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Xia Y, Li Z, Wang C, Zhang X, Li J, Zhou Q, Yang J, Chen Q, Meng X, Wang J. Dynamic alterations of locomotor activity and the microbiota in zebrafish larvae with low concentrations of lead exposure. ENVIRONMENTAL SCIENCE AND POLLUTION RESEARCH INTERNATIONAL 2024; 31:2042-2052. [PMID: 38051486 DOI: 10.1007/s11356-023-31279-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/22/2023] [Accepted: 11/24/2023] [Indexed: 12/07/2023]
Abstract
Lead (Pb) is a ubiquitous heavy metal associated with developmental and behavioral disorders. The establishment of pioneer microbiota overlaps with the development of the brain during early life, and Pb-induced developmental neurotoxicity may be partially caused by early-life microbiota dysbiosis. This study investigated the locomotor activity and the microbiota in developing zebrafish at multiple developmental time points (five days post fertilization [5 dpf], 6 dpf, and 7 dpf) under exposure to low concentrations of lead (0.05 mg/L). Time-dependent reductions in the number of activities and the average movement distance of larvae compared to the control were observed following Pb exposure. Furthermore, Pb exposure significantly altered the composition of the gut microbiota of zebrafish larvae. At the phylum level, the abundance of Proteobacteria decreased from 5 to 7 dpf, while that of Actinobacteria increased in the control groups. At the class level, the proportion of Alphaproteobacteria decreased, while that of Actinobacteria increased in the control groups. Notably, all showed the opposite trend in Pb groups. A correlation analysis between indices of locomotor activity and microbial communities revealed genus-level features that were clearly linked to the neurobehavioral performance of zebrafish. Seven genera were significantly correlated with the two performance indicators of the locomotion analysis, namely Rhodococcus, Deinococcus, Bacillus, Bosea, Bradyrhizobium, Staphylococcus, and Rhizobium. Rhizobium was dominant in zebrafish and increased in the Pb groups in a time-dependent manner. In addition, the expression levels of bdnf, trkb1, trkb2, and p75ntr changed in zebrafish from 5 to 7 dpf under Pb exposure. Collectively, these results suggest that Pb-induced neurotoxicity could potentially be treated by targeting the gut microbiota.
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Affiliation(s)
- Yuan Xia
- School of Public Health, Guangdong Pharmaceutical University, Jianghaidadao, Guangzhou, 283, Guangdong, China
| | - Ziyi Li
- School of Public Health, Guangdong Pharmaceutical University, Jianghaidadao, Guangzhou, 283, Guangdong, China
| | - Chunyu Wang
- School of Public Health, Guangdong Pharmaceutical University, Jianghaidadao, Guangzhou, 283, Guangdong, China
| | - Xiaoshun Zhang
- Department of Occupational Health and Occupational Medicine, Guangdong Provincial Key Laboratory of Tropical Disease Research, School of Public Health, Southern Medical University, Guangzhou, Guangdong, China
| | - Junyi Li
- School of Public Health, Guangdong Pharmaceutical University, Jianghaidadao, Guangzhou, 283, Guangdong, China
| | - Qin Zhou
- Department of Occupational Health and Occupational Medicine, Guangdong Provincial Key Laboratory of Tropical Disease Research, School of Public Health, Southern Medical University, Guangzhou, Guangdong, China
| | - Jian Yang
- School of Public Health, Guangdong Pharmaceutical University, Jianghaidadao, Guangzhou, 283, Guangdong, China
| | - Qingsong Chen
- School of Public Health, Guangdong Pharmaceutical University, Jianghaidadao, Guangzhou, 283, Guangdong, China
| | - Xiaojing Meng
- Department of Occupational Health and Occupational Medicine, Guangdong Provincial Key Laboratory of Tropical Disease Research, School of Public Health, Southern Medical University, Guangzhou, Guangdong, China
| | - Junyi Wang
- School of Public Health, Guangdong Pharmaceutical University, Jianghaidadao, Guangzhou, 283, Guangdong, China.
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Chen YH, Ma ZQ, Watkins SM. Individual and Neighborhood Characteristics Associated With Confirmatory and Follow-up Blood Lead Testing Among Children With Elevated Blood Lead Levels. JOURNAL OF PUBLIC HEALTH MANAGEMENT AND PRACTICE 2023; 29:250-261. [PMID: 36715597 DOI: 10.1097/phh.0000000000001652] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/31/2023]
Abstract
OBJECTIVES The aim of this study was to assess the proportions and likelihood of children who receive confirmatory and follow-up blood lead testing within the recommended time frames after an initial capillary elevated blood lead level (EBLL) and confirmed EBLL, respectively, by individual and neighborhood-level sociodemographic characteristics. DESIGN We linked and used blood testing and sociodemographic characteristics data from a Pennsylvania birth cohort including children born between 2017 and 2018. Generalized linear mixed models were constructed to examine the associations between sociodemographic factors and having recommended confirmatory and follow-up testing. SETTING A population-based, retrospective cohort study. PARTICIPANTS In this birth cohort, children who underwent at least 1 BLL test were followed up to 24 months of age. Children with a first unconfirmed (n = 6259) and confirmed BLL (n = 4213) ≥ 5 μg/dL were included in the analysis. MAIN OUTCOME MEASURE Children had confirmatory and follow-up testing within the recommended time frames. RESULTS Of the children with unconfirmed and confirmed EBLLs, 3555 (56.8%) and 1298 (30.8%) received confirmatory and follow-up testing, respectively. The proportions of the 2 outcome measures were lower among children experiencing certain sociodemographic disadvantages. In the univariate analyses, lower initial BLLs, older age, non-Hispanic Blacks, lower maternal educational levels, maternal Medicaid, The Special Supplemental Nutrition Program for Women, Infants, and Children (WIC) enrollment, maternal smoking, and higher quartiles of neighborhood poverty and old housing were associated with lower odds of having confirmatory and follow-up testing. However, in multivariate models, children with lower initial BLLs, older age, maternal smoking, and non-Hispanic Blacks were significantly less likely to have confirmatory and follow-up testing. CONCLUSIONS There were deficiencies in having recommended confirmatory and follow-up blood lead testing among children, especially those with sociodemographic disadvantages. Public health agencies and stakeholders should finetune policies to improve follow-up testing in conjunction with primary and secondary preventions for early detection and reduction of lead exposure among targeted children at risk of lead poisoning.
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Jenkins D, Grossman D, Slusky D, Danagoulian S. Blood Lead Testing in Flint Before and After Water Contamination. Pediatrics 2022; 150:189898. [PMID: 36325806 DOI: 10.1542/peds.2022-056541] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 09/21/2022] [Indexed: 11/05/2022] Open
Abstract
OBJECTIVE Lead is a neurotoxicant that negatively affects health. Reducing lead exposure and early detection among children are important public health goals. Our objective with this study was to determine if the September 2015 lead advisory in Flint, Michigan affected lead testing among children when possible exposure was widely publicized. METHOD This study included 206 001 children born in Michigan from 2013 to 2015 and enrolled in Medicaid, using 2013 to 2017 claims data to determine if and at what age an individual received a lead test. Difference-in-differences regression models were used to compare the receipt of lead tests among children in Flint with other cities in Michigan before and after September 2015, when a lead advisory was issued for the city warning about potential exposure to lead in publicly supplied water. RESULTS Before the lead advisory, approximately 50% of children in Flint received a lead test by 12 months of age and nearly 75% received a lead test by 24 months of age. After the September 2015 advisory, the receipt of lead tests among children in Flint increased 10 percentage points by 12 months compared with other cities. Effects by 10-month cohorts, as of 2016, revealed a 20-percentage-point increase for children in Flint compared with other cities. CONCLUSIONS Despite a highly publicized lead advisory, children in Flint enrolled in Medicaid received lead tests earlier, but the proportion of Medicaid-eligible children who were tested did not change. This suggests that increasing lead testing is a difficult policy goal to achieve and, therefore, supports recent efforts focusing on primary prevention to reduce lead exposure.
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Zartarian V, Poulakos A, Garrison VH, Spalt N, Tornero-Velez R, Xue J, Egan K, Courtney J. Lead Data Mapping to Prioritize US Locations for Whole-of-Government Exposure Prevention Efforts: State of the Science, Federal Collaborations, and Remaining Challenges. Am J Public Health 2022; 112:S658-S669. [PMID: 36179290 PMCID: PMC9528653 DOI: 10.2105/ajph.2022.307051] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 07/13/2022] [Indexed: 09/03/2023]
Abstract
For this state-of-science overview of geospatial approaches for identifying US communities with high lead-exposure risk, we compiled and summarized public data and national maps of lead indices and models, environmental lead indicators, and children's blood lead surveillance data. Currently available indices and models are primarily constructed from housing-age and sociodemographic data; differing methods, variables, data, weighting schemes, and geographic scales yield maps with different exposure risk profiles. Environmental lead indicators are available (e.g., air, drinking water, dust, soil) at different spatial scales, but key gaps remain. Blood lead level data have limitations as testing, reporting, and completeness vary across states. Mapping tools and approaches developed by federal agencies and other groups for different purposes present an opportunity for greater collaboration. Maps, data visualization tools, and analyses that synthesize available geospatial efforts can be evaluated and improved with local knowledge and blood lead data to refine identification of high-risk locations for prioritizing prevention efforts and targeting risk-reduction strategies. Remaining challenges are discussed along with a work-in-progress systematic approach for cross-agency data integration, toward advancing "whole-of-government" public health protection from lead exposures. (Am J Public Health. 2022;112(S7):S658-S669. https://doi.org/10.2105/AJPH.2022.307051).
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Affiliation(s)
- Valerie Zartarian
- Valerie Zartarian, Rogelio Tornero-Velez, and Jianping Xue are with the US Environmental Protection Agency (EPA), Office of Research and Development, Research Triangle Park, NC. Antonios Poulakos is with LinTech Global Inc, Boston, MA (contractor for US EPA Office of Research and Development). Veronica Helms Garrison is with the US Department of Housing and Urban Development (HUD), Office of Policy Development and Research. Nicholas Spalt is with the US Environmental Protection Agency, Office of Enforcement and Compliance Assurance, Washington, DC. Kathryn Egan is with the Centers for Disease Control and Prevention (CDC), Agency for Toxic Substances and Disease Registry, Office of Community Health and Hazard Assessment, and the CDC, National Center for Environmental Health, Division of Environmental Health Science and Practice, Atlanta. Joseph Courtney is with the CDC, National Center for Environmental Health, Division of Environmental Health Science and Practice
| | - Antonios Poulakos
- Valerie Zartarian, Rogelio Tornero-Velez, and Jianping Xue are with the US Environmental Protection Agency (EPA), Office of Research and Development, Research Triangle Park, NC. Antonios Poulakos is with LinTech Global Inc, Boston, MA (contractor for US EPA Office of Research and Development). Veronica Helms Garrison is with the US Department of Housing and Urban Development (HUD), Office of Policy Development and Research. Nicholas Spalt is with the US Environmental Protection Agency, Office of Enforcement and Compliance Assurance, Washington, DC. Kathryn Egan is with the Centers for Disease Control and Prevention (CDC), Agency for Toxic Substances and Disease Registry, Office of Community Health and Hazard Assessment, and the CDC, National Center for Environmental Health, Division of Environmental Health Science and Practice, Atlanta. Joseph Courtney is with the CDC, National Center for Environmental Health, Division of Environmental Health Science and Practice
| | - Veronica Helms Garrison
- Valerie Zartarian, Rogelio Tornero-Velez, and Jianping Xue are with the US Environmental Protection Agency (EPA), Office of Research and Development, Research Triangle Park, NC. Antonios Poulakos is with LinTech Global Inc, Boston, MA (contractor for US EPA Office of Research and Development). Veronica Helms Garrison is with the US Department of Housing and Urban Development (HUD), Office of Policy Development and Research. Nicholas Spalt is with the US Environmental Protection Agency, Office of Enforcement and Compliance Assurance, Washington, DC. Kathryn Egan is with the Centers for Disease Control and Prevention (CDC), Agency for Toxic Substances and Disease Registry, Office of Community Health and Hazard Assessment, and the CDC, National Center for Environmental Health, Division of Environmental Health Science and Practice, Atlanta. Joseph Courtney is with the CDC, National Center for Environmental Health, Division of Environmental Health Science and Practice
| | - Nicholas Spalt
- Valerie Zartarian, Rogelio Tornero-Velez, and Jianping Xue are with the US Environmental Protection Agency (EPA), Office of Research and Development, Research Triangle Park, NC. Antonios Poulakos is with LinTech Global Inc, Boston, MA (contractor for US EPA Office of Research and Development). Veronica Helms Garrison is with the US Department of Housing and Urban Development (HUD), Office of Policy Development and Research. Nicholas Spalt is with the US Environmental Protection Agency, Office of Enforcement and Compliance Assurance, Washington, DC. Kathryn Egan is with the Centers for Disease Control and Prevention (CDC), Agency for Toxic Substances and Disease Registry, Office of Community Health and Hazard Assessment, and the CDC, National Center for Environmental Health, Division of Environmental Health Science and Practice, Atlanta. Joseph Courtney is with the CDC, National Center for Environmental Health, Division of Environmental Health Science and Practice
| | - Rogelio Tornero-Velez
- Valerie Zartarian, Rogelio Tornero-Velez, and Jianping Xue are with the US Environmental Protection Agency (EPA), Office of Research and Development, Research Triangle Park, NC. Antonios Poulakos is with LinTech Global Inc, Boston, MA (contractor for US EPA Office of Research and Development). Veronica Helms Garrison is with the US Department of Housing and Urban Development (HUD), Office of Policy Development and Research. Nicholas Spalt is with the US Environmental Protection Agency, Office of Enforcement and Compliance Assurance, Washington, DC. Kathryn Egan is with the Centers for Disease Control and Prevention (CDC), Agency for Toxic Substances and Disease Registry, Office of Community Health and Hazard Assessment, and the CDC, National Center for Environmental Health, Division of Environmental Health Science and Practice, Atlanta. Joseph Courtney is with the CDC, National Center for Environmental Health, Division of Environmental Health Science and Practice
| | - Jianping Xue
- Valerie Zartarian, Rogelio Tornero-Velez, and Jianping Xue are with the US Environmental Protection Agency (EPA), Office of Research and Development, Research Triangle Park, NC. Antonios Poulakos is with LinTech Global Inc, Boston, MA (contractor for US EPA Office of Research and Development). Veronica Helms Garrison is with the US Department of Housing and Urban Development (HUD), Office of Policy Development and Research. Nicholas Spalt is with the US Environmental Protection Agency, Office of Enforcement and Compliance Assurance, Washington, DC. Kathryn Egan is with the Centers for Disease Control and Prevention (CDC), Agency for Toxic Substances and Disease Registry, Office of Community Health and Hazard Assessment, and the CDC, National Center for Environmental Health, Division of Environmental Health Science and Practice, Atlanta. Joseph Courtney is with the CDC, National Center for Environmental Health, Division of Environmental Health Science and Practice
| | - Kathryn Egan
- Valerie Zartarian, Rogelio Tornero-Velez, and Jianping Xue are with the US Environmental Protection Agency (EPA), Office of Research and Development, Research Triangle Park, NC. Antonios Poulakos is with LinTech Global Inc, Boston, MA (contractor for US EPA Office of Research and Development). Veronica Helms Garrison is with the US Department of Housing and Urban Development (HUD), Office of Policy Development and Research. Nicholas Spalt is with the US Environmental Protection Agency, Office of Enforcement and Compliance Assurance, Washington, DC. Kathryn Egan is with the Centers for Disease Control and Prevention (CDC), Agency for Toxic Substances and Disease Registry, Office of Community Health and Hazard Assessment, and the CDC, National Center for Environmental Health, Division of Environmental Health Science and Practice, Atlanta. Joseph Courtney is with the CDC, National Center for Environmental Health, Division of Environmental Health Science and Practice
| | - Joseph Courtney
- Valerie Zartarian, Rogelio Tornero-Velez, and Jianping Xue are with the US Environmental Protection Agency (EPA), Office of Research and Development, Research Triangle Park, NC. Antonios Poulakos is with LinTech Global Inc, Boston, MA (contractor for US EPA Office of Research and Development). Veronica Helms Garrison is with the US Department of Housing and Urban Development (HUD), Office of Policy Development and Research. Nicholas Spalt is with the US Environmental Protection Agency, Office of Enforcement and Compliance Assurance, Washington, DC. Kathryn Egan is with the Centers for Disease Control and Prevention (CDC), Agency for Toxic Substances and Disease Registry, Office of Community Health and Hazard Assessment, and the CDC, National Center for Environmental Health, Division of Environmental Health Science and Practice, Atlanta. Joseph Courtney is with the CDC, National Center for Environmental Health, Division of Environmental Health Science and Practice
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Kamai EM, Daniels JL, Delamater PL, Lanphear BP, MacDonald Gibson J, Richardson DB. Patterns of Children's Blood Lead Screening and Blood Lead Levels in North Carolina, 2011-2018-Who Is Tested, Who Is Missed? ENVIRONMENTAL HEALTH PERSPECTIVES 2022; 130:67002. [PMID: 35647633 PMCID: PMC9158533 DOI: 10.1289/ehp10335] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/16/2021] [Revised: 05/02/2022] [Accepted: 05/04/2022] [Indexed: 05/31/2023]
Abstract
BACKGROUND No safe level of lead in blood has been identified. Blood lead testing is required for children on Medicaid, but it is at the discretion of providers and parents for others. Elevated blood lead levels (EBLLs) cannot be identified in children who are not tested. OBJECTIVES The aims of this research were to identify determinants of lead testing and EBLLs among North Carolina children and estimate the number of additional children with EBLLs among those not tested. METHODS We linked geocoded North Carolina birth certificates from 2011-2016 to 2010 U.S. Census data and North Carolina blood lead test results from 2011-2018. We estimated the probability of being screened for lead and created inverse probability (IP) of testing weights. We evaluated the risk of an EBLL of ≥3μg/dL at <30 months of age, conditional on characteristics at birth, using generalized linear models and then applied IP weights to account for missing blood lead results among unscreened children. We estimated the number of additional children with EBLLs of all North Carolina children using the IP-weighted population and bootstrapping to produce 95% credible intervals (CrI). RESULTS Mothers of the 63.5% of children (402,002 of 633,159) linked to a blood lead test result were disproportionately young, Hispanic, Black, American Indian, or on Medicaid. In full models, maternal age ≤20y [risk ratio (RR)=1.10; 95% confidence interval (CI): 1.13, 1.20] or smoking (RR=1.14; 95% CI: 1.12, 1.17); proximity to a major roadway (RR=1.10; 95% CI: 1.05, 1.15); proximity to a lead-releasing Toxics Release Inventory site (RR=1.08; 95% CI: 1.03, 1.14) or a National Emissions Inventory site (RR=1.11; 95% CI: 1.07, 1.14); and living in neighborhoods with more housing built before 1950 (RR=1.10; 95% CI: 1.05, 1.14) or before 1940 (RR=1.18; 95% CI: 1.11, 1.25) or more vacant housing (RR=1.14; 95% CI: 1.11, 1.17) were associated with an increased risk of EBLL, whereas overlap with a public water service system was associated with a decreased risk of EBLL (RR=0.85; 95% CI: 0.83, 0.87). Children of Black mothers were no more likely than children of White mothers to have EBLLs (RR=0.98; 95% CI: 0.96, 1.01). Complete blood lead screening in 2011-2018 may have identified an additional 17,543 (95% CrI: 17,462, 17,650) children with EBLLs ≥3μg/dL. DISCUSSION Our results indicate that current North Carolina lead screening strategies fail to identify over 30% (17,543 of 57,398) of children with subclinical lead poisoning and that accounting for characteristics at birth alters the conclusions about racial disparities in children's EBLLs. https://doi.org/10.1289/EHP10335.
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Affiliation(s)
- Elizabeth M. Kamai
- Department of Epidemiology, University of North Carolina at Chapel Hill (UNC-Chapel Hill), Chapel Hill, North Carolina, USA
- Department of Population and Public Health Sciences, Keck School of Medicine, University of Southern California, Los Angeles, California, USA
| | - Julie L. Daniels
- Department of Epidemiology, University of North Carolina at Chapel Hill (UNC-Chapel Hill), Chapel Hill, North Carolina, USA
- Department of Maternal and Child Health, UNC-Chapel Hill, Chapel Hill, North Carolina, USA
| | - Paul L. Delamater
- Department of Geography, UNC-Chapel Hill, Chapel Hill, North Carolina, USA
- Carolina Population Center, UNC-Chapel Hill, North Carolina, USA
| | - Bruce P. Lanphear
- Faculty of Health Sciences, Simon Fraser University, Vancouver, British Columbia, Canada
| | | | - David B. Richardson
- Department of Environmental and Occupational Health, University of California, Irvine, California, USA
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