developmental Pb exposure. The sex-dependent variability in outcomes from developmental Pb exposure may arise from a combination of complex factors, including, but not limited to, intrinsic sex-specific molecular/genetic mechanisms and external risk factors including sex-specific responses to environmental stressors which may act through shared epigenetic pathways to influence the genome and behavioral output.

Background lead and mercury exposures: Psychological and behavioral problems in children

BACKGROUND

The potential harm from exposure to nonessential metals, particularly mercury (Hg) and lead (Pb), has been the focus of research for years. Initial interest focused on relatively high exposures; however, recent evidence suggests that even background exposures might have adverse consequences for child development. Identifying the extent of these consequences is now a priority.

METHODS

We assessed blood Pb and Hg levels in a biracial sample of 9-11 year-old children (N = 203). Neurodevelopment and psychological functioning assessments included hostility, disruptive behaviors, emotion regulation, and autism spectrum disorder behaviors. Parasympathetic (vagal) responses to acute stress were indexed by heart rate variability (HRV) at rest and during stress.

RESULTS

With increasing Pb levels, children exhibit higher levels of hostile distrust and oppositional defiant behaviors, were more dissatisfied and uncertain about their emotions, and had difficulties with communication. These significant associations were found within a range of blood Pb levels from 0.19 to 3.25μg/dL, well below the "reference value" for children of >5μg/dL. Vagal reactivity interacted with Hg such that increasing Hg was associated with increasing autism spectrum behaviors for those children with sustained vagal tone during acute stress.

CONCLUSIONS

This study is the first to demonstrate an association between very low-level Pb exposure and fundamental psychological mechanisms that might explain prior associations with more complex outcomes such as delinquency. Analyses of vagal reactivity yielded entirely novel associations suggesting that Hg may increase autism spectrum behaviors in children with sustained vagal tone during acute stress. The novelty of these later findings requires additional research for confirmation and the cross-sectional nature of the data caution against assumptions of causality without further research.

Phytoextraction of contaminated urban soils by Panicum virgatum L. enhanced with application of a plant growth regulator (BAP) and citric acid

Lead (Pb) contamination in soil represents a threat to human health. Phytoextraction has gained attention as a potential alternative to traditional remediation methods because of lower cost and minimal soil disruption. The North American native switchgrass (Panicum virgatum L.) was targeted due to its ability to produce high biomass and grow across a variety of ecozones. In this study switchgrass was chemically enhanced with applications of the soil-fungicide benomyl, chelates (EDTA and citric acid), and PGR to optimize phytoextraction of Pb and zinc (Zn) from contaminated urban soils in Atlanta, GA. Exogenous application of two plant hormones was compared in multiple concentrations to determine effects on switchgrass growth: indole-3-acetic acid (IAA), and Gibberellic Acid (GA₃), and one PGR benzylaminopurine (BAP), The PGR BAP (1.0 μM) was found to generate a 48% increase in biomass compared to Control plants. Chemical application of citric acid, EDTA, benomyl, and BAP were tested separately and in combination in a pot experiment in an environmentally controlled greenhouse to determine the efficacy of phtyoextraction by switchgrass. Soil acidification by citric acid application resulted in highest level of aluminum (Al) and iron (Fe) in plants foliage resulting in severe phytotoxic effects. Total Pb phytoextraction was significantly highest in plants treated with combined chemical application of B + C and B + C + H. Suppression of AMF activities by benomyl application significantly increased concentrations of Al and Fe in roots. Application of benomyl reduced AMF colonization but was also shown to dramatically increase levels of septa fungi infection as compared to Control plants.

Childhood Blood Lead Levels in Children Aged <5 Years - United States, 2009-2014

This report provides data concerning childhood blood lead levels (BLLs) in the United States during 2009-2014. These data were collected and compiled from raw data extracts sent by state and local health departments to CDC's Childhood Blood Lead Surveillance (CBLS) system. These raw data extracts have been de-identified and coded into a format specifically for childhood blood lead reporting. The numbers of children aged <5 years for 2014 are reported with newly confirmed BLLs ≥10 µg/dL by month (Table 1) and geographic location (Table 2). The incidence of BLLs ≥10 µg/dL is reported by age group for 2009-2014 (Table 3). The numbers of children aged <5 years are reported by the prevalence of BLLs 5-9 µg/dL by age group and sample type during 2009-2014 (Tables 4 and 5). For the period 2009-2014, the numbers of children newly confirmed with BLLs ≥70 µg/dL are summarized (Figure 1) as well as the percentage of children with BLLs ≥5 µg/dL (Figure 2).

Bromide-assisted catalytic oxidation of lead(ii) solids by chlorine in drinking water distribution systems

This study investigated the effect of bromide on the oxidation of three lead(ii) solids by chlorine – a redox process critical to the control of lead release in drinking water distribution systems.

Epidemiologic Characteristics of Children with Blood Lead Levels ≥45 μg/dL

OBJECTIVES

To identify risk factors and describe outcomes for children newly identified with blood lead levels (BLLs) ≥45 µg/dL in New York City (NYC) during 2004-2010 to promote timely identification as well as inform clinical practice and public health policy.

STUDY DESIGN

Inclusion criteria were residence in NYC and an elevated confirmatory venous test within 2 weeks of the initial BLL ≥45 µg/dL. Data collected during case coordination of these children were linked with blood testing data and home inspection reports. Children with BLLs ≥45 µg/dL also were compared with the general population of children younger than 18 years of age in NYC.

RESULTS

A total of 145 children <18 years of age were newly identified with BLLs ≥45 µg/dL. The mean age was 3.83 years, and the median time for BLL to decline below 10 µg/dL was 3.26 years. Major reported risk factors were eating paint (36%), spending time outside the US (34%), having a developmental delay (27%), using imported products (26%), being foreign born (14%), being of Pakistani descent (12%), eating soil (5%), and having sickle cell disease (4%). Compared with the age-standardized NYC population, cases were more likely to be Asian or black and live in housing built before 1940.

CONCLUSIONS

Although the incidence of lead poisoning has declined in the US, severe cases still occur. Physicians should be especially vigilant in certain at-risk populations including children who eat paint chips or soil, spend time outside the US (particularly in Pakistan), use imported products, or have developmental delays or sickle cell disease.

Blood Lead Levels in Children Aged <5 Years - United States, 2007-2013

This report provides data concerning childhood blood lead levels (BLLs) in the United States during 2007-2013. These data were collected and compiled from raw data extracts sent by state and local health departments to CDC's Childhood Blood Lead Surveillance (CBLS) system. These raw data extracts have been de-identified and coded into a format specifically for childhood lead reporting. The numbers of children aged <5 years reported to CDC for 2013 with newly confirmed BLLs ≥10 µg/dL are provided in tabular form by month (Table 1) and geographic location (Table 2). The incidence of BLLs ≥10 µg/dL is reported by age group for 2007-2013 (Table 3). The numbers of children aged <5 years with BLLs 5-9µg/dL for 2013 are reported (Table 4). For the period 2007-2013, the numbers of children newly confirmed with BLLs ≥70 µg/dL are summarized (Figure 1) as well as the percentage of children with BLLs ≥5 µg/dL (Figure 2). This report is a part of the Summary of Notifiable Noninfectious Conditions and Disease Outbreaks - United States, which encompasses various surveillance years but is being published in 2016 (1). The Summary of Notifiable Noninfectious Conditions and Disease Outbreaks appears in the same volume of MMWR as the annual Summary of Notifiable Infectious Diseases (2).

Evaluating Oral Fluid as a Screening Tool for Lead Poisoning

CONTEXT

Screening for lead poisoning is necessary in young children, but obtaining the needed blood sample is unpleasant and sometimes very difficult. Use of an alternative screening method that is less unpleasant and less difficult would likely help to increase the percent of children receiving screening.

OBJECTIVES

To evaluate the correlation of oral fluid and blood lead in a clinical setting, and to ascertain the acceptability and feasibility of obtaining oral fluid from a young child in the clinical setting.

METHODS

Oral fluid samples were collected from a convenience sample of 431 children aged 6 months to 5 years already due to receive a blood lead test in a primary care clinic. Blood lead results obtained at the same time were available for 407 children. The results of the two tests were compared with the blood lead test considered to be the "gold standard". Data analysis used Pearson correlations, scatter plots, linear regression, ANOVA and Bland-Altman analysis.

RESULTS

431 patients had oral fluid samples available for analysis, and 407 patients had blood samples available. Patients who had both blood concentrations <5 µg/dL and oral fluid values below the screening cutoff value were 223, while eight had both blood concentrations ≥ 5 µg/dL and oral fluid values above the screening threshold. Elevated oral fluid but blood lead values less than the value recommended for further intervention occurred in 176; no patients had elevated blood lead values with below-intervention oral fluid values. The negative predictive value of an oral fluid lead below the screening cutoff value was 100%.

CONCLUSIONS

The use of oral fluid to screen for elevated body burdens of lead instead of the usual blood lead sample is feasible with a negative predictive value of 100%, while eliminating the need for blood for lead screening in more than half of these children.

Research Review: Environmental exposures, neurodevelopment, and child mental health - new paradigms for the study of brain and behavioral effects

BACKGROUND

Environmental exposures play a critical role in the genesis of some child mental health problems.

METHODS

We open with a discussion of children's vulnerability to neurotoxic substances, changes in the distribution of toxic exposures, and cooccurrence of social and physical exposures. We address trends in prevalence of mental health disorders, and approaches to the definition of disorders that are sensitive to the subtle effects of toxic exposures. We suggest broadening outcomes to include dimensional measures of autism spectrum disorders, attention-deficit hyperactivity disorder, and child learning capacity, as well as direct assessment of brain function.

FINDINGS

We consider the impact of two important exposures on children's mental health: lead and pesticides. We argue that longitudinal research designs may capture the cascading effects of exposures across biological systems and the full-range of neuropsychological endpoints. Neuroimaging is a valuable tool for observing brain maturation under varying environmental conditions. A dimensional approach to measurement may be sensitive to subtle subclinical toxic effects, permitting the development of exposure-related profiles and testing of complex functional relationships between brain and behavior. Questions about the neurotoxic effects of chemicals become more pressing when viewed through the lens of environmental justice.

CONCLUSIONS

Reduction in the burden of child mental health disorders will require longitudinal study of neurotoxic exposures, incorporating dimensional approaches to outcome assessment, and measures of brain function. Research that seeks to identify links between toxic exposures and mental health outcomes has enormous public health and societal value.

Neurotoxicants, Micronutrients, and Social Environments

SUMMARY—Systematic research evaluating the separate and interacting impacts of neurotoxicants, micronutrients, and social environments on children's cognition and behavior has only recently been initiated. Years of extensive human epidemiologic and animal experimental research document the deleterious impact of lead and other metals on the nervous system. However, discrepancies among human studies and between animal and human studies underscore the importance of variations in child nutrition as well as social and behavioral aspects of children's environments that mitigate or exacerbate the effects of neurotoxicants.

In this monograph, we review existing research on the impact of neurotoxic metals, nutrients, and social environments and interactions across the three domains. We examine the literature on lead, mercury, manganese, and cadmium in terms of dispersal, epidemiology, experimental animal studies, effects of social environments, and effects of nutrition.

Research documenting the negative impact of lead on cognition and behavior influenced reductions by the Center for Disease Control in child lead-screening guidelines from 30 micrograms per deciliter (μg/dL) in 1975 to 25 μg/dL in 1985 and to 10 μg/dL in 1991. A further reduction is currently being considered. Experimental animal research documents lead's alteration of glutamate-neurotransmitter (particularly N-methyl-D-aspartate) activity vital to learning and memory. In addition, lead induces changes in cholinergic and dopaminergic activity. Elevated lead concentrations in the blood are more common among children living in poverty and there is some evidence that socioeconomic status influences associations between lead and child outcomes. Micronutrients that influence the effects of lead include iron and zinc.

Research documenting the negative impact of mercury on children (as well as adults) has resulted in a reference dose (RfD) of 0.1 microgram per kilogram of body weight per day (μg/kg/day). In animal studies, mercury interferes with glutamatergic, cholinergic, and dopaminergic activity. Although evidence for interactions of mercury with children's social contexts is minimal, researchers are examining interactions of mercury with several nutrients.

Research on the effects of cadmium and manganese on child cognition and behavior is just beginning. Experimental animal research links cadmium to learning deficits, manganese to behaviors characteristic of Parkinson's disease, and both to altered dopaminergic functioning.

We close our review with a discussion of policy implications, and we recommend interdisciplinary research that will enable us to bridge gaps within and across domains.

Low-level prenatal lead exposure and infant sensory function

BACKGROUND

Lead is a pervasive neurotoxicant that has been associated with poorer cognitive, behavioral, and motor outcomes in children. The effects of lead on sensory function have not been well characterized. The aim of this study was to assess the effects of prenatal lead exposure on infant sensory function, as measured by auditory brainstem response (ABR) and grating visual acuity (VA).

METHODS

Lead was measured in maternal blood in mid- and late-pregnancy (mean gestational age = 15.5 and 39.0 weeks, respectively) and umbilical cord blood in a cohort of full-term infants in rural northeastern China. ABR latencies (peaks I, III, V) were measured in newborns during unsedated sleep (n = 315). The ABR central-to-peripheral (C-P) ratio was calculated as the ratio between the III-V and I-III interpeak intervals. VA was measured in 6-week-olds using Teller Acuity Cards (n = 1019) and assigned as the narrowest grid the infant fixated on. Multivariate linear regression was used to evaluate relationships between tertiles of mid-pregnancy, late-pregnancy, or cord lead and newborn ABR or 6-week VA.

RESULTS

Higher late-pregnancy lead levels were associated with higher ABR C-P ratios and lower VA. In covariate-adjusted analyses, mean C-P ratios were 4.6 and 3.2 % higher in infants whose mothers had lead > 3.8 μg/dL and lead = 2-3.8 μg/dL, respectively, than for infants whose mothers had lead < 2 μg/dL (p-trend =0.002). In adjusted analyses for VA, mean scores were 8.5 and 7.2 % lower for maternal lead > 3.8 μg/dL and lead = 2-3.8 μg/dL, respectively, compared to lead < 2 μg/dL (p-trend =0.009).

CONCLUSION

Auditory and visual systems maturation appears delayed in infants with higher prenatal lead exposure during late-pregnancy, even at relatively low levels. Both systems start myelinating in late gestation and mature rapidly in infancy. Higher ABR C-P ratio and lower grating VA scores suggest effects of low-level lead exposure on sensory system myelination.

Spatial distribution of lead in soils of Pb-Zn mining and smelting area of the Mitrovica Region, Republic of Kosovo

An area of 301 km(2) in the Mitrovica region, Republic of Kosovo, was selected in order to evaluate the lead distribution in the soil. In total, 156 surface soil samples (0 to 5 cm) were collected. The lead content was determined by inductively coupled plasma-mass spectrometry (ICP-MS). It was found that the average content of lead in the surface soil is 450 mg/kg (with a range of 35-35000 mg/kg). For the entire study area 93% of the samples had lead levels above 100 mg/kg, eight samples below 100 mg/kg and only one sample had lead levels at 30 mg/kg. The effects of mining and metallurgical activities were further assessed using the enrichment factor (EF) value. The lead average exceeded the optimum value specified in the New Dutchlist by five times, while EU average value exceeded it up to 20 times. An area of 113 km(2) of the study area was enriched with Pb higher than the action value (530 mg/kg) while 287 km(2) had significant concentration levels with Pb (358 mg/kg) higher than the optimal value (85 mg/kg), according to New Dutchlist.

The relationship between atmospheric lead emissions and aggressive crime: an ecological study

BACKGROUND

Many populations have been exposed to environmental lead from paint, petrol, and mining and smelting operations. Lead is toxic to humans and there is emerging evidence linking childhood exposure with later life antisocial behaviors, including delinquency and crime. This study tested the hypothesis that childhood lead exposure in select Australian populations is related to subsequent aggressive criminal behaviors.

METHODS

We conducted regression analyses at suburb, state and national levels using multiple analytic methods and data sources. At the suburb-level, we examined assault rates as a function of air lead concentrations 15-24 years earlier, reflecting the ubiquitous age-related peak in criminal activity. Mixed model analyses were conducted with and without socio-demographic covariates. The incidence of fraud was compared for discriminant validity. State and national analyses were conducted for convergent validity, utilizing deaths by assault as a function of petrol lead emissions.

RESULTS

Suburb-level mixed model analyses showed air lead concentrations accounted for 29.8 % of the variance in assault rates 21 years later, after adjusting for socio-demographic covariates. State level analyses produced comparable results. Lead petrol emissions in the two most populous states accounted for 34.6 and 32.6 % of the variance in death by assault rates 18 years later.

CONCLUSIONS

The strong positive relationship between childhood lead exposure and subsequent rates of aggressive crime has important implications for public health globally. Measures need to be taken to ameliorate exposure to lead and other environmental contaminants with known neurodevelopmental consequences.

Tentative reference values for environmental pollutants in blood or urine from the children of Kinshasa

The DRC, as most of African nations, does not have a national biomonitoring programme and there is a lack of information on background levels of environmental pollutants in the general DRC population, particularly in children. The focus of the data presented in this report aims to establish the background levels of a range of environmental pollutants in urine or blood from the children population of Kinshasa. Based on the representative data collection of the Kinshasa population, the survey selected 125 children aged 1-14years and living in Kinshasa (6years on average, 56% of girls, 100% of non-smokers, without amalgam fillings and consumers of fish 3 times per week). Biomarkers of a range of metals (As, Cd, Hg and Pb), pyrene (PAH) and benzene were analyzed in the blood or urine samples. Globally, the results indicate that the exposure levels of children living in Kinshasa are 10 times higher than those published by the American, Canadian and German children surveys. This study provides the first Reference Values of environmental pollutants [As, Cd, Hg, Pb, pyrene (PAH) and benzene] in the Kinshasa children population and reveals elevated levels of all biomarkers studied. The data set of this study may allow environmental and health authorities of DRC to undertake a national biomonitoring programme, especially with four insights for the protection of human heath.

Lead exposure in preterm infants receiving red blood cell transfusions

BACKGROUND

Preterm infants may inadvertently be exposed to lead from the packed red blood cell (pRBC) transfusions with almost no or very limited data available. The aim of the study was to quantify this exposure in preterm infants ≤30 wk gestational age (GA).

METHODS

Prospective cohort study, infants ≤30 wk GA were eligible, infants < 23 wk GA and known chromosomal diseases were excluded. Blood lead levels (BLLs) were obtained at birth, before and after each transfusion, and at discharge. BLLs were also obtained from the donor pRBC aliquot transfused. A linear mixed model analysis was done.

RESULTS

Of 75 infants, 34 received a total of 126 pRBC transfusions. Each infant had an average of 3.7 transfusions. 92% of lead levels in the transfused aliquot were ≤ 5 mcg/dl, 6.8% were between 6-8 mcg/dl and 1 had a level of 56 mcg/dl. Average total lead load was 1.3 mcg/dl. For each 1 mcg/dl increase in transfused pRBC lead level, infant's post-transfusion BLL increased by 0.20 mcg/dl (95% CI: 0.07 mcg/dl, 0.33 mcg/dl; P = 0.002), adjusting for GA and birth weight. There was no significant increase in discharge BLLs, which were similar for both transfused and nontransfused infants.

CONCLUSION

Post-transfusion infant BLLs correlate significantly with the transfused pRBCs lead level.

Olfactory recognition memory is disrupted in young mice with chronic low-level lead exposure

Chronic developmental lead exposure yielding very low blood lead burden is an unresolved child public health problem. Few studies have attempted to model neurobehavioral changes in young animals following very low level exposure, and studies are needed to identify tests that are sensitive to the neurobehavioral changes that may occur. Mechanisms of action are not yet known however results have suggested that hippocampus/dentate gyrus may be uniquely vulnerable to early chronic low-level lead exposure. This study examined the sensitivity of a novel odor recognition task to differences in pre-adolescent C57BL/6J mice chronically exposed from birth to PND 28, to 0 ppm (control), 30 ppm (low-dose), or 330 ppm (higher-dose) lead acetate (N=33). Blood lead levels (BLLs) determined by ICP-MS ranged from 0.02 to 20.31 μg/dL. Generalized linear mixed model analyses with litter as a random effect showed a significant interaction of BLL×sex. As BLLs increased olfactory recognition memory decreased in males. Among females, non-linear effects were observed at lower but not higher levels of lead exposure. The novel odor detection task is sensitive to effects associated with early chronic low-level lead exposure in young C57BL/6J mice.

Induced Phytoextraction of Lead Through Chemical Manipulation of Switchgrass and Corn; Role of Iron Supplement

The effects of combined chemical application of benomyl, ethylenedianinetetraacetate (EDTA), and iron (Fe) (foliar and root) on lead (Pb) phytoextraction by switchgrass (Panicum virgatum) and corn (Zea mays) was examined. Switchgrass was grown in Pb-contaminated urban topsoil with the following treatments: (C) Control, (B) benomyl, (E) EDTA, (F) foliar-Fe, (BE) benomyl + EDTA, (BF) benomyl + foliar-Fe, (FE) foliar-Fe + EDTA, (BFE) benomyl + foliar-Fe + EDTA. Corn was grown in sand-culture supplemented with Pb (500 mg kg(-1)) with the following treatments: (C) control, (B) benomyl, (E) EDTA, (F) root-Fe, (BE) benomyl + EDTA, (BF) benomyl + root-Fe, (FE) root-iron + EDTA, and, (BFE) benomyl + root-Fe + EDTA. All treatments were replicated three times and pots were arranged in a completely randomized design. Plants were analyzed for element concentration (Fe, Zn, P, and Pb) using either inductively coupled plasma (argon) atomic emission spectroscopy (ICP-AES) or graphite furnace atomic absorption spectrometer. Iron supplementation (foliar and root) affected Pb-translocation in plants. Foliar-Fe treatment increased translocation ratio of Pb (TF-Pb) significantly compared to other treatments with the exception of plants treated with benomyl and BF. Root-Fe treatment in combination with EDTA (FE) increased TF-Pb significantly compared to other treatments. Phytoextraction was improved by the combined chemical application; plants treated with BFE treatment increased Pb-total-phytoextraction by 424% compared to Control plants.

Monitoring lead in hair of children and adolescents of Alcalá de Henares, Spain. A study by gender and residential areas

In recent years there has been an increased interest from the European Union (EU) in the development of large Human Bio-monitoring (HBM) studies across Europe, especially biomonitoring toxic metals. In Spain, most studies using hair as a biomarker have been conducted to determine occupational or industrial exposures, and have involved adult populations. Few studies have involved adolescents and children, despite these groups being sensitive to environmental contamination and pollutants. Therefore, the objective of the present study was to determine the degree of lead exposure in children and adolescents residing in Alcalá de Henares, Spain. Lead poisoning is the number one toxicological threat in the environment. So, lead (Pb) was selected as it is a persistent environmental contaminant, is measureable and is also a neurotoxin that can affect brain development. The city of Alcalá de Henares was divided into four zones to determine the influence of residence area on Pb levels. A range of other variables including age and gender were also considered within the study. The study comprised 115 children (6-9 years old) and 96 adolescents (13-16 years old). There was a significant difference between the levels of Pb in the hair of adolescents, for different gender and area of residence (p<0.001 and p<0.01 respectively). There was no significant difference in the Pb levels in hair of children, for different gender or area of the city. The levels of Pb were significantly (p<0.001) elevated in children compared to adolescents (1.48 vs. 0.70 μg/g), and there was a significant difference in Pb levels in male and female adolescent hair (0.53 vs. 0.77 μg/g) (p<0.001). The association observed between areas of residence and the Pb level in hair of the adolescent group could be mainly attributed to dietary habits and/or socioeconomic status.

Early chronic lead exposure reduces exploratory activity in young C57BL/6J mice

Research has suggested that chronic low-level lead exposure diminishes neurocognitive function in children. Tests that are sensitive to behavioral effects at lowest levels of lead exposure are needed for the development of animal models. In this study we investigated the effects of chronic low-level lead exposure on exploratory activity (unbaited nose poke task), exploratory ambulation (open field task) and motor coordination (Rotarod task) in pre-adolescent mice. C57BL/6J pups were exposed to 0 ppm (controls), 30 ppm (low-dose) or 230 ppm (high-dose) lead acetate via dams' drinking water administered from birth to postnatal day 28, to achieve a range of blood lead levels (BLLs) from not detectable to 14.84 µg dl(-1) ). At postnatal day 28, mice completed behavioral testing and were killed (n = 61). BLLs were determined by inductively coupled plasma mass spectrometry. The effects of lead exposure on behavior were tested using generalized linear mixed model analyses with BLL, sex and the interaction as fixed effects, and litter as the random effect. BLL predicted decreased exploratory activity and no threshold of effect was apparent. As BLL increased, nose pokes decreased. The C57BL/6J mouse is a useful model for examining effects of early chronic low-level lead exposure on behavior. In the C57BL/6J mouse, the unbaited nose poke task is sensitive to the effects of early chronic low-level lead exposure. This is the first animal study to show behavioral effects in pre-adolescent lead-exposed mice with BLL below 5 µg dl(-1).