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Angrand RC, Collins G, Landrigan PJ, Thomas VM. Relation of blood lead levels and lead in gasoline: an updated systematic review. Environ Health 2022; 21:138. [PMID: 36572887 PMCID: PMC9793664 DOI: 10.1186/s12940-022-00936-x] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/13/2022] [Accepted: 10/22/2022] [Indexed: 05/13/2023]
Abstract
BACKGROUND Millions of tons of lead were added to gasoline worldwide beginning in 1922, and leaded gasoline has been a major source of population lead exposure. In 1960s, lead began to be removed from automotive gasoline. Removal was completed in 2021. OBJECTIVES To determine whether removal of lead from automotive gasoline is associated with declines in population mean blood lead levels (BPb). METHODS We examined published studies that reported population blood leaded levels for two or more years, and we calculated average concentrations of lead in gasoline corresponding to the years and locations of the blood lead level measurements. RESULTS Removal of lead from gasoline is associated with declines in BPb in all countries examined. In some countries, BPb continues to fall after lead has been eliminated from gasoline. Following elimination of lead from gasoline, BPb less than 1 μg/dL have been observed in several European and North American countries, and BPb less than 3 μg/dL have been documented in several studies from South America. DISCUSSION There remain many countries for which no multi-year studies of populations BPb have been identified, including all of Central America, high population countries including Pakistan and Indonesia, and major lead producers including Australia and Russia. CONCLUSION Removal of lead from gasoline has been a public health success. Elimination of lead from gasoline has enabled many countries to achieve population mean BPb levels of 1 μg/dL or lower. These actions have saved lives, increased children's intelligence and created great economic benefit in countries worldwide.
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Affiliation(s)
- Ruth C Angrand
- Department of Internal Medicine, Stony Brook University Hospital, Stony Brook, NY, USA
| | - Geoffrey Collins
- Department of Population Health Science and Policy, Mount Sinai School of Medicine, New York, NY, USA
| | - Philip J Landrigan
- Biology Department and Global Observatory on Planetary Health, Boston College, Boston, MA, USA
- Centre Scientifique de Monaco, Monaco, MC, Monaco
| | - Valerie M Thomas
- H. Milton Stewart School of Industrial and Systems Engineering, and School of Public Policy, Georgia Institute of Technology, Atlanta, GA, USA.
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A Call for Biomonitoring Systems in Latin America and the Caribbean: Considerations for Potentially Toxic Metals/Metalloids. Ann Glob Health 2022; 88:80. [PMID: 36185997 PMCID: PMC9479654 DOI: 10.5334/aogh.3637] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/23/2021] [Accepted: 06/10/2022] [Indexed: 11/21/2022] Open
Abstract
The Latin America and the Caribbean (LAC) region makes up 8.4% of the world’s population. Human biomonitoring (HBM) programs, which can shed light on population-level exposure to environmental contaminants such as toxic metals and thus, improve the health of the populations are inexistent in LAC countries. We call for the creation of HBM programs in the region and identify three viable design options for HBM at the individual level, through national surveys, newborn blood collection, and biobanks. We highlight some of challenges to the implementation of HBM programs, including financial and human resources, technical constrains (laboratory), sample, and data logistics. Finally, we provide the case studies of Brazil, Chile, Mexico, and Uruguay, to illustrate a range of responses to toxic metal exposure in non-occupational populations. Although different in many respects, the individual country responses share two commonalities: 1) academic centers drive the research to raise awareness of governmental entities; 2) reference levels are adapted from international norms rather than arising from the studied populations. Well-designed and sufficiently funded biomonitoring systems need to be established in each country of the LAC region. HBM programs are key to promoting human health by informing the public and contributing to policy processes that establish sustainable environmental controls and health prevention programs.
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Mourino N, Ruano-Raviña A, Varela Lema L, Fernández E, López MJ, Santiago-Pérez MI, Rey-Brandariz J, Giraldo-Osorio A, Pérez-Ríos M. Serum cotinine cut-points for secondhand smoke exposure assessment in children under 5 years: A systemic review. PLoS One 2022; 17:e0267319. [PMID: 35511766 PMCID: PMC9070924 DOI: 10.1371/journal.pone.0267319] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/09/2021] [Accepted: 04/06/2022] [Indexed: 11/19/2022] Open
Abstract
Background Serum cotinine has become the most widely used biomarker of secondhand smoke exposure (SHS) over time in all ages. The aim of this study was to review the serum cotinine cut-points used to classify children under 5 years as exposed to SHS. Methods A systematic review performed in the Pubmed (MEDLINE) and EMBASE databases up to April 2021 was conducted using as key words "serum cotinine", “tobacco smoke pollution” (MeSH), "secondhand smoke", "environmental tobacco smoke" and “tobacco smoke exposure”. Papers which assessed SHS exposure among children younger than 5 years old were included. The PRISMA 2020 guidelines were followed. Analysis was pre-registered in PROSPERO (registration number: CRD42021251263). Results 247 articles were identified and 51 fulfilled inclusion criteria. The selected studies were published between 1985–2020. Most of them included adolescents and adults. Only three assessed postnatal exposure exclusively among children under 5 years. None of the selected studies proposed age-specific cut-points for children < 5 years old. Cut-point values to assess SHS exposure ranged from 0.015 to 100 ng/ml. The most commonly used cut-point was 0.05 ng/ml, derived from the assay limit of detection used by the National Health and Nutrition Examination Survey (NHANES). Conclusions No studies have calculated serum cotinine age-specific cut-points to ascertained SHS exposure among children under 5 years old. Children’s age-specific cut-points are warranted for health research and public health purposes aimed at accurately estimating the prevalence of SHS exposure and attributable burden of disease to such exposure, and at reinforcing 100% smoke-free policies worldwide, both in homes, private vehicles and public places.
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Affiliation(s)
- Nerea Mourino
- Department of Preventive Medicine and Public Health, University of Santiago de Compostela, Santiago de Compostela, Spain
| | - Alberto Ruano-Raviña
- Department of Preventive Medicine and Public Health, University of Santiago de Compostela, Santiago de Compostela, Spain
- CIBER Epidemiology and Public Health, CIBERESP, Madrid, Spain
| | - Leonor Varela Lema
- Department of Preventive Medicine and Public Health, University of Santiago de Compostela, Santiago de Compostela, Spain
- * E-mail:
| | - Esteve Fernández
- Tobacco Control Unit, WHO Collaborating Center for Tobacco Control, Institut Català d’Oncologia (ICO), Badalona, Spain
- Tobacco Control Research Group, Institut d’Investigació Biomèdica de Bellvitge (IDIBELL), Barcelona, Spain
- School of Medicine and Health Sciences, Universitat de Barcelona, Barcelona, Spain
- CIBER of Respiratory Diseases (CIBERES), Madrid, Spain
| | - María José López
- CIBER Epidemiology and Public Health, CIBERESP, Madrid, Spain
- Servicio de Evaluación y Métodos de Intervención, Agència de Salut Pública de Barcelona, Barcelona, Spain
- Institut d’Investigació Biomèdica de Sant Pau (IIB Sant Pau), Barcelona, Spain
| | | | - Julia Rey-Brandariz
- Department of Preventive Medicine and Public Health, University of Santiago de Compostela, Santiago de Compostela, Spain
| | - Alexandra Giraldo-Osorio
- Department of Preventive Medicine and Public Health, University of Santiago de Compostela, Santiago de Compostela, Spain
- Departamento de Salud Pública, Grupo de investigación Promoción de la Salud y Prevención de la Enfermedad (GIPSPE), Universidad de Caldas, Manizales, Colombia
- Fundación Carolina, Madrid, Spain
| | - Mónica Pérez-Ríos
- Department of Preventive Medicine and Public Health, University of Santiago de Compostela, Santiago de Compostela, Spain
- CIBER Epidemiology and Public Health, CIBERESP, Madrid, Spain
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Olympio KPK, Gonçalves CG, Salles FJ, Ferreira APSDS, Soares AS, Buzalaf MAR, Cardoso MRA, Bechara EJH. What are the blood lead levels of children living in Latin America and the Caribbean? ENVIRONMENT INTERNATIONAL 2017; 101:46-58. [PMID: 28159393 DOI: 10.1016/j.envint.2016.12.022] [Citation(s) in RCA: 29] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/17/2016] [Revised: 12/21/2016] [Accepted: 12/21/2016] [Indexed: 06/06/2023]
Abstract
INTRODUCTION Information on the prevalence of lead exposure is essential to formulate efficient public health policies. Developed countries have implemented successful public policies for the prevention and control of lead poisoning. In the United States, Canada, Japan and the European Union, for instance, periodically repeated prevalence studies show that blood lead levels (BLLs) in children have decreased overall. Although BLL of Latino children in the U.S. have also dropped in recent years, the geometric mean remains higher than that of white children. Little is known about lead exposure in children in Latin America and the Caribbean (LAC). In this review, we responded to two questions: What is currently known about lead sources and levels in children in LAC? Are there public policies to prevent children's exposure to lead in LAC? METHOD We conducted a literature review covering the period from January 2000 to March 2014 in the PubMed and Lilacs databases to obtain English, Portuguese and Spanish language studies reporting the prevalence of BLLs in children aged 0-18years living in LAC countries. No specific analytical method was selected, and given the scarcity of data, the study was highly inclusive. RESULTS Fifty-six papers were selected from 16 different LAC countries. The children's BLLs found in this review are high (≥10μg/dL) compared to BLLs for the same age group in the U. S. However, most studies reported an association with some type of "lead hot spot", in which children can be exposed to lead levels similar to those of occupational settings. Only Peru and Mexico reported BLLs in children from population-based studies. CONCLUSIONS Most BLLs prevalence studies carried out in LAC were in areas with known emission sources. The percentage of children at risk of lead poisoning in LAC is unknown, and probably underestimated. Thus, there is an urgent need to establish public health policies to quantify and prevent lead poisoning, specifically by prioritizing the identification and control of "hot spots".
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Affiliation(s)
| | - Cláudia Gaudência Gonçalves
- Departamento de Controle Ambiental/Grupo Técnico Permanente de Áreas Contaminadas - Secretaria do Verde e Meio Ambiente de São Paulo, Brazil
| | - Fernanda Junqueira Salles
- Departamento de Saúde Ambiental, Faculdade de Saúde Pública, Universidade de São Paulo, São Paulo, SP, Brazil
| | | | - Agnes Silva Soares
- Sustainable Development and Health Equity, Pan American Health Organization, Washington, DC, United States
| | - Marília Afonso Rabelo Buzalaf
- Departamento de Ciências Biológicas, Faculdade de Odontologia de Bauru, Universidade de São Paulo, Bauru, SP, Brazil
| | - Maria Regina Alves Cardoso
- Departamento de Epidemiologia, Faculdade de Saúde Pública, Universidade de São Paulo, São Paulo, SP, Brazil
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Smolders R, Den Hond E, Koppen G, Govarts E, Willems H, Casteleyn L, Kolossa-Gehring M, Fiddicke U, Castaño A, Koch HM, Angerer J, Esteban M, Sepai O, Exley K, Bloemen L, Horvat M, Knudsen LE, Joas A, Joas R, Biot P, Aerts D, Katsonouri A, Hadjipanayis A, Cerna M, Krskova A, Schwedler G, Seiwert M, Nielsen JKS, Rudnai P, Közepesy S, Evans DS, Ryan MP, Gutleb AC, Fischer ME, Ligocka D, Jakubowski M, Reis MF, Namorado S, Lupsa IR, Gurzau AE, Halzlova K, Fabianova E, Mazej D, Tratnik Snoj J, Gomez S, González S, Berglund M, Larsson K, Lehmann A, Crettaz P, Schoeters G. Interpreting biomarker data from the COPHES/DEMOCOPHES twin projects: Using external exposure data to understand biomarker differences among countries. ENVIRONMENTAL RESEARCH 2015; 141:86-95. [PMID: 25440294 DOI: 10.1016/j.envres.2014.08.016] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/20/2014] [Revised: 08/13/2014] [Accepted: 08/14/2014] [Indexed: 06/04/2023]
Abstract
In 2011 and 2012, the COPHES/DEMOCOPHES twin projects performed the first ever harmonized human biomonitoring survey in 17 European countries. In more than 1800 mother-child pairs, individual lifestyle data were collected and cadmium, cotinine and certain phthalate metabolites were measured in urine. Total mercury was determined in hair samples. While the main goal of the COPHES/DEMOCOPHES twin projects was to develop and test harmonized protocols and procedures, the goal of the current paper is to investigate whether the observed differences in biomarker values among the countries implementing DEMOCOPHES can be interpreted using information from external databases on environmental quality and lifestyle. In general, 13 countries having implemented DEMOCOPHES provided high-quality data from external sources that were relevant for interpretation purposes. However, some data were not available for reporting or were not in line with predefined specifications. Therefore, only part of the external information could be included in the statistical analyses. Nonetheless, there was a highly significant correlation between national levels of fish consumption and mercury in hair, the strength of antismoking legislation was significantly related to urinary cotinine levels, and we were able to show indications that also urinary cadmium levels were associated with environmental quality and food quality. These results again show the potential of biomonitoring data to provide added value for (the evaluation of) evidence-informed policy making.
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Affiliation(s)
- R Smolders
- Flemish Institute of Technological Research (VITO), Environmental Risks and Health Unit, Boeretang 200, 2400 Mol, Belgium.
| | - E Den Hond
- Flemish Institute of Technological Research (VITO), Environmental Risks and Health Unit, Boeretang 200, 2400 Mol, Belgium
| | - G Koppen
- Flemish Institute of Technological Research (VITO), Environmental Risks and Health Unit, Boeretang 200, 2400 Mol, Belgium
| | - E Govarts
- Flemish Institute of Technological Research (VITO), Environmental Risks and Health Unit, Boeretang 200, 2400 Mol, Belgium
| | - H Willems
- Flemish Institute of Technological Research (VITO), Environmental Risks and Health Unit, Boeretang 200, 2400 Mol, Belgium
| | | | | | - U Fiddicke
- Federal Environment Agency (UBA), Germany
| | - A Castaño
- Instituto de Salud Carlos III, Spain
| | - H M Koch
- Institute for Prevention and Occupational Medicine of the German Social Accident Insurance - Institute of the Ruhr-Universität Bochum (IPA), Germany
| | - J Angerer
- Institute for Prevention and Occupational Medicine of the German Social Accident Insurance - Institute of the Ruhr-Universität Bochum (IPA), Germany
| | - M Esteban
- Instituto de Salud Carlos III, Spain
| | - O Sepai
- Public Health England, United Kingdom
| | - K Exley
- Public Health England, United Kingdom
| | - L Bloemen
- Environmental Health Sciences International, The Netherlands
| | - M Horvat
- Jožef Stefan Institute, Slovenia
| | | | | | | | - P Biot
- FPS Health, Food Chain Safety and Environment, Belgium
| | - D Aerts
- FPS Health, Food Chain Safety and Environment, Belgium
| | - A Katsonouri
- State General Laboratory, Ministry of Health, Cyprus
| | | | - M Cerna
- National Institute of Public Health, Czech Republic
| | - A Krskova
- National Institute of Public Health, Czech Republic
| | | | - M Seiwert
- Federal Environment Agency (UBA), Germany
| | | | - P Rudnai
- National Institute of Environmental Health, Hungary
| | - S Közepesy
- National Institute of Environmental Health, Hungary
| | - D S Evans
- Health Service Executive (HSE), Ireland
| | - M P Ryan
- University College Dublin (UCD), Ireland
| | - A C Gutleb
- Centre de Recherche Public - Gabriel Lippmann, Luxembourg
| | | | - D Ligocka
- Nofer Institute of Occupational Medicine, Poland
| | - M Jakubowski
- Nofer Institute of Occupational Medicine, Poland
| | - M F Reis
- Faculdade de Medicina de Lisboa, Portugal
| | - S Namorado
- Faculdade de Medicina de Lisboa, Portugal
| | - I-R Lupsa
- Environmental Health Center, Romania
| | | | - K Halzlova
- Úrad verejného zdravotníctva Slovenskej republiky, Slovakia
| | - E Fabianova
- Úrad verejného zdravotníctva Slovenskej republiky, Slovakia
| | - D Mazej
- Jožef Stefan Institute, Slovenia
| | | | - S Gomez
- Instituto de Salud Carlos III, Spain
| | | | | | | | - A Lehmann
- Federal Office of Public Health (FOPH), Switzerland
| | - P Crettaz
- Federal Office of Public Health (FOPH), Switzerland
| | - G Schoeters
- Flemish Institute of Technological Research (VITO), Environmental Risks and Health Unit, Boeretang 200, 2400 Mol, Belgium; University of Antwerp, Belgium; Southern Denmark University, Odense, Denmark
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Allen Counter S, Buchanan LH, Ortega F. Blood Lead Levels in Andean Infants and Young Children in Ecuador: An International Comparison. JOURNAL OF TOXICOLOGY AND ENVIRONMENTAL HEALTH. PART A 2015; 78:778-787. [PMID: 26090561 DOI: 10.1080/15287394.2015.1031050] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/04/2023]
Abstract
Lead (Pb) exposure in infants and children remains an international health concern. Blood lead (PbB) levels of a cohort of 130 Ecuadorian infants and young children aged 0.33 to 5.8 yr were compared to values reported for similar age groups in Africa, Asia, Europe, Latin America, and the United States. The mean PbB level for the total group of 130 Ecuadorian infants and young children in this study was 29.4 μg/dl (SD: 24.3; range: 3.0-128.2; median: 21.7; geometric mean: 20.7 μg/dl). The mean PbB level for the 0-2 yr age group (infants) was 33.6 μg/dl (SD: 28.9; median: 22.0; range: 3.9-119.7; geometric mean: 23.6 μg/dl), while the average PbB level for the 3-5 yr age group (young children) was 27.9 μg/dl (SD: 22.5: median: 22; range: 3-128.2; geometric mean: 19.8 μg/dl). The difference between the mean PbB levels for the infants and young children was not statistically significant. The average PbB level of 32.6 μg/dl for males was not statistically different from the mean PbB level of 26.3 μg/dl for females. The PbB levels observed in Ecuadorian infants and young children in this investigation were elevated above the World Health Organization (WHO) level of concern of 10 μg/dl and Centers for Disease Control and Prevention (CDC) current reference value of 5 μg/dl. Values were comparable to concentrations found in Pakistan, where occupational use of Pb is prevalent. These findings further indicate that infants and young children exposed to Pb from Pb glazing of ceramics in Andean Ecuadorian villages exhibit greater potential metal-mediated poisoning than children of similar ages in Asia, Europe, other Latin American countries, and the United States.
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Affiliation(s)
- S Allen Counter
- a Department of Neurology , Harvard Medical School/The Biological Laboratories , Cambridge , Massachusetts , USA
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Cañas AI, Cervantes-Amat M, Esteban M, Ruiz-Moraga M, Pérez-Gómez B, Mayor J, Castaño A. Blood lead levels in a representative sample of the Spanish adult population: The BIOAMBIENT.ES project. Int J Hyg Environ Health 2014; 217:452-9. [DOI: 10.1016/j.ijheh.2013.09.001] [Citation(s) in RCA: 43] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/03/2013] [Revised: 08/29/2013] [Accepted: 09/03/2013] [Indexed: 11/26/2022]
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Zahran S, Laidlaw MAS, McElmurry SP, Filippelli GM, Taylor M. Linking source and effect: resuspended soil lead, air lead, and children's blood lead levels in Detroit, Michigan. ENVIRONMENTAL SCIENCE & TECHNOLOGY 2013; 47:2839-45. [PMID: 23428083 DOI: 10.1021/es303854c] [Citation(s) in RCA: 34] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/03/2023]
Abstract
This study evaluates atmospheric concentrations of soil and Pb aerosols, and blood lead levels (BLLs) in 367839 children (ages 0-10) in Detroit, Michigan from 2001 to 2009 to test a hypothesized soil → air dust → child pathway of contemporary Pb risk. Atmospheric soil and Pb show near-identical seasonal properties that match seasonal variation in children's BLLs. Resuspended soil appears to be a significant underlying source of atmospheric Pb. A 1% increase in the amount of resuspended soil results in a 0.39% increase in the concentration of Pb in the atmosphere (95% CI, 0.28 to 0.50%). In turn, atmospheric Pb significantly explains age-dependent variation in child BLLs. Other things held equal, a change of 0.0069 μg/m(3) in atmospheric Pb increases BLL of a child 1 year of age by 10%, while approximately 3 times the concentration of Pb in air (0.023 μg/m(3)) is required to induce the same increase in BLL of a child 7 years of age. Similarly, a 0.0069 μg/m(3) change in air Pb increases the odds of a child <1 year of age having a BLL ≥ 5 μg/dL by a multiplicative factor of 1.32 (95% CI, 1.26 to 1.37). Overall, the resuspension of Pb contaminated soil explains observed seasonal variation in child BLLs.
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Affiliation(s)
- Sammy Zahran
- Department of Economics, Colorado State University, Fort Collins, Colorado 80523, USA
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Monaci F, Fantozzi F, Figueroa R, Parra O, Bargagli R. Baseline element composition of foliose and fruticose lichens along the steep climatic gradient of SW Patagonia (Aisén Region, Chile). ACTA ACUST UNITED AC 2012; 14:2309-16. [DOI: 10.1039/c2em30246b] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
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Cakmak S, Dales RE, Vidal CB. Air pollution and hospitalization for epilepsy in Chile. ENVIRONMENT INTERNATIONAL 2010; 36:501-5. [PMID: 20452673 DOI: 10.1016/j.envint.2010.03.008] [Citation(s) in RCA: 26] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/18/2009] [Revised: 03/23/2010] [Accepted: 03/25/2010] [Indexed: 05/03/2023]
Abstract
OBJECTIVE To determine the association between gaseous and fine particulate air pollution (PM(2.5)) and epilepsy in a general population sample. METHOD A daily time-series analyses tested the association between daily hospitalization for epilepsy in seven Chilean urban centers during the period 2001 and 2005. Results were adjusted for long term trends, day-of-the-week, and average humidex on the day of hospitalization and the day before. RESULTS Pooled city estimates of relative risk (95% CI) of hospitalization for epilepsy associated with changes in pollutant concentrations equivalent to their interquartile range were: 1.098(1.045, 1.155) for carbon monoxide (CO); 1.100 (1.025, 1.181) for ozone O(3); 1.085 (1.03, 1.144) for sulfur dioxide (SO(2)); 1.108 (1.021, 1.204) for nitrogen dioxide (NO(2)); 1.083(1.038, 1.13) for particulate matter <or= 10 microm diameter (PM(10)); and 1.065(1.002, 1.132) for fine particulate matter <or=2.5 microm diameter (PM(2.5)). These results were not significantly influenced by age, sex, or season. INTERPRETATION Air pollution may be a risk factor for hospitalization for epilepsy.
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Affiliation(s)
- Sabit Cakmak
- Health Canada, Ottawa, Canada, Department of Statistics, Ottawa Health Research Institute, Ottawa, ON, Canada.
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Lozoff B, Jimenez E, Wolf AW, Angelilli ML, Zatakia J, Jacobson SW, Kaciroti N, Clark KM, Tao M, Castillo M, Walter T, Pino P. Higher infant blood lead levels with longer duration of breastfeeding. J Pediatr 2009; 155:663-7. [PMID: 19595371 PMCID: PMC3118670 DOI: 10.1016/j.jpeds.2009.04.032] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/17/2008] [Revised: 03/04/2009] [Accepted: 04/13/2009] [Indexed: 10/20/2022]
Abstract
OBJECTIVE To determine whether longer breastfeeding is associated with higher infant lead concentrations. STUDY DESIGN Data were analyzed from 3 studies of developmental effects of iron deficiency in infancy: Costa Rica (1981-1984), Chile (1991-1996), and Detroit (2002-2003). The relation between duration of breastfeeding and lead levels was assessed with Pearson product-moment or partial correlation coefficients. RESULTS More than 93% of the Costa Rica and Chile samples was breastfed (179 and 323 breastfed infants, respectively; mean weaning age, 8-10 months), as was 35.6% of the Detroit sample (53 breastfed infants; mean weaning age, 4.5 months). Lead concentrations averaged 10.8 microg/dL (Costa Rica, 12-23 months), 7.8 microg/dL (Chile, 12 months), and 2.5 microg/dL (Detroit, 9-10 months). Duration of breastfeeding as sole milk source and total breastfeeding correlated with lead concentration in all samples (r values = 0.14-0.57; P values = .06-<.0001). CONCLUSIONS Longer breastfeeding was associated with higher infant lead concentration in 3 countries, in 3 different decades, in settings differing in breastfeeding patterns, environmental lead sources, and infant lead levels. The results suggest that monitoring lead concentrations in breastfed infants be considered.
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Affiliation(s)
- Betsy Lozoff
- Center for Human Growth and Development, Department of Pediatrics and Communicable Diseases, University of Michigan, Ann Arbor, MI, USA
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Clark HF, Hausladen DM, Brabander DJ. Urban gardens: lead exposure, recontamination mechanisms, and implications for remediation design. ENVIRONMENTAL RESEARCH 2008; 107:312-9. [PMID: 18456252 DOI: 10.1016/j.envres.2008.03.003] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/17/2007] [Revised: 03/12/2008] [Accepted: 03/14/2008] [Indexed: 05/14/2023]
Abstract
Environmental lead contamination is prevalent in urban areas where soil represents a significant sink and pathway of exposure. This study characterizes the speciation of lead that is relevant to local recontamination and to human exposure in the backyard gardens of Roxbury and Dorchester, MA, USA. One hundred forty-one backyard gardens were tested by X-ray fluorescence, and 81% of gardens have lead levels above the US EPA action limit of 400 microg/g. Raised gardening beds are the in situ exposure reduction method used in the communities to promote urban gardening. Raised beds were tested for lead and the results showed that the lead concentration increased from an initial range of 150+/-40 microg/g to an average of 336 microg/g over 4 years. The percent distribution of lead in the fine grain soil (<100 microm) and the trace metal signature of the raised beds support the conclusion that the mechanism of recontamination is wind-transported particles. Scanning electron microscopy and sequential extraction were used to characterize the speciation of lead, and the trace metal signature of the fine grain soil in both gardens and raised gardening beds is characteristic of lead-based paint. This study demonstrates that raised beds are a limited exposure reduction method and require maintenance to achieve exposure reduction goals. An exposure model was developed based on a suite of parameters that combine relevant values from the literature with site-specific quantification of exposure pathways. This model suggests that consumption of homegrown produce accounts for only 3% of children's daily exposure of lead while ingestion of fine grained soil (<100 microm) accounts for 82% of the daily exposure. This study indicates that urban lead remediation on a yard-by-yard scale requires constant maintenance and that remediation may need to occur on a neighborhood-wide scale.
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Affiliation(s)
- Heather F Clark
- Department of Geosciences, Wellesley College, Wellesley, MA 02481, USA.
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Smolders R, Koppen G, Schoeters G. Translating biomonitoring data into risk management and policy implementation options for a European Network on Human Biomonitoring. Environ Health 2008; 7 Suppl 1:S2. [PMID: 18541068 PMCID: PMC2423451 DOI: 10.1186/1476-069x-7-s1-s2] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/26/2023]
Abstract
BACKGROUND The "European Environment & Health Action Plan 2004-2010" originates from the concern of the European Commission on the well-being of individuals and the general population. Through this plan, the Commission has set the objectives to improve the information chain for a better understanding of the link between sources of pollution and health effects, to better identify existing knowledge gaps, and improve policy making and communication strategies. Human biomonitoring (HBM) has been included as one of the tools to achieve these objectives. As HBM directly measures the amount of a chemical substance in a person's body, taking into account often poorly understood processes such as bioaccumulation, excretion, metabolism and the integrative uptake variability through different exposure pathways, HBM data are much more relevant for risk assessment than extrapolations from chemical concentrations in soil, air, and water alone. However, HBM primarily is a stepping stone between environmental and health data, and the final aim should be an integrated and holistic systematic risk assessment paradigm where HBM serves as a pivotal point between environment and health, on the one hand leaning on environmental data to provide detailed information on the sources and pathways of pollutants that enter the human body, and on the other hand clarifying new and existing hypotheses on the relationship between environmental pollutants and the prevalence of diseases. With the large amount of data that is being gathered in the different national survey projects, and which is expected to become available in Europe in the near future through the expected European Pilot Project on HBM, a framework to optimize data interpretation from such survey projects may greatly enhance the usefulness of HBM data for risk managers and policy makers. RESULTS This paper outlines an hierarchic approach, based on the stepwise formulation of 4 subsequent steps, that will eventually lead to the formulation of a variety of policy relevant risk reduction options. CONCLUSION Although the usefulness of this approach still needs to be tested, and potential fine-tuning of the procedure may be necessary, approaching the policy implications of HBM in an objective framework will prove to be essential.
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Affiliation(s)
- R Smolders
- VITO, Environmental Toxicology Department, Boeretang 200, 2500 Mol, Belgium
| | - G Koppen
- VITO, Environmental Toxicology Department, Boeretang 200, 2500 Mol, Belgium
| | - G Schoeters
- VITO, Environmental Toxicology Department, Boeretang 200, 2500 Mol, Belgium
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Ibrahim D, Froberg B, Wolf A, Rusyniak DE. Heavy Metal Poisoning: Clinical Presentations and Pathophysiology. Clin Lab Med 2006; 26:67-97, viii. [PMID: 16567226 DOI: 10.1016/j.cll.2006.02.003] [Citation(s) in RCA: 93] [Impact Index Per Article: 5.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
Abstract
Humans have had a long and tumultuous relationship with heavy metals. Their ubiquitous nature and our reliance on them for manufacturing have resulted at times in exposures sufficient to cause systemic toxicity. Their easy acquisition and potent toxicity have also made them popular choices for criminal poisonings. This article examines the clinical manifestation and pathophysiology of poisoning from lead, mercury, arsenic, and thallium.
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Affiliation(s)
- Danyal Ibrahim
- Department of Emergency Medicine, Division of Medical Toxicology, Indiana University School of Medicine, 1050 Wishard Boulevard, Room 2200, Indianapolis, IN 46202, USA
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