Cross-sectional study on the effects of socioeconomic factors on lead exposure in children by gender in Serpong, Indonesia

Antibody Prevalence and Risk Factors Associated with Rickettsia spp. in a Pediatric Cohort: SFGR Remains Underdiagnosed and Underreported in El Salvador

Spotted fever group rickettsioses (SFGR) are caused by a group of tick-borne pathogens that are increasing in incidence globally. These diseases are typically underreported and undiagnosed in low- and middle-income countries, and thus, have been classified as neglected bacterial pathogens. Countries with high poverty, low human development index score, and limited health infrastructure—like El Salvador in Central America—lack necessary surveillance for SFGR and other tick-borne pathogens. This paucity of baseline SFGR infection prevalence leaves vulnerable populations at risk of misdiagnosis. Further, tick-borne disease burdens in El Salvador are severely limited. To lay the foundation for tick-borne disease epidemiology in El Salvador, our team conducted two different enzyme-linked immunosorbent assays (ELISA) on banked human sera samples from a cohort of approximately 1000 pediatric participants from a high-risk vector-borne disease population. Eleven percent of all tested banked pediatric sera were positive for at least one ELISA assay at the time of enrollment: 10.7% were positive for only IgM antibodies (acute SFGR infection), and 2.5% were positive for IgG antibodies (a past SFGR infection). Older, male, children enrolled during the wet season, with a household history of infectious disease and higher maternal education level had higher odds of SFGR antibodies. Additionally, children from households with domestic poultry birds and previous knowledge of other vector-borne diseases had significantly reduced odds of SFGR antibodies. The large percentage of acute SFGR infections indicates that it continues to remain an underreported and undiagnosed issue in El Salvador and the Central American region. Much is still unknown regarding the complexity of the tick, animal host, and human host ecology transmission cycle of SFGR in El Salvador.

Impact of Lead Exposure on Thyroid Status and IQ Performance among School-age Children Living Nearby a Lead-Zinc Mine in China

BACKGROUND

Lead exposure is one of the most concerning public health problems worldwide, particularly among children. Yet the impact of chronic lead exposure on the thyroid status and related intelligence quotient performance among school-age children remained elusive.

OBJECTIVE

The aim of this study was to evaluate the influence of lead exposure on the thyroid hormones, amino acid neurotransmitters balances, and intelligence quotient (IQ) among school-age children living nearby a lead-zinc mining site. Other factors such as rice lead levels, mothers' smoking behavior, and diet intake were also investigated.

METHODS

A total of 255 children aged 7-12 years old were recruited in this study. Blood lead level (BLL), thyroid hormones including free triiodothyronine (FT3), free thyroxine (FT4) and thyroid stimulating hormone (TSH), and amino acid neurotransmitters such as glutamate (Glu), glutamine (Gln), and γ-aminobutyric acid (GABA) were measured using graphite furnace atomic absorption spectroscopy (GFAAS), chemiluminescence immunoassay, high performance liquid chromatography (HPLC). Raven's standard progressive matrices (SPM) and the questionnaire were used to determine IQ and collect related influence factors.

RESULTS

The average BLL of children was 84.8 μg/L. The occurrence of lead intoxication (defined as the BLL ≥ 100 μg/L) was 31.8%. Serum TSH levels and IQ of lead-intoxicated children were significantly lower than those without lead toxicity. The GABA level of girls with the lead intoxication was higher than those with no lead-exposed group. Correlation analyses revealed that BLL were inversely associated with the serum TSH levels (R= -0.186, p < 0.05), but positively related with IQ grades (R = 0.147, p < 0.05). Moreover, BLL and Glu were inversely correlated with IQ. In addition, this study revealed four factors that may contribute to the incidence of lead intoxication among children, including the frequency of mother smoking (OR = 3.587, p < 0.05) and drinking un-boiled stagnant tap water (OR = 3.716, p < 0.05); eating fresh fruits and vegetables (OR = 0.323, p < 0.05) and soy products regularly (OR = 0.181, p < 0.05) may protect against lead intoxication.

CONCLUSION

Lead exposure affects the serum TSH, GABA levels and IQ of school-aged children. Developing good living habits, improving environment, increasing the intake of high-quality protein and fresh vegetable and fruit may improve the condition of lead intoxication.

A review of human biomonitoring in selected Southeast Asian countries

Rapid development and industrialization in Southeast (SE) Asia has led to environmental pollution, potentially exposing the general population to environmental contaminants. Human biomonitoring (HBM), measurement of chemical and/or their metabolites in human tissues and fluids, is an important tool for assessing cumulative exposure to complex mixtures of chemicals and for monitoring chemical exposures in the general population. While there are national HBM programs in several developed countries, there are no such national programs in most of the SE Asian countries. However, in recent years there has been progress in the field of HBM in many of the SE Asian countries. In this review, we present recent HBM studies in five selected SE Asian countries: Bangladesh, Indonesia, Malaysia, Myanmar and Thailand. While there is extensive HBM research in several SE Asian countries, such as Thailand, in other countries HBM studies are limited and focus on traditional environmental pollutants (such as lead, arsenic and mercury). Further development of this field in SE Asia would be benefited by establishment of laboratory capacity, improving quality control and assurance, collaboration with international experts and consortiums, and sharing of protocols and training both for pre-analytical and analytical phases. This review highlights the impressive progress in HBM research in selected SE Asian countries and provides recommendations for development of this field.

Relationship of lead and essential elements in whole blood from school-age children in Nanning, China

OBJECTIVES

The aim of this study was to investigate blood lead level and its relationship to essential elements (zinc, copper, iron, calcium and magnesium) in school-age children from Nanning, China.

METHODS

A total of 2457 children aged from 6 to 14 years were enrolled in Nanning, China. The levels of lead (Pb), zinc (Zn), copper (Cu), iron (Fe), calcium (Ca) and magnesium (Mg) were determined by an atomic absorption spectrometer.

RESULTS

The mean blood lead level (BLL) was 57.21±35.00μg/L. 188 (7.65%) asymptomatic children had toxic lead level higher than 100μg/L. The school-age boys had similar lead level among different age groups, while the elder girls had less BLL. The blood Zn and Fe were found to be increased in the boys with elevated BLL, but similar trends were not observed in the girls. Positive correlations between Pb and Fe or Mg (r=0.112, 0.062, respectively, p<0.01) and a negative correlation between Pb and Ca (r=-0.047, p<0.05) were further established in the studied children.

CONCLUSIONS

Lead exposure in school-age children was still prevalent in Nanning. The boys and girls differed in blood levels of lead and other metallic elements. Lead exposure may induce metabolic disorder of other metallic elements in body.

Blood lead concentrations in Jamaican children with and without autism spectrum disorder

Autism Spectrum Disorder (ASD) is a neurodevelopmental disorder manifesting by early childhood. Lead is a toxic metal shown to cause neurodevelopmental disorders in children. Several studies have investigated the possible association between exposure to lead and ASD, but their findings are conflicting. Using data from 100 ASD cases (2–8 years of age) and their age- and sex-matched typically developing controls, we investigated the association between blood lead concentrations (BLC) and ASD in Jamaican children. We administered a questionnaire to assess demographic and socioeconomic information as well as exposure to potential lead sources. We used General Linear Models (GLM) to assess the association of BLC with ASD status as well as with sources of exposure to lead. In univariable GLM, we found a significant difference between geometric mean blood lead concentrations of ASD cases and controls (2.25 μg/dL cases vs. 2.73 μg/dL controls, p < 0.05). However, after controlling for potential confounders, there were no significant differences between adjusted geometric mean blood lead concentrations of ASD cases and controls (2.55 μg/dL vs. 2.72 μg/dL, p = 0.64). Our results do not support an association between BLC and ASD in Jamaican children. We have identified significant confounders when assessing an association between ASD and BLC.