Intoxicação por chumbo e saúde infantil: ações intersetoriais para o enfrentamento da questão

A Systematic Review of Children's Environmental Health in Brazil

In the region of the Americas, approximately 100,000 children under the age of 5 years die each year due to environmental hazards. Brazil, due to its large size and wide range of environmental challenges, presents numerous hazards to children's health. The aim of this study was to systematically review the scientific literature that describes children's exposures to environmental pollutants in Brazil and their effects on Brazilian children's health. A systematic review of the scientific literature was performed without language restrictions and time of publication (years). The literature search was conducted in the following key resources: PubMed (MEDLINE), Scopus and Web of Science with the MeSH Terms: Environmental exposure AND Brazil (filters: Human, Child [birth to 18 years] and Affiliation Author). The Virtual Health Library was also employed to access the databases Scielo and Lilacs. The search strategy was [DeCS Terms]: Child OR adolescent AND Environmental exposure AND Brazil. Health effects in children associated with exposure to environmental pollutants in Brazil were reported in 74 studies, during the period between 1995 and 2015. The most frequently cited effect was hospital admission for respiratory causes including wheezing, asthma, and pneumonia among children living in areas with high concentrations of air pollutants. A broad spectrum of other health effects possibly linked to pollutants also was found such as prematurity, low birth weight, congenital abnormality (cryptorchidism, hypospadia, micropenis), poor performance in tests of psychomotor and mental development, and behavioral problems. Exposure to pesticides in utero and postnatally was associated with a high risk for leukemia in children <2 years old. These results show that there is a need in Brazil for stricter monitoring of pollutant emissions and for health surveillance programs especially among vulnerable populations such as pregnant women and young children.

A study of the routes of contamination by lead and cadmium in Santo Amaro, Brazil

The problem of contamination by cadmium and lead in Santo Amaro, Brazil, has been studied since 1970 and the severity of this contamination case has been demonstrated by many authors. This study evaluates the persistence of the superficial soil contamination around the metallurgical plant and attempts to correlate the lead and cadmium concentrations to the past atmospheric emissions from the lead plant and with the presence of lead debris under urban road surface and in the backyards of homes. Past emissions still play an important role in soil contamination. In areas without debris, about 30% of the soil samples had lead concentrations above the agricultural use limit of 180 parts per million (ppm) (according to CONAMA 420, 2009), 20% of the samples had concentrations above 300 ppm (maximum for residential use) and 9.6% of the samples had concentrations above 900 ppm (maximum for industrial use). These concentrations are higher cldse to the chimney of the metallurgical plant. An average lead concentration of 1316 ppm was found in the backyard samples. About 80% of the houses had lead concentrations above 300 ppm and about 50% of the samples had values above 900 ppm, indicating the importance of the lead debris in the contamination scenario. Although a matter of concern, the cadmium concentrations seem to be less problematic than lead at the present time, probably due to the higher mobility of cadmium. The cadmium concentrations in the atmospheric dispersion and backyard samples showed similar trends, while the influence of the lead debris on the soil contamination is less evident.

Correlation analysis of the long latency auditory evoked potential N2 and cognitive P3 with the level of lead poisoning in children

INTRODUCTION

 The effects of lead on children's health have been widely studied.

AIM

 To analyze the correlation between the long latency auditory evoked potential N2 and cognitive P3 with the level of lead poisoning in Brazilian children.

METHODS

 This retrospective study evaluated 20 children ranging in age from 7 to 14 years at the time of audiological and electrophysiological evaluations. We performed periodic surveys of the lead concentration in the blood and basic audiological evaluations. Furthermore, we studied the auditory evoked potential long latency N2 and cognitive P3 by analyzing the absolute latency of the N2 and P3 potentials and the P3 amplitude recorded at Cz. At the time of audiological and electrophysiological evaluations, the average concentration of lead in the blood was less than 10 ug/dL.

RESULTS

 In conventional audiologic evaluations, all children had hearing thresholds below 20 dBHL for the frequencies tested and normal tympanometry findings; the auditory evoked potential long latency N2 and cognitive P3 were present in 95% of children. No significant correlations were found between the blood lead concentration and latency (p = 0.821) or amplitude (p = 0.411) of the P3 potential. However, the latency of the N2 potential increased with the concentration of lead in the blood, with a significant correlation (p = 0.030).

CONCLUSION

 Among Brazilian children with low lead exposure, a significant correlation was found between blood lead levels and the average latency of the auditory evoked potential long latency N2; however, a significant correlation was not observed for the amplitude and latency of the cognitive potential P3.

Determinants of lead exposure in children on the outskirts of Salvador, Brazil

Lead (Pb) is a toxic heavy metal that is widely distributed throughout the environment. Pb is an important neurotoxic metal and children are more susceptible to its effect due to their higher absorption rate and greater susceptibility of the developing nervous system. In this work, we evaluated the lead exposure levels in children living near a metallurgical plant and identified risk factors associated with its internal dose. All children, aged 1-10 years and 11 months, living near a metallurgical plant in the great Salvador area, Brazil were evaluated in this cross-sectional study and compared with children from a non exposed area. Occipital hair and blood were used to assess exposure. Air lead levels in the respirable fraction (PM(2.5)) were also measured in both areas. Blood lead levels (BLL), hair lead levels (PbH) and air lead were determined by graphite furnace atomic absorption spectrometry. Spearman correlations analysis was used to evaluate correlations between BLL, PbH and descriptors. Significant risk factors were modeled using multivariate linear regression analysis. Air lead levels were approximately ten-folds lower than EPA reference concentration (0.15 μg/m(3)). Median BLL and PbH were 1.65 ± 1.45 μg/dL and 1.26 ± 3.70 μg/g, respectively, in exposed children. In the referents, medians were BLL 1.20 ± 1.20 μg/dL; PbH 2.09 ± 2.06 μg/g. No significant difference was observed in biomarkers levels between boys and girls. It was observed a positive weak correlation (Spearman rho = 0.197, p = 0.033) between BLL and PbH. Our data show that children's lead body burden measured as BLL or PbH are low when compared with the recommended reference values. Despite that, we were able to identify four risk factors associated with increased biological lead levels: age, living near industrial site, environmental tobacco smoking and, above all, domestic waste burning. In order to prevent such avoidable exposure, environmental education and proper waste management should be implemented, especially in developing countries.