Lead sources, behaviors, and socioeconomic factors in relation to blood lead of native american and white children: a community-based assessment of a former mining area

Association of Environmental Injustice and Cardiovascular Diseases and Risk Factors in the United States

BACKGROUND

While the impacts of social and environmental exposure on cardiovascular risks are often reported individually, the combined effect is poorly understood.

METHODS AND RESULTS

Using the 2022 Environmental Justice Index, socio-environmental justice index and environmental burden module ranks of census tracts were divided into quartiles (quartile 1, the least vulnerable census tracts; quartile 4, the most vulnerable census tracts). Age-adjusted rate ratios (RRs) of coronary artery disease, strokes, and various health measures reported in the Prevention Population-Level Analysis and Community Estimates data were compared between quartiles using multivariable Poisson regression. The quartile 4 Environmental Justice Index was associated with a higher rate of coronary artery disease (RR, 1.684 [95% CI, 1.660-1.708]) and stroke (RR, 2.112 [95% CI, 2.078-2.147]) compared with the quartile 1 Environmental Justice Index. Similarly, coronary artery disease 1.057 [95% CI,1.043-1.0716] and stroke (RR, 1.118 [95% CI, 1.102-1.135]) were significantly higher in the quartile 4 than in the quartile 1 environmental burden module. Similar results were observed for chronic kidney disease, hypertension, diabetes, obesity, high cholesterol, lack of health insurance, sleep <7 hours per night, no leisure time physical activity, and impaired mental and physical health >14 days.

CONCLUSIONS

The prevalence of CVD and its risk factors is highly associated with increased social and environmental adversities, and environmental exposure plays an important role independent of social factors.

Distribution of blood lead and cadmium levels in healthy children aged 0 to 18 years and analysis of related influencing factors in Henan, China: data findings from 2017 to 2022

BACKGROUND

There is still a lack of data on blood lead levels (BLLs) and blood lead levels (BLLs) in healthy children of all ages from 0 to 18 years in China. This study was performed to analyze the BLLs and BCLs in healthy children aged 0-18 years from 2017 to 2022 in urban and rural areas of Henan Province, Central China, as well as their relationships with socio-demographic variables and certain relevant exposure factors. To provide a basis for evaluating public health policy development and exposure risk management.

METHODS

This was an observational study containing data from 17 prefecture-level cities in Henan, China. Blood Pb and Cd levels were determined using a triple quadrupole inductively coupled plasma mass spectrometer equipped with an autosampler. We first calculated the concentrations of Pb and Cd elements in participants of different genders, ages and years, and then created visual graphs depicting the distribution of each element in terms of gender, age and year (2017-2022). The rates between different groups were compared using the Chi-square test or Fisher exact test (if applicable). The means were compared by one-way ANOVA, medians were compared with the Kruskal-Wallis rank-sum test. Generalized linear models (GLM) were performed to estimate the effects of various factors on blood Pb and Cd concentrations in children.

RESULTS

We recruited a total of 25,920 children (16,142 boys and 9,778 girls) aged 0.01 to 18.00 years (2.58 (1.00,6.25)). The median of BLLs was 23.48µg/L, around 9.39% of studied children had elevated BLLs. The median of BCLs was 0.66µg/L, around 1.84% of studied children had elevated BCLs. The median blood Pb concentration was higher in boys (23.90µg/L) than in girls (22.75µg/L) (P<0.001). The median blood Pb concentration was highest in the 3-7 years group (24.51µg/L) and the median blood Cd concentration was highest in the 1-3 years group (0.66µg/L) among all age groups. Both BLLs and BCLs were substantially higher in children in 2020-2022 compared to 2017-2019. Rural children had lower BLLs and higher BCLs. The results of the generalized linear model showed that children in households using Oil, coal, pellet or other wood as a fuel for heating, children with higher frequency of exposure to tobacco smoke and beverage intake had significantly increased chances of elevated BLLs and BCLs.

CONCLUSIONS

Pb and Cd exposure of children in this area is relatively low, but associated risk factors continue to exist in vulnerable populations. This study is the first big data analysis of Pb and Cd in children in Henan, China, and provides baseline information for future research.

Maternal Iron Deficiency and Environmental Lead (Pb) Exposure Alter the Predictive Value of Blood Pb Levels on Brain Pb Burden in the Offspring in a Dietary Mouse Model: An Important Consideration for Cumulative Risk in Development

Maternal iron deficiency (ID) and environmental lead (Pb) exposure are co-occurring insults that both affect the neurodevelopment of offspring. Few studies have investigated how ID affects brain-region-specific Pb accumulations using human-relevant Pb concentrations. Furthermore, how these Pb exposures impact blood and brain Fe levels remains unclear. Importantly, we also wanted to determine whether the use of blood Pb levels as a surrogate for the brain Pb burden is affected by underlying iron status. We exposed virgin Swiss Webster female mice to one of six conditions differing by iron diet and Pb water concentration (0 ppm, 19 ppm, or 50 ppm lead acetate) and used Inductively Coupled Plasma Mass Spectrometry to measure the maternal and offspring circulating, stored, and brain Pb levels. We found that maternal ID rendered the offspring iron-deficient anemic and led to a region-specific depletion of brain Fe that was exacerbated by Pb in a dose-specific manner. The postnatal iron deficiency anemia also exacerbated cortical and hippocampal Pb accumulation. Interestingly, BPb levels only correlated with the brain Pb burden in ID pups but not in IN offspring. We conclude that ID significantly increases the brain Pb burden and that BPb levels alone are insufficient as a clinical surrogate to make extrapolations on the brain Pb burden.

Epigenetic Biomarkers of Lead Exposure and Cardiovascular Disease: Prospective Evidence in the Strong Heart Study

Background Lead is a cardiotoxic metal with a variety of adverse health effects. In the absence of data on bone lead exposure, epigenetic biomarkers can serve as indicators of cumulative lead exposure and body burden. Herein, we leveraged novel epigenetic biomarkers of lead exposure to investigate their association with cardiovascular disease (CVD) incidence and mortality. Methods and Results Blood DNA methylation was measured using the Illumina MethylationEPIC BeadChip among 2231 participants of the Strong Heart Study (SHS) at baseline (1989-1991). Epigenetic biomarkers of lead levels in blood, patella, and tibia were estimated using previously identified cytosine-guanine dinucleotide (CpG) sites. CVD incidence and mortality data were available through 2017. Median concentrations of lead epigenetic biomarkers were 13.8 μg/g, 21.3 μg/g, and 2.9 μg/dL in tibia, patella, and blood, respectively. In adjusted models, the hazard ratio (HR) (95% CI) of CVD mortality per doubling increase in lead epigenetic biomarkers were 1.42 (1.07-1.87) for tibia lead, 1.22 (0.93-1.60) for patella lead, and 1.57 (1.16-2.11) for blood lead. The corresponding HRs for incident CVD were 0.99 (0.83-1.19), 1.07 (0.89-1.29), and 1.06 (0.87-1.30). The association between the tibia lead epigenetic biomarker and CVD mortality was modified by sex (interaction P value: 0.014), with men at increased risk (HR, 1.42 [95% CI, 1.17-1.72]) compared with women (HR, 1.04 [95% CI, 0.89-1.22]). Conclusions Tibia and blood epigenetic biomarkers were associated with increased risk of CVD mortality, potentially reflecting the cardiovascular impact of cumulative and recent lead exposures. These findings support that epigenetic biomarkers of lead exposure may capture some of the disease risk associated with lead exposure.

Effects of Exogenous Application of Plant Growth Regulators (SNP and GA3) on Phytoextraction by Switchgrass (Panicum virgatum L.) Grown in Lead (Pb) Contaminated Soil

Soil lead (Pb) contamination is a major environmental and public health risk. Switchgrass (Panicum virgatum), a second-generation biofuel crop, is potentially useful for the long-term phytoremediation and phytoextraction of Pb contaminated soils. We evaluated the efficacy of a coordinated foliar application of plant growth regulators and soil fungicide and a chelator in order to optimize phytoextraction. Plants were grown in soil culture under controlled conditions. First, three exogenous nitric oxide (NO) donors were evaluated at multiple concentrations: (1) S-nitroso-N-acetylpenicillamine (SNAP); (2) sodium nitroprusside (SNP); and (3) S-nitrosoglutathione (GSNO). Second, the effect of SNP (0.5 μM) was examined further with the model chelate EDTA and the soil fungicide propicanazole. Third, a combined foliar application of SNP and gibberellic acid (GA3) was examined with EDTA and propicanazole. The soil application of propiconazole (a broad-spectrum fungicides) reduced AMF colonization and allowed greater Pb phytoextraction. The foliar application of SNP resulted in similar concentrations of Pb (roots and foliage) to plants that were challenged with chelates and soil fungicides. The combined foliar application of SNP and GA3 resulted in significantly greater average Pb concentration (243 mg kg−1) in plant foliage in comparison to control plants (182 mg kg−1) and plants treated with GA3 alone (202 mg kg−1). The combined foliar application of SNP and GA3 resulted in the greatest phytoextraction efficiency and could therefore potentially improve phytoextraction by switchgrass grown in Pb contaminated soils.

Effects of Toxic Metal Contamination in the Tri-State Mining District on the Ecological Community and Human Health: A Systematic Review

Although extensive research exists on toxic environments in the Tri-State Mining District (TSMD), there has been a lack of research on how harmful effects in TSMD could affect residents living in those areas. However, quite recently, such research regarding relationships between the health conditions of residents and toxic elements in the TSMD began to grow. The increase of empirical studies means greater complexity of the findings that require a more intricate understanding. To meet the goals of this study, an extensive, systematic review of the literature using PRISMA was conducted. This method resulted in 19 articles that define the harmful effects of the TSMD on the ecology and the physical health of residents. This research found that toxic metals not only negatively impact natural processes in the TSMD environments (fish species reduction, kidney and liver problems, and toxic diet) but also continuously affect the health of residents (high blood Pb and mortality).This study makes a vital contribution building upon the existing outcomes of the correlations between toxic elements in the TSMD areas and the health of residents. Furthermore, conclusions of this study provide updated information to policymakers and health-related professionals by providing adequate and innovative remediations and health-related services in the TSMD.

Blood lead in children and associations with trace elements and sociodemographic factors

BACKGROUND

No safe blood lead concentration in children has been identified. Lead can affect nearly every system in the body and is especially harmful to the developing central nervous system of children. The aim of this study is to analyze blood lead in a population of children and its association with sociodemographic variables, biochemical parameters, copper, iron, selenium and zinc.

METHODS

We recruited 155 children (86 boys and 69 girls) with a mean age of 7.3 (SD:4.1). Blood lead and serum selenium concentrations were measured by electrothermal atomic absorption spectrometry. Serum copper and zinc concentrations were measured by flame atomic absorption spectrometry. Serum iron levels were determined by colorimetric assay. A risk exposure questionnaire for lead was administered to the participants.

RESULTS

The median blood lead level was 1.1 (IQR 0.7-1.6) μg/dL. Regarding risk exposure factors, the youngest children (<2 years) who played outdoors presented a median blood lead concentration of 1.1 μg/dL IQR: 0.48-1.48, compared to the median of 0.3 μg/dL IQR:0.2-0.48 in the children who stated they played at home (p = 0.024). Significant differences were also found when taking into account those parents who smoked (median 1.3 IQR 0.8-1.9 μg/dL vs 0.9 IQR 0.5-1.4 μg/dL of non-smokers, p = 0.002). Children who drank tap water had higher blood lead levels (median 1.2 IQR 0.7-1.6 μg/dL) than those who drank bottled water (median 0.7 IQR 0.2-1.3 μg/dL p = 0.014). In addition, children whose mothers had not finished school had higher blood lead levels (median 1.7 IQR 1.2-2.3 μg/dL) than those whose mothers had finished school (median 1.2 IQR 0.7-1.7 μg/dL) and those whose mothers had gone to university (median 0.9 IQR 0.5-1.4 μg/dL) p = 0.034. In the multivariate lineal regression analysis we continue to observe the association between mother's higher level of education and lower blood levels (p = 0.04) and the interaction between age and outdoor play (p = 0.0145).

CONCLUSIONS

In spite of the decline in blood lead concentrations, associated risk factors continue to exist in vulnerable populations such as children.

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

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

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

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

Metal stress-related gene expression patterns in two marine invertebrates, Hediste diversicolor (Annelida, Polychaeta) and Littorina littorea (Mollusca, Gastropoda), at a former mining site

Abandoned mines often contaminate sediments with dissolved heavy metals and are known to impact many taxa. Physiological responses needed to avoid oxidative stress from metal toxicity include the upregulation of detoxification and metal-binding proteins such as glutathione-s-transferases and metallothioneins, which have been studied in diverse species. Fewer studies, however, have focused on gene expression changes to better understand these molecular mechanisms, especially across multiple species at a single contaminated site. To this end, the purpose of this study was to characterize metal stress-related gene expression in two species from different phyla, Hediste diversicolor (Annelida, Polychaeta) and Littorina littorea (Mollusca, Gastropoda), at a former mine site (Callahan Mine, Maine, USA). Both species and sediments were collected from a mine-affected tidal estuary (Goose Pond) and a nearby reference site. Elevated sediment metal levels were confirmed at Goose Pond. H. diversicolor individuals weighed significantly less at Goose Pond, while L. littorea weighed similarly at both sites. Transcript levels were stable in H. diversicolor but weakly upregulated in L. littorea, which likely reflect the importance of other physiological strategies for metal sequestration, or variable metal exposure at the individual level, respectively. In addition, patterns in glutathione-s-transferase expression differed across isoforms in H. diversicolor, while L. littorea exhibited divergent expression patterns in foot muscle and hepatopancreas. Overall, these results reinforce that diverse species likely undergo different physiological responses to metal toxicity, and more research is needed to investigate these mechanisms.

Prevalence of Blood Lead among Children Living in Battery Recycling Communities in Greater Jakarta, Indonesia

This study aimed to assess the prevalence of blood lead levels (BLLs) among children 1 to 5 years old who reside near and distant to informally used lead-acid battery (ULAB) recycling locations and examine risk factors for elevated BLLs. A cross-sectional study was conducted in three greater Jakarta neighborhoods where informal ULAB recycling occurs. Venous BLLs among 279 children were analyzed using portable blood lead testing machines. Demographic, child activities, and sources of lead exposure inside and outside homes were assessed. Multivariate analysis was performed to evaluate factors associated with the prevalence of BLLs. Forty-seven percent of children had BLLs ≥ 5 µg/dL and 9% had BLLs ≥ 10 µg/dL. No differences in geometric mean BLLs were observed between children who lived near and distant to ULAB locations. Older child age groups [Prevalence Ratio (PR) 2.14, 95% Confidence Interval (CI) 1.16, 4.18) and low household income (PR 1.58, 95% CI 1.03, 2.40) were associated with BLLs 5-9 µg/dL. Low educational attainment of the child's father (PR 3.17, 95% CI 1.23, 8.16) and frequent outdoor child activity (PR 4.93, 95% CI 1.09, 22.21) were predictors of BLLs ≥ 10 µg/dL. This study shows the association between lead exposure among children and environmental sources. Public health officials can consider expanded surveillance, health care provider education, and development of strategies to reduce lead exposure.

Review of built and natural environment stressors impacting American-Indian/Alaska-Native children

Children's exposures to chemical and non-chemical stressors from their everyday environment affects their overall health and well-being. American-Indian/Alaska-Native (AI/AN) children may have a disproportionate burden of stressors from their built and natural environments when compared to children from other races/ethnicities. Our objectives were to identify chemical and non-chemical stressors from AI/AN children's built and natural environments and evaluate their linkages with health and well-being outcomes from the peer reviewed literature. Library databases (e.g. PubMed) were searched to identify studies focused on these stressors. References were excluded if they: did not discuss AI/AN children or they were not the primary cohort; discussed tribes outside the United States (U.S.); were reviews or intervention studies; or did not discuss stressors from the built/natural environments. Out of 2539 references, 35 remained. Sample populations were predominantly (70%) in New York (NY) and Alaska (AK); 14 studies reported on the same cohort. Studies with matching stressors and outcomes were few, ruling out a quantitative review. Respiratory and developmental outcomes were the main outcomes evaluated. Primary non-chemical stressors were residential proximity to polluted landscapes, lack of indoor plumbing, and indoor use of wood for heating or cooking. The main chemical stressors were volatile organic compounds (VOCs), particulate matter (PM2.5), polychlorinated biphenyls (PCBs), p,p'-DDE, hexachlorobenzene (HCB), lead, and mercury. Our qualitative review was suggestive of a potential increase in respiratory illness from indoor wood use or no plumbing, which can be used as a guide to promote healthy environments for AI/AN children. We identified limited studies (<40), demonstrating this population as understudied. Future studies need to consider: sample populations from other tribes in the U.S., stressors outside the household, other elements of the natural environment, and an evaluation of stressors from AI/AN children's total environment (built, natural, and social).

Arsenic, selenium, boron, lead, cadmium, copper, and zinc in naturally contaminated rocks: A review of their sources, modes of enrichment, mechanisms of release, and mitigation strategies

Massive and ambitious underground space development projects are being undertaken by many countries around the world to decongest megacities, improve the urban landscapes, upgrade outdated transportation networks, and expand modern railway and road systems. A number of these projects, however, reported that substantial portions of the excavated debris are oftentimes naturally contaminated with hazardous elements, which are readily released in substantial amounts once exposed to the environment. These contaminated excavation debris/spoils/mucks, loosely referred to as "naturally contaminated rocks", contain various hazardous and toxic inorganic elements like arsenic (As), selenium (Se), boron (B), and heavy metals like lead (Pb), cadmium (Cd), copper (Cu), and zinc (Zn). If left untreated, these naturally contaminated rocks could pose very serious problems not only to the surrounding ecosystem but also to people living around the construction and disposal sites. Several incidents of soil and ground/surface water contamination, for example, have been documented due to the false assumption that excavated materials are non-hazardous because they only contain background levels of environmentally regulated elements. Naturally contaminated rocks are hazardous wastes, but they still remain largely unregulated. In fact, standard leaching tests for their evaluation and classification are not yet established. In this review, we summarized all available studies in the literature about the factors and processes crucial in the enrichment, release, and migration of the most commonly encountered hazardous and toxic elements in naturally contaminated geological materials. Although our focus is on naturally contaminated rocks, analogue systems like contaminated soils, sediments, and other hazardous wastes that have been more widely studied will also be discussed. Classification schemes and leaching tests to properly identify and regulate excavated rocks that may potentially pose environmental problems will be examined. Finally, management and mitigation strategies to limit the negative effects of these hazardous wastes are introduced.

High Content of Lead Is Associated with the Softness of Drinking Water and Raised Cardiovascular Morbidity: A Review

Daily ingestion of lead (Pb), even through piped drinking water, has long time been an important issue of concern, attracting for decades research in environmental science and toxicology, and again comes to prominence because of recent high-profile cases of exposure of populations in several countries to Pb-contaminated water. Numerous studies have reported an association between Pb in water and the risk of cardiovascular pathologies. Low levels of magnesium and calcium, i.e., low degree of hardness of the drinking water, may accentuate Pb leaching from water pipes and furthermore increase Pb absorption. This review evaluates the evidence for an association between Pb exposure from drinking water and cardiovascular end points in human populations.

Environmental Lead Exposure and Adult Literacy in Myanmar: An Exploratory Study of Potential Associations at the Township Level

Environmental lead exposure is a population health concern in many low- and middle-income countries. Lead is found throughout Myanmar and prior to the 1940s the country was the largest producer of lead worldwide. The aim of this study was to examine any potential association between lead mining and adult literacy rates at the level of 330 townships in Myanmar. Townships were identified as lead or non-lead mining areas and 2015 census data were examined with association being identified using descriptive, analytical and spatial statistical methods. Overall, there does appear to be a significant relationship between lead mining activity and adult literacy levels among townships with both low access (p = 0.05; OR = 2.701 (1.136–6.421)) as well with high access to safe sanitation (p = 0.01; OR = 18.40 (1.794–188.745)). Local Indicators of Spatial Association (LISA) cluster maps confirm these findings. This exploratory analysis is a first step in the examination of potential environmental lead exposure and its implications in Myanmar.

Smelting Remains a Public Health Risk Nearly a Century Later: A Case Study in Pueblo, Colorado, USA

Pueblo, Colorado has a long history of smelting activities, and recent studies raised concerns about lead exposure. This study tested 240 children in Pueblo for blood lead levels (BLLs) and found a significant association between distance from old smelters and children BLLs. Around 7.5% of Pueblo children had BLLs above the Centers for Disease Control and Prevention reference level of 5 µg/dL for elevated BLL, and 18.3% had BLLs between 3.3⁻4.9 µg/dL. Out of the 36 children who lived near former smelters, 13.9% had BLLs above 5 µg/dL vs. 6.37% for children living away from old smelters. The proportion of Pueblo children with elevated BLL was nearly three times the 2007⁻2010 United States national average (7.5% vs. 2.6%), and this was higher in the immediate vicinity of old smelters (13.9% vs. 2.6%). Genetic polymorphisms for ALAD-1 or ALAD-2 alleles, which play a role in susceptibility to lead toxicity, were not associated with children BBLs. Around 38.5% of houses sampled near the smelters had topsoil lead levels higher than the Environmental Protection Agency’s benchmark of 400 mg/kg. Our study resulted in the addition of areas of Pueblo to the EPA Superfund National Priorities List in December 2014, and cleanup is currently underway to minimize the public health risks.

A systematic review of socioeconomic status measurement in 13 years of U.S. injury research

OBJECTIVE

The purpose of this review was to assess the impact of socioeconomic status (SES) on injury and to evaluate how U.S. injury researchers have measured SES over the past 13years in observational research studies.

DESIGN & METHODS

This systematic review included 119 US injury studies indexed in PubMed between January 1, 2002 and August 31, 2015 that used one or more individual and/or area-level measures of SES as independent variables. Study findings were compared to the results of a previous review published in 2002.

RESULTS

Findings indicate SES remains an important predictor of injury. SES was inversely related to injury in 78 (66%) of the studies; inverse relationships were more consistently found in studies of fatal injury (77.4%) than in studies of non-fatal injury (58%). Approximately two-thirds of the studies (n=73, 61%) measured SES along a gradient and 59% used more than one measure of SES (n=70). Studies that used a gradient measure of SES and/or more than one measure of SES identified significant relationships more often. These findings were essentially equivalent to those of a similar 2002 review (Cubbin & Smith, 2002).

CONCLUSIONS

There remains a need to improve measurement of SES in injury research. Public health training programs should include best practices for measurement of SES, which include: measuring SES along a gradient, selecting SES indicators based on the injury mechanism, using the smallest geographic region possible for area-level measures, using multiple indicators when possible, and using both individual and area-level measures as both contribute independently to injury risk. Area-level indicators of SES are not accurate estimates of individual-level SES.

PRACTICAL APPLICATIONS

Injury researchers should measure SES along a gradient and incorporate individual and area-level SES measures that are appropriate to the injury outcome under study.

Using Public Health Data for Soil Pb Hazard Management in Ohio

OBJECTIVES

To evaluate how frequently elevated soil lead (Pb) hazards (≥400 ppm Pb) were identified in existing blood Pb site investigations in Ohio.

DESIGN

This study evaluated 3050 site investigations from the Ohio Department of Health for children with blood Pb levels at or above 10 μg dL that contained bare soil Pb data.

SETTING

Data were collected from existing databases maintained by the Ohio Department of Health.

PARTICIPANTS

All data were de-identified prior to analysis. The data used included blood Pb level test results for children (18 years or younger) in Ohio, with most data coming from children younger than 6 years.

MAIN OUTCOME MEASURES

The main outcome measures were blood Pb levels and identified Pb concentrations in environmental media, including soil, paint, and dust.

METHODS

Data were organized and summarized according to county. Summary statistics were generated on the basis of type of environmental media and county.

RESULTS

Soil samples were collected in approximately 5% of all blood Pb cases in Ohio between 1999 and 2015. Median bare soil Pb was 1030 mg Pb kg (range, 0-345 021 mg Pb kg soil). Fifty-six of Ohio's 88 counties had at least 1 soil sample above 10 000 ppm (mg Pb kg). Multiple Pb hazards were identified, including bare soil (74% frequency), deteriorated exterior Pb paint (74%), deteriorated interior Pb paint (72%), and settled Pb dust (72%). Bare soil collected from identified dripline areas contained 2638 ppm Pb above soils collected from bare soil play areas (P = .02). Ninety assessments (3%) contained a bare soil hazard, with no other identified hazards. No trend was found comparing county mean or median Pb with county population. Previously identified high-risk counties for elevated blood Pb levels did not have an elevated prevalence of bare soil Pb hazards compared with other counties (P = .64).

CONCLUSIONS

Site investigators should anticipate finding and managing elevated bare soil Pb in locations throughout Ohio. When communicating with the public about bare soil Pb hazards, practitioners and policy makers should emphasize the importance of addressing all potential Pb exposure sources. Findings demonstrate the importance of the individual home environment for exposure, as previously identified high-risk counties for elevated blood Pb levels were not different from other counties.

Mining-Related Sediment and Soil Contamination in a Large Superfund Site: Characterization, Habitat Implications, and Remediation

Historical mining activity (1850-1970) in the now inactive Tri-State Mining District provided an ongoing source of lead and zinc to the environment including the US Environmental Protection Agency Superfund site located in Cherokee County, southeast Kansas, USA. The resultant contamination adversely affected biota and caused human health problems and risks. Remediation in the Superfund site requires an understanding of the magnitude and extent of contamination. To provide some of the required information, a series of sediment and soil investigations were conducted in and near the Superfund site to characterize lead and zinc contamination in the aquatic and floodplain environments along the main-stem Spring River and its major tributaries. In the Superfund site, the most pronounced lead and zinc contamination, with concentrations that far exceed sediment quality guidelines associated with potential adverse biological effects, was measured for streambed sediments and floodplain soils located within or downstream from the most intensive mining-affected areas. Tributary streambeds and floodplains in affected areas are heavily contaminated with some sites having lead and zinc concentrations that are an order of magnitude (or more) greater than the sediment quality guidelines. For the main-stem Spring River, the streambed is contaminated but the floodplain is mostly uncontaminated. Measured lead and zinc concentrations in streambed sediments, lakebed sediments, and floodplain soils documented a persistence of the post-mining contamination on a decadal timescale. These results provide a basis for the prioritization, development, and implementation of plans to remediate contamination in the affected aquatic and floodplain environments within the Superfund site.

Risk factors for children's blood lead levels in metal mining and smelting communities in Armenia: a cross-sectional study

Background

Children’s exposure to lead poses a significant risk for neurobehavioral consequences. Existing studies documented lead contamination in residential soil in mining and smelting communities in Armenia. This study aimed to assess blood lead levels (BLL) in children living in three communities in Armenia adjacent to metal mining and smelting industries, and related risk factors.

Methods

This cross-sectional study included 159 children born from 2007 to 2009 and living in Alaverdi and Akhtala communities and Erebuni district in Yerevan - the capital city. The BLL was measured with a portable LeadCare II Blood Lead Analyzer; a survey was conducted with primary caregivers.

Results

Overall Geometric Mean (GM) of BLL was 6.0 μg/dl: 6.8 for Akhtala, 6.4 for Alaverdi and 5.1 for Yerevan. In the sample 68.6 % of children had BLL above CDC defined reference level of 5 μg/dl: 83.8 % in Akhtala, 72.5 % in Alaverdi, and 52.8 % in Yerevan. Caregiver’s lower education, dusting furniture less than daily, and housing distance from toxic source(s) were risk factors for higher BLL. Additional analysis for separate communities demonstrated interaction between housing distance from toxic source(s) and type of window in Erebuni district of Yerevan.

Conclusions

The study demonstrated that children in three communities adjacent to metal mining and smelting industries were exposed to lead. Investigation of the risk factors suggested that in addition to promoting safe industrial practices at the national level, community-specific interventions could be implemented in low- and middle-income countries to reduce BLL among children.

Associations between metals in residential environmental media and exposure biomarkers over time in infants living near a mining-impacted site

Infant exposures to metals are a concern for mining-impacted communities, although limited information is available to assess residential exposures over the first year of life. We measured lead (Pb), manganese, arsenic, and cadmium in indoor air, house dust, yard soil, and tap water from 53 infants' homes near the Tar Creek Superfund Site (Oklahoma, USA) at two time points representing developmental stages before and during initial ambulation (age 0-6 and 6-12 months). We measured infant metal biomarkers in: umbilical cord blood (n=53); 12- (n=43) and 24- (n=22) month blood; and hair at age 12 months (n=39). We evaluated cross-sectional and longitudinal associations between infant residential and biomarker concentrations. A doubling of mean dust Pb concentration was consistently associated with 36-49% higher 12-month blood Pb adjusting for cord blood Pb (P⩽0.05). Adjusted dust concentration explained 29-35% of blood Pb variance, and consistent associations with other media were not observed. Although concentrations in dust and blood were generally low, strong and consistent associations between dust and body burden suggest that house dust in mining-impacted communities may impact children's health. These relationships were observed at a young age, typically before blood Pb levels peak and when children's development may be particularly vulnerable to toxic insult.

Associations between metals in residential environmental media and exposure biomarkers over time in infants living near a mining-impacted site

Infant exposures to metals are a concern for mining-impacted communities, although limited information is available to assess residential exposures over the first year of life. We measured lead (Pb), manganese, arsenic, and cadmium in indoor air, house dust, yard soil, and tap water from 53 infants' homes near the Tar Creek Superfund Site (Oklahoma, USA) at two time points representing developmental stages before and during initial ambulation (age 0-6 and 6-12 months). We measured infant metal biomarkers in: umbilical cord blood (n=53); 12- (n=43) and 24- (n=22) month blood; and hair at age 12 months (n=39). We evaluated cross-sectional and longitudinal associations between infant residential and biomarker concentrations. A doubling of mean dust Pb concentration was consistently associated with 36-49% higher 12-month blood Pb adjusting for cord blood Pb (P⩽0.05). Adjusted dust concentration explained 29-35% of blood Pb variance, and consistent associations with other media were not observed. Although concentrations in dust and blood were generally low, strong and consistent associations between dust and body burden suggest that house dust in mining-impacted communities may impact children's health. These relationships were observed at a young age, typically before blood Pb levels peak and when children's development may be particularly vulnerable to toxic insult.

Environmental lead exposure and its relationship to traffic density among Senegalese children: a cross-sectional study

Leaded-gasoline is probably the primary source of lead (Pb) exposure in Dakar (Senegal). The present cross sectional study was undertaken to investigate the levels of Pb in Senegalese children and to present helpful data on the relationship between Pb levels and changes in biological markers of heme biosynthesis and oxidative stress. A total of 330 children, living since birth either in rural or urban areas (ie, Khombole (n=162) and Dakar (n=168), respectively) were included. During this cross sectional study, the mean blood (B)-Pb level in all children was 7.32±5.33 ųg/dL, and was influenced by the area of residence and gender. In rural children, 27 subjects (16.7%), 18 boys (19.6%) and nine girls (12.9%), had a B-Pb level >10 ųg Pb/dL, whereas 99 urban children (58.9%), respectively, 66 boys (71.8%) and 33 girls (43.4%), had alarmingly high B-Pb levels. Accordingly, urine delta-aminolevulinic acid levels were higher in children living in the urban area than in the rural areas (P B±0.001), and closely correlated with the B-Pb levels (P B±0.01). Moreover, glutathione peroxidase (GPx) activity, selenium (Se) level, glutathione reductase (GR) activity, and glutathione status were significantly influenced by area of residence and/or by gender. GPx activity and Se level were not only negatively correlated with B-Pb levels, but also positively correlated together (P B±0.01). Taken together, the present results allow us to conclude that urban children have higher B-Pb levels than rural children, and that of these children, boys have higher B-Pb levels than girls, leading thereby to alterations of heme biosynthesis and pro-oxidant/antioxidant balance. We also suggest that exposure to Pb and the Pb-induced adverse effects merits attention and that the development of preventive actions are of increasing importance in Senegal.

Perinatal and Childhood Exposure to Cadmium, Manganese, and Metal Mixtures and Effects on Cognition and Behavior: A Review of Recent Literature

Lead (Pb) and mercury (Hg) neurotoxicity is well established. In recent years, a growing body of evidence suggests that environmental exposure to other metals including arsenic (As), cadmium (Cd), and manganese (Mn) and their mixtures also poses public health threats. In this paper, we summarize the recent literature examining the relationship of prenatal and childhood environmental metal exposures with cognitive and behavioral outcomes in children. We conducted a literature search to identify epidemiologic studies that examined the relationship of Cd, Mn, and metal mixtures with children's neurodevelopmental/cognitive and behavioral outcomes. We restricted the search to peer-reviewed studies published in English between January 2009 and March 2015. We identified a total of 31 articles of which 16, 17, and 16 studies examined the effects of Cd, Mn, or metal mixtures, respectively. Based on our review, there is suggestive evidence that prenatal/childhood Cd exposure may be associated with poorer cognition, but additional research is clearly needed. We found little evidence of behavioral effects of early life Cd exposure, and no studies found a significant relationship with attention deficit hyperactivity disorder. Studies of early life Mn exposure consistently reported negative impacts on both cognition and behavior. There is also growing evidence that co-exposure to multiple metals can result in increased neurotoxicity compared to single-metal exposure, in particular during early life. Few studies have evaluated behavioral effects related to metal co-exposure.

Native Americans: Where in Environmental Justice Research?

While the last two decades have seen important theoretical, empirical, and policy advancements in environmental justice generally, much remains to be done regarding Native Americans. Unique political and cultural dynamics shape the study and pursuit of environmental justice (EJ) in Native American communities. This review summarizes Native American EJ issues based on a cross-disciplinary search of over 60 publications. In so doing, we discuss the unique nature of Native American EJ in terms of conducting research and working toward reducing the continuation of historical trauma associated with environmental ills, the types of strategies used in Native American EJ research, and issues of Native American climate justice. We conclude with discussion of remaining knowledge gaps and future research needs.

P, Muckelbauer R, Casiot C, Freydier R, Duprey JL, Chen CM, Müller-Nordhorn J, Keil T. Toxic trace elements in maternal and cord blood and social determinants in a Bolivian mining city

This study assessed lead, arsenic, and antimony in maternal and cord blood, and associations between maternal concentrations and social determinants in the Bolivian mining city of Oruro using the baseline assessment of the ToxBol/Mine-Niño birth cohort. We recruited 467 pregnant women, collecting venous blood and sociodemographic information as well as placental cord blood at birth. Metallic/semimetallic trace elements were measured using inductively coupled plasma mass spectrometry. Lead medians in maternal and cord blood were significantly correlated (Spearman coefficient = 0.59; p < 0.001; 19.35 and 13.50 μg/L, respectively). Arsenic concentrations were above detection limit (3.30 μg/L) in 17.9% of maternal and 34.6% of cord blood samples. They were not associated (Fischer's p = 0.72). Antimony medians in maternal and cord blood were weakly correlated (Spearman coefficient = 0.15; p < 0.03; 9.00 and 8.62 μg/L, respectively). Higher concentrations of toxic elements in maternal blood were associated with maternal smoking, low educational level, and partner involved in mining.

Blood lead levels in children aged 0-6 years old in Hunan Province, China from 2009-2013

Objectives

The aim of this study is to describe blood lead levels (BLLs) and the prevalence of elevated blood lead levels (EBLLs) in children aged 0–6 years old and to analyze the BLL trend in children from 2009 to 2013 in China.

Methods

A total of 124,376 children aged 0–6 years old were recruited for this study from January 1^st 2009 to December 31^st 2013. Their blood lead levels were analyzed using atomic absorption spectrometry.

Results

The median BLL was 64.3 μg/L (IQR: 49.6–81.0), and the range was 4.3–799.0 μg/L. Blood lead levels were significantly higher in boys (66.0 μg/L) than in girls (61.9 μg/L) (P<0.001). The overall prevalence of BLLs≥100 μg/L was 10.54% in children aged 0–6 years in Hunan Province. Between 2009 and 2013, the prevalence of EBLLs (≥100 μg/L) decreased from 18.31% to 4.26% in children aged 0–6 years and increased with age. The prevalence of EBLLs has dramatically decreased in two stages (2009–2010 and 2012–2013), with a slight fluctuation in 2010 and 2011.

Conclusions

Both BLLs and the prevalence of EBLLs in children aged 0–6 years old declined substantially from 2009 to 2013 in Hunan Province; however, both remain at unacceptably high levels compared to developed countries. Comprehensive strategies are required to further reduce blood lead levels in children.

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.

Health hazard prospecting by modeling wind transfer of metal-bearing dust from mining waste dumps: application to Jebel Ressas Pb-Zn-Cd abandoned mining site (Tunisia)

This work presents a modeling approach to simulate spatial distribution of metal contamination in aerosols with evaluation of health hazard. This approach offers the advantage to be non-intrusive, less expensive than sampling and laboratory analyses. It was applied to assess the impact of metal-bearing dust from mining wastes on air quality for a nearby community and agricultural lands in Jebel Ressas (Tunisia) locality. Dust emission rates were calculated using existing parameterization adapted to the contamination source composed of mining wastes. Metal concentrations were predicted using a Gaussian model (fugitive dust model) with, as input: emission rates, dump physical parameters and meteorological data measured in situ for 30 days in summertime. Metal concentration maps were built from calculated PM10 particle concentrations. They evidence the areas where Pb and Cd concentrations exceeded WHO guidelines (0.5 and 0.005 µg/m(3), respectively). Maximum concentrations of Pb and Cd in PM10 are, respectively, of 5.74 and 0.0768 µg/m(3) for measured wind speed values up to 22 m/s. Preferential areas of contamination were determined in agricultural lands to the NW from the source dump where Pb and Cd exceeded guidelines up to a distance of 1,200 m. The secondary spreading directions were SW and E, toward the village. Health hazard prospecting shown that a major part of the village was exposed to contaminated dust and that daily hazard quotient (HQ) values reached locally 118 and 158, respectively, for Pb and Cd during the study period. However, HQ variations in the village are high, both temporally and geographically.

Toxic metal levels in children residing in a smelting craft village in Vietnam: a pilot biomonitoring study

BACKGROUND

In Vietnam, environmental pollution caused by small-scale domestic smelting of automobile batteries into lead ingot is a growing concern. The village of Nghia Lo is a smelting craft village located roughly 25 km southeast of Hanoi in the Red River Delta. Despite the concern of toxic metal exposure in the village, biomonitoring among susceptible populations, such as children, has not been previously conducted. The aim of this study was to determine the body burden of toxic metals in children residing in a smelting craft village.

METHODS

Twenty children from Nghia Lo, Vietnam, ages 18 months to four years were selected for capillary whole blood and toenail biomonitoring. Whole blood lead levels (BLLs) were measured using a portable lead analyzer, and toenail levels of arsenic, cadmium, chromium, lead, manganese, and mercury were analyzed with inductively coupled plasma-mass spectrometry.

RESULTS

The findings show that all of the 20 children had detectable BLLs, and every child had levels that exceeded the Centers for Disease Control and Prevention guideline level of 5 μg/dL. Eighty percent of tested subjects had BLLs higher than 10 μg/dL. Five children (25%) had BLLs greater than 45 μg/dL, the level of recommended medical intervention. In addition to blood lead, all of the children had detectable levels of arsenic, cadmium, chromium, lead, manganese, and mercury in toenail samples. Notably, average toenail lead, manganese, and mercury levels were 157 μg/g, 7.41 μg/g, and 2.63 μg/g respectively, well above levels previously reported in children. Significant Spearman's rank correlations showed that there were relationships between blood and toenail lead levels (r = 0.65, p < 0.05), toenail levels of lead and cadmium (r = 0.66, p < 0.05), and toenail levels of manganese and chromium (r = 0.72, p < 0.001). Linear regression showed that reducing the distance to the nearest active smelter by half was associated with a 116% increase in BLL (p < 0.05).

CONCLUSIONS

The results suggest that children in battery recycling and smelting craft villages in Vietnam are co-exposed to toxic metals. There is an urgent need for mitigation to control metal exposure related to domestic smelting.

Racial disparities in children's blood lead levels: possible implication of divalent metal transporter 1

Adverse effects of lead exposure at low-dose (<10 μg/dL) in children showed a growing interest over the last decades. Black ethnicity is usually associated with elevated blood lead levels (BLLs), independently of age and socioeconomic conditions. The gastrointestinal uptake of lead represents a key step in the process of lead kinetic and toxicity. The involvement of divalent metal transporter 1 (DMT1) in the lead absorption has been previously presumed and reported. I postulate that inter-ethnic differences in DMT1 expression may explain a large part of the racial disparity in children's BLLs, and suggest a few analyses to test this hypothesis. The hypothesis rests on some observations from previous researches. The inverse association between BLLs and iron intake has been reported in both cross-sectional and follow-up studies. It appears that no study specifically addressed the modifying effect of ethnicity in this association. Previous reports suggest that DMT1 is the primary mechanism for gastrointestinal iron absorption. There are four forms of DMT1 expressed in the enterocytes, which did not respond similarly to iron changes. It is not excluded that some children be more likely to uptake ingested lead depending on DMT1 isoform expressed. I hypothesize that the expression of the more active DMT1 isoform (+1A/+IRE) is more common in Non-Hispanic Black compared with Non-Hispanic White children, and I suggest how to test this hypothesis. If the hypothesis is confirmed, this would suggest that the prevention of iron-deficiency must be included in the primary programs for preventing increase of BLLs in Non-Hispanic Black children, rather than as part of secondary prevention. Moreover, thorough studies would be useful to characterize the interaction between environmental lead levels and DMT1 expression in relation to BLLs in young children.

Spatial variability of metal bioaccumulation in estuarine killifish (Fundulus heteroclitus) at the Callahan mine superfund site, Brooksville, ME

The former Callahan Mine Site in Brooksville, ME, is an open-pit, hardrock mine site in an intertidal system, thus providing a unique opportunity to evaluate how metal-enriched sediments and overlying water impact estuarine food webs. Copper, zinc, cadmium, and lead concentrations in sediment, whole water, and Atlantic killifish (Fundulus heteroclitus) were evaluated at sites in Goose Pond (GP; Callahan Mine Site) and at reference sites. The metal concentrations of sediment, water, and fish were spatially distinct and significantly greater at the mine site than in the reference estuary. Sediment concentrations were particularly elevated and were above probable effects levels for all four metals adjacent to the tailings pile. Even in this well-mixed system, water metal concentrations were significantly elevated adjacent to the tailings pile, and concentrations of Cu and Zn were above ambient water-quality criteria for chronic marine exposure. Neither organic matter in the sediment nor salinity or pH of the water explained the metal concentrations. Adjacent to the tailings pile, killifish metal body burdens were elevated and were significantly related to both sediment and aqueous concentrations. In conclusion, (1) the contaminated sediment and seepage from the tailings impoundment and waste rock pile no. 3 create a continual flux of metals into the water column, (2) the metals are bioavailable and bioconcentrating as evident in the killifish tissue concentrations, and (3) Callahan Mine is directly affecting metal bioaccumulation in fauna residing in the GP estuary and, potentially, in Penobscot Bay by the way of “trophic nekton relay.”

Associations between soil lead concentrations and populations by race/ethnicity and income-to-poverty ratio in urban and rural areas

Lead (Pb) is a well-studied environmental contaminant that has many negative health effects, especially for children. Both racial/ethnic and income disparities have been documented with respect to exposure to Pb in soils. The objectives of this study were to assess whether soil Pb concentrations in rural and urban areas of South Carolina USA, previously identified as having clusters of intellectual disabilities (ID) in children, were positively associated with populations of minority and low-income individuals and children (≤ 6 years of age). Surface soils from two rural and two urban areas with identified clusters of ID were analyzed for Pb and concentrations were spatially interpolated using inverse distance weighted analysis. Population race/ethnicity and income-to-poverty ratio (ITPR) from United States Census 2000 block group data were aerially interpolated by block group within each area. Urban areas had significantly higher concentrations of Pb than rural areas. Significant positive associations between black, non-Hispanic Latino, individuals and children ≤ 6 years of age and mean estimated Pb concentrations were observed in both urban (r = 0.38, p = 0.0007) and rural (r = 0.53, p = 0.04) areas. Significant positive associations also were observed between individuals and children with an ITPR < 1.00 and Pb concentrations, though primarily in urban areas. Racial/ethnic minorities and low ITPR individuals, including children, may be at elevated risk for exposure to Pb in soils.

Assessment of environmental health children's population living in environmental injustice scenarios

We conducted a cross sectional study, involving 145 children randomly selected from three different socioeconomic locations. We selected social, environment and health indicators and measured the prevalence and prevalence odds ratios. Children from the brick producing site (segregation index 5), are exposed to high levels of multiple toxic agents, and showed the highest morbidity rates and malnutrition, anemia, dental fluorosis, and the lowest IQ, followed by children from municipal garbage dump (segregation index 4), where we detected the highest prevalence of dermatological and enteric diseases. Children from the Central Zone (segregation index 2) showed the lowest rates of malnutrition and higher IQ than the other two groups. A unified vision of social, health and environmental indicators opens the possibility of novel intervention programs and a legal framework that specifically protect children against environmental exposures.

Lead exposure from soil in Peruvian mining towns: a national assessment supported by two contrasting examples

OBJECTIVE

To estimate the population of Peru living in the vicinity of active or former mining operations that could be exposed to lead from contaminated soil.

METHODS

Geographic coordinates were compiled for 113 active mines, 138 ore processing plants and 3 smelters, as well as 7743 former mining sites. The population living within 5 km of these sites was calculated from census data for 2000. In addition, the lead content of soil in the historic mining town of Cerro de Pasco and around a recent mine and ore processing plant near the city of Huaral was mapped in 2009 using a hand-held X-ray fluorescence analyser.

FINDINGS

Spatial analysis indicated that 1.6 million people in Peru could be living within 5 km of an active or former mining operation. Two thirds of the population potentially exposed was accounted for by 29 clusters of mining operations, each with a population of over 10 000 each. These clusters included 112 active and 3438 former mining operations. Soil lead levels exceeded 1200 mg/kg, a reference standard for residential soil, in 35 of 74 sites tested in Cerro de Pasco but in only 4 of 47 sites tested around the newer operations near Huaral.

CONCLUSION

Soil contamination with lead is likely to be extensive in Peruvian mining towns but the level of contamination is spatially far from uniform. Childhood exposure by soil ingestion could be substantially reduced by mapping soil lead levels, making this information public and encouraging local communities to isolate contaminated areas from children.

Child neurodevelopment in a Bolivian mining city

This study evaluates the neurodevelopment of children living near contaminated mining industries during their first year of life. Participants from the city of Oruro (Bolivia) were prospectively recruited during pregnancy. Follow-up occurred between May 2007 and November 2009. Information about the socioeconomic status and medical history of the pregnant women were collected using questionnaires. Neurodevelopment was evaluated for 246 children using the Bayley Scales of Infant Development (BSID) at 10.5-12.5 months of age. Exposure to trace elements (Pb, As, Cd, Sb, Cs, Zn, Fe, Cu, Se, Rb, and Sr) during prenatal life was evaluated by testing maternal blood concentrations before delivery. Almost all measured levels were lower than the control limits. The blood lead concentration of pregnant women was low, considering the contaminated environmental context. The geometric mean was 1.76 μg/dL (95% CI: 1.68-1.84), a level comparable with those observed in non-contaminated areas. The only element found to be relatively elevated was antimony, with a geometric mean of 1.03 μg/dL (95% CI: 0.96-1.11). Our results suggest that women from this mining area were not highly exposed. The Bayley Scales of Infant Development (BSID) did not reveal mental or psychomotor abnormalities. Surprisingly, at the observed low levels, lead was positively associated with the children's BSID performance.

Metal sources and exposures in the homes of young children living near a mining-impacted Superfund site

Children living near hazardous waste sites may be exposed to environmental contaminants, yet few studies have conducted multi-media exposure assessments, including residential environments where children spend most of their time. We sampled yard soil, house dust, and particulate matter with aerodynamic diameter <2.5 in 59 homes of young children near an abandoned mining area and analyzed samples for lead (Pb), zinc (Zn), cadmium (Cd), arsenic (As), and manganese (Mn). In over half of the homes, dust concentrations of Pb, Zn, Cd, and As were higher than those in soil. Proximity to mine waste (chat) piles and the presence of chat in the driveway significantly predicted dust metals levels. Homes with both chat sources had Pb, Zn, Cd, and As dust levels two to three times higher than homes with no known chat sources after controlling for other sources. In contrast, Mn concentrations in dust were consistently lower than in soil and were not associated with chat sources. Mn dust concentrations were predicted by soil concentrations and occupant density. These findings suggest that nearby outdoor sources of metal contaminants from mine waste may migrate indoors. Populations farther away from the mining site may also be exposed if secondary uses of chat are in close proximity to the home.

Identification of sources of lead exposure in French children by lead isotope analysis: a cross-sectional study

BACKGROUND

The amount of lead in the environment has decreased significantly in recent years, and so did exposure. However, there is no known safe exposure level and, therefore, the exposure of children to lead, although low, remains a major public health issue. With the lower levels of exposure, it is becoming more difficult to identify lead sources and new approaches may be required for preventive action. This study assessed the usefulness of lead isotope ratios for identifying sources of lead using data from a nationwide sample of French children aged from six months to six years with blood lead levels ≥25 μg/L.

METHODS

Blood samples were taken from 125 children, representing about 600,000 French children; environmental samples were taken from their homes and personal information was collected. Lead isotope ratios were determined using quadrupole ICP-MS (inductively coupled plasma - mass spectrometry) and the isotopic signatures of potential sources of exposure were matched with those of blood in order to identify the most likely sources.

RESULTS

In addition to the interpretation of lead concentrations, lead isotope ratios were potentially of use for 57% of children aged from six months to six years with blood lead level ≥ 25 μg/L (7% of overall children in France, about 332,000 children), with at least one potential source of lead and sufficiently well discriminated lead isotope ratios. Lead isotope ratios revealed a single suspected source of exposure for 32% of the subjects and were able to eliminate at least one unlikely source of exposure for 30% of the children.

CONCLUSIONS

In France, lead isotope ratios could provide valuable additional information in about a third of routine environmental investigations.

Pollution sources and mortality rates across rural-urban areas in the United States

PURPOSE

To conduct an assessment of rural environmental pollution sources and associated population mortality rates.

METHODS

The design is a secondary analysis of county-level data from the Environmental Protection Agency (EPA), Department of Agriculture, National Land Cover Dataset, Energy Information Administration, Centers for Disease Control and Prevention, the US Census, and others. We described the types of pollution sources present in metropolitan and nonmetropolitan counties and examined the associations between these sources and rates of all-cause, cardiovascular, respiratory, and cancer mortality while controlling for age, race, and other covariates.

FINDINGS

Rural counties had 65,055 EPA-monitored pollution discharge sites. As expected, rural counties had significantly greater exposure to potential agriculture-related pollution. Regression models specific to rural counties indicated that greater density of water pollution sources was significantly associated with greater total and cancer mortality. Rural air pollution sources were associated with greater cancer mortality rates. Rural coal mining areas had higher total, cancer, and respiratory disease mortality rates. Agricultural production was generally associated with lower mortality rates. Greater levels of human development were significantly related to higher adjusted total and cancer mortality.

CONCLUSIONS

The association between pollution sources and mortality risk is not a phenomenon limited to metropolitan areas. Results carry policy implications regarding the need for effective environmental standards and monitoring. Further research is needed to better understand the types and distributions of pollution in rural areas, and the health consequences that result.

Potential for childhood lead poisoning in the inner cities of Australia due to exposure to lead in soil dust

This article presents evidence demonstrating that the historical use of leaded gasoline and lead (Pb) in exterior paints in Australia has contaminated urban soils in the older inner suburbs of large cities such as Sydney and Melbourne. While significant attention has been focused on Pb poisoning in mining and smelting towns in Australia, relatively little research has focused on exposure to Pb originating from inner-city soil dust and its potential for childhood Pb exposures. Due to a lack of systematic blood lead (PbB) screening and geochemical soil Pb mapping in the inner cities of Australia, the risks from environmental Pb exposure remain unconstrained within urban population centres.

Estimation of leaded (Pb) gasoline's continuing material and health impacts on 90 US urbanized areas

The subject of this paper is lead (Pb) additives in gasoline and their material and health impact from Pb dust inputs into 90 US urbanized areas (UAs). The mass of Pb additives for 90 UAs as a total of the US Pb additives in 1982 were estimated from vehicle travel, vehicle fuel economy (miles/gallon), ratio of leaded to unleaded fuel, and Pb/gallon. About 500 billion (10⁹) miles of travel in 90 UA's during 1982 account for ~18,000 metric tons (MT), or nearly 30% of the US Pb additives in 1982. Applying the 1982 proportions to the 90 UAs for 1950 through 1982 fuel sales by state accounts for ~1.4 million MT Pb of the US national total of 4.6 million MT during the same years. Fates of Pb additives in engine systems were used to calculate Pb aerosol inputs into the 90 UAs. The inputs range from 100's to more than 100,000 MT of Pb depending on a given UA's traffic flow patterns. Soils are the reservoir of urban Pb dust. The median background soil Pb for the US is 16.5mg/kg (range 10.3 to 30.1mg/kg), and less by an order of magnitude or more than soil Pb within larger UAs. Recognizing the US input of massive gasoline Pb additives into UAs assists with comprehending soil Pb differences between large and small UAs, inner and outer areas of UAs, health disparities, and school achievement issues within UAs. The findings underscore the need for controlling accumulated exterior urban Pb dust from gasoline additives along with paint sources that have accumulated in soil to meet the goal of primary childhood Pb exposure prevention.

Comparing household listing techniques in a rural midwestern Vanguard Center of the National Children's Study

The National Children's Study (NCS) is a longitudinal study that will examine the influence of environmental and social factors on the health and development of 100,000 children, following them from before birth until age 21. Proposed participant recruitment methods call for locating and listing all dwelling units (DUs) located within randomly selected segments within the 105 NCS sites. One of seven Vanguard Centers of the NCS includes four rural counties that span approximately 2,500 square miles. The size of this sampling area presents unique geographic challenges. In order to determine the most efficient method for listing DUs within this large area, a study was undertaken to investigate the differences in the percent of DUs identified and the cost of four different approaches. It compared the on-site listing method of physically identifying each DU with three other methods: plat maps, postal listings, and Geographic Information Systems (GIS)/satellite imagery techniques. The on-site method had the strongest kappa (.85) in terms of identifying true DUs. There was a moderate agreement (.59) with the plat map method, fair agreement (.34) with the postal method, and only a slight agreement (.14) with the GIS/satellite imagery method. The plat map, postal listing, and GIS/satellite methods were less time-consuming than the on-site method.

Community- and family-level factors influence care-giver choice to screen blood lead levels of children in a mining community

CONTEXT

Bunker Hill, in Kellogg, Idaho, formerly a lead mine (1884-1981) and smelter (1917-1981), is now a Superfund site listed on the Environmental Protection Agency's (EPA) National Priorities List. Lead contamination from the site is widespread due to past smelter discharges to land, water, and air, placing children at risk for both exposure to lead and resultant health effects of lead. Since 1983, the EPA has used child blood lead levels to inform the clean-up standards for the Bunker Hill Superfund site. This study was undertaken to examine factors that have contributed to the significant fall-off in the rates and numbers of children being screened for blood lead in Kellogg (number screened decreased from 195 to 8 from 2002 to 2007). The goal of this research project was to define community- and family-level factors which influence care-giver choice to screen blood lead levels of their children in this environment.

METHODS

This formative research study used mixed methods and was comprised of three research components: (1) preliminary interviews using community-based participatory research methods to define key research questions of relevance to community members, government and NGOs working in relation to the Bunker Hill clean-up; (2) a quantitative analysis of a cross-sectional household survey conducted with adult care-givers about child blood lead screening in Kellogg; and (3) ethnographic community rapid assessment methods formed the in-depth interview process and qualitative analysis.

RESULTS

The survey showed the likelihood of blood lead screening that for children under the age of 18 years increases 34% with each one-year increase in current age of the child (95% CI, 1.08-1.67, p-value=0.009), and decreases 45% with annual household income greater than $10,000 (95% CI, 0.35-0.88, p-value=0.013). Sibling birth order increased the likelihood of blood lead screening by 61% (95% CI, 1.04-2.48, p-value=0.032) for each successive child. Female children were rated by their care-givers as 3.7 times less agitated or easily angered than male children (95% CI, 1.5-8.8, p-value=0.005). Across all levels of interviews, regulators, residents, and non-governmental organization representatives reported that Kellogg's long history as a mining town has continued to influence attitudes and actions of care-givers to access blood lead screening for their children. The mining context has been described as instilling stigmas, parental blame and a sense of shame about lead exposure and resultant health effects.

DISCUSSION

Children under 6 years of age are currently the least likely to have been screened for lead in Kellogg and screening rates decreased in the 2000s. According to most indicators, socio-economic status did not influence the likelihood of a care-giver to screen children's blood lead levels. However, children in homes with an annual income below $10,000 were more likely to have been screened than the rest of the population. Former concerted screening efforts, including outreach, support, follow-up, and financial incentives in the 1980s-1990s to screen children, may have influenced low-income residents. Programmatic outreach for children under 6 years of age in Kellogg should focus on increasing female child and first child blood lead screening, rather than targeting only low-income families, by improving approaches to promotion, implementation and environmental follow-up for child lead screening. Some families have resided in Kellogg for five to six generations, and the long-term mining context influences community values and perceptions of lead exposure and screening for children through a conflicted combination of pride in the mining history, attachment to the past economy that supported the community in juxtaposition to the personalized blame, shame, guilt, and stigma associated with children having high blood lead levels. Health communication and other programs should prioritize methods of reducing parental feelings of blame, shame and guilt, and stigmas associated with the health effects of lead in a way that respects the pride of former mine workers, their families, and the history of the town.

Using network analysis to assess the evolution of organizational collaboration in response to a major environmental health threat

Effective inter-organizational collaboration is essential to a community's ability to leverage social and material resources for community problem solving, particularly in the face of complex public health problems. This study used network analysis to document the evolution of collaboration among 21 organizations in the Tar Creek Superfund site in northeastern Oklahoma from 1997 to 2005. The Tar Creek Superfund site was part of a major lead and zinc mining operation and suffers from widespread heavy metal contamination. An organizational network of 21 organizations and a subset of eight tribes were assessed through interviews at three points in time for density and centrality. In addition to collaboration on any topic, we examined information exchange and joint planning related to lead. Density scores were consistently higher in 2005 than in 1997 for both the full and tribal networks. Centralization indices for information exchange showed a marked reduction in the hierarchical structure of information exchange over time. Of particular note is that tribal linkages with local, state and federal agencies increased over time, as did inter-tribal linkages to address the lead issue.

Primary prevention of lead poisoning in rural Native American children: behavioral outcomes from a community-based intervention in a former mining region

The current study examined the effectiveness of a community-based lay health advisor intervention, combined with youth engagement, in improving lead poisoning prevention behaviors and associated beliefs in a rural Native American population located in and near a Superfund site containing mining waste. Three sequential (1997, 2000, and 2004) cross-sectional assessments involving in-person interviews with Native American and White caregivers of young children were conducted. Results showed significant improvements over time for Native American, but not for White, for children washing their hands before meals and snacks, and for annual blood lead testing of both Native American and White children. Findings lend support to the value of community-based education for primary prevention of lead poisoning in Native American and rural communities.

Lead loadings in household dust in Delhi, India

Lead in household dust is dangerous to children who ingest lead from playing close to the ground, and having frequent hand-to-mouth contact. Although there have been several investigations of lead levels in India in air, blood and new paint, the literature is sparse on the levels of lead in household dust. This study analyzed 99 samples of dust taken from bare floors and 49 samples of dust taken from windowsills in a cross-section of Delhi, India houses for lead loadings. The arithmetic mean of lead loading for floor samples and windowsill dust samples was found to be 36.24 microg/ft(2) and 129.5 microg/ft(2), respectively. The geometric mean of dust lead loading for floor and interior windowsill samples was found to be 19.7 microg/ft(2) and 75.5 microg/ft(2), respectively. Comparing the results with US geometric mean dust lead levels from a national cross-section of US housing, which in 2000 were 1.1 microg/ft(2) and 9.4 microg/ft(2) on floors and windowsills, respectively as reported by Jacobs et al. (2002) suggests that the lead content of the dust in Delhi homes is much higher than that in the national data in the US and that the levels pose a hazard to children. Practical Implications The present study is first of its kind in this part of the world. In the context of ongoing efforts to eliminate lead from paints worldwide this research will help the scientists and policy makers in assessing the Children's exposure to lead in developing country as well. Since more than one half of the housing units tested had at least one dust lead sample exceeding US health-based standards, health care providers and public health officials need to give attention to possible lead poisoning in Delhi children. Routine blood lead screening of children should follow recommended public health practice for children at risk. Additional larger-scale studies are needed in Delhi and elsewhere to determine how representative these findings are and to attempt to delineate the sources of the high dust lead which are expected to vary depending on the location. Knowledge of the sources is needed to appropriately allocate resources. From other studies performed in India it is likely that lead-based paint is one of the sources and its continued use should be discontinued.

Blood lead levels of children and its trend in China

To evaluate Chinese children's blood lead levels (BLLs) and identify its distribution features, we collected articles on children's BLLs published from Jan, 2004 to Aug, 2007 with sampling time since 2001, by searching Chinese Biomedical Disk (CBMDisk), Chinese Journal Full-test Database (CJFD) and other ways. After a rigorous investigation, 35 articles eligible for inclusion criteria were reviewed. Meanwhile, to reveal the trend of Chinese children's BLLs, the data was compared with the results from our former study carried out in 2004, which reviewed the articles published since 1995 to 2003. The results showed that the mean BLLs of Chinese children from 2001 to 2007 was 80.7 microg/L (45.5-165.3 microg/L), and 23.9% (3.2%-80.7%) of children's BLLs was higher than 100 microg/L. Both BLLs and prevalence of BLLs higher than 100 microg/L were lower than that of 1995 to 2003. Of 24 provinces or cities, only 4 showed higher BLLs and higher prevalence rates of lead poisoning (BLLs > or =100 microg/L) than that of 1995 to 2003. The mean BLLs of children living in industrial areas were higher than those in urban and suburban areas, and suburban higher than urban areas. Boys' BLLs were 79.3 microg/L, significantly higher than girls 76.9 microg/L (P<0.001). The results also showed that children's BLLs increased with their ages, and the decreased BLLs for all age were observed comparing with the results of our former study in 2004. Overall, our study revealed that the BLLs of children in China showed a decreasing trend after gasoline with lead was banned in China in 1st July 2000. Our study also showed that the BLLs of children in China were still higher than that in developed countries, which suggested that children's lead poisoning prevention and controlling would be a long-term mission in China.

Potential health impacts of heavy-metal exposure at the Tar Creek Superfund site, Ottawa County, Oklahoma

The potential impact of exposure to heavy metals and health problems was evaluated at the Tar Creek Superfund site, Ottawa County, Oklahoma, USA. Observed versus expected mortality was calculated for selected conditions in the County and exposed cities. Excess mortality was found for stroke and heart disease when comparing the exposed County to the state but not when comparing the exposed cities to the nonexposed rest of the County. However, sample sizes in the exposed area were small, population emigration has been ongoing, and geographic coding of mortality data was incomplete. In an exposed community, 62.5% of children under the age of 6 years had blood lead levels exceeding 10 microg/dl. The relationships between heavy-metal exposure and children's health and chronic disease in adults are suggestive that a more thorough investigation might be warranted. A number of possible environmental and health studies are suggested, including those focusing on possible central nervous system impacts. Unfortunately, the exposed population is dispersing. One lesson learned at this site is that health studies need to be conducted as soon as possible after an environmental problem is identified to both study the impact of the most acute exposures and to maximize study sample size-including those exposed to higher doses-and minimize the loss of individuals to follow-up.