Epidemiologic Characteristics of Children with Blood Lead Levels ≥45 μg/dL

Keller, Brett; Faciano, Andrew; Tsega, Adey; Ehrlich, Jacqueline

doi:10.1016/j.jpeds.2016.09.017

Cited by 29 publications

(16 citation statements)

References 14 publications

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“…In the present day, Black children continue to have the highest average BLLs in the US compared to either non-Hispanic White or Hispanic children [38]. Black race remains a strong independent predictor of more blood Pb throughout childhood [39][40][41][42][43][44][45][46]. Geospatial analyses have demonstrated that increasing concentrations of exposure to Pb from the air, soil, water, or industrial releases are associated with early childhood BLLs [47][48][49][50][51][52][53][54], while an increasing percent Black population is a strong predictor for higher blood Pb among young children in US cities, states, and nationwide across the US [32][33][34]39,40,53,[55][56][57][58][59][60][61][62][63].…”

Section: Introductionmentioning

confidence: 99%

Disparity in Risk Factor Severity for Early Childhood Blood Lead among Predominantly African-American Black Children: The 1999 to 2010 US NHANES

Yeter¹,

Banks

Aschner

2020

IJERPH

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There is no safe detectable level of lead (Pb) in the blood of young children. In the United States, predominantly African-American Black children are exposed to more Pb and present with the highest mean blood lead levels (BLLs). However, racial disparity has not been fully examined within risk factors for early childhood Pb exposure. Therefore, we conducted secondary analysis of blood Pb determinations for 2841 US children at ages 1-5 years with citizenship examined by the cross-sectional 1999 to 2010 National Health and Nutrition Examination Survey (NHANES). The primary measures were racial disparities for continuous BLLs or an elevated BLL (EBLL) ≥5 µg/dL in selected risk factors between non-Hispanic Black children (n = 608) and both non-Hispanic White (n = 1208) or Hispanic (n = 1025) children. Selected risk factors included indoor household smoking, low income or poverty, older housing built before 1978 or 1950, low primary guardian education <12th grade/general education diploma (GED), or younger age between 1 and 3 years. Data were analyzed using a regression model corrected for risk factors and other confounding variables. Overall, Black children had an adjusted +0.83 µg/dL blood Pb (95% CI 0.65 to 1.00, p < 0.001) and a 2.8 times higher odds of having an EBLL ≥5 µg/dL (95% CI 1.9 to 3.9, p < 0.001). When stratified by risk factor group, Black children had an adjusted 0.73 to 1.41 µg/dL more blood Pb (p < 0.001 respectively) and a 1.8 to 5.6 times higher odds of having an EBLL ≥5 µg/dL (p ≤ 0.05 respectively) for every selected risk factor that was tested. For Black children nationwide, one in four residing in pre-1950 housing and one in six living in poverty presented with an EBLL ≥5 µg/dL. In conclusion, significant nationwide racial disparity in blood Pb outcomes persist for predominantly African-American Black children even after correcting for risk factors and other variables. This racial disparity further persists within housing, socio-economic, and age-related risk factors of blood Pb outcomes that are much more severe for Black children.

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Section: Introductionmentioning

confidence: 99%

Disparity in Risk Factor Severity for Early Childhood Blood Lead among Predominantly African-American Black Children: The 1999 to 2010 US NHANES

Yeter¹,

Banks

Aschner

2020

IJERPH

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“…Mitra et al reported that, in Bangladesh, among 345 children (6 months–12 years old), 39% were detected with BLLs ≥ 10 µg/dL [ 6 ]. Finally, Pakistan is also characterized as a country of elevated risk for lead exposure [ 34 , 35 ].…”

Section: Discussionmentioning

confidence: 99%

Lead Exposure and Associated Risk Factors among New Migrant Children Arriving in Greece

Tanaka

Petsios

Dikalioti

et al. 2018

IJERPH

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Background: This study aims to assess lead exposure and associated risk factors among newly arrived migrant (M) (immigrant and refugees) children in Greece and a matched control of native (N) children. Methods: A prospective, cross-sectional study was performed in an outpatient clinic of a tertiary children’s hospital. Results: From 2010 to 2014, 598 children (M/N: 349/249) with a mean age of 6.96 years old (range 1–14, SD 3.76) were enrolled. Blood lead levels (BLLs) ranged from 0.7 to 21 μg/dL in migrant and from 0.4 to 10 μg/dL in native Greek children. Elevated BLLs ≥ 5 μg/dL were detected in 27.7% of migrants and 1.2% of natives (p < 0.001). A significant association was found between EBLLs and childrens’ age (≤5 years) (OR: 1.8, p-value 0.02) and EBLLs with Asian origin (OR: 3.63, p-value 0.023). Conclusion: New migrant children presented with increased BLLs when compared to their age- and sex-matched controls. Younger age and Asian origin were significant risk factors associated with elevated BLLs among children. Early screening, secondary prevention, and regular follow-up could prove useful in this vulnerable population.

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“…While typical environmental sources predominate as the cause of lead poisoning, cultural factors are also important. Besides lead-containing paint, various sources of lead were identified for children with BLL ≥ 45 μg/dL in New York City: imported spices, cosmetics, as well as traditional folk medicines [ 8 ]. A detailed history about the usage of traditional folk medicine is essential.…”

Section: Discussionmentioning

confidence: 99%

“…Extremely elevated BLLs (BLLs ≥70 μg/dL) now occur rarely in children [ 8 ]. We report three cases of severe childhood lead poisoning from folk medications specifically prescribed for treating rhinitis.…”

Section: Introductionmentioning

confidence: 99%

Folk prescription for treating rhinitis as a rare cause of childhood lead poisoning: a case series

2018

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BackgroundFolk prescriptions continue to be important sources of childhood lead poisoning. Nasal spray folk prescriptions for treating rhinitis has only been reported once previously as a cause of lead poisoning.Case presentationWe identified three pediatric cases of severe lead poisoning caused by nasal spray folk medicines prescribed for treating rhinitis. The three patients had similar clinical manifestations including: severe abdominal pain, headache, pale appearance and fatigue. Liver function tests were abnormal. Blood lead levels (BLLs) of the three patients were 91 μg/dL, 91 μg/dL, and 105 μg/dL, respectively. After chelation BLLs decreased. The lead content of the three folk remedies as measured by inductively coupled plasma mass spectrometry (ICP-MS) were 14.8, 22.3, and 33.4%. All the symptoms resolved during a course of chelation therapy. There were no severe side effects of treatment.ConclusionsNasal spray folk prescriptions for treating rhinitis may contain extremely high bio-accessible lead content and are potential sources of lead poisoning. Clinicians should be alert to this possibility especially in those children presenting with multisystem symptoms.

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Epidemiologic Characteristics of Children with Blood Lead Levels ≥45 μg/dL

Cited by 29 publications

References 14 publications

Disparity in Risk Factor Severity for Early Childhood Blood Lead among Predominantly African-American Black Children: The 1999 to 2010 US NHANES

Disparity in Risk Factor Severity for Early Childhood Blood Lead among Predominantly African-American Black Children: The 1999 to 2010 US NHANES

Lead Exposure and Associated Risk Factors among New Migrant Children Arriving in Greece

Folk prescription for treating rhinitis as a rare cause of childhood lead poisoning: a case series

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