Burden of cardiovascular disease attributable to lead exposure in China: a comprehensive analysis of data from 1990 to 2019.

OBJECTIVE: To analyze the burden of cardiovascular disease (CVD) caused by lead pollution exposure in China from 1990 to 2019. METHODS: Utilizing data from the Global Burden of Disease 2019 (GBD 2019), this research examines the changes in the number of CVD deaths, deaths rates, disability-adjusted life years (DALYs) and DALY rates, as well as their age-normalization rates, due to lead pollution exposure in China from 1990 to 2019. Joinpoint was used to estimate average annual percentage of change (AAPC) and reflect the time change trend of the burden of CVD caused by lead pollution exposure in China, the world and different socio-demographic index (SDI) regions. RESULTS: The age-standardized mortality rate and age-standardized DALY rate showed a decreasing trend in China from 1990 to 2019, with an average annual decrease of -1.17% (95% confidence interval (CI): -3.49~-3.14, P<0.05) and -1.90% (95% CI: -2.04~-1.75, P<0.05), respectively. In 2019, age-standardized CVD mortality and DALY rates attributed to lead exposure in China were higher than those in the global, high-SDI, medium-high SDI and moderate SDI regions. In 2019, 5.94% of CVD deaths in China were caused by lead exposure. Compared to 1990, the number of attributable deaths and mortality increased by 0.73% and 0.44%, respectively, and the attributable DALY and DALY rates increased by 30.04% and 8.22%, respectively. From 1990 to 2019, the mortality rate and DALY rate of males were higher than those of females, and the mortality rate and DALY rate increased with the increase of age, reaching the highest in the age group of 70 years and above. CONCLUSION: In 2019, the standardized death rate of CVD and the standardized DALY rate attributed to lead pollution exposure in China were higher than those in the global regions with high SDI, medium-high SDI and medium SDI. The findings highlight demographic disparities in CVD deaths and DALYs attributable to lead exposure, with males and the elderly identified as high-risk groups.

The influence of adult urine lead exposure on bone mineral densit: NHANES 2015-2018.

Introduction: Previous studies have indicated that exposure to heavy metals related to bone health is primarily limited to some common harmful metals, and the impact of lead has not been fully understood. This study aims to explore the relationship between urine lead exposure and bone density. Methods: 1,310 adults were included from the NHANES database (2015-2018), and through generalized linear regression analysis and constrained cubic spline models, the association between lead levels and total bone density as well as lumbar spine bone density was explored. The study also examined the impact of combined exposure to lead and cadmium on bone density. Results and conclusions: Urinary lead levels were significantly negatively correlated with total bone mineral density (ß: -0.015; 95%CI: -0.024, -0.007) and lumbar spine bone mineral density (ß: -0.019; 95%CI: -0.031, -0.006). Compared to the lowest three quartiles of lead levels, the adjusted odds ratios for T3 changes in total bone mineral density and lumbar spine bone mineral density were 0.974 (95%CI: 0.959, 0.990) and 0.967 (95%CI: 0.943, 0.991), indicating a significant negative trend. Further analysis with constrained cubic spline models revealed a non-linear decreasing relationship between urinary lead and total bone mineral density as well as lumbar spine bone mineral density. Stratified analyses suggested that the relationship between urinary lead levels and bone mineral density might be significantly influenced by age, while gender showed no significant impact on the relationship. Moreover, combined exposure to lead and cadmium was found to be associated with decreased bone mineral density, emphasizing the potential synergistic effects between lead and cadmium on bone health. However, the specific mechanisms of lead and its effects on different populations require further comprehensive research. This study provides valuable insights for further exploration and development of relevant public health policies.

Factors Influencing Customer Participation in a Program to Replace Lead Pipes for Drinking Water.

Many public water systems are struggling to locate and replace lead pipes that distribute drinking water across the United States. This study investigates factors associated with customer participation in a voluntary lead service line (LSL) inspection and replacement program. It also uses quasi-experimental and experimental methods to evaluate the causal impacts of two grant programs that subsidized homeowner replacement costs on LSL program participation. LSLs were more prevalent in areas with a higher concentration of older housing stock, Black and Hispanic residents, renters, and lower property values. Owner-occupied and higher valued properties were more likely to participate in the LSL program. Results from the two grant program evaluations suggest that subsidies for low-income homeowners to cover LSL replacement costs can significantly boost participation, but only when the programs are well publicized and easy to access. Even then, there was still significant non-participation among properties with confirmed LSLs.

Lead exposure of a fossorial rodent varies with the use of ammunition across the landscape.

Exposure to heavy metals has been documented in a wide range of wildlife species, but infrequently in ground squirrels. This is despite their tendency to be targets of recreational shooters and the accumulation of lead ammunition in the soil environments they inhabit. We analyzed lead and copper concentrations in liver (nPb = 116, nCu = 101) and femur (nPb = 116, nCu = 116) of Piute ground squirrels (Urocitellus mollis) and in soil (n = 75) on public lands in southwestern Idaho to understand how lead exposure may vary across a gradient of intensities and histories of shooting activity. The liver and femur of squirrels from areas used for recreational shooting for >30 years had elevated lead concentrations relative to areas where shooting was rare or did not occur (our negative control), but as expected, lower than areas used for military target training for >70 years (our positive control). Lead concentration in soils were higher in areas used for military target training than in those used for recreational shooting. There were no differences in copper concentrations in biological or soil samples among sites. These data suggest that ground squirrels can be influenced by the history of lead use in their local environment, and they illustrate another pathway by which human activity can influence toxicant exposure to wildlife.

Assessment of Diagnostic Accuracy and Clinical Utility of DNA Methylation (5-mC) in Detecting Severity of Occupational Lead Exposure.

This study investigated the diagnostic accuracy (DA) and clinical utility (CU) of DNA methylation (5 methylcytosine) in occupational Pb-exposure from Pb based industry. Blood Lead levels (BLLs) were measured using the ICP-OES method. The total DNA methylation (5-mC) was quantified using ELISA method. Based on their BLLs, the Pb-exposed workers were categorised into three groups: low (< 10 µg/dL), moderate (10-30 µg/dL), and high exposure (> 30 µg/dL). DNA methylation (5-mC) was significantly lower in moderate and high Pb-exposure groups when compared to the low Pb-exposure group. Workers exposed to high levels of Pb-exposure, the DA variables of 5-mC showed that the sensitivity was 74.7% [95% CI 65.4-84.0], specificity was 69.6% [95% CI 50.8-88.4], positive predictive value (PPV) was 89.9% [95% CI 82.7-97.0], Postive likelihood ratio (LR+) was 2.454 [95% CI 1.3-4.6], and diagnostic odds ratio (DOR) is 6.3 [95% CI 6.5-7.7]. In moderate Pb-exposure, the DA variables of 5-mC revealed that the sensitivity is 64.9% [95% CI 55.2-74.5], the specificity is 69.6% [95% CI 50.8-88.4], the PPV is 89.7% [95% CI 82.5-97.0], the LR+ is 2.132 [95% CI 1.13-4.03], and the DOR is 4.2 [95% CI 3.6-5.7]. The high Pb-exposure group had higher DA metrics when compared to moderate Pb exposure. The clinical utility (CU+) of 5-mC was found to have good utility of 0.671 [95% CI 0.566-0.776] in the high Pb exposure group and fair utility of 0.582 [95% CI 0.470-0.694] in moderate Pb exposure group. In conclusion, DNA methylation (5mC) could be used as a predictive biomarker for high Pb-exposure.

Evaluation of lead exposure effects on tissue accumulation, behavior, morphological and hemato-biochemical changes in common carp, Cyprinus carpio.

BACKGROUND: Heavy metal pollution, particularly lead (Pb), poses a significant threat to aquatic ecosystems and their inhabitants, threatening their delicate balance and long-term viability. This study highlights the urgent need to mitigate heavy metal pollution in aquatic ecosystems. OBJECTIVE: This study investigates Pb(NO3)2 exposure effects on tissue accumulation, behavioral abnormalities, and hemato-biochemical parameters in common carp (Cyprinus carpio), a widely distributed freshwater fish species. METHODOLOGY: Fish (115 ± 5.23 g) were exposed to various Pb(NO3)2 concentrations for 10 and 20 days, representing control (0 %), 25 %, 50 %, and 75 % of the LC50 equivalent to 19.33, 38.66, and 58.0 mg/l, respectively. The standard manual procedure was used for blood sampling. The lead concentration in fish tissue was determined using an atomic absorption spectrophotometer. RESULTS: Results revealed that fish gills showed significant (P < 0.05) increase in Pb(NO3)2 after 10 days, further rising after 20 days. Liver concentrations also rose significantly (P < 0.05) with prolonged exposure and increasing Pb levels. Muscle had lower concentrations. Hematological parameters (RBC, WBC, HB, HCT) decreased with higher Pb(NO3)2 levels. Behavioral and morphological changes were significantly more pronounced in the exposure groups when compared to the control group. Hepatic enzyme activities (AST, ALT), glucose, and lipid levels increased, while total protein decreased. CONCLUSIONS: The study highlights Pb(NO3)2 harmful effects on common carp, impacting tissue accumulation, hematological parameters, and biochemical disruptions. It emphasizes the need to monitor and mitigate heavy metal pollution in aquatic environments to safeguard freshwater organisms and ecosystems, and to further increase our understanding of Pb toxicity in freshwater ecosystems.

Ferroptosis contributes to lead-induced cochlear spiral ganglion neurons injury.

The underlying mechanisms of lead exposure-induced cochlear spiral ganglion neurons (SGNs) injury are not yet clear. This study explored whether ferroptosis is involved in lead-induced SGNs injury and investigated the mechanism of lead-induced iron overload in SGNs. A primary culture cell model of lead acetate-induced SGNs damage was established. The changes in levels of iron ions, reactive oxygen species, lipid peroxides, and glutathione in SGNs were measured after lead acetate intervention and ferroptosis inhibitors pre-treatment. The morphology of mitochondria was also observed, and the expression of ferroptosis marker genes glutathione peroxidase 4 (GPX4) and solute carrier family 7 member 11 (SLC7A11), as well as iron metabolism-related proteins transferrin receptor protein 1 (TFR1), nuclear receptor coactivator 4 (NCOA4), heme oxygenase-1 (HO-1), and ferroportin (FPN) were detected. Results showed that lead acetate exposure induced SGNs injury in a time- and dose-dependent manner. Intracellular iron accumulation, increased levels of reactive oxygen species and lipid peroxide with decreased level of antioxidant capacity were occurred in SGNs after lead exposure. Meanwhile, decreased expressions of GPX4 and SLC7A11 and increased expressions of iron metabolism-related proteins (TFR1, NCOA4, and HO-1) were also found. Lead acetate intervention also caused mitochondrial shrinkage with blurred and fragmented morphology. Pre-treatment with ferroptosis inhibitors (Fer-1 and DFOM) significantly ameliorated lead-induced SGNs injury. In summary, lead exposure can induce ferroptosis in SGNs, the antioxidant defense system and iron metabolism disorder are involved in lead-induced SGNs ferroptosis. Thus, inhibiting ferroptosis may be a new strategy for preventing and treating lead exposure-related hearing loss.

Influences of quality of maternal care and environmental enrichment on associative memory function in rats with early life lead exposure.

INTRODUCTION: Children in low socioeconomic status (SES) communities are at higher risk of exposure to lead (Pb) and potentially more severe adverse outcomes from Pb exposures. While the factors encompassing SES are complex, low SES households often have less enriching home environments and parent-child interactions. This study investigated the extent to which environmental/behavioral factors (quality of maternal care and richness of the postnatal environment) may modify adverse effects from Pb exposure. METHODS: Long-Evans female rats were randomly assigned to Control (no Pb), Early Postnatal (EPN: birth through weaning), or Perinatal (PERI: 14 days pre-mating through weaning) Pb exposure groups. From postnatal days (PNDs) 2-9, maternal care behaviors were observed, and dams were classified as low or high maternal care based on amounts of licking/grooming and arched back nursing. At weaning, pups were randomly assigned to enriched or non-enriched environments. At PND 55, animals began trace fear conditioning and associative memory was tested on days 1, 2, and 10 postconditioning. RESULTS: Control offspring showed no significant effects of maternal care or enrichment on task performance. Females with EPN-Pb exposure and males with PERI-Pb exposure living in the non-enriched environment and having an LMC mother had significant memory impairments at days 2 and 10 that were not observed in comparably housed animals with HMC mothers. Enriched animals had no deficits, regardless of maternal care status. CONCLUSION: These results show the potential for modulatory influences of maternal care and housing environment on protecting against or reversing at least one aspect of Pb-induced cognitive/behavioral dysfunction.

High lead contamination in Mother's breastmilk in Bihar (India): Health risk assessment of the feeding children.

Lead poisoning in the recent times has caused serious health threats in the exposed human population. It is estimated that about 815 million people are exposed to lead poisoning worldwide and in India total 275 million children are exposed to blood lead contamination. The present study was carried outed in 6 districts of Bihar to know the extent of lead exposure in the children through their mother's breastmilk. The biological samples such as breastmilk, mother's urine, child's urine, and mother's blood samples were collected for quantitative lead estimation. Moreover, the selected household water sources (handpump) and the food consumed by the individuals-wheat, rice and potato samples were also collected for lead quantification. The study reveals that the breastmilk had high lead content in 92% of the samples (highest value 1309 µg/L), in blood presence of lead was observed in 87% studied samples (highest value 677.2 µg/L). In mother's urine the highest lead value was 4168 µg/L (62%) and in child's urine the highest value was 875.4 µg/L (62%) respectively of the studied samples. Moreover, in the studied food samples, wheat had lead content in 45% the studied samples (highest value 7910 µg/kg). In rice in 40% of the studied samples (highest value 6972 µg/kg) and in potato 90% of the studied samples (highest value = 13786 µg/kg) were found with elevated lead content respectively. The hazard quotient (HQ) and the cancer risk (CR) for lead contamination was very much higher in mothers followed by their children. The entire study indicated that lead exposure through food (wheat, rice and potato) has reached the mother's breastmilk and from their it has reached their child's body. This could cause serious hazards in the exposed children causing serious neurological damages, low IQ, low memory, and low mental growth in them. Therefore, a strategic action is required to control the present problem.

Childhood lead exposure increases the risk of attention-deficit-hyperactivity disorder: A meta-analysis.

Environmental lead exposure has been a much-discussed risk factor for the development of ADHD for decades. However, due to methodological shortcomings, the existing research on this topic is highly inconsistent. We will attempt to clarify this question by performing a meta-analysis based on a systematic literature search until February 2024 including different databases such as Pubmed and Google Scholar. The effects of environmental lead exposure were synthesized by odds ratios. A random effects model was deployed with a Paule-Mandel estimator using Hedges' invariance weighting. In addition, we carried out sensitivity analyses to examine the robustness of effects, including the detection of outliers, publication bias, p-hacking and moderating variables. In total, 14 studies with 14 effect sizes were included which had investigated the effects of lead exposure on the development of ADHD. The analyses were based on a final sample size of N = 7618 with n = 2554 ADHD cases (33,53 %) and n = 5064 healthy controls (66.47 %). Our results show that lead exposure was significantly associated with a higher risk of ADHD development. Regression analyses demonstrated that increased age of participants and increased lead significantly enhanced the risk of ADHD. Summing up we present novel results concerning the relationship between environmental lead exposure and the development of ADHD, while discussing underlying pathomechanisms as well as limitations. Finally, we provide recommendations for future studies and public health policies.

Mitigating lead-induced osteoporosis: The role of butyrate in gut-bone axis restoration.

Lead (Pb) is an environmentally widespread bone toxic pollutant, contributes to the development of osteoporosis. Butyric acid, mainly produced by the fermentation of indigestible dietary fiber by gut microbiota, plays a pivotal role in the maintenance of bone homeostasis. However, the effects of butyric acids on the Pb induced osteoporosis have not yet been elucidated. In this study, our results showed that Pb exposure was negatively related to the abundance of butyric acid, in the Pb-exposed population and Pb-exposed mice. Pb exposure caused gut microbiota disorders, resulting in the decline of butyric acid-producing bacteria, such as Butyrivibrio_crossotus, Clostridium_sp._JN9, and the butyrate-producing enzymes through the acetyl-CoA pathway. Moreover, results from the NHANES data suggested that dietary intake of butyrate was associated with a reduced risk of osteoporosis in lead-burdened populations, particularly among men or participants aged 18-60 years. In addition, butyrate supplementation in mice with chronic Pb exposure improved the bone microarchitectures, repaired intestinal damage, upregulated the proportion of Treg cells. Taken together, these results demonstrated that chronic Pb exposure disturbs the gut-bone axis, which can be restored by butyric acid supplement. Our results suggest that butyrate supplementation is a possible therapeutic strategy for lead-induced bone toxicity.

How will Severe Acute Respiratory Syndrome Coronavirus-2 (SARS-CoV-2) and lead (Pb) exposure interact in the cardiovascular system?

The combined effects of lead exposure and the severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) and how they cause cardiovascular dysfunction are examined in this viewpoint manuscript. Lead was picked as a representative environmental contaminant because it has been studied extensively for more than 40 years, while SARS-CoV-2 illustrates the unpredictability of a new infectious agent that can quickly increase the environmental burden on communities. Given that this interaction represents a plausible combined exposure for many people, it is crucial to discuss how it might happen at a mechanistic level. SARS-CoV-2 causes the coronavirus disease 2019 (COVID-19), which can spread by contact and respiratory droplets. One may be exposed to lead and SARS-CoV-2 simultaneously depending on their living situation. Uncertainty exists regarding the consequences of this exposure on cardiovascular disease and its underlying processes. This paper aims to investigate these mechanisms and provide potential causes behind them. The interaction of lead with SARS-CoV-2 and its effects on the cardiovascular system are likely caused by direct damage, the promotion of reactive oxygen species (ROS) production, oxidative stress, and inflammation. In particular, the stimulation of nuclear factor kappa B (NF-B), interleukin-6 (IL-6), and tumor necrosis factor-alpha (TNF) were all identified as potentially important pathways. Blood clotting, cytokine storm cycle development, and increased hypoxia may also be the results of this. In summary, the effects on the immune system, coagulation, the renin-angiotensin-aldosterone system, and cardiac contractility were the four primary areas identified.

Lead contamination in human milk affects infants' language trajectory: results from a prospective cohort study.

Infants growing up in low- and middle-income countries are at increased risk of suffering adverse childhood experiences, including exposure to environmental pollution and lack of cognitive stimulation. In this study, we aimed to examine the levels of metals in the human milk of women living in São Paulo City, Brazil, and determine the effects on infants' neurodevelopment. For such, a total of 185 human milk samples were analyzed for arsenic (As), lead (Pb), mercury (Hg), and cadmium (Cd) using inductively coupled plasma mass spectrometry (ICP-MS). We applied the Bayley scales of infant and toddler development Third Edition (Bayley-III) to assess developmental milestones. In our analysis, we found a mean (standard deviation) concentration of As in human milk equal to 2.76 (4.09) µg L-1, followed by Pb 2.09 (5.36) and Hg 1.96 (6.68). Cd was not detected. We observed that infants exposed to Pb presented language trajectories lower than non-exposed infants (ß = -0.413; 95% CI -0.653, -0.173) after adjustment for infant age, maternal education, socioeconomic status, infant sex, and sample weights. Our results report As, Pb, and Hg contamination in human milk, and that infant exposure to Pb decreased infants' language development. These results evidence maternal-child environmental exposure and its detrimental impact on infants' health.

Different Short-Chain Fatty Acids Unequally Modulate Intestinal Homeostasis and Reverse Obesity-Related Symptoms in Lead-Exposed High-Fat Diet Mice.

Our previous study showed that heavy metal lead (Pb) exposure exacerbates high-fat-diet (HFD)-induced metabolic damage and significantly depletes the gut microbiota-derived metabolite short-chain fatty acid (SCFA) levels. However, it remains unclear whether SCFA is a key metabolite involved in accelerating adverse consequences after Pb exposure. In this study, we explored the effects of exogenous supplementation of acetate, propionate, and butyrate on a metabolic disorder model in Pb-exposed HFD mice. We found that three SCFA interventions attenuated glycolipid metabolism disorders and liver damage, with butyrate performing the best effects in improving obesity-related symptoms. All three SCFA promoted the abundance of Muribaculaceae and Muribaculum, acetate specifically enriched Christensenellaceae, Blautia, and Ruminococcus, and butyrate specifically enriched Parasutterella, Rikenella, Prevotellaceae_UCG-001, and Bacteroides, which contributed to the positive promotion of SCFA production forming a virtuous cycle. Besides, butyrate inhibited Gram-negative bacteria Escherichia-Shigella. All of these events alleviated the intestinal Th17/Treg imbalance and inflammatory response through crosstalk between the G protein-coupled receptor (GPR)/histone deacetylase 3 (HDAC3) and lipopolysaccharide (LPS)/toll-like receptors 4 (TLR4)/nuclear factor κ-B (NF-κB) pathways and ultimately improved the intestinal barrier function. SCFA further upregulated the monocarboxylate transporter 1 (MCT1) and GPR43/adenosine 5'-monophosphate-activated protein kinase (AMPK) pathways to inhibit hepatic lipid accumulation. Overall, SCFA, especially butyrate, is an effective modulator to improve metabolic disorders in obese individuals exposed to heavy metals by targeting gut microecology.

Estimating lead-attributable mortality burden by socioeconomic status in the USA.

BACKGROUND: This study aimed to estimate population-level and state-level lead-attributable mortality burdens stratified by socioeconomic status (SES) class in the USA. METHODS: Based on the National Health and Nutrition Examination Survey (NHANES), we constructed individual-level SES scores from income, employment, education and insurance data. We assessed the association between the blood lead levels (BLL) and all-cause mortality by Cox regression in the NHANES cohort (n = 31 311, 4467 deaths). With estimated hazard ratios (HR) and prevalences of medium (2-5 µg/dL) and high (≥ 5 µg/dL) BLL, we computed SES-stratified population-attributable fractions (PAFs) of all-cause mortality from lead exposure across 1999-2019. We additionally conducted a systematic review to estimate the lead-attributable mortality burden at state-level. RESULTS: The HR for every 2-fold increase in the BLL decreased from 1.23 (1.10-1.38) for the lowest SES class to 1.05 (0.90-1.23) for the highest SES class. Across all SES quintiles, medium BLL exhibited a greater mortality burden. Individuals with lower SES had higher lead-attributable burdens, and such disparities haver persisted over the past two decades. In 2017-19, annually 67 000 (32 000-112 000) deaths in the USA were attributable to lead exposure, with 18 000 (2000-41 000) of these deaths occurring in the lowest SES class. Substantial disparities in the state-level mortality burden attributable to lead exposure were also highlighted. CONCLUSIONS: These findings suggested that disparities in lead-attributable mortality burden persisted within US adults, due to heterogeneities in the effect sizes of lead exposure as well as in the BLL among different SES classes.

Exploring Blood Lead Level Determinants in Refinery Workers: A Cross-Sectional Study.

BACKGROUND: Occupational lead exposure poses a significant risk to workers in industrial settings, especially in petroleum refineries. The study aimed to examine the prevalence and determinants of high blood lead concentrations among refinery workers in Kirkuk, Iraq. It has also been aimed to provide evidence-based approaches to identify associated risk factors. METHODS: A cross-sectional study was conducted among 187 workers from three departments (transportation, storage, and production) in a petroleum refinery from August 2023 to April 2024. Blood lead levels (BLLs) were measured using graphite furnace atomic absorption spectroscopy (GFAAS) (Agilent, Santa Clara, CA). The elevated BLLs were defined as lead levels in blood samples greater than 10 µg/dL. Data on demographic characteristics, such as occupations, smoking habits, and drinking milk, were collected using a researcher-developed information sheet. Statistical analyses included the Kruskal-Wallis test and Pearson Chi-Square test, and logistic regression was used to address the determinants of elevated BLLs. The corresponding associations were reported using odds ratios (OR) and adjusted OR (AOR) along with 95% confidence intervals (CIs). RESULTS: Eighty-five percent of the workers had high BLLs, with a median BLL of 17.11 µg/dL. The findings revealed that workers employed in outdoor settings had 4.25 times higher AOR (95% CI: 1.24-14.48) of experiencing high BLLs compared to those working indoors, after adjusting for other factors. This was especially true for workers who spent nine to 16 hours outdoors. Additionally, age and smoking were also found to be associated with an increased risk of high BLLs. On the other hand, the analysis indicated that drinking milk had a protective effect against high BLLs. CONCLUSION: The high prevalence of elevated BLLs among refinery workers in Kirkuk underscores the urgency for immediate interventions. Regular monitoring of BLLs, improved training, dietary adjustments (e.g., consuming calcium and phosphate-rich milk, which can help lower BLLs), and smoking cessation programs are recommended to reduce lead exposure and safeguard workers' health. Furthermore, the results suggest that drinking milk could potentially reduce BLLs among petroleum refinery workers. Additional research is necessary to evaluate the effectiveness of these interventions and to continue monitoring exposure levels.

Evidence of turmeric adulteration with lead chromate across South Asia.

Food adulteration with toxic chemicals is a global public health threat. Lead chromate adulterated spices have been linked with lead poisoning in many countries, from Bangladesh to the United States. This study systematically assessed lead chromate adulteration in turmeric, a spice that is consumed daily across South Asia. Our study focused on four understudied countries that produce >80 % of the world's turmeric and collectively include 1.7 billion people, 22 % of the world's population. Turmeric samples were collected from wholesale and retail bazaars from 23 major cities across India, Pakistan, Sri Lanka, and Nepal between December 2020 and March 2021. Turmeric samples were analyzed for lead and chromium concentrations and maximum child blood lead levels were modeled in regions where samples had detectable lead. A total of 356 turmeric samples were collected, including 180 samples of dried turmeric roots and 176 samples of turmeric powder. In total, 14 % of the samples (n = 51) had detectable lead above 2 µg/g. Turmeric samples with lead levels greater than or equal to 18 µg/g had molar ratios of lead to chromium near 1:1, suggestive of lead chromate adulteration. Turmeric lead levels exceeded 1000 µg/g in Patna (Bihar, India) as well as Karachi and Peshawar (Pakistan), resulting in projected child blood lead levels up to 10 times higher than the CDC's threshold of concern. Given the overwhelmingly elevated lead levels in turmeric from these locations, urgent action is needed to halt the practice of lead chromate addition in the turmeric supply chain.

Assessment of prevalence of elevated blood lead levels and risk factors among children and pregnant women in Bihar, India.

BACKGROUND: While modeled estimates and studies in contaminated areas indicate high lead exposure among children in Bihar, India, local data on lead exposure in the child population is limited. OBJECTIVES: To characterize lead exposure, and assess potential sources of lead exposure among a state-representative sample of children and their pregnant mothers residing in Bihar. METHODS: Blood samples were collected from 697 children under five and 55 pregnant women from eight districts in Bihar. Blood lead levels were determined using capillary blood and a portable lead analyzer. Household demographics, home environment, behavior, and nutrition information were collected through computer-assisted personal interviews with primary caregivers. Logistic regression was used to assess associations between potential risk factors and elevated blood lead levels. RESULTS: More than 90% of children and 80% of pregnant women reported blood lead levels ≥5 µg/dL. Living near a lead-related industry and pica behavior of eating soil were significantly associated with increased odds of having elevated blood lead levels. Additional risk factors for having a blood level ≥5 µg/dL included the use of skin lightning cream (aOR = 5.11, 95%CI: 1.62, 16.16) and the use of eyeliners (aOR = 2.81, 95%CI: 1.14, 6.93). Having blood lead levels ≥10 µg/dL was also significantly associated with the household member who had an occupation or hobby involving the use of lead (aOR = 1.75, 95%CI: 1.13, 2.72). DISCUSSION: Elevated blood lead levels were prevalent among children and pregnant women in Bihar, indicating the urgent need for a comprehensive lead poisoning prevention strategy.

Assessment of occupational exposure to lead among workers engaged in a city bus garage in Addis Ababa, Ethiopia: a comparative cross-sectional study.

BACKGROUND: Lead is one of the most nonessential toxic heavy metal agents found in automotive garages. The occupational exposure of garage workers to lead commonly poses acute and chronic health risks that can be prevented. In Ethiopia, there have been limited studies on lead exposure among garage workers, who overemphasize exposure to lead. This study aimed to assess occupational blood lead levels and associated factors in garage workers using a cross-sectional comparative design. METHODS: A comparative cross-sectional study design was used to compare the occupational blood lead levels of 36 randomly selected garage workers and 34 office workers who were matched by age and sex. Blood specimens were collected by trained medical laboratory experts. The collected blood samples were tested in a certified laboratory using a microwave plasma atomic emission spectrometry (MP-AES) device at a wavelength of 405.78 nm. Excel and SPSS Version 26 were used for data management and analysis, respectively. RESULTS: The mean (SD) age of the exposed group was 39.0 (7.5) years, whereas the mean age of the unexposed group was 38.0 (6.1) years. The occupational mean (SD) blood-lead-level in the exposed groups was 29.7 (12.2) µg/dl, compared to 14.8 (9.9) µg/dl among the unexposed groups. The mean blood-lead level among the exposed workers was significantly different from that among the unexposed workers (P < 0.01). Of all the study participants, only 22.2% of the exposed groups had blood lead levels higher than the World Health Organization's recommended limit of 40 µg/dl. The main significant predictors of occupational blood-lead-level exposure among workers were extra working hours, service years, and having a previous (prior) employment history in a garage. The occupations of the two groups did not significantly differ in terms of blood-lead levels (p > 0.05). CONCLUSIONS: The BLL of the Garage workers was significantly greater than that of the Non-Garage workers. Hence, it is advised that garage management should encourage workers to use exposure prevention methods, such as washing their hands before eating and taking showers after the completion of work, by providing regular occupational safety training.