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The objective was to determine, from analysis of the naturally occurring stable isotopes of lead, the relative contribution of food, handdust, housedust, soil and air lead to the absorbed (urinary) lead and the blood lead of children living in a former smelter city. A longitudinal 12 month study was conducted of 21 children, 2 - 3 years of age, living in central Omaha, balanced for race, gender and socioeconomic status. Field clean samples were collected monthly of 24 hour duplicate diet, handwipe and urine, with quarterly blood lead, annual environmental lead, weekly air for total lead and 206Pb, 207Pb and 208Pb by thermal ionization/mass spectrometry with a 205Pb spike in a Class II laboratory. Despite residence in a smelter city each child had a unique isotopic ratio of handwipe, blood and urine lead, the latter being identical. There was no correlation of handwipe isotopic ratio with proximity to a lead emission source or to the decade of the housing stock. The isotopic ratio of the annual mean handwipe lead predicted 43% of the variance of the annual mean blood and urine lead ratio (r2 = .43; p = .001). Handwipe lead ratios correlated (p < or = .05) with those of the windowsills and air ducts. The mean isotopic ratios of blood and urine lead were lower than those of handwipe and food, consistent with a contribution by endogenous bone lead. Clean catch urine provides a noninvasive index of blood lead isotopic ratio in children, as in adults.

Nurses practicing in long-term care facilities were surveyed on the adequacy of their nutrition education, nutrition knowledge, and general attitudes about the diet of elderly residents. While 78% of the 95 responding nurses reported taking a required nutrition course during their training, only 61% indicated the quantity of their nutrition education was sufficient and 66% indicated the quality of their education was sufficient. The mean nutrition knowledge score was 60% correct with 51 subjects scoring at this level or less. Since the nurse is such an important caregiver for the institutionalized elderly it is recommended that more emphasis be placed upon nutrition of the elderly in the nurses' education as well as the provision of more inservice training for practicing nurses utilizing the registered dietitian.

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