Probabilistic modeling of aggregate lead exposure in children of urban China using an adapted IEUBK model

Lead exposure in Chinese children: Urbanization lowers children's blood lead levels (BLLs)

Lead is a toxic metal that can pose a huge threat to children's health. China has experienced rapid urbanization since the reform in 1978; however, there has been no examination of the potential influence of this urbanization on children's blood lead levels (BLLs). This study is the initial investigation to explore the correlation between urbanization and BLLs in Chinese children. Five windows of time are considered: pre-2000, 2001-2005, 2006-2010, 2011-2015 and 2016-2021. The results show that urbanization affected lead distribution in urban soil and agricultural soil during the above periods, especially in northern China. The higher non-carcinogenic risk of lead for children is consistent with the lead pollution in soil (3 < Igeo ≤ 4). Urban children's BLLs are slightly higher than those of rural children in 2001-2010, but rural children's BLLs in 2011-2021 are higher than those of urban children during China's urbanization. The areas of rural decline and the areas of urban growth increased across all the window periods. However, the BLLs decrease in all rural and urban areas during all window periods, especially in urban areas. Children's BLLs have a significantly negative correlation with urban areas (p < 0.01). Therefore, China's urbanization has a significant effect on the decrease in children's BLLs. The significance of this study is to provide a fresh perspective and innovative strategy for policymaking in order to reduce children's BLLs and prevent lead exposure. This can be achieved by transforming their external living environment from a rural lifestyle to an urban one, while also ensuring access to well education and maintaining a balanced nutrient intake.

Association Between Natural/Built Campus Environment and Depression Among Chinese Undergraduates: Multiscale Evidence for the Moderating Role of Socioeconomic Factors After Controlling for Residential Self-Selection

Aim

Evidence on the association between natural-built environments and depression is largely derived from the general population and prone to residential self-selection bias because of the nature of cross-sectional research design. Despite emerging adulthood, which includes the university years, is a critical stage for forming life-long health habits, studies on this topic focusing on undergraduate students are limited. The current study aims to illustrate the underlying mechanisms for how the campus-based environments affect depression in undergraduate students.

Methods

Based on a nationwide representative analytical sample of 22,009 Chinese undergraduates in 2018, we examined participants' reports of depression and campus-centered natural/built environments within multiple buffer sizes including 0.5, 1.0, and 2.5 km. After disentangling residential self-selection, we explored the moderating role of the socioeconomic attributes of undergraduates. The depression outcome was measured by the nine-item Patient Health Questionnaire (PHQ9). Indicators of exposure to green and blue space, transportation infrastructure, and food environments were objectively assessed using different circular buffers around each campus address.

Results

Modeling results indicated that campus neighborhoods with more scattered trees (0.5 km), water (0.5, 1.0, and 2.5 km), and street intersections (1.0 and 2.5 km) were protective against depression. In contrast, those living near denser distributions of outlets serving take-away sweets and fast food (0.5, 1.0, and 2.5 km) were susceptible to depression. These associations were modified by undergraduates' socioeconomic attributes (e.g., grade, Hukou status, and ethnicity) and varied according to geographical scales and exposure metrics.

Conclusion

To deliver effective environmental interventions to curb the prevalence of depression among undergraduate students, further planning policies should focus on the careful conception of the campus-based environment, especially regarding different spatial scales.

Exposure and health risk assessment from consumption of Pb contaminated water in Addis Ababa, Ethiopia

Exposure to lead (Pb) through drinking water has been linked to adverse health outcomes. Children are particularly susceptible. This study was designed to measure Pb contamination level in drinking water of the Ethiopian city Addis Ababa and assess the associated health risks. Eighty-eight fully-flushed drinking water samples were collected from all ten sub-cities of Addis Ababa. Pb concentration was measured using an Inductively Coupled Plasma Mass Spectrometer (ICP-MS). The chronic daily intake (CDI), the hazard quotient (HQ), and the cancer risk (CR) of Pb were determined to assess exposure levels and health effects. Blood lead level (B-Pb) for children was modelled using the integrated exposure uptake biokinetic model (IEUBK). The mean concentration of Pb in the drinking water was 17.8 μg/l, where >50% of the samples exceeded WHO's 10 μg/l guideline. Significant spatial variation of Pb was noticed among sub-cities. The mean CDI was 1.43 and 0.59 μg/kg/day for children and adults, respectively. The HQ showed that 8% of children and 2.3% of adults exceeded the safe limit. The predicted geometric mean of B-Pb ranged from 3.23 to 14.65 μg/dl. The risk of a child having a B-Pb level >5 μg/dl at the median water Pb concentration (10.5 μg/l) was estimated at 13.4%. Based on the 95^th percentile Pb concentration (75.1 μg/l), 89.6% of children would have B-Pb levels above the 5 μg/dl threshold. The estimated CR was found in the range of 1 × 10^-7 to 9.9 × 10^-5; hence cancer risks are not a concern. The study concluded that Addis Ababa's drinking water is likely to be a source of lead exposure where consumers at specific city locations are at risk of numerous non-cancer health effects. The impacts are expected to be severe in the Ethiopian context; hence further investigations and coordinated interventions are required.

Comprehensive screen the lead and other toxic metals in total environment from a coal-gas industrial city (NW, China): Based on integrated source-specific risks and site-specific blood lead levels of 0-6 aged children

A new integrated source-specific risk model and site-specific blood lead levels (BLLs) of 0-6 children were introduced to comprehensive understand the status of the toxic metals in soil-dust-plant total environment from a Coal-Gas industrial city, NW China. 144 samples were collected and ten toxic metals (As, Ba, Co, Cr, Cu, Mn, Ni, Sr, Pb, and Zn) were screened by XRF and ICP-MS. It was found that the occurrences of toxic metals deferred in the different medium, such as Co, Cu, Pb, and Zn observed the trend of accumulating in soil and plant compared to clustered distributions of Cr, Mn and Ni preferred to accumulate in dust. However, few bioaccumulations observed in Ulmus pumila L. Toxic metals distributions in majority of sites influenced by coal combustion mixed sources and industrial activities posed the high integrated ecological risks and caused significant non-carcinogenic and carcinogenic integrated risks for local 0-6 children identified by new integrated source-specific risk model, especially observed in the priority contaminants Co and Pb. The site-specific BLLs confirmed that younger children fewer than 4 lived in the north region were more vulnerable to priority Pb pollution as their BLLs above 50 μg/L, almost up to 80 μg/L. Although proportions of source-specific risks to toxic metals changed in soil and dust, the critical sources from coal combustions and industrial activities posed the most important contribution to the local risks. Therefore, effective strategies targeting at critical sources on coal industries should be conducted to reduce risks, and mostly emphasize on the north hotspot areas.

Issues and Challenges in the Application of the IEUBK Model in the Health Risk Assessment of Lead: A Case Study from Blantyre Malawi

The risk assessment of lead (Pb) requires the use of biokinetic models to translate measured concentrations of Pb in food and environmental media into blood lead (BPb). The aim of this study was to assess the applicability of the Integrated Exposure Uptake Biokinetic (IEUBK) model in the health risk assessment of Pb among children in Blantyre. Children (152) aged 1–6 years were recruited into this cross-sectional study, and foods, house dust, playground soil, water, and venous blood (1 mL) were collected and analyzed for Pb. A seven-day food frequency questionnaire (FFQ) was used to collect food consumption data. The concentrations of Pb ranged from 0.01 to 3.3 mg/kg in food, 2.3 to 265 mg/kg and 1.5 to 482 mg/kg in house dust and playground soil, respectively, as well as 2.0 µg/dL to 50.4 µg/dL and 6.8 to 39.2 µg/dL for measured and predicted BPb, respectively. Various statistical tests indicated less than satisfactory agreement between measured and predicted BPb values. Despite the lack of reliable food consumption data and other limitations, both the predicted and measured BPb values indicate that children in Blantyre are exposed to high levels of Pb, largely through food and soil as a minor source.

A probabilistic toxicokinetic modeling approach to the assessment of the impact of daily variations of lead concentrations in tap water from schools and daycares on blood lead levels in children

The aim of this study was to assess the impact of exposure to tap water lead concentration ([Pb]_TW) occurring in schools or daycares on blood lead level (BLL) of attending children. Given the potentially wide variations in space and time of ([Pb]_TW) documented in the literature, a simple probabilistic toxicokinetic (STK) model that allows the simulation of the time-varying evolution of BLL in response to these variations was developed. Thus, basic toxicokinetic equations were assembled to simulate BLL in a typical infant, toddler and pupil. The STK model's steady-state BLL predictions showed good correspondence when validated against Integrated Exposure and Uptake BioKinetic model predictions for comparable [Pb]_TW values. Exposures to three distributions of [Pb]_TW in specific sets of Canadian schools and daycares documented in the scientific literature were simulated probabilistically with Monte Carlo simulations. For the highest distribution of [Pb]_TW simulated (median, 90th percentile = 24, 412 μg/L), average annual BLL (median, 97.5th percentile) varies between 1.5 and 6.4 μg/dL in infant and 1.1 and 3 μg/dL in pupils. Toddler's results were midway between those from the infants and pupils. Under this exposure scenario, the infant may present BLL > 5 μg/dL for a significant number of days over the course of the academic year (median; 97.5th: 17; 227 days). However, peak exposure may remain unnoticed if rare and drowned out by the background BLL. In conclusion, even if they may be sparse, peak exposure episodes to [Pb]_TW in schools and daycares may suffice to increased BLL in attending individuals. This finding emphasizes the need for further characterization of [Pb]_TW in schools and daycares in order to identify potentially problematic institutions and therefore avoid undesirable exposures for the children attending them.

Characteristics and Risk Assessment of Soil Polluted by Lead around Various Metal Mines in China

The contamination of soil by lead (Pb) is a serious and widespread problem in China, especially in mining areas. This paper summarized the available data regarding Pb-contaminated soils around various metal mines in China. Based on these data, the Pb concentration in the soil and its temporal and spatial changes were analyzed. Potential ecological hazards and adult lead models were also used to estimate ecological and health risks. The results indicated that the concentration of Pb was closely related with the type of mine. Compared with other types of mine, soil around lead-zinc (Pb-Zn) and tin (Sn) mines with high Pb contents in the metallic ores and high pollutant emission coefficient were more strongly polluted by Pb. The characteristic spatial and temporal variations of Pb pollution status in China were clarified, and the results showed that the concentration was high in the southern, southwestern, and central regions of China where many mining areas were located, and the mean value passed a turning point in 2012. Ecological risk assessments indicated that some areas around mines were at considerable to high risk, and the risk was relatively severe in Pb-Zn mining areas. According to the adult lead model, Pb-Zn mines had a greater impact on blood Pb concentration than the other types of mine.

Snack foods and lead ingestion risks for school aged children: A comparative evaluation of potentially toxic metals and children's exposure response of blood lead, copper and zinc levels

Snack foods are common and highly advertised to children and serve their natural predispositions for sweet and salty tastes. However, the risk issues of low-cost snacks eaten by 0-6 aged children are lack of more concern. To better understand the issue of low-cost snacks this study considered potentially toxic metals (PTMs) impact on children's health risk, measured PTMs in a collection of 570 collected low-cost snacks contributed by 1342 voluntary participants children aged 0-6 years involved in Xi'an city are conducted. Nine priority PTMs and amounts ranked as Mn > Zn > Cu > Cr > Sb > Pb > Ni > Cd > Co. The Estimated Weekly Intake of PTMs in snacks for children accounted for a proportion of the Provisional Tolerance Weekly Intake. Children's daily snack ingestion of Cr, Cd and Pb were especially concerning. It was noted that all PTMs in flour products contribute to the total Target Hazard Quotient (THQ>1) were observed having a non-carcinogenic risk compared to the single metals Cr, Co and Cd with carcinogenic risk. The correlations between Cu, Pb, Zn in low-cost snacks and children's bloods reflected PTMs especially for Pb that transfers into children's bodies mostly through low-cost foodstuffs ingestion. Also, the elevated blood lead levels (BLLs) depended on readily available, low-quality snacks accessible for children. Therefore, multi-initiatives aimed at improving the quality, increasing awareness, and a PTM monitoring program for low-cost snack food market to young children should be undertaken.

Potentially toxic metals and the risk to children's health in a coal mining city: An investigation of soil and dust levels, bioaccessibility and blood lead levels

Coal is a primary energy source in the world. Potentially toxic metals (PTMs) emission from coal mining and combustion are posing a serious public health concern. In order to quantify and evaluate the effect of PTMs on children's health, the concentrations of 12 PTMs (As, Co, Cr, Cu, Mn, Ni, Pb, Sr, Zn, Ca, Fe, and Mg) bound in urban soil and street dust are determined and blood lead levels of these PTMs in 229 children (0-6 years old) are collected from the coal mining city of Yulin, China. In vitro pulmonary bioaccessibilities of PTMs are evaluated by artificial lysosomal fluid and Gamble's solution, and gastrointestinal bioaccessibilities by the unified BAGRE method (UBM); correlations between chemical speciation of PTMs and their bioaccessibility are examined, and children's (0-6 years old) health risks are systematically studied. Similar distribution levels of PTMs are found in soils and dusts, with the most polluted metals being Co, Sr, Ca and Pb. All PTMs (except Cr, Fe) are from the considerable artificial lysosomal fluid extraction both in soil and dust, while Ca and Co are favorably extracted in gastro and intestinal phases than others. Significant correlations are observed between the bioaccessibilities (lung and gastrointestinal) and Fe/Mn hydroxide-bound and carbonate-bound phases, which are key factors influencing and determining PTMs' bioaccessibility. Blood lead levels for children (0-6 years old) are 27.47 (21.65, 33.30) for 0-1 year olds, 32.29 (26.39, 38.19) for 1-2 year olds, 36.99 (28.16, 45.81) for 2-3 year olds, 30.79 (22.56, 39.01) for 3-4 year olds, 27.12 (17.31, 36.93) for 4-5 year olds, 34.59 (24.22, 44.97) for 5-6 year olds and 37.83 (24.15, 51.51) μg/L for 6-7 year olds, respectively, with 3.93%, 3.49%, 4.80%, 2.62%, 1.31%, 1.75% and 1.31% exceeding 50 μg/L, respectively. This indicates that the blood lead levels elevate for 1-2 year and 5-6 year old groups, which should be paid more attention. Although the non-carcinogenic and carcinogenic risks of most PTMs are under the acceptable level, the higher carcinogenic risk of Ni and non-carcinogenic risk of Pb should be monitored continuously. We suggest that further actions will be taken to reduce PTMs exposure for children through sustainable clean and ecological energy technology for coal mining, especially for those infants of 1-2 years old.

Status of lead accumulation in agricultural soils across China (1979-2016)

The first national-scale assessment of lead (Pb) contamination in agricultural soils across China was conducted based on >1900 articles published between 1979 and 2016. Pb concentrations, temporal and spatial variations, and influencing factors were analyzed. Children's blood lead levels (BLLs) were also estimated using the integrated exposure uptake biokinetic (IEUBK) model. Pb concentrations in different areas of China varied greatly, which was closely associated with the distribution of Pb-related industries, especially Pb-zinc mine smelting, non-ferrous polymetallic mine smelting, e-waste recycling, and leaded gasoline consumption. The year 2000 was a significant transition year for Pb concentrations, with a rapid increase pre-2000 and a subsequent slow upward trend. Pb concentrations were found to be strongly associated with indicators of economic and social development including gross domestic product (GDP), population size, and vehicle ownership. Leaded gasoline, coal combustion, and non-ferrous smelting were the main sources of atmospheric Pb during the different periods. Predicted BLLs were higher in South China than those in the north. This study details the overall Pb contamination status of agricultural soils in China, and thus provides insights for policymakers with respect to pollution prevention measures.

Public Health Consequences of Lead in Drinking Water

PURPOSE OF REVIEW

Lead can enter drinking water from lead service lines and lead-containing plumbing, particularly in the presence of corrosive water. We review the current evidence on the role of drinking water as a source of lead exposure and its potential impacts on health, with an emphasis on children. Drinking water guidelines and mitigation strategies are also presented.

RECENT FINDINGS

The impact of lead on neurodevelopmental effects in children even at low levels of exposure is well established. Population and toxicokinetic modeling studies have found a clear relationship between water lead levels and blood lead levels in children at low levels of lead in drinking water. Various mitigation strategies can lower lead levels in water. The importance of drinking water as a contributor to total lead exposure depends on water lead levels and the amount consumed, as well as the relative contribution of other sources. Efforts should be made to reduce lead exposure for all sources, including drinking water, considering that no threshold level of exposure exists for the neurodevelopmental effects of lead in children.

The impact of chronic environmental metal and benzene exposure on human urinary metabolome among Chinese children and the elderly population

The health effects of metals and benzene exposure have been extensively investigated; however, information on the impact of chronic environmental metal and benzene exposure on human urinary metabolome is limited. In this study, a total of 566 participants, including 352 elderly and 214 children, were split into the "exposed" and "control" groups. The urine samples of all the participants were collected and stored at - 80 °C until analysis. The urinary levels of 17 metals and S-phenylmercapturic acid (S-PMA) were determined by the ICP-MS and LC-MS/MS methods to comprehensively assess the personal metal and benzene exposure levels, respectively. Then, the individual levels of metal and benzene exposure were correlated to the metabolic consequences of ambient pollutant exposure, which were previously observed in our metabolomics study. As a result, multiple metals, including Cd, Co, Cr, Cu, Fe, Hg, Li, Mo, Ni, Pb, Se, and Zn, exhibited a significant linear dose-dependent association with one or more urinary metabolites, including two amino acids (pyroglutamic acid and 3-methylhistidine), three organic acids (azelaic acid, decenedioic acid, and hydroxytetradecanedioic acid), ten medium-chainacylcarnitines (heptenedioylcarnitine, octenedioylcarnitine, nonenedioylcarnitine, decenedioylglucuronide, 3-hydroxydecanoylcarnitine, dodecanedioylcarnitine, nonanoylcarnitine, decadienylcarnitine, hydroxydodecenoylcarnitine, dodecadienylcarnitine, and dodecenoylcarnitine), and one glucuronide conjugate (decenedioylglucuronide). These observations indicate that the increased environmental metal exposure has caused various oxidative stress-related effects, including the depletion of antioxidants, accelerated muscle proteolysis, elevated activity of UGTs, increased lipid peroxidation, and the disorder of mitochondrial lipid metabolism among exposed children and the elderly. The current study provides new insights into the biological effects induced by metal exposure in the environment.

Lead exposure in young children over a 5-year period from urban environments using alternative exposure measures with the US EPA IEUBK model - A trial

The US Environmental Protection Agency (EPA) Integrated Exposure Uptake Biokinetic (IEUBK) model has been widely used to predict blood lead (PbB) levels in children especially around industrial sites. Exposure variables have strongly focussed on the major contribution of lead (Pb) in soil and interior dust to total intake and, in many studies, site-specific data for air, water, diet and measured PbB were not available. We have applied the IEUBK model to a comprehensive data set, including measured PbB, for 108 children monitored over a 5-year period in Sydney, New South Wales, Australia. To use this data set, we have substituted available data (with or without modification) for standard inputs as needed. For example, as an alternative measure for soil Pb concentration (μg/g), we have substituted exterior dust sweepings Pb concentration (μg/g). As alternative measures for interior dust Pb concentration (μg/g) we have used 1) 30-day cumulative petri dish deposition data (PDD) (as µg Pb/m²/30days), or 2) hand wipe data (as μg Pb/hand). For comparison, simulations were also undertaken with estimates of dust Pb concentration derived from a prior regression of dust Pb concentration (μg/g) on dust Pb loading (μg/ft²) as concentration is the unit specified for the Model. Simulations for each subject using observed data aggregated over the 5-year interval of the study, the most usual application of the IEUBK model, showed using Wilcoxon tests that there was a significant difference between the observed values and the values predicted by the Model containing soil with hand wipes (p < 0.001), and soil and PDD (p = 0.026) but not those for the other two sets of predictors, based on sweepings and PDD or sweepings and wipes. Overall, simulations of the Model using alternative exposure measures of petri dish dust (and possibly hand wipes) instead of vacuum cleaner dust and dust sweepings instead of soil provide predicted PbB which are generally consistent with each other and observed values. The predicted geometric mean PbBs were 2.17 ( ± 1.24) μg/dL for soil with PDD, 1.95 ( ± 1.17) μg/dL for soil with hand wipes, 2.36 ( ± 1.75) μg/dL for sweepings with PDD, and 2.15 ( ± 1.69) for sweepings with hand wipes. These results are in good agreement with the observed geometric mean PbB of 2.46 ( ± 0.99) μg/dL. In contrast to all other IEUBK model studies to our knowledge, we have stratified the data over the age ranges from 1 to 5 years. The median of the predicted values was lower than that for the observed values for every combination of age and set of measures; in some cases, the difference was statistically significant. The differences between observed and predicted PbB tended to be greatest for the soil plus wipes measure and for the oldest age group. Use of 'default dust' values calculated from the site-specific soil values, a common application of the IEUBK model, results in predicted PbB about 22% (range 0 to 52%) higher than those from soil with PDD data sets. Geometric mean contributions estimated from the Model to total Pb intake for a child aged 1-2 years was 0.09% for air, 42% for diet, 5.3% for water and 42% for soil and dust. Our results indicate that it is feasible to use alternative measures of soil and dust exposure to provide reliable predictions of PbB in urban environments.