A comprehensive analysis of children's blood lead levels in Latin America and the Caribbean over the last eight years: Progress and recommendations.

In 2017 we published a review on blood lead levels (BLL) in children from Latin America and the Caribbean (LAC) for data available up to 14th of March 2014 and recommended the identification and control of "lead hot spots". In the present study, an evaluation of progress toward reducing BLL in the region was carried out. A systematic review of the latest literature on lead exposure in the LAC region held on the PubMed, Web of Science and LILACS databases (January 2014 to March 2022) was conducted using the PRISMA methodology. Only original papers published in peer-reviewed English, Spanish, or Portuguese journals were eligible. A total of 558 papers were retrieved, 77 of which met the selection criteria and 31 (40.25 %) were carried out in Mexico. The prevalence of children with BLL above 10 µg. dL-1 was 22.08 % in the previous review versus 6.78 % in the current study. In the present review, the prevalence of children with BLL above 5 µg. dL-1 was 29.62 %, and only one study reported a BLL prevalence rate between 3.3 and 5 µg. dL-1. The highest BLLs were associated with well-known sources or occupational exposures. The number of countries (n = 13) that published data on BLL in children was lower compared to the previous review (n = 16). Most studies were conducted in areas with known lead exposure sources, similar to the earlier review. The percentage of children at risk of lead poisoning in the region remains unknown because few studies have published data on environmental exposure levels and most samples were relatively small. The recommendation to identify and control sources of lead exposure was maintained, while further suggestions for establishing a systematic public health surveillance system for lead were proposed to help reduce the knowledge gap and inform public health policy-making in LAC.

Occupational exposure to potentially toxic elements alters gene expression profiles in formal and informal Brazilian workers.

Chemical elements, such as toxic metals, have previously demonstrated their ability to alter gene expression in humans and other species. In this study, microarray analysis was used to compare the gene expression profiles of different occupational exposure populations: a) informal workers who perform soldering of jewelry inside their houses (n = 22) in São Paulo (SP) State; and b) formal workers from a steel company (n = 10) in Rio de Janeiro (RJ) state, Brazil. Control participants were recruited from the same neighborhoods without occupational chemical exposure (n = 19 in SP and n = 8 in RJ). A total of 68 blood samples were collected and RNA was extracted and hybridized using an Agilent microarray platform. Data pre-processing, statistical and pathway analysis were performed using GeneSpring software. Different expression was detected by fold-change analysis resulting in 16 up- and 33 down-regulated genes in informal workers compared to the control group. Pathway analysis revealed genes enriched in MAPK, Toll-like receptor, and NF-kappa B signaling pathways, involved in inflammatory and immune responses. In formal workers, 20 up- and 50 down-regulated genes were found related to antimicrobial peptides, defensins, neutrophil degranulation, Fc-gamma receptor-dependent phagocytosis, and pathways associated with atherosclerosis development, which is one of the main factors involved in the progression of cardiovascular diseases. The gene IFI27 was the only one commonly differentially expressed between informal and formal workers and is known to be associated with various types of cancer. In conclusion, differences in gene expression related to occupational exposure are mainly associated with inflammation and immune response. Previous research has identified a link between inflammation and immune responses and the development of chronic diseases, suggesting that prolonged occupational exposures to potentially toxic elements in Brazilian metal workers could lead to negative health outcomes. Further analysis should be carried out to investigate its direct effects and to validate causal associations.

Is chemical exposure present in informal work associated with Sars-CoV-2 infection?

OBJECTIVE: To compare the incidence of covid-19 symptoms between informal home-based workers and a control group and to assess the association of these cases with blood elements concentrations and other relevant risk factors for Sars-Cov-2 infection. METHODS: Welders chemically exposed to potentially toxic elements (PTEs) (n = 26) and control participants (n = 25) answered questionnaires on adherence to social distancing and signs and symptoms of the disease for five months during the covid-19 pandemic. After follow-up, covid-19 serology tests were performed on a subsample of 12 chemically exposed workers and 20 control participants. Before the pandemic, PTE concentrations in blood (As, Mn, Ni, Cd, Hg, Sb, Sn, Cu, Zn, and Pb) were measured by ICP-MS. RESULTS: The chemically exposed group had higher lead and cadmium levels in blood (p < 0.01). The control group presented lower adherence to social distancing (p = 0.016). Although not significant, welders had a 74% greater chance of having at least one covid-19 symptom compared with control participants, but their adherence to social distancing decreased this chance by 20%. The use of taxis for transportation was a risk factor significantly associated with covid-19 symptoms. CONCLUSION: The lower adherence to social distancing among the control group greatly influences the development of covid-19. The literature lacks data linking exposure to PTEs and Sars-Cov-2 infection and/or severity. In this study, despite chemical exposure, working from home may have protected welders against covid-19, considering that they maintained greater social distancing than control participants.

Is chemical exposure present in informal work associated with Sars-CoV-2 infection?

ABSTRACT OBJECTIVE To compare the incidence of covid-19 symptoms between informal home-based workers and a control group and to assess the association of these cases with blood elements concentrations and other relevant risk factors for Sars-Cov-2 infection. METHODS Welders chemically exposed to potentially toxic elements (PTEs) (n = 26) and control participants (n = 25) answered questionnaires on adherence to social distancing and signs and symptoms of the disease for five months during the covid-19 pandemic. After follow-up, covid-19 serology tests were performed on a subsample of 12 chemically exposed workers and 20 control participants. Before the pandemic, PTE concentrations in blood (As, Mn, Ni, Cd, Hg, Sb, Sn, Cu, Zn, and Pb) were measured by ICP-MS. RESULTS The chemically exposed group had higher lead and cadmium levels in blood (p < 0.01). The control group presented lower adherence to social distancing (p = 0.016). Although not significant, welders had a 74% greater chance of having at least one covid-19 symptom compared with control participants, but their adherence to social distancing decreased this chance by 20%. The use of taxis for transportation was a risk factor significantly associated with covid-19 symptoms. CONCLUSION The lower adherence to social distancing among the control group greatly influences the development of covid-19. The literature lacks data linking exposure to PTEs and Sars-Cov-2 infection and/or severity. In this study, despite chemical exposure, working from home may have protected welders against covid-19, considering that they maintained greater social distancing than control participants.

A Low-Cost Method Shows Potentially Toxic Element Levels in Dust Correlated with Elevated Blood Levels of These Chemicals in Children Exposed to an Informal Home-Based Production Environment.

Dust is recognized as a route of exposure to environmental pollutants. The city of Limeira, Sao Paulo state, Brazil, is a production center for jewelry and fashion jewelry, where part of this jewelry production is home-based, informal, and outsourced. The aim of this study was to evaluate exposure to Potentially Toxic Elements (PTE: Cr, Sn, Mn, Sb, Ni, Cu, Zn, Cd, Pb, and As) in dust among children from households of informal workers using electrostatic dust cloths (EDC). Dust samples were collected in 21 exposed and 23 control families using EDC from surfaces where dust deposits had accumulated for approximately 14 days. In exposed families, dust samples were also collected from welders' workstations. PTE concentrations were then determined using inductively coupled mass spectrometry (ICP-MS). The results raised concerns in relation to Cr, As, and Cd exposure among children within the informal home-based production environment. Blood PTE concentrations in children showed a moderate correlation with levels of Cr (Rho 0.40), Zn (Rho −0.43), and As (Rho 0.40), and a strong correlation with Cd (Rho 0.80) (p < 0.05), detected in dust. In conclusion, analyzing dust collected using EDC proved a potentially low-cost tool for determining PTE in dust. In addition, the results confirmed that informal home-based work poses a risk for children residing in these households. Public policies are needed to assist these families and promote better conditions of occupational health and safety for the whole family.

Study of controlled migration of cadmium and lead into foods from plastic utensils for children.

Lead (Pb) is a highly neurotoxic chemical element known for reducing intelligence quotient (IQ) and promoting antisocial behavior in children and adolescents, while cadmium (Cd) is a carcinogenic bioaccumulative element. Both these metals are included in the priority pollutant list of the United States Environmental Protection Agency and in the WHO List of Chemicals of Major Public Health Concern, where contaminated foods and beverages are the most common pathways of exposure. The objective of this study was to determine total Cd and Pb levels in colored plastic utensils (cups, mugs, bowls, feeding bottles, and plates) for use by children and to measure the specific migration of these elements into beverages and foods. Total contaminant levels were determined using a handheld X-ray fluorescence analyzer. Specific migration tests were conducted using the simulant solutions acetic acid 3% (m/v) and water. Migration levels were determined by ICP-MS. Specific migration tests for Pb were also performed on commercially available samples (cola soft drink, orange juice, vinegar, and milk), with levels determined by graphite-furnace atomic absorption spectrometry (GF-AAS). A total of 674 utensils were analyzed in loco at major commercial centers in Greater São Paulo, of which 87 were purchased for containing Cd and Pb concentrations above permitted limits. Mean concentrations of the metals detected in the purchased utensils were 1110 ppm for Pb and 338 ppm for Cd. For specific migration assays, Pb levels were 187, 13, and 380 times above the permitted limit (0.01 mg.kg -1) for acetic acid, water, and orange juice, respectively. Cd levels were 50 and 2.4 times above the maximum permitted limit (0.005 mg.kg -1) for acetic acid and water, respectively. The districts where the utensils were purchased were grouped according to their social vulnerability index and compared using ANOVA. Pb levels were different between low and medium/high social vulnerability groups (p = 0.006). The findings corroborate the initial hypothesis that these utensils constitute a major source of exposure to PTEs such as Cd and Pb, pointing to the need for stricter regulation and inspection by the Brazilian regulatory agencies.

Potentially Toxic Elements in Costume Cosmetics Used by Children and Adults Are Associated with Cancer Risk.

(1) Background: Costume cosmetics, such as face paints and pancakes, are used by adults and children during Halloween, Carnival, or children's parties. However, the metallic-based pigments used as dyes in these products may contain toxic elements associated with different levels of exposure. Objectives: (a) to determine the Al, As, Ba, Cd, Co, Cr, Cu, Ni, Pb, Sb, Sn, and Sr concentrations in face paints and pancakes; and (b) to estimate cancer and non-cancer risks posed by the concentrations of each element in these products for dermal and ingestion exposure scenarios during children and adult use. (2) Methods: A total of 95 samples of face paints and pancakes (four brands in different textures and colors) were purchased at the largest high-street commercial center in São Paulo city, Brazil. An extraction procedure with nitric acid was carried out using a graphite-covered digester block. Toxic element determinations were performed using an ICP-MS. (3) Results: The non-cancer risks estimated were lower than 1, except for dermal exposure in adults for some target systems. High cancer risk values raise concerns in both groups. The risk for children ranged from 10-8 to 10-5 and proved higher in cases of accidental exposure by ingestion. For occupational exposure in adults, cancer risks were even higher, ranging from 10-3 to 10-5, with the highest values associated with dermal exposure. (4) Conclusions: The study results suggest the presence of potentially toxic elements (PTEs) in cosmetics should be regulated/monitored to protect human health, especially for occupational exposure and use by children.

Integration of proteomic and metabolomic analyses: New insights for mapping informal workers exposed to potentially toxic elements.

Occupational exposure to potentially toxic elements (PTEs) is a concerning reality of informal workers engaged in the jewelry production chain that can lead to adverse health effects. In this study, untargeted proteomic and metabolomic analyses were employed to assess the impact of these exposures on informal workers' exposome in Limeira city, São Paulo state, Brazil. PTE levels (Cr, Mn, Ni, Cu, Zn, As, Cd, Sn, Sb, Hg, and Pb) were determined in blood, proteomic analyses were performed for saliva samples (n = 26), and metabolomic analyses in plasma (n = 145) using ultra-high performance liquid chromatography (UHPLC) coupled with quadrupole-time-of-flight (Q-TOF) mass spectrometry. Blood PTE levels of workers, controls, and their family members were determined by inductively coupled plasma-mass spectrometry (ICP-MS). High concentration levels of Sn and Cu were detected in welders' blood (p < 0.001). Statistical analyses were performed using MetaboAnalyst 4.0. The results showed that 26 proteins were upregulated, and 14 proteins downregulated on the welder group, and thirty of these proteins were also correlated with blood Pb, Cu, Sb, and Sn blood levels in the welder group (p < 0.05). Using gene ontology analysis of these 40 proteins revealed the biological processes related to the upregulated proteins were translational initiation, SRP-dependent co-translational protein targeting to membrane, and viral transcription. A Metabolome-Wide Association Study (MWAS) was performed to search for associations between blood metabolites and exposure groups. A pathway enrichment analysis of significant features from the MWAS was then conducted with Mummichog. A total of 73 metabolomic compounds and 40 proteins up or down-regulated in welders were used to perform a multi-omics analysis, disclosing seven metabolic pathways potentially disturbed by the informal work: valine leucine and isoleucine biosynthesis, valine leucine and isoleucine degradation, arginine and proline metabolism, ABC transporters, central carbon metabolism in cancer, arachidonic acid metabolism and cysteine and methionine metabolism. The majority of the proteins found to be statistically up or downregulated in welders also correlated with at least one blood PTE level, providing insights into the biological responses to PTE exposures in the informal work exposure scenario. These findings shed new light on the effects of occupational activity on workers' exposome, underscoring the harmful effects of PTE.

Home-based outsourced informal work by children and adolescents impacts sleep and leisure-a preliminary study.

Child labor is a serious and controversial issue. Despite governments establishing health policies prohibiting or restricting the age of entry to the job market, there is still a large number of working children and adolescents worldwide, particularly informal workers. This study aimed to evaluate the living and working conditions of adolescents. Work activities were home-based involving the production of jewelry and fashion jewelry, in a Brazilian city, Limeira, São Paulo. Participants were 11-17-year-old workers and non-workers, who answered a comprehensive questionnaire on their living and working conditions and filled out a time-budget protocol for 10 consecutive days. Both instruments were applied twice during both school and vacation terms. Chi-square/Fisher and Student's t tests were used, and Bonferroni corrections were performed in the significance levels of the statistical methods. During school time, working children/adolescents had lower mean sleep duration (p < 0.01) than non-working ones. During vacation, non-working youths enjoyed longer leisure time (p < 0.04). Comparing school and vacation times, working youths showed no significant difference in daily routine (p > 0.05), while non-workers spent more time on leisure activities during the vacation period (p = 0.005). In summary, this study found that working at home had a deleterious effect on the sleep and leisure of the youths studied. These data should be considered as an exposome component (specific external exposure) in evaluations of long-term health endpoints and their possible causes.

Hairdressers are exposed to high concentrations of formaldehyde during the hair straightening procedure.

The fact that hairdressers are exposed to toxic substances through the handling of creams and smoothing products prompted this study whose aim was to quantify the occupational exposure of hairdressers to formaldehyde by comparing the results of exposure for different types of beauty salon. The study population consisted of 23 beauty salons located in the city of Bauru, São Paulo state, Brazil. The samples were collected by inhaled air tests during the most critical 15-min period of the hair straightening procedure and during the 8-h work shift. The concentrations of formaldehyde contained in the formulations of these products were also evaluated and compared with exposure levels. The results were evaluated according to the exposure limits prescribed in Brazilian (NR15) and North American (US OSHA and US NIOSH) standards. The analysis of the smoothing products showed concentrations of formaldehyde of between 3 and 11% in their compositions, i.e., up to 54 times above the 0.2% limit allowed by the National Agency of Sanitary Surveillance (ANVISA). The present study showed that hairdressers are chronically exposed to high concentrations of formaldehyde in the workplace and these exposures are mainly associated with the work process, where many variables of this process influence the intensity of exposure.

Brazilian preschool children attending day care centers show an inadequate micronutrient intake through 24-h duplicate diet.

Inadequate micronutrient intake in childhood harms growth and development, and it is related to increased rates of morbidity and mortality. The aim of this study is to evaluate the dietary intake and prevalence of inadequate micronutrient intake in preschool children (1-4 years old) attending two-day care centers. To assess children's dietary micronutrient intake, 24-h duplicate diets (n = 64) were collected for one week-day, including everything the children ate and drank both at home and in kindergarten. Anthropometric measurements were carried out to evaluate the children's nutritional status. The micronutrients copper, iron, calcium, magnesium, selenium, zinc, potassium, sodium, and manganese were determined by inductively coupled plasma mass spectrometry or graphite furnace atomic absorption spectrometry. Calcium and selenium were found with high inadequate intake rates: 50% and 42%, respectively, for children aged 1-3 years old, and 93% and 90% for children aged 4 years. Potassium was consumed in very low amounts, 13% and 5% of children aged 1-3 and 4 years old, respectively, achieved the adequate intake for the nutrient. Sodium intakes were excessive: 23% of the 1-3-year old and 42% of the 4-year-old children, respectively, had an intake higher than the tolerable upper levels. Regarding the nutritional status, overweight and obesity prevalence was 17%. Therefore, considering the damaging health effects for children of micronutrient deficiency and overweight and obesity status, it is necessary that government authorities be aware and update public policies and educational programs in order to promote healthy eating habits in early childhood.

The human exposome unraveling the impact of environment on health: promise or reality?

Considering the innovative nature of the approach to human exposome, we present the state of the art of studies on exposome, and discuss current challenges and perspectives in this area. Several reading and discussion activities were conducted by the Expossoma e Saúde do Trabalhador (eXsat - Group Exposome and Worker's Health), with systematization of the literature in the area published between January 2005 and January 2017, available in the databases PubMed and Web of Science. This comment brings a thematic analysis to encourage the dissemination of the exposome approach for studies in the Public Health area.

The human exposome unraveling the impact of environment on health: promise or reality? / O expossoma humano desvendando o impacto do ambiente sobre a saúde: promessa ou realidade?

ABSTRACT Considering the innovative nature of the approach to human exposome, we present the state of the art of studies on exposome, and discuss current challenges and perspectives in this area. Several reading and discussion activities were conducted by the Expossoma e Saúde do Trabalhador (eXsat - Group Exposome and Worker's Health), with systematization of the literature in the area published between January 2005 and January 2017, available in the databases PubMed and Web of Science. This comment brings a thematic analysis to encourage the dissemination of the exposome approach for studies in the Public Health area.

RESUMO Levando em consideração a natureza inovadora da abordagem do expossoma humano, apresentamos o estado da arte dos estudos sobre expossoma, e discutimos os desafios e perspectivas atuais nessa área. Foram realizadas diversas atividades de leitura e discussão pelo grupo eXsat (Expossoma e Saúde do Trabalhador), com sistematização da literatura da área publicada entre janeiro de 2005 e janeiro de 2017, disponíveis nas bases de dados PubMed e Web of Science. O presente comentário traz uma análise da temática de forma a incentivar a disseminação da abordagem do expossoma nos estudos da área de Saúde Pública.

Home-based and informal work exposes the families to high levels of potentially toxic elements.

The city of Limeira presents a relevant productive chain of jewelry and fashion jewelry, including a scenario of outsourcing informal home practices. It is highly complex to understand the potentially toxic elements (PTE: Cr, Mn, Ni, Cu, Zn, As, Cd, Sn, Sb, Hg, and Pb) exposures of the workers because this productive chain encompasses households. This study aimed to investigate the associations between blood PTE levels and informal work in the home environment. Fifty-two families divided into Exposed group (n = 112) and Control group (n = 53) were included. Families' blood (n = 165) and welder's breathing zone air samples (n = 9) were collected and PTEs concentrations were determined by ICP-MS. Questionnaires were applied to collect sociodemographic information and workplace details. Principal component analysis, Mann-Whitney test, cluster and a logistic regression analysis based on environment-wide association studies (EWAS) were carried out. Ni, Cu, Zn, Cd and Pb concentrations in the air samples were higher than occupational guidelines. Eighty percent of the workers were female, and 43.5% of those females then worked as welder. A significant difference was found for Pb concentration between the exposed and control group (p < 0.0001) and between sexes (p = 0.0046). For Cu (p < 0.0001) and Sb (p = 0.0434), differences were found between the sexes. The receiver operating characteristic of the EWAS was 0.80, providing evidence of a potential model to associate exposure levels and occupational factors. PTEs concentrations in the air samples raised concerns, particularly for children, who were in the same exposure scenario. Inadequate work conditions were observed in the houses, revealing the need of public actions to protect these families.

Lead exposure from households and school settings: influence of diet on blood lead levels.

Lead is known as a potent toxicant to human health, particularly for children while their central nervous system is developing. The aim of this study was to investigate the associations between blood lead levels (BLLs) and lead exposure in the children's diet, home, and school environments. A cross-sectional study was conducted with 153 children aged 1-4 years, in four day care centers (DCCs), where a high prevalence of lead exposure was previously found. Lead determination by graphite furnace atomic absorption spectrometry (GF-AAS) was performed for venous blood, drinking water collected in the DCCs, and the 24-h diet (n = 64). Environmental screenings were conducted to evaluate lead concentrations in the tableware, buildings, and playground items in all DCCs and children's homes (n = 18) by using a field-portable X-ray fluorescence analyzer (FP-XRF). The BLL mean was 2.71 µg dL-1. Means for 24-h lead concentrations in the diet were 1.61 and 2.24 µg kg-1 of body weight (BW) in two DCCs. Lead concentrations in the water supply were lower than 2 µg L-1. More than 11% of the DCCs' environmental analyses presented lead concentrations higher than or equal to 1 mg cm-2, as defined by the USEPA. The diet was not found to be a risk factor for lead exposure, but households and DCC settings raised concern. Children's exposure to lead in DCC environments, where they spend the most part of their weekdays, appeared to be relevant. Graphical abstract ᅟ.

Lead, Cadmium, and Arsenic Bioaccessibility of 24 h Duplicate Diet Ingested by Preschool Children Attending Day Care Centers in Brazil.

Lead, known as a metal with high neurotoxicity to children, cadmium, which is a carcinogenic and bioaccumulative contaminant, and arsenic, a class 1 carcinogenic according to the International Agency for Research on Cancer, are toxic elements (TEs) whose relevant route of exposure may be diet. We determined the bio-accessible fraction of lead, cadmium, and arsenic from the diet of preschool children from two day care centers (DCC). A cross-sectional study was conducted with 64 one⁻four-year-old children from two DCCs where the 24-h duplicate diet samples were collected. The diet samples were analyzed by ICP-MS for lead, cadmium, and arsenic total concentrations (n = 64) and their bio-accessibility were analyzed for a subsample (n = 10). The dietary intake (DI) mean for lead, cadmium, and arsenic were 0.18 ± 0.11 µg kg-1 bw, 0.08 ± 0.04 µg kg-1 bw, and 0.61 ± 0.41 µg kg-1 bw, respectively. All DI calculated for TEs, considering total intake, were found lower than the tolerable limits (TL) (European Union, or World Health Organization, WHO, when applicable) except for one child's Pb intake. Bio-accessibilities ranged between 0% to 93%, 0% to 103%, and 0% to 69%, for lead, cadmium, and arsenic, respectively. Although DI for TEs has been found lower than TL, these reference values have been recently decreased or withdrawn since it was for lead and arsenic whose TL were withdrawn by WHO.

High blood lead levels are associated with lead concentrations in households and day care centers attended by Brazilian preschool children.

BACKGROUND: A previous study observed high blood lead levels (BLL) in preschool children attending 50 day care centers (DCC) in São Paulo, Brazil. OBJECTIVE: To identify whether lead levels found in both homes and DCC environments are associated with high blood lead levels. METHODS: Children attending 4 DCCs, quoted here as NR, VA, PS and PF, were divided into two groups according to BLL: high exposure (HE: ≥13.9 µg/dL; 97.5 percentile of the 2013 year sample) and low exposure (LE: <5 µg/dL). For in situ lead measurements (lead paint mode: mg/cm2 and ROHS mode: µg/g) in the children's households and in the DCC environments, a field portable X-ray-fluorescence analyzer was used. Multiple logistic regressions were performed to control for confounding factors. Odds ratios were adjusted for age, sex, day care center's measured lead, and tobacco. RESULTS: In an NR DCC building, 33.8% of the measurements had lead levels >600 µg/g, whereas such levels were observed in 77.1% of NR playground measurements. In VA DCC, 22% and 23% of the measurements in the building and in the playgrounds had levels higher than 600 µg/g, respectively. The percentage of high lead levels in the children's houses of the LE group was 5.9% (95% CI: 4.3-7.6%) and 13.2 (95% CI: 8.3-18.0%) in the HE group. Moreover, a significant association was found between high BLLs and lead levels found both in households and DCCs (p < 0.001). Most of the high lead measurements were found in tiles and playground equipment. CONCLUSIONS: Lead exposure estimated from the DCCs, where children spend about 10 h/day, can be as relevant as their household exposure. Therefore, public authorities should render efforts to provide a rigorous surveillance for lead-free painting supplies and for all objects offered to children.

Blood lead and cadmium levels in preschool children and associated risk factors in São Paulo, Brazil.

In Brazil, there are scarce data on lead (Pb) and cadmium (Cd) contamination, especially for more vulnerable populations such as preschool children. In this paper, we answer two questions: (1) What are the exposure levels of lead and cadmium in preschool children, in Sao Paulo, Brazil? and (2) What are the risk factors associated with this exposure? This cross-sectional study included 50 day care centers (DCCs), totaling 2463 children aged 1-4 years. Venous blood samples were analyzed by ICP-MS. Questionnaires were administered to the parents. Multiple logistic regression models were used to identify associations between blood lead levels (BLLs) and blood cadmium levels (BCLs) and potential risk factors. The geometric mean for BLLs was 2.16 µg/dL (95% CI: 2.10-2.22 µg/dL), and the 97.5th percentile was 13.9 µg/dL (95% CI: 10.0-17.3 µg/dL). For cadmium exposure, the geometric mean for BCLs was 0.48 µg/L (95% CI: 0.47-0.50 µg/L), and the 95th percentile was 2.57 µg/L (95% CI: 2.26-2.75 µg/L). The DCCs' geographic region was associated with high BLLs and BCLs, indicating hot spots for lead and cadmium exposures. In addition, it was found that the higher the vehicles flow, the higher were the BLLs in children. Red lead in household gates was also an important risk factor for lead exposure. Comparing these results with the findings of the Fourth National Report on Human Exposure to Environmental Chemicals by CDC-2013, it was found that in Brazilian preschool children the BLLs are almost three times higher (97.5th percentile) and the BCLs are almost twelve times higher (95th percentile) than those in U.S. children. This information is essential to formulate public health policies.

The environmental impact of informal and home productive arrangement in the jewelry and fashion jewelry chain on sanitary sewer system.

The outsourcing informal home practices adopted in jewelry and fashion jewelry chain can cause toxic substance elimination in the effluents and raise a concern for its environmental impact. This study evaluates if this informal work alters the concentration of potentially toxic elements (PTEs: As, Cd, Cr total and Cr-VI, Cu, Hg, Ni, Pb, Sn, and Zn) in the sewage network. The sanitary sewage samples (n = 540) were collected in 15 manholes during two campaigns in three different areas of Limeira-SP, Brazil (industrial area, with informal work and without known industrial/informal activity). The sewage sludge (n = 12), raw (n = 12), and treated sewage (n = 12) were collected in two wastewater treatment plants (WWT: AS and TATU) operating with different treatment process. The PTE determination was performed by ICP-OES, direct mercury analysis, and UV-Vis spectroscopy. Cr-VI, Cu, Ni, and Zn were the only elements above the quantification limit. Four samples exceeded Cu or Zn values permitted to be discharged into sewage system; however, the concentration average was lower than that established by Brazilian legislation. A difference was found between values above and below the 75th percentile for campaign and total organic carbon values (p < 0.015). The AS-treated sewage presented low concentrations of Cu (p < 0.05), Zn (p = 0.02), and Ni (p = 0.01) compared to treated sewage from TATU. In the sludge samples, the Cu means exceeded the limits of the Brazilian legislation (1500 mg kg-1) and the Zn results were very close to the limits (2800 mg kg-1). The heterogeneity of the results can indicate the sporadic nature of the PTE's sanitary disposal. PTEs used in jewelry and fashion jewelry chain may precipitate on the sludge, where presented high concentrations of Cu and Zn which require controlled destination.