Blood lead concentrations in sub-Saharan African children below 6 years: systematic review

The role of geophagy and artisanal gold mining as risk factors for elevated blood lead levels in pregnant women in northwestern Tanzania

Neither artisanal and small-scale gold mining (ASGM) or geophagy practices have received substantial attention related to blood lead levels despite the well documented deleterious effects of lead. This cross-sectional analytical study aimed to document the risk of lead exposure from geophagy and mining-related occupational activities for pregnant women. The study recruited 1056 pregnant women (883 in an ASGM area and 173 in a non-ASGM area) between April 2015 -April 2017. Generalized Linear Model with an identity link function was used to model the association between blood lead levels (BLLs) and geophagy practices and involvement in gold mining. The prevalence of geophagy was 36.2% (95% CI: 33.6, 39.4%) and 6.3% engaged in mining as a primary occupation. Practicing geophagy increased BLLs by 22% (β = 1.22, 95% CI: 1.116, 1.309, p<0.0001). Living in a gold mining area increased BLLs by 33.4% (β = 1.334, 95% CI: 1.2, 1.483, p<0.0001). Having mining as a primary occupation increased BLLs by 1.3% β = 1.013, 95% CI: 0.872, 1.176, p = 0.869) even though the association was not statistically significant. Socioeconomic wealth quantile (β = 1.037, 95% CI: 1.021, 1.054, p<0.001) increased blood lead levels by 3.7%. Developing a comprehensive inventory capturing sources of community-level lead exposure is essential. Further, increasing public health campaigns and education are crucial to limit geophagy practices and to minimize work in gold mining activities during pregnancy.

Characteristic features of toxic metal content in hair samples of foreign students at RUDN University from different geographic regions

BACKGROUND

This study explores the regional variations in toxic metal accumulation among RUDN University students from various global regions.

METHODS

This comparative analysis examined hair samples from students hailing from different regions, including Russia, Asia, the Middle East, Africa, and Latin America. The concentrations of Aluminium (Al), Arsenic (As), Cadmium (Cd), Mercury (Hg), Lead (Pb), and Tin (Sn) were measured in the hair samples. The data was then evaluated using regression models to assess the link between the region of residence and toxic metal content in the hair.

RESULTS

The analysis indicated significant regional variations in the levels of toxic metals in the students' hair. The highest content of Al, Cd, and Pb was observed in students from Africa (13.542, 0.028, 0.794 µg/g) and Latin America (9.947, 0.025, 0.435 µg/g). Arsenic levels in students from all regions exceeded that of Russian students by over two-fold. No substantial group differences were found in the Sn content. The regression models suggested that residing in Asia, Africa, and Latin America was a predictor of high Hg levels in hair (0.130, 0.096, 0.227 µg/g). Living in Africa was significantly associated with higher Pb levels (0.794 µg/g), and living in Latin America was close to significantly associated with the Cd level in the hair (0.025 µg/g).

CONCLUSION

This study confirmed an increased accumulation of toxic metals, especially Hg, Cd, and Pb, in students primarily from Latin America and Africa. The findings highlighted the importance of understanding the regional variations in toxic metal accumulation to address associated health risks and the potential impact on students' well-being and academic performance. These insights may guide the development of targeted interventions to reduce exposure to toxic metals in students from various regions around the world.

Arsenic, cadmium, mercury, and lead levels in hair and urine in first-year RUDN University students of different geographic origins

The objective of the present study was to assess the markers of arsenic, cadmium, mercury, and lead exposure in first-year RUDN University students of different geographic origins. A total of 274 first-year students of the RUDN University originating from Russia (n = 65), Asia (n = 57), Middle East (n = 84), Africa (n = 40), and Latin America (n = 28) were enrolled in the present study. Evaluation of As, Cd, Hg, and Pb levels in urine and hair was performed using inductively coupled plasma-mass spectrometry. The obtained data demonstrate that hair As levels in foreign students exceed that in Russian examinees. The highest Cd and Pb levels were detected in subjects from Africa and Latin America, whereas hair Hg content was significantly higher in Latin America students. Urinary Cd levels in foreign students exceeded those in Russian counterparts. In turn, the highest Hg concentration in urine was revealed in students originating from Middle East and especially Latin America. Urinary Pb levels were found to be the highest in students from Africa. Multiple regression analysis demonstrated that Asian, African, and Latin American origins were considered as a significant predictor of hair Hg content. Higher urinary Hg levels were associated with Asia, Middle East, and Latin American origins. Prior habitation in Africa and Asia was considered as predictor of higher hair Pb and urinary Cd levels. The observed difference may be indicative of geographic difference in toxic metal exposure patterns.

Immobilization of cadmium and lead by Lactobacillus rhamnosus GR-1 mitigates apical-to-basolateral heavy metal translocation in a Caco-2 model of the intestinal epithelium

Heavy metals are highly toxic elements that contaminate the global food supply and affect human and wildlife health. Purification technologies are often too expensive or not practically applicable for large-scale implementation, especially in impoverished nations where heavy metal contamination is widespread. Lactobacillus rhamnosus GR-1 (LGR-1) was shown in previous work to reduce heavy metal bioaccumulation in a Tanzanian cohort of women and children through indeterminant mechanisms. Here, it was hypothesized that LGR-1 could sequester the heavy metals lead (Pb) and cadmium (Cd), thereby reducing their absorption across intestinal epithelium. LGR-1 and other lactobacilli significantly reduced the amount of Pb and Cd in solution at all concentrations tested (0.5 mg/L - 50 mg/L) and exhibited sustained binding profiles over a 48-hour period. Relative binding efficiency of LGR-1 decreased as Pb concentration increased, with an absolute minimum binding threshold apparent at concentrations of 2 mg/L and above. Electron microscopy revealed that Pb formed irregular cell-surface clusters on LGR-1, while Cd appeared to form intracellular polymeric clusters. Additionally, LGR-1 was able to significantly reduce apical-to-basolateral translocation of Pb and Cd in a Caco-2 model of the intestinal epithelium. These findings demonstrate the absorbent properties of LGR-1 can immobilize Pb and Cd, effectively reducing their translocation across the intestinal epithelium in vitro. Oral administration of heavy metal-binding Lactobacillus spp. (many of which are known human symbionts and strains of established probiotics) may offer a simple and effective means to reduce the amount of heavy metals absorbed from foods in contaminated regions of the world.

Heavy Metal Mixture Exposure and Effects in Developing Nations: An Update

The drive for development and modernization has come at great cost. Various human activities in developed and developing countries, particularly in sub-Saharan Africa (SSA) have given rise to environmental safety concerns. Increased artisanal mining activities, illegal refining, use of leaded petrol, airborne dust, arbitrary discarding and burning of toxic waste, absorption of production industries in inhabited areas, inadequate environmental legislation, and weak implementation of policies, have given rise to the incomparable contamination and pollution associated with heavy metals in recent decades. This review evaluates the public health effects of heavy metals and their mixtures in SSA. This shows the extent and size of the problem posed by exposure to heavy metal mixtures in regard to public health.

Preeclampsia and blood lead (and other metals) in Lubumbashi, DR Congo

Among parturient women in Lubumbashi, blood lead concentrations [geometric means (25th-75th percentiles)] were higher among 40 women with preeclampsia [6.66 µg/dL (5.16-79.4)] than among 39 control women matched for age and gestation duration [5.08 µg/dL (4.27-6.30)]. Blood lead exceeded 5 µg/dL in 33 (83%) preeclamptic women and 17 (44%) control women [odds ratio 6.1 (95%CI 2.1-17.1)]. In another study, we found high levels of lead in surface dust collected in front of homes in Lubumbashi (36/127 samples exceeding 120 µg lead/g dust). Our findings support the conclusions of a systematic review that increased blood lead level increases the likelihood of preeclampsia. Moreover, our study indicates that, as in other urban areas in Africa, exposure to lead is unacceptably high among pregnant women in Lubumbashi. Preventive measures are needed to protect mothers and children from the serious adverse effects of lead exposure.

Lead Exposure and Associated Risk Factors among New Migrant Children Arriving in Greece

Background: This study aims to assess lead exposure and associated risk factors among newly arrived migrant (M) (immigrant and refugees) children in Greece and a matched control of native (N) children. Methods: A prospective, cross-sectional study was performed in an outpatient clinic of a tertiary children’s hospital. Results: From 2010 to 2014, 598 children (M/N: 349/249) with a mean age of 6.96 years old (range 1–14, SD 3.76) were enrolled. Blood lead levels (BLLs) ranged from 0.7 to 21 μg/dL in migrant and from 0.4 to 10 μg/dL in native Greek children. Elevated BLLs ≥ 5 μg/dL were detected in 27.7% of migrants and 1.2% of natives (p < 0.001). A significant association was found between EBLLs and childrens’ age (≤5 years) (OR: 1.8, p-value 0.02) and EBLLs with Asian origin (OR: 3.63, p-value 0.023). Conclusion: New migrant children presented with increased BLLs when compared to their age- and sex-matched controls. Younger age and Asian origin were significant risk factors associated with elevated BLLs among children. Early screening, secondary prevention, and regular follow-up could prove useful in this vulnerable population.

Study of the influencing factors of the blood levels of toxic elements in Africans from 16 countries

Africa's economy is growing faster than any other continent and it has been estimated that the middle class in Africa now exceeds 350 million people. This has meant a parallel increase in the importation of consumer goods and in the implementation of communication and information technologies (ICT), but also in the generation of large quantities of e-waste. However, inadequate infrastructure development remains a major constraint to the continent's economic growth and these highly toxic residues are not always adequately managed. Few studies have been conducted to date assessing the possible association between socioeconomic development factors, including e-waste generation, and blood levels of inorganic elements in African population. To disclose the role of geographical, anthropogenic, and socioeconomic development determinants on the blood levels of Ag, Al, As, Be, Cd, Co, Cr, Hg, Ni, Pb, Sb, and V -all of them frequently found in e-waste-, an immigrant population-based study was made including a total of 245 subjects from 16 countries recently arrived to the Canary Islands (Spain). Women presented higher levels of blood elements than men, and Northern Africans (Moroccans) were the most contaminated. People from low-income countries exhibited significantly lower blood levels of inorganic elements than those from middle-income countries. We found a significant association between the use of motor vehicles and the implementation of information and communication technologies (ICT) and the level of contamination. Immigrants from the countries with a high volume of imports of second-hand electronic equipment, telephone and internet use had higher levels of inorganic elements. In general terms, the higher level of economic development the higher the blood levels of inorganic pollutants, suggesting that the economic development of Africa, in parallel to e-waste generation and the existence of informal recycling sites, have directly affected the level of contamination of the population of the continent.

Biomonitoring of 29 trace elements in whole blood from inhabitants of Cotonou (Benin) by ICP-MS

This study aimed to investigate the blood concentration of 29 trace elements, metals or metalloids, in a healthy population of Cotonou not directly exposed to metals in order to propose reference values. Blood samples from 70 blood donors were collected in K2 EDTA tubes for trace elements during September 2015 and a questionnaire was used to assess lifestyle exposure. Blood metal concentrations were determined by inductively coupled plasma mass spectrometry (ICP-MS) equipped with a quadrupole-based reaction cell. Among the selected blood donors 51.4% were aged from 18 to 36 years and 49.6% from 37 to 65 years. Among the 29 elements analyzed As, Pb, Mn, Pd, Sb, Co, Se, Sr showed blood concentrations higher than the reference values found in the literature for non-exposed healthy European populations and their geometric means were respectively 5.81; 47.39; 19.71; 1.91; 7.50; 0.66; 163.01; 30.53μg/L. This study provides the first reference value (5th-95th percentiles) for each element in Cotonou, which enables us to carry out further investigations on environmental and occupational exposure.

Geophagy during pregnancy: Is there a health risk for infants?

Prenatal lead exposure is a public health concern. Geophagy, the practice of soil eating, is documented for pregnant women of sub-Saharan Africa to treat pregnancy-related malaise. The soils however can contain substantial amounts of lead. In an exploratory study on 48 mother-child pairs in the Democratic Republic of Congo, we found striking site-specific differences in prenatal lead exposure, i.e., higher lead levels at Kisangani than at Isiro. Kisangani women consumed 1/ more often soil during the first trimester of pregnancy as well as 2/ a different type of soil compared to Isiro women (P<0.05). We conclude geophagy may be a potential source of prenatal lead exposure.

Lead and Cadmium Levels in Residential Soils of Lagos and Ibadan, Nigeria

BACKGROUND

Lead and cadmium are components of paints sold in Nigeria. These heavy metals are associated with adverse neurological, cardiovascular and other human health effects.

OBJECTIVES

This study assesses the levels of lead and cadmium in topsoil of residential areas in Lagos and Ibadan potentially resulting from painting of buildings.

METHODS

Samples were pre-treated prior to metal determination using atomic absorption spectrophotometry. Metal speciation was determined using modified Tessier sequential extraction. Soil characteristics were determined by standard methods. Soil contamination was assessed using contamination factor, geo-accumulation and pollution load indices. The United States Environmental Protection Agency integrated exposure uptake biokinetic (IEUBK) model was used to estimate and predict children's blood lead levels (BLL).

RESULTS

Lead and cadmium concentrations in residential areas in Lagos and Ibadan ranged from 1.56-419 mg/kg and not detected-2.8 mg/kg, respectively. Metal contamination factor and pollution load index were highest at the Lagos low income settlement. Results of IEUBK modelling showed that the Lagos low income settlement had the highest probability density for children between 1-7 years of age with an estimated BLL of >10 μg/dL. This population made up less than 0.01% of those within this age range.

CONCLUSIONS

Lead and cadmium concentrations in soil around the residential buildings were higher than those in the control sample. Contamination factor and pollution load index showed significant contamination in average and low income settlements. These results suggested that there was accumulation of the metals in the soil, which can persist in the environment. This may pose serious health risks, especially to vulnerable groups such as children.

Elevated Blood Lead Levels in Infants and Mothers in Benin and Potential Sources of Exposure

Lead in childhood is well known to be associated with poor neurodevelopment. As part of a study on maternal anemia and offspring neurodevelopment, we analyzed blood lead level (BLL) with no prior knowledge of lead exposure in 225 mothers and 685 offspring 1 to 2 years old from Allada, a semi-rural area in Benin, sub-Saharan Africa, between May 2011 and May 2013. Blood samples were analyzed by inductively coupled plasma mass spectrometry. Environmental assessments in households and isotopic ratio measurements were performed for eight children with BLL > 100 µg/L. High lead levels (BLL > 50 µg/L) were found in 44% of mothers and 58% of children. The median BLL was 55.1 (interquartile range 39.2–85.0) and 46.6 (36.5–60.1) µg/L, respectively. Maternal BLL was associated with offspring’s consumption of piped water and animals killed by ammunition. Children’s BLL was associated with presence of paint chips in the house and consumption of animals killed by ammunition. In this population, with 98% of children still breastfed, children’s BLL was highly associated with maternal BLL on multivariate analyses. Environmental measures and isotopic ratios supported these findings. Offspring may be highly exposed to lead in utero and probably via breastfeeding in addition to lead paint exposure.

Environmental and Occupational Lead Exposure Among Children in Cairo, Egypt: A Community-Based Cross-Sectional Study

The aim of this study was to assess childhood lead exposure in a representative sample of Cairo, and to investigate the possible risk factors and sources of exposure. This cross-sectional study was conducted from November 2014 through April 2015. The target population was children aged 6 to 18 years, recruited into 4 groups, garbage city, moderate-living standard area, urban and suburban schools, and workshops in the city of Cairo. Blood lead levels (BLLs) and hemoglobin (Hb) concentrations were measured. Also, potential local environmental sources were assessed for hazardous lead contamination. Analysis on 400 participants has been carried out. A total of 113 children had BLLs in the range 10 to 20 μg/dL. Smoking fathers, housing conditions, playing outdoors, and exposure to lead in residential areas were significantly correlated with high BLLs. The mean values of hemoglobin were inversely correlated with BLLs. Children involved in pottery workshops had the highest BLLs and the lowest Hb values with a mean of (43.3 μg/dL and 8.6 g/dL, respectively). The mean value of environmental lead in workshop areas exceeded the recommended levels. Also, those values measured in dust and paint samples of garbage city were significantly high. Moreover, the mean lead levels in the soil samples were significantly higher in urban schools (P = 0.03) than the suburban ones. Childhood lead poisoning accounts for a substantial burden in Egypt, which could be preventable. Development of national prevention programs including universal screening program should be designed to reduce incidence of lead toxicity among children.

Elevated Blood Lead Levels Are Associated with Reduced Risk of Malaria in Beninese Infants

INTRODUCTION

Elevated blood lead levels (BLL) and malaria carry an important burden of disease in West Africa. Both diseases might cause anemia and they might entail long-term consequences for the development and the health status of the child. Albeit the significant impact of malaria on lead levels described in Nigeria, no evaluation of the effect of elevated BLL on malaria risk has been investigated so far.

MATERIALS AND METHODS

Between 2010 and 2012, blood lead levels of 203 Beninese infants from Allada, a semi-rural area 50km North from Cotonou, were assessed at 12 months of age. To assess lead levels, blood samples were analyzed by mass spectrometry. In parallel, clinical, microbiological and hematological data were collected. More precisely, hemoglobin, serum ferritin, CRP, vitamin B12, folate levels, and Plasmodium falciparum parasitemia were assessed and stool samples were also analyzed.

RESULTS

At 12 months, the mean BLL of infants was 7.41 μg/dL (CI: 65.2; 83), and 128 infants (63%) had elevated blood lead levels, defined by the CDC as BLL>5 μg/dL. Lead poisoning, defined as BLL>10 μg/dL, was found in 39 infants (19%). Twenty-five infants (12.5%) had a positive blood smear at 12 months and 144 infants were anemic (71%, hemoglobin<110 g/L). Elevated blood lead levels were significantly associated with reduced risk of a positive blood smear (AOR = 0.38, P-value = 0.048) and P. falciparum parasite density (beta-estimate = -1.42, P-value = 0.03) in logistic and negative binomial regression multivariate models, respectively, adjusted on clinical and environmental indicators.

CONCLUSION

Our study shows for the first time that BLL are negatively associated with malarial risk considering other risk factors. Malaria is one of the main causes of morbidity and mortality in infants under 5 years worldwide, and lead poisoning is the 6th most important contributor to the global burden of diseases measured in disability adjusted life years (DALYs) according to the Institute of Health Metrics. In conclusion, due to the high prevalence of elevated BLL, health interventions should look forward to minimize the exposure to lead to better protect the population in West Africa.

Lead concentration in the blood of the general population living near a lead-zinc mine site, Nigeria: Exposure pathways

Lead (Pb) poisoning in children is a major public health catastrophe worldwide. This report summarises both exposure pathways and blood Pb levels in children below 7 years of age and adults (above 18 years) from the Adudu community living near a lead-zinc mine in Nasawara, Nigeria. The average and median blood Pb levels in children and adults were 2.1 and 1.3 μg/dL, 3.1 and 1.8 μg/dL, respectively. However, Pb in 14% of adults' blood exceeded 5 μg/dL, which is the recommended threshold blood Pb concentration in adults as established by the Centers for Disease Control and Prevention (CDC). Furthermore 68% of adults' blood exceeded blood Pb action level of 2 μg/dL. For children, 11.4% and 31% of the blood samples exceeded 5 μg/dL and 2 μg/dL, respectively, while no safe blood Pb level in children has been recommended. In Nasawara, a significant difference (p<0.05) was observed between the various age groups in children with 2-4 years old having the highest levels and 6 year old children having the lowest Pb levels. Although this study did not detect elevated levels of Pb in children's blood in regions such as Zamfara, Nigeria and Kabwe, Zambia, a high percentage of samples exceeded 2 μg/dL. Soils, floor dusts, water and crops also reveal that Pb contamination in the study area could potentially be the major cause of blood Pb in the community exposed to mining. This study also observed a significant correlation between water Pb levels of adults and blood Pb levels, suggesting that water is the major exposure pathway. This analysis highlights the need to properly manage mining activities so that the health of communities living in the vicinity of a Pb-Zn mine is not compromised.

Towards bio monitoring of toxic (lead) and essential elements in whole blood from 1- to 72-month old children: a cross-sectional study

OBJECTIVES

Minerals such as zinc, copper, selenium, calcium, and magnesium are essential for normal human development and functioning of the body. They have been found to play important roles in immuno-physiologic functions. The study is to evaluate the distribution and correlation of nonessential (lead) and essential elements in whole blood from 1- to 72-month old children.

METHODS

The cross-sectional study was performed in 1551 children. Six element concentrations, including copper (Cu), zinc (Zn), calcium (Ca), magnesium (Mg), iron (Fe) and lead (Pb) in the blood were determined by atomic absorption spectrometry. Distributions and correlations of trace elements in different age groups were analyzed and compared. A Pearson correlation controlled for age and gender was used to assess the relationship of non essential (lead) and essential elements.

RESULTS

Levels of copper and magnesium were 18.09 ± 4.42 µmol/L and 1.42 ± 0.12 mmol/L, respectively. 6.04% of all children showed copper levels below the normal threshold, the levels of Magnesium were stable in different age groups. Though the overall mean blood zinc and iron concentrations (61.19 ± 11.30 µmol/L and 8.24 ± 0.59 mmol/L, respectively) gradually increased with age and the overall deficiency levels (24.1% and 36.0%, respectively) decreased with age, zinc and iron deficiencies were still very stable. Controlling for gender and age, significant positive correlations were found when comparing copper to zinc, calcium, magnesium, and iron ((r = 0.333, 0.241, 0.417, 0.314 ,p < 0.01); zinc to magnesium and iron (r = 0.440, 0.497p < 0.01); and magnesium to Calcium and iron (r = 0.349, 0.645, p < 0.01). The overall mean blood lead levels (41.16 ± 16.10) were relatively unstable among different age groups. The prevalence of lead intoxication in all children was 1.3% .Calcium levels decreased gradually with age, with an overall concentration of 1.78 ± 0.13 mmol/L.

CONCLUSION

Significant negative correlations were also noted between Pb and Zn, Fe (r = -0.179, -0.124.p < 0.01) .The importance of calcium deficiency and supplementation is well realized, but the severity of iron and zinc deficiency is not well recorded. The degree of lead intoxication in all the children studied was low; The established reference intervals for Cu, Zn, Ca and Mg provide an important guidance for the reasonable supplementation of essential elements during different age groups.

Pathways of Pb and Mn observed in a 5-year longitudinal investigation in young children and environmental measures from an urban setting

We monitored 108 children ≤5 years on a 6-month basis for up to 5 years in a major urban setting. Samples (n ∼ 7000) included blood, urine, handwipes (interior, and after exterior playing), 6-day duplicate diet, drinking water, interior house and day care dust-fall accumulation using petri dishes, exterior dust-fall accumulation, exterior dust sweepings, paint, soil and urban air. The geometric mean blood Pb (PbB) was 2.1 μg/dL and blood Mn (MnB) was 10.0 μg/L. Following a path modelling approach, mixed model analyses for a fully adjusted model showed the strongest associations for PbB were with interior house dust and soil; for MnB there were no significant associations with any predictors. Predictor variables only explained 9% of the variance for Pb and 0.7% for Mn. Relationships between environmental measures and PbB in children are not straightforward; soil and dust sweepings contribute only about 1/5th of the amounts to PbB found in other studies.