Predictors of elevated blood lead levels among 3-year-old Ukrainian children: a nested case-control study.

OBJECTIVES: Lead is common in the general population. However, data are lacking for the Ukraine and many other countries from the former Soviet Union (FSU). In this study we evaluate the level of blood lead among 212 Ukrainian children and determine predictors of elevated lead levels. We also describe the health effects associated with elevated blood lead. METHODS: A nested case-control study from a prospective cohort of Ukrainian 3-year-old children was conducted in March 1998. Blood assays were analyzed for lead by labs at the Centers for Disease Control and using portable examination kits. We evaluated predictors of elevated blood lead (blood levels in the upper quartile >4.65 microg/dL) using a multivariable logistic regression model. The model included socioeconomic status, parent occupation, environmental tobacco smoke, hygiene, diet, and health status. RESULTS: The geometric mean lead level was 3.15 microg/dL (range, 0.7--22.7). In our adjusted model, we observed a strong association between lead levels in the upper quartile and children whose fathers worked manual labor jobs in industries associated with lead exposures [adjusted odds ratio (OR)=2.25; P=0.025] and mothers who smoke indoors (adjusted OR=2.87; P=0.047). Daily hygiene and dietary habits were not associated with elevated lead levels. No increased risks of overall morbidity or lead-associated illness were observed (anemia, dental caries, renal disease, cardiovascular diseases, and musculoskeletal complaints). CONCLUSION: This is the first study to describe lead levels and associated variables among Ukrainian children in the peer-reviewed literature. Elevated lead levels in these children were associated with paternal occupation and mothers smoking indoors. At age 3 no adverse health effects were observed. More data are needed to determine the level of heavy metal contamination in children from the Ukraine and many other former Soviet nation-states.

Hospital admissions during pregnancy in two urban areas of Ukraine.

Hospital admissions are generally regarded as a marker of severe pregnancy complications, and a low ratio of antenatal admissions to deliveries is considered an indicator of maternal-fetal well-being. We investigated the reasons for hospital admissions in a sample of deliveries from Ukraine, a country of the former eastern bloc. All hospitalisations were traced among 3099 women who delivered live singletons of at least 20 weeks gestation in two urban areas of Ukraine and data were abstracted from their medical records. More than a third of the women were admitted to hospital during their pregnancy, and 91% of the admissions were for a pregnancy complication, primarily threatened abortion or early labour. Median length of stay for all admissions was 12 days. The ratio of admissions to deliveries was 52 per 100. The Ukrainian ratio of hospitalisations to deliveries is notably higher than any that have been published in studies from the United States and Australia, reflecting patterns of care that stress hospital-based treatment. This high ratio does not necessarily mean that Ukrainian women are sicker, although that may be the case. The comparison of hospitalisation to delivery ratios is meaningful only when other factors, such as resources, patterns of care, costs and access, are taken into account.

Polycyclic aromatic hydrocarbons in placenta.

Concentrations of chrysene, benz [a] anthracene, benzo [a]-pyrene, benzo [b] fluoranthene, indeno [1,2,3-c,d] pyrene, dibenz [a,h] anthracene, and benzo [g,h,i] perylene were measured in placentas from 200 women from two cities in Ukraine, Kyiv and Dniprodzerzhinsk. The participants had no special exposures and were chosen from among subjects in an ongoing study of reproductive health. All seven of the polycyclic aromatic hydrocarbons (PAHs) were found in all placentas, with the sole exception of benzo [a] pyrene in one placenta. Chrysene was present at the highest concentrations, with median 1.38 ng/g dry weight. Dibenz [a,h] anthracene and benzo [g,h,i] perylene had the lowest concentrations; each had median 0.73 ng/g dry weight. Concentrations in Kyiv were slightly higher than those in Dniprodzerzhinsk, but the difference was significant only for dibenz [a,h] anthracene. Dibenz [a,h] anthracene and benzo [g,h,i] perylene increased significantly with maternal body mass index, but other PAHs showed no such pattern. Placentas from deliveries in autumn or winter had slightly but not significantly higher concentrations. Concentrations were not related to maternal age. There were too few smokers in the sample for meaningful evaluation. No associations were seen between any of the placental PAH concentrations and birth weight of the infant.