A regional comparison of children's blood cadmium, lead, and mercury in rural, urban and industrial areas of six European countries, and China, Ecuador, and Morocco.

OBJECTIVES: The authors aimed to evaluate whether blood cadmium (B-Cd), lead (B-Pb) and mercury (B-Hg) in children differ regionally in 9 countries, and to identify factors correlating with exposure. MATERIAL AND METHODS: The authors performed a cross-sectional study of children aged 7-14 years, living in 2007-2008 in urban, rural, or potentially polluted ("hot spot") areas (ca. 50 children from each area, in total 1363 children) in 6 European and 3 non-European countries. The authors analyzed Cd, Pb, and total Hg in blood and collected information on potential determinants of exposure through questionnaires. Regional differences in exposure levels were assessed within each country. RESULTS: Children living near industrial "hot-spots" had B-Cd 1.6 (95% CI: 1.4-1.9) times higher in the Czech Republic and 2.1 (95% CI:1.6-2.8) times higher in Poland, as compared to urban children in the same countries (geometric means [GM]: 0.13 µg/l and 0.15 µg/l, respectively). Correspondingly, B-Pb in the "hot spot" areas was 1.8 (95% CI: 1.6-2.1) times higher than in urban areas in Slovakia and 2.3 (95% CI: 1.9-2.7) times higher in Poland (urban GM: 19.4 µg/l and 16.3 µg/l, respectively). In China and Morocco, rural children had significantly lower B-Pb than urban ones (urban GM: 64 µg/l and 71 µg/l, respectively), suggesting urban exposure from leaded petrol, water pipes and/or coal-burning. Hg "hot spot" areas in China had B-Hg 3.1 (95% CI: 2.7-3.5) times higher, and Ecuador 1.5 (95% CI: 1.2-1.9) times higher, as compared to urban areas (urban GM: 2.45 µg/l and 3.23 µg/l, respectively). Besides industrial exposure, traffic correlated with B-Cd; male sex, environmental tobacco smoke, and offal consumption with B-Pb; and fish consumption and amalgam fillings with B-Hg. However, these correlations could only marginally explain regional differences. CONCLUSIONS: These mainly European results indicate that some children experience about doubled exposures to toxic elements just because of where they live. These exposures are unsafe, identifiable, and preventable and therefore call for preventive actions. Int J Occup Med Environ Health. 2023;36(3):349-64.

Easier said than done: challenges of applying the Ecohealth approach to the study on heavy metals exposure among indigenous communities of the Peruvian Amazon.

BACKGROUND: The renewed interest in community participation in health research is linked to its potential for bridging gaps between research and practice. Its main attributes are the generation of knowledge that can lead to socially robust, long-lasting solutions and the creation of a co-learner relationship between researchers and research users. Following this philosophy, Ecohealth has evolved into a specialized framework for participatory research on the impact of pollution on ecosystems and human health. However, its principles pose considerable challenges. Its outcomes are strongly influenced by contextual factors that are impossible to control for ahead of time.This paper describes how the Ecohealth principles were applied to an epidemiological study of heavy metals exposure among indigenous communities of the Peruvian Amazon. It illustrates how knowledge generated from participatory research does not necessarily imply solving a public health problem. This study aimed to contribute to the understanding of the benefits and barriers of following the basic principles of the Ecohealth approach, and assist researchers working in similar contexts. RESEARCH PROCESS: Based upon their personal experience as participant observers, the authors describe the research process; then, they discuss the most important challenges faced, their implications, and the attempted strategies for resolution. CHALLENGES: Challenges were grouped into four themes: (1) building trust; (2) one partnership, many stakeholders, multiple agendas; (3) being a researcher; and (4) communicating complex and unexpected findings. CONCLUSIONS: Integrating the principles of transdisciplinarity and participation posed a series of challenges to the research process that were difficult, and sometimes impossible to overcome. However, positive outcomes from this experience were the lessons learned by the different actors. Despite the lack of immediate action, it is expected that useful interventions to prevent and control lead exposure in the Corrientes population will be implemented in the medium term.

Cadmium, mercury and lead in the blood of urban women in Croatia, the Czech Republic, Poland, Slovakia, Slovenia, Sweden, China, Ecuador and Morocco.

OBJECTIVES: The aim of the study was to make an international comparison of blood levels of cadmium (B-Cd), lead (B-Pb) and mercury (B-Hg) of women in seven European, and three non-European cities, and to identify determinants. MATERIALS AND METHODS: About 50 women (age: 46-62) from each city were recruited (totally 480) in 2006-2009. Interview and questionnaire data were obtained. Blood samples were analysed in one laboratory to avoid interlaboratory variation. RESULTS: Between the European cities, the B-Pb and B-Cd results vary little (range of geometric means: 13.5-27.0 µg/l and 0.25-0.65 µg/l, respectively); the variation of B-Hg was larger (0.40-1.38 µg/l). Between the non-European cities the results for B-Pb, B-Cd and B-Hg were 19.2-68.0, 0.39-0.99 and 1.01-2.73 µg/l, respectively. Smoking was a statistically significant determinant for B-Cd, while fish and shellfish intakes contributed to B-Hg and B-Pb, amalgam fillings also contributed to B-Hg. CONCLUSIONS: The present results confirm the previous results from children; the exposure to lead and cadmium varies only little between different European cities suggesting that other factors than the living area are more important. The study also confirms the previous findings of higher cadmium and lead levels in some non-European cities. The geographical variation for mercury is significant.

Lead exposure among children from native communities of the Peruvian Amazon basin.

OBJECTIVE: To assess potential risk factors associated with elevated blood lead levels (BLLs) among children in two communities from the Corrientes River basin in the Peruvian Amazon. METHODS: Children aged 0-17 years were screened for BLLs, hemoglobin levels, and anthropometric measures. Dwelling, family, and child data were collected through a parental questionnaire. Statistical analysis included descriptive and bivariate analysis. Multiple linear and logistic regressions using generalized estimating equations were also conducted to determine associated risk factors. A map of each community was drawn to examine the spatial distribution of BLLs. RESULTS: Of 208 children (88 from 23 households of the Peruanito community and 120 from 28 households of Santa Isabel), 27.4% had BLLs > 10 µg/dL. The geometric mean (± standard deviation) BLL was 8.7 ± 4.0 µg/dL (range 3.0-26.8 µg/dL). In the total population, linear regression analysis indicated that age was positively associated with BLLs (P < 0.05). Logistic regression analysis showed that boys had 2.12 times greater odds of having BLLs > 10 µg/dL than girls (P < 0.05). Among the children 0-3 years, those whose mothers had BLLs > 10 µg/dL had 45.0% higher odds of presenting BLLs > 10 µg/dL than children whose mothers had BLLs < 10 µg/dL (P < 0.05). CONCLUSIONS: Older age, male gender, and mothers' BLL > 10 µg/dL were the main risk factors for elevated BLLs. The higher risk in boys 7-17 years suggests that exposure could be related to specific activities in this group, such as fishing and hunting. Continuous monitoring of BLLs in the Corrientes River population is recommended.

Lead exposure among children from native communities of the Peruvian Amazon basin / Exposición al plomo en niños de comunidades indígenas de la cuenca del Amazonas en el Perú

Objective. To assess potential risk factors associated with elevated blood lead levels (BLLs) among children in two communities from the Corrientes River basin in the Peruvian Amazon.Methods. Children aged 0–17 years were screened for BLLs, hemoglobin levels, and anthropometric measures. Dwelling, family, and child data were collected through a parental questionnaire. Statistical analysis included descriptive and bivariate analysis. Multiple linear and logistic regressions using generalized estimating equations were also conducted to determine associated risk factors. A map of each community was drawn to examine the spatialdistribution of BLLs. Results. Of 208 children (88 from 23 households of the Peruanito community and 120 from28 households of Santa Isabel), 27.4% had BLLs ≥ 10 μg/dL. The geometric mean (± standard deviation) BLL was 8.7 ± 4.0 μg/dL (range 3.0–26.8 μg/dL). In the total population, linearregression analysis indicated that age was positively associated with BLLs (P < 0.05). Logistic regression analysis showed that boys had 2.12 times greater odds of having BLLs ≥ 10 μg/dLthan girls (P < 0.05). Among the children 0–3 years, those whose mothers had BLLs ≥ 10 μg/ dL had 45.0% higher odds of presenting BLLs ≥ 10 μg/dL than children whose mothers had BLLs < 10 μg/dL (P < 0.05). Conclusions. Older age, male gender, and mothers’ BLL ≥ 10 μg/dL were the main risk factors for elevated BLLs. The higher risk in boys 7–17 years suggests that exposure could berelated to specific activities in this group, such as fishing and hunting. Continuous monitoring of BLLs in the Corrientes River population is recommended.

Objetivo. Evaluar los potenciales factores de riesgo asociados con niveles elevados de plomo en sangre (Pbs) en niños de dos comunidades de la cuenca del río Corrientes en la Amazonia peruana. Métodos. Se estudiaron de manera sistemática los niveles de PbS, la concentración de hemoglobina y las medidas antropométricas en niños de 0 a 17 años. A través de un cuestionario efectuado a los padres se recopilaron datos sobre la vivienda, la familiay los niños. El análisis estadístico incluyó el análisis descriptivo y de dos variables. También se llevaron a cabo análisis de regresión logística y lineal múltiple usando ecuaciones predictivas generales para determinar los factores de riesgo asociados. Se trazó un mapa de cada comunidad para examinar la distribución espacial de los niveles de PbS. Resultados. De 208 niños (88 de 23 hogares de la comunidad de Peruanito y 120 de 28 hogares de Santa Isabel), 27,4% presentaron niveles de PbS ≥ 10 μg/dL. La mediageométrica (± desviación estándar) de los niveles de PbS fue 8,7 μg/dL ± 4,0 (amplitud 3,0 a 26,8 μg/dL). En la población total, el análisis de regresión lineal indicó que la edad se asociaba de manera positiva con los niveles de PbS (P < 0,05). El análisis de regresión logística demostró que los varones presentaron una probabilidad 2,12 vecesmayor de tener niveles de PbS ≥ 10 μg/dL que las niñas (P < 0,05). En los niños de ambos sexos de 0 a 3 años, aquellos cuyas madres tuvieron niveles de PbS ≥ 10 μg/ dL presentaron 45,0% más probabilidades de exhibir niveles de PbS ≥ 10 μg/dL que los niños cuyas madres tuvieron niveles de PbS < 10 μg/dL (P < 0,05).

Blood cadmium, mercury, and lead in children: an international comparison of cities in six European countries, and China, Ecuador, and Morocco.

Children's blood-lead concentration (B-Pb) is well studied, but little is known about cadmium (B-Cd) and mercury (B-Hg), in particular for central Europe. Such information is necessary for risk assessment and management. Therefore, we here describe and compare B-Pb, B-Cd and B-Hg in children in six European, and three non-European cities, and identify determinants of these exposures. About 50 school children (7-14 years) from each city were recruited (totally 433) in 2007-2008. Interview and questionnaire data were obtained. A blood sample was analyzed: only two laboratories with strict quality control were used. The European cities showed only minor differences for B-Cd (geometric means 0.11-0.17 µg/L) and B-Pb (14-20 µg/L), but larger for B-Hg (0.12-0.94 µg/L). Corresponding means for the non-European countries were 0.21-0.26, 32-71, and 0.3-3.2 µg/L, respectively. For B-Cd in European samples, traffic intensity close to home was a statistically significant determinant, for B-Hg fish consumption and amalgam fillings, and for B-Pb sex (boys higher). This study shows that European city children's B-Cd and B-Pb vary only little between countries; B-Hg differs considerably, due to varying tooth restoration practices and fish intake. Traffic intensity seemed to be a determinant for B-Cd. The metal concentrations were low from a risk perspective but the chosen non-European cities showed higher concentrations than the cities in Europe.

Sources and risk factors for lead exposure in indigenous children of the Peruvian Amazon, disentangling connections with oil activity.

INTRODUCTION: In the Corrientes river basin, Peruvian Amazon, lead exposure among indigenous communities was first reported in 2006. To address controversy regarding the main source of exposure, this study aimed to identify the sources and risk factors for lead exposure among children from the communities in question, and to clarify the potential relationship with oil activity. METHODS: This cross-sectional study was conducted in six communities. Participants were children aged 0-17 years and their mothers. Data collection included blood lead levels (BLLs) and hemoglobin determination, a questionnaire on risk factors and environmental sampling. We used age-stratified multivariate regression models, with generalized estimating equation to account for correlation within households. RESULTS: Twenty-seven percent of the children had BLLs ≥10 µg/dl. Mother's BLLs ≥10 µg/dl, playing and chewing lead scraps, fishing ≥three times/week, and living in highly oil-exposed communities increased the risk of having BLLs ≥10 µg/dl. Lead concentrations in sediment, soil, dust, and fish samples were below reference values. CONCLUSIONS: Mother's BLLs ≥10 µg/dl, playing and chewing lead scraps to manufacture fishing sinkers were the most important risk factors for children's BLLs ≥10 µg/dl. The connection with oil activity appears to be through access to metal lead from the industry's wastes.

Lead exposure in indigenous communities of the Amazon basin, Peru.

Since 2006, three studies have reported elevated levels of lead (Pb) among the indigenous population of the Corrientes river, in the Amazon basin of Peru. Due to the large evidence of environmental pollution related to oil exploitation in the area, this activity has been suggested as the source of exposure. This study aimed to evaluate Pb levels in the population and environment of two communities exposed and one community non-exposed to the oil exploitation activity. Blood lead levels (BLL) were determined by the instrument Leadcare. A comparison with the graphite furnace atomic absorption technique was performed in order to validate the Leadcare results. Environmental samples were analyzed by inductively coupled plasma atomic emission spectroscopy. Among 361 capillary samples, the mean BLL was 9.4 µg/dl. Mean BLL of the communities exposed (n=171, x¯=9.5 µg/dl) and non-exposed (n=190, x¯=9.2 µg/dl) to the oil activity were not significantly different. Pb levels in environmental samples were below the maximum permissible levels. The sources of exposure could not be identified. Elevated levels of Pb in the oil-non-exposed community pointed out at other sources not yet clarified.