Children drinking private well water have higher blood lead than those with city water.

Although the Flint, Michigan, water crisis renewed concerns about lead (Pb) in city drinking water, little attention has been paid to Pb in private wells, which provide drinking water for 13% of the US population. This study evaluates the risk of Pb exposure in children in households relying on private wells. It is based on a curated dataset of blood Pb records from 59,483 North Carolina children matched with household water source information. We analyze the dataset for statistical associations between children's blood Pb and household drinking water source. The analysis shows that children in homes relying on private wells have 25% increased odds (95% CI 6.2 to 48%, P < 0.01) of elevated blood Pb, compared with children in houses served by a community water system that is regulated under the Safe Drinking Water Act. This increased Pb exposure is likely a result of corrosion of household plumbing and well components, because homes relying on private wells rarely treat their water to prevent corrosion. In contrast, corrosion control is required in regulated community water systems. These findings highlight the need for targeted outreach to prevent Pb exposure for the 42.5 million Americans depending on private wells for their drinking water.

Reduced regional volumes associated with total psychopathy scores in an adult population with childhood lead exposure.

Childhood lead exposure has been correlated to acts of delinquency and criminal behavior; however, little research has been conducted to examine its potential long term influence on behavioral factors such as personality, specifically psychopathic personality. Neuroimaging studies have demonstrated that the effects of childhood lead exposure persist into adulthood, with structural abnormalities found in gray and white matter regions involved in behavioral decision making. The current study examined whether measurements of adult psychopathy were associated with neuroanatomical differences in structural brain volumes for a longitudinal cohort with measured childhood lead exposure. We hypothesized that increased total psychopathy scores and increased blood lead concentration at 78 months of age (PbB78) would be inversely associated with volumetric measures of gray and white matter brain structures responsible for executive and emotional processing. Analyses did not display a direct effect between total psychopathy score and gray matter volume; however, reduced white matter volume in the cerebellum and brain stem in relation to increased total psychopathy scores was observed. An interaction between sex and total psychopathy score was also detected. Females displayed increased gray matter volume in the frontal, temporal, and parietal lobes associated with increased total psychopathy score, but did not display any white matter volume differences. Males primarily displayed reductions in frontal gray and white matter brain volume in relation to increased total psychopathy scores. Additionally, reduced gray and white matter volume was associated with increased blood lead levels in the frontal lobes; reduced white matter volume was also observed in the parietal and temporal lobes. Females demonstrated gray and white matter volume loss associated with increased PbB78 values in the right temporal lobe, as well as reduced gray matter volume in the frontal lobe. Males displayed reduced white matter volumes associated with increased PbB78 values in the frontal, temporal, and parietal lobes. Comparison of the two primary models revealed a volumetric decrease in the white matter of the left prefrontal cortex associated with increased total psychopathy scores and increased blood lead concentration in males. The results of this study suggested that increased psychopathy scores in this cohort may be attributable to the neuroanatomical abnormalities observed and that childhood lead exposure may be influential to these outcomes.

[Intelligence quotient loss in Mexican pottery artisan's children]. / Pérdida de coeficiente intelectual en hijos de alfareros mexicanos.

BACKGROUND: In Mexico, artisans frequently use lead oxide or greta in order to produce utensils, which are destined to preparation and storage of food and drinks. Additionally, the risk of lead poisoning of artisans and their families is greater than in general population, and within these families, children are the most susceptible to lead poisoning. The aim of this study was to estimate IQ loss in Mexican children from potter families exposed to lead. METHODS: Lead concentrations in soil were determined in 19 potter's homes that functioned as pottery workshops in seven Mexican states between 2009 and 2012. This information was used to estimate blood lead levels through the integrated exposure uptake biokinetic (IEUBK) model. The loss of IQ points was then estimated according to the Lanphear and Schwartz models. RESULTS: The mean lead concentration found in the workshops' soil was 1098.4 ppm. Blood lead levels estimated in children under 8 years old were 26.4 µg/dL and the loss of IQ points comprised from 7.13 to 8.84 points depending on the model. CONCLUSIONS: It is possible that 11 children from families of artisans in Mexico may be losing between 7.13 to 8.84 IQ points, due to lead exposure in their houses-workshops. This loss in IQ points could have important health, economic and social impacts.

Introducción: en México, los alfareros continúan usando frecuentemente el óxido de plomo o greta para producir utensilios, los cuales se destinan a la preparación y almacenamiento de alimentos y bebidas. Adicionalmente, el riesgo de intoxicación por plomo de los alfareros y sus familias es mayor que en la población general, y en tales familias, los niños son los más susceptibles a la intoxicación por plomo. El objetivo del estudio fue estimar la pérdida de puntos de coeficiente intelectual (CI) en hijos de alfareros mexicanos expuestos al plomo. Métodos: durante el periodo de 2009 a 2012 se determinaron las concentraciones de plomo en suelo de 19 casas-talleres de alfareros en siete estados mexicanos. Esta información se utilizó para estimar el nivel de plomo en sangre, por medio del modelo biocinético integrado de absorción por exposición (IEUBK, por sus siglas en inglés). Posteriormente, se calcularon los puntos perdidos de CI según los modelos de Schwartz y Lanphear. Resultados: la concentración promedio de plomo en suelo fue de 1098.4 ppm. Se estimó un nivel de plomo en sangre de 26.4 µg/dL para menores de 8 años. La pérdida de puntos de CI estimada fue 7.13 y 8.84, según el modelo utilizado. Conclusión: es posible que al menos 11 niños de familias alfareras mexicanas estén perdiendo entre 7.13 y 8.84 puntos de CI, debido a la exposición al plomo en sus casas-talleres, lo que supone importantes impactos económicos, sociales y de salud.

Environmental and Occupational Lead Exposure Among Children in Cairo, Egypt: A Community-Based Cross-Sectional Study.

The aim of this study was to assess childhood lead exposure in a representative sample of Cairo, and to investigate the possible risk factors and sources of exposure. This cross-sectional study was conducted from November 2014 through April 2015. The target population was children aged 6 to 18 years, recruited into 4 groups, garbage city, moderate-living standard area, urban and suburban schools, and workshops in the city of Cairo. Blood lead levels (BLLs) and hemoglobin (Hb) concentrations were measured. Also, potential local environmental sources were assessed for hazardous lead contamination. Analysis on 400 participants has been carried out. A total of 113 children had BLLs in the range 10 to 20 µg/dL. Smoking fathers, housing conditions, playing outdoors, and exposure to lead in residential areas were significantly correlated with high BLLs. The mean values of hemoglobin were inversely correlated with BLLs. Children involved in pottery workshops had the highest BLLs and the lowest Hb values with a mean of (43.3 µg/dL and 8.6 g/dL, respectively). The mean value of environmental lead in workshop areas exceeded the recommended levels. Also, those values measured in dust and paint samples of garbage city were significantly high. Moreover, the mean lead levels in the soil samples were significantly higher in urban schools (P = 0.03) than the suburban ones. Childhood lead poisoning accounts for a substantial burden in Egypt, which could be preventable. Development of national prevention programs including universal screening program should be designed to reduce incidence of lead toxicity among children.

Investigation of Childhood Lead Poisoning from Parental Take-Home Exposure from an Electronic Scrap Recycling Facility ­ Ohio, 2012.

Lead affects the developing nervous system of children, and no safe blood lead level (BLL) in children has been identified. Elevated BLLs in childhood are associated with hyperactivity, attention problems, conduct problems, and impairment in cognition. Young children are at higher risk for environmental lead exposure from putting their hands or contaminated objects in their mouth. Although deteriorating lead paint in pre-1979 housing is the most common source of lead exposure in children, data indicate that ≥30% of children with elevated BLLs were exposed through a source other than paint. Take-home contamination occurs when lead dust is transferred from the workplace on employees' skin, clothing, shoes, and other personal items to their car and home. Recycling of used electronics (e-scrap) is a relatively recent source of exposure to developmental neurotoxicants, including lead. In 2010, the Cincinnati Health Department and Cincinnati Children's Hospital Pediatric Environmental Health Specialty Unit (PEHSU) investigated two cases of childhood lead poisoning in a single family. In 2012, CDC's National Institute for Occupational Safety and Health (NIOSH) learned about the lead poisonings during an evaluation of the e-scrap recycling facility where the father of the two children with lead poisoning worked. This report summarizes the case investigation. Pediatricians should ask about parents' occupations and hobbies that might involve lead when evaluating elevated BLLs in children, in routine lead screening questionnaires, and in evaluating children with signs or symptoms of lead exposure.

Childhood lead exposure in an industrial town in China: coupling stable isotope ratios with bioaccessible lead.

Fingerprinting based on stable isotopes of lead (Pb) in blood and environmental media helps to identify Pb exposure pathways in children. However, previous studies used stable isotopes of total Pb in media. In this study, a wire rope production town in China (Zhuhang) was selected for investigating the effectiveness of using isotope ratios in bioaccessible Pb to identify childhood Pb exposure pathways. Blood Pb levels of 115 children in Zhuhang were 1.7-20.4 µg dL(-1), averaging 6.1 ± 3.2 µg dL(-1) (mean ± standard deviation), and were ∼1.6 times the national average in China (3.9 ± 1.8 µg dL(-1)). Among different environmental media (housedust, soil, PM10, vegetables, rice, and drinking water), housedust (695 ± 495 mg kg(-1)) and vegetables [0.36 ± 0.40 mg (kg of fresh weight)(-1)] contained elevated Pb concentrations. The isotope ratios ((207)Pb/(206)Pb and (208)Pb/(206)Pb) of total Pb were the highest in housedust (0.8587 ± 0.0039 and 2.1049 ± 0.0087) but lower than blood Pb ratios (0.8634 ± 0.0027 and 2.1244 ± 0.0061). When using bioaccessible Pb in housedust (0.8639 ± 0.0018 and 2.1171 ± 0.0036), the isotope ratios overlapped with blood Pb ratios, suggesting that incidental ingestion of housedust was the predominant contributor to children's blood Pb. Coupling the stable isotope technique with bioaccessible Pb is more reliable for identifying Pb exposure pathways than total Pb determinations.

Occupational and environmental lead exposure to adolescent workers in battery recycling workshops.

Lead (Pb), as other environmental neurotoxicant substances, has the capability to interfere with many biochemical events present in cells throughout the body. In the present study, the environmental and occupational exposure to Pb has been assessed by analyzing the scalp hair samples of male adolescents aged 12-15 years, who have worked for the last 12-36 months in Pb battery recycling workshops (BRWs). For comparative purposes, gender and age-matched subjects living in the vicinity of recycling workshops as well as in areas without industrial activity were used as controls. The scalp hair samples were oxidized by acid in a microwave oven prior to determination of Pb by electrothermal atomic absorption spectrometry. The results indicated that both workers and nonworking exposed subjects had higher levels of Pb than nonexposed controls. The contents of Pb in scalp hair of adolescent workers in the present study were compared with those reported in other studies.

Early childhood lead exposure and academic achievement: evidence from Detroit public schools, 2008-2010.

OBJECTIVES: We assessed the long-term effect of early childhood lead exposure on academic achievement in mathematics, science, and reading among elementary and junior high school children. METHODS: We linked early childhood blood lead testing surveillance data from the Detroit Department of Health and Wellness Promotion to educational testing data from the Detroit, Michigan, public schools. We used the linked data to investigate the effect of early childhood lead exposure on academic achievement among school-aged children, both marginally and adjusted for grade level, gender, race, language, maternal education, and socioeconomic status. RESULTS: High blood lead levels before age 6 years were strongly associated with poor academic achievement in grades 3, 5, and 8. The odds of scoring less than proficient for those whose blood lead levels were greater than 10 micrograms per deciliter were more than twice the odds for those whose blood lead levels were less than 1 micrograms per deciliter after adjustment for potential confounders. CONCLUSIONS: Early childhood lead exposure was negatively associated with academic achievement in elementary and junior high school, after adjusting for key potential confounders. The control of lead poisoning should focus on primary prevention of lead exposure in children and development of special education programs for students with lead poisoning.

Comparing the population neurodevelopmental burdens associated with children's exposures to environmental chemicals and other risk factors.

To estimate the population burden of an exposure that is associated with neurodevelopmental impairment, it is necessary to consider both the effect size associated with the exposure (i.e., the decrease in function per unit increase in biomarker level) and the prevalence of the exposure. An exposure with a modest effect size might, nevertheless, be associated with a substantial population burden if many children are exposed at levels at which the exposure is known to have a detrimental impact. This illustrates the important distinction between individual risk and population risk. A method is described that can be used to compare different risk factors in terms of their contributions to the population burden of neurodevelopmental impairment. Combining estimates of the incidence/prevalence/distribution of different conditions or exposures with estimates, derived from meta-analyses, for the impact of different risk factors on children's Full-Scale IQ scores (FSIQ), the total FSIQ losses associated with each were calculated for the U.S. population of children less than 5 years of age. The losses associated with non-chemical risk factors ranged widely: 34,000,000 FSIQ points for preterm birth, 17,000,000 for Attention Deficit Hyperactivity Disorder, 9,000,000 for iron deficiency, 136,000 for acute lymphocytic leukemia, and 37,000 for brain tumors. The FSIQ losses could be estimated for three chemicals: lead, 23,000,000 points; methylmercury, 285,000 points; and organophosphate pesticides, 17,000,000 points. Many caveats attend these calculations, but the findings suggest that in continuing to apply standards appropriate to evaluating the impact of chemical exposures on an individual child rather than on the population as a whole, we risk underestimating the population burdens associated with them.

Developmental origins of adult diseases and neurotoxicity: epidemiological and experimental studies.

To date, only a small number of commercial chemicals have been tested and documented as developmental neurotoxicants. Moreover, an increasing number of epidemiological, clinical and experimental studies suggest an association between toxicant or drug exposure during the perinatal period and the development of metabolic-related diseases and neurotoxicity later in life. The four speakers at this symposium presented their research results on different neurotoxic chemicals relating to the developmental origins of health and adult disease (DOHaD). Philippe Grandjean presented epidemiological data on children exposed to inorganic mercury and methylmercury, and discussed the behavioral outcome measures as they relate to age and stage of brain development. Donald A. Fox presented data that low-dose human equivalent gestational lead exposure produces late-onset obesity only in male mice that is associated with neurodegeneration. Didima de Groot presented results on prenatal exposure of rats to methylazoxymethanol and discussed the results in light of the etiology of western Pacific amyotrophic lateral sclerosis and Parkinson-dementia complex. Merle G. Paule addressed the long-term changes in learning, motivation and short-term memory in aged Rhesus monkeys following acute 24 h exposure to ketamine during early development. Overall, these presentations addressed fundamental issues in the emerging areas of lifetime neurotoxicity testing, differential vulnerable periods of exposure, nonmonotonic dose-response effects and neurotoxic risk assessment. The results indicate that developmental neurotoxicity results in permanent changes, thus emphasizing the need to prevent such toxicity.

Environmental lead exposure and otoacoustic emissions in Andean children.

Studies relating sensory hearing impairment to lead (Pb) exposure in children have presented inconsistent results. The objective of this study was to measure distortion product otoacoustic emissions (DPOAE), sounds emanating from the outer hair cells of the inner ear, in Pb-exposed children to determine the effects of Pb poisoning on the inner ear. DPOAE were recorded for 9 f(2) frequencies from 1187 to 7625 Hz on 102 ears of 53 Pb-exposed children (aged 6-16 yr) residing in Pb-contaminated environments in the Andes Mountains of Ecuador where Pb glazing of ceramics is the primary livelihood. Blood lead (PbB) levels ranged from 4.2 to 94.3 µg/dl (mean: 37.7; SD: 25.7; median: 36.4). The median PbB level was markedly higher than the Centers for Disease Control and Prevention (CDC) and World Health Organization (WHO) 10-µg/dl action level. Spearman rho correlation analyses of the relation between PbB level and DPOAE amplitude and between PbB level and DPOAE signal-to-noise ratio revealed no significant associations at any of the f(2) frequencies tested. In addition, no significant correlation (Spearman rho) between PbB level and hearing sensitivity for 6 pure-tone test frequencies from 1000 to 8000 Hz was found. Although the study group was found to have abnormally elevated PbB levels, in contrast to some earlier reports, the results of the current study showed no consistent Pb-induced sensory effects on the cochlea of Pb-intoxicated children.

Lead exposure and visual-motor abilities in children from Chennai, India.

Lead exposure poses a major environmental hazard in India, but little information is available on the impact of lead exposure on visuo-motor development in Indian children. We hypothesize that higher blood lead levels are associated with poorer visual-motor, visual-spatial and fine motor functioning among children. We conducted a cross-sectional study of 814 school children, aged 3-7 years. Lead in whole blood was measured using the LeadCare Analyzer. The Wide Range of Visual Motor Abilities Test (WRAVMA) was administered to each child by trained examiners. The mean blood lead level was 11.4±5.3 µg/dL. In multivariate analyses adjusting for mother's education level, father's education level, average monthly income, hemoglobin and sex, WRAVMA scores were inversely related to blood lead level. An increase of 10 µg/dL was associated with a decrease of 2.6 points (95% CI: -4.5 to -0.7, P=0.006) in the Visual Motor Composite score and a decrease of 2.9 points (95% CI: -5.1 to -0.7, P=0.011) in the Drawing subtest. Exploration of the shape of the dose-effect relationships using spline functions indicated some non-linearities, with the steepest declines in visual-motor skills occurring at higher blood lead levels. Among urban Indian children, higher blood lead levels are associated with decreased visual-motor abilities, particularly visual-motor integration.

Lead poisoning among Burmese refugee children--Indiana, 2009.

Recent routine screening revealed multiple cases of unexplained lead poisoning among children of Burmese refugees living in Fort Wayne, Indiana. A cross-sectional study was conducted to determine (a) the prevalence of elevated blood lead levels (BLLs) among Burmese children and (b) potential sources of lead exposure. A case was defined as an elevated venous BLL (≥10 µg/dL); prevalence was compared with all Indiana children screened during 2008. Environmental and product samples were tested for lead. In all, 14 of 197 (7.1%) children had elevated BLLs (prevalence ratio: 10.7) that ranged from 10.2 to 29.0 µg/dL. Six cases were newly identified; 4 were among US-born children. Laboratory testing identified a traditional ethnic digestive remedy, Daw Tway, containing a median 520 ppm lead. A multilevel linear regression model identified daily use of thanakha, an ethnic cosmetic, and Daw Tway use were related to elevated BLLs (P < .05). Routine monitoring of BLLs among this population should remain a priority.

Environmental justice and the health of children.

Environmental injustice is the inequitable and disproportionately heavy exposure of poor, minority, and disenfranchised populations to toxic chemicals and other environmental hazards. Environmental injustice contributes to disparities in health status across populations of differing ethnicity, race, and socioeconomic status. Infants and children, because of their unique biological vulnerabilities and age-related patterns of exposure, are especially vulnerable to the health impacts of environmental injustice. These impacts are illustrated by sharp disparities across children of different racial and ethnic backgrounds in the prevalence of 3 common diseases caused in part by environmental factors: asthma, lead poisoning, and obesity. Documentation of linkages between health disparities and environmental injustice is an important step toward achieving environmental justice.

Mass lead intoxication from informal used lead-acid battery recycling in dakar, senegal.

BACKGROUND AND OBJECTIVES: Between November 2007 and March 2008, 18 children died from a rapidly progressive central nervous system disease of unexplained origin in a community involved in the recycling of used lead-acid batteries (ULAB) in the suburbs of Dakar, Senegal. We investigated the cause of these deaths. METHODS: Because autopsies were not possible, the investigation centered on clinical and laboratory assessments performed on 32 siblings of deceased children and 23 mothers and on 18 children and 8 adults living in the same area, complemented by environmental health investigations. RESULTS: All 81 individuals investigated were poisoned with lead, some of them severely. The blood lead level of the 50 children tested ranged from 39.8 to 613.9 microg/dL with a mean of 129.5 microg/dL. Seventeen children showed severe neurologic features of toxicity. Homes and soil in surrounding areas were heavily contaminated with lead (indoors, up to 14,000 mg/kg; outdoors, up to 302,000 mg/kg) as a result of informal ULAB recycling. CONCLUSIONS: Our investigations revealed a mass lead intoxication that occurred through inhalation and ingestion of soil and dust heavily contaminated with lead as a result of informal and unsafe ULAB recycling. Circumstantial evidence suggested that most or all of the 18 deaths were due to encephalopathy resulting from severe lead intoxication. Findings also suggest that most habitants of the contaminated area, estimated at 950, are also likely to be poisoned. This highlights the severe health risks posed by informal ULAB recycling, in particular in developing countries, and emphasizes the need to strengthen national and international efforts to address this global public health problem.

A blood lead benchmark for assessing risks from childhood lead exposure.

Lead exposure is an insidious problem, causing subtle effects in children at low exposure levels where clinical signs are not apparent. Although a target blood lead concentration (Pb(B)) of ten micrograms per deciliter (10 microg/dL) has been used as the basis for environmental decision-making in California for nearly two decades, recent epidemiologic evidence suggests a relationship between cognitive deficits and Pb(B) at concentrations < 10 microg/dL. Based on a published meta-analysis of children's IQ scores and their blood lead concentrations, we developed a new blood lead benchmark: an incremental increase in blood lead concentration (DeltaPb(B)) of 1 microg/dL, an increase that we estimate could decrease the IQ score in an average school child in California by up to one point. Although there is no evidence to date for a threshold for the neurobehavioral effects of lead, a one-point IQ decrement was chosen to represent a de minimus change. To safeguard the intellectual potential of all children, additional efforts to reduce or eliminate multiple-source exposures to lead are warranted.