Probabilistic estimates of prenatal lead exposure at 195 toxic hotspots in low- and middle-income countries.
Environ Res
; 183: 109251, 2020 04.
Article
em En
| MEDLINE
| ID: mdl-32311907
ABSTRACT
BACKGROUND:
Prior estimates of pediatric lead-related disease burden in low- and middle-income countries (LMICs) used population estimates of maternal blood lead levels (BLLs). This approach may underestimate fetal BLLs by not considering potentially high prenatal lead exposure from toxic hotspots.OBJECTIVES:
We developed a probabilistic approach to using the Adult Lead Methodology (ALM) to estimate fetal BLLs from prenatal exposure to lead-contaminated soil at hotspots in the Toxic Site Identification Program (TSIP).METHODS:
We created distributions for each ALM parameter using published literature and extracted soil lead measurements from the TSIP database. Each iteration of the probabilistic ALM randomly selected values from the input distributions to generate a site-specific fetal BLL estimate. For each site, we ran 5000 model iterations, producing a site-specific fetal BLL distribution.RESULTS:
195 TSIP sites, in 33 LMICs, met our study inclusion criteria; an estimated 820,000 women of childbearing age are at risk for lead exposure at these sites. The predicted geometric means (GM) for site-specific fetal BLLs ranged from 3.3 µg/dL to 534 µg/dL, and 98% of sites had estimated GM fetal BLLs >5 µg/dL, the current reference level of the United States Centers for Disease Control and Prevention (CDC), while 11 sites had estimated GM fetal BLLs above the CDC chelation threshold of 45 µg/dL.DISCUSSION:
The TSIP soil lead data and this probabilistic approach to the ALM show that pregnant women living near TSIP sites may have BLLs that put their fetus at risk for neurologic damage and other sequelae, underscoring the need for interventions to reduce lead exposure at toxic hotspots.Palavras-chave
Texto completo:
1
Coleções:
01-internacional
Base de dados:
MEDLINE
Assunto principal:
Modelos Estatísticos
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Exposição Materna
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Exposição Ambiental
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Chumbo
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Intoxicação por Chumbo
Tipo de estudo:
Prognostic_studies
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Risk_factors_studies
Limite:
Adult
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Child
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Female
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Humans
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Pregnancy
Idioma:
En
Revista:
Environ Res
Ano de publicação:
2020
Tipo de documento:
Article