Environmental determinants of different blood lead levels in children: A quantile analysis from a nationwide survey

Abstract

Blood lead levels (BLLs) have substantially decreased in recent decades in children in France. However, further reducing exposure is a public health goal because there is no clear toxicological threshold. The identification of the environmental determinants of BLLs as well as risk factors associated with high BLLs is important to update prevention strategies. We aimed to estimate the contribution of environmental sources of lead to different BLLs in children in France. We enrolled 484 children aged from 6months to 6years, in a nationwide cross-sectional survey in 2008-2009. We measured lead concentrations in blood and environmental samples (water, soils, household settled dusts, paints, cosmetics and traditional cookware). We performed two models: a multivariate generalized additive model on the geometric mean (GM), and a quantile regression model on the 10th, 25th, 50th, 75th and 90th quantile of BLLs. The GM of BLLs was 13.8μg/L (=1.38μg/dL) (95% confidence intervals (CI): 12.7-14.9) and the 90th quantile was 25.7μg/L (CI: 24.2-29.5). Household and common area dust, tap water, interior paint, ceramic cookware, traditional cosmetics, playground soil and dust, and environmental tobacco smoke were associated with the GM of BLLs. Household dust and tap water made the largest contributions to both the GM and the 90th quantile of BLLs. The concentration of lead in dust was positively correlated with all quantiles of BLLs even at low concentrations. Lead concentrations in tap water above 5μg/L were also positively correlated with the GM, 75th and 90th quantiles of BLLs in children drinking tap water. Preventative actions must target household settled dust and tap water to reduce the BLLs of children in France. The use of traditional cosmetics should be avoided whereas ceramic cookware should be limited to decorative purposes.

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

“…With the shrunk usage of leadcontaining gasoline (and other industrial products) and the surged awareness of lead exposure and toxicities in the community [11], lead exposure to children has been reduced significantly in China. The current BLL of children in Nanning, China was comparable to that of peer children in other developing countries such as Saudi Arabia (49.4 ± 33.80 g/L) [1], but yet higher than those in the welldeveloped countries like France and United States (13.8 g/L for France and 12 g/L for US) [3,19]. The difference of lead exposure between Nanning, China and developed countries may well reflect the negative impact of booming industrial development in China and warrant further improvements in industrial transformation and environmental protection.…”

“…Environmental lead exposure, affecting both adults and children, is increasingly becoming a healthy concern [2,3]. Pb enters into the body mainly through the respiratory system and the digestive tract, and causes a series of documented adverse effects particularly in the nervous systems [4][5][6], such as developmental delays, insomnia, irritability, tremors, hearing loss, deficits in behavioral functioning, impaired cognitive and learning abilities, and social withdrawal [7][8][9].…”

Exposure of children to metals via tap water ingestion at home: Contamination and exposure data from a nationwide survey in France

“…Indeed, 78,500 (CI 95: 17,200-140,000) children were consuming water containing over 10 μg/L of lead. Lead in water has been confirmed as contributing to blood lead levels in children, even at low concentrations (Levallois et al, 2013;Oulhote et al, 2013;Etchevers et al, 2015). Although French data is not published for more precise age groups, we suppose water consumption may vary a lot within the 6-months to 6-years age span.…”

“…Although French data is not published for more precise age groups, we suppose water consumption may vary a lot within the 6-months to 6-years age span. Although not addressed here, the use of tap water for cooking may also contribute to exposure (Etchevers et al, 2015) and children may also be exposed outside the home -at school or kindergarten for instance. Health effects may occur even at the new drinking-water standard for lead: the EFSA Panel on Contaminants in the Food Chain (CONTAM) (2010) concluded that with consumption of drinkingwater containing lead at a concentration of 2.1 μg/L, the dietary exposure of sensitive subgroups (infants and foetuses) to lead results in a margin-of-exposure value of b 1 -indicating that risks to young children regarding neurodevelopmental effects cannot be excluded.…”

Lead Exposure and Environmental Health

“…However, the amount of Pb in the environment is still high, and both occupational and environmental exposures to Pb remain a serious problem in many developing and industrializing countries, as well as in some developed countries (Zheng et al, 2013a,b;Min and Min, 2015;Monnot et al, 2015). In most developed countries, however, introduction of Pb into the human environment has decreased in recent years, largely due to public health campaigns and a decline in its commercial usage, particularly in petrol (Tong et al, 2000;Etchevers et al, 2015). Acute lead poisoning has become rare in such countries, but chronic exposure to low levels of the metal is still a public health issue, especially among some minorities and socioeconomically disadvantaged groups.…”