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Regencia ZJG, Zhao W, Torres-Roja C, Jones BC, Baja ES. Association between lead and circulating markers of inflammation among traffic enforcers in Metro Manila, Philippines: the MMDA traffic enforcer's health study. Int Arch Occup Environ Health 2024; 97:303-311. [PMID: 38351350 DOI: 10.1007/s00420-023-02044-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/23/2023] [Accepted: 12/30/2023] [Indexed: 03/19/2024]
Abstract
PURPOSE Several epidemiological studies have linked lead (Pb) exposure to induced oxidative stress and the promotion of inflammatory response. We performed a within-subjects study (repeated measures study) to evaluate the relationship between the concentration of blood lead (B-Pb) and toenail lead (T-Pb) and circulating markers of inflammation. METHODS We evaluated the associations between B-Pb concentrations and T-Pb concentrations and circulating markers of inflammation, soluble intracellular adhesion molecule-1 (s-ICAM-1), soluble vascular adhesion molecule-1 (s-VCAM-1), and high-sensitivity C-reactive protein (hs-CRP) on 158 traffic enforcers from the Metropolitan Manila Development Authority (MMDA) traffic enforcer's health study. Linear mixed-effects models with random subject-specific intercepts were fitted to estimate the association between B-Pb and T-Pb exposure and circulating markers of inflammation, adjusting for confounding factors. RESULTS Traffic enforcers were middle-aged men (89.4%) with a mean age (± SD) of 37.1 years ± 8.9 years and had a total of 293 valid markers of inflammation measurements. B-Pb concentration was related to increased hs-CRP levels. A 10% increase in B-Pb was associated with a 5.7% increase in hs-CRP level [95% confidence interval (95% CI): 1.3-10.1]. However, B-Pb was not associated with s-ICAM-1 and s-VCAM-1. Furthermore, no associations were observed between T-Pb and all the circulating markers of inflammation. CONCLUSIONS Low-level B-Pb may increase hs-CRP among traffic enforcers. Moreover, the study suggests that Pb via the oxidative and inflammation pathways may have an essential role in the development of cardiovascular disease. Furthermore, MMDA and the Department of Labor and Employment can use our study's findings as evidence to conduct routine screening of blood heavy metals, especially Pb, among MMDA and other traffic enforcers as part of their yearly medical examination.
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Affiliation(s)
- Zypher Jude G Regencia
- Department of Clinical Epidemiology, College of Medicine, University of the Philippines Manila, Room 103, Paz Mendoza Bldg., 547 Pedro Gil Street, 1000, Manila, Philippines
- Institute of Clinical Epidemiology, National Institutes of Health, University of the Philippines Manila, Room 201, NIH Bldg., 623 Pedro Gil Street, Ermita, 1000, Manila, Philippines
| | - Wenyuan Zhao
- Department of Genetics, Genomics and Informatics, The University of Tennessee Health Science Center, Memphis, TN, USA
| | - Carolina Torres-Roja
- Department of Genetics, Genomics and Informatics, The University of Tennessee Health Science Center, Memphis, TN, USA
| | - Byron C Jones
- Department of Genetics, Genomics and Informatics, The University of Tennessee Health Science Center, Memphis, TN, USA
| | - Emmanuel S Baja
- Department of Clinical Epidemiology, College of Medicine, University of the Philippines Manila, Room 103, Paz Mendoza Bldg., 547 Pedro Gil Street, 1000, Manila, Philippines.
- Institute of Clinical Epidemiology, National Institutes of Health, University of the Philippines Manila, Room 201, NIH Bldg., 623 Pedro Gil Street, Ermita, 1000, Manila, Philippines.
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Dai T, Dai Q. Effect of blood lead levels on periodontitis in American adults: a cross-sectional analysis from the national health and nutrition examination survey. BMC Oral Health 2024; 24:364. [PMID: 38515151 PMCID: PMC10956260 DOI: 10.1186/s12903-024-04068-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/16/2023] [Accepted: 02/23/2024] [Indexed: 03/23/2024] Open
Abstract
BACKGROUND The primary objective of this study was to assess the impact of blood lead levels on the development and progression of periodontitis. METHODS This study included 8600 participants from the National Nutrition and Health Examination Survey conducted the United States between 2009 and 2014. The exposure variable was the blood lead level, while the outcome variable was periodontitis. To evaluate the relationship between the blood lead level and periodontitis, a multivariate logistic regression model was used. RESULTS A positive association was observed between blood lead levels and the risk of periodontitis in Model 1 (OR = 7.04, 95% CI = 5.95-8.31). After adjusting for age (continuous), sex, ethnicity, and BMI (continuous) in Model 2, the significant association between blood lead levels and periodontitis risk remained evident (OR = 3.06, 95% CI: 2.54-3.70). Consequently, even after comprehensive adjustment for potential confounding factors in Model 3, the robust association between blood lead levels and periodontitis risk persisted (OR = 2.08, 95% CI = 1.67-2.60). When considering the serum lead concentration as a categorical variable and after adjusting for potential confounders in Model 3, we observed that the odds ratios (ORs) of periodontitis in the T2 (0.94 µg/dL-1.60 µg/dL) and T3 (lead ≥ 1.60 µg/dL) groups increased from 1.27 (OR = 1.27, 95% CI: 1.11-1.44) to 1.57 (OR = 1.57, 95% CI: 1.36-1.81) compared to T1 group. Subgroup analysis revealed no effect modifiers. CONCLUSIONS Our main findings suggest that there is no safe range of blood lead levels regarding periodontitis risk and that increasing blood lead levels can significantly increase the prevalence of periodontitis.
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Affiliation(s)
- Tangye Dai
- Nanchang University Affiliated Stomatological Hospital, Jiangxi Province, China.
- Hangzhou stomatological hospital, Hangzhou, Zhejiang, China.
| | - Qun Dai
- Nanchang University Affiliated Stomatological Hospital, Jiangxi Province, China.
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Chen S, Zhang M, Zhang W, Shao X, Yang X, Yang Z, Nan K. The Causal Association Between Blood Lead and Sleep Disorders: Evidence from National Health and Nutrition Examination Survey and Mendelian Randomization Analysis. J Epidemiol Glob Health 2024:10.1007/s44197-024-00199-4. [PMID: 38372894 DOI: 10.1007/s44197-024-00199-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/26/2023] [Accepted: 01/22/2024] [Indexed: 02/20/2024] Open
Abstract
BACKGROUND Poor sleep quality is a global public health concern. This study aimed to identify the risk factors for sleep disorders and clarify their causal effects. METHODS Data were obtained from the National Health and Nutrition Examination Survey (NHANES) and Mendelian randomization (MR)-Base databases. Baseline characteristics of individuals with and without sleep disorders were compared. A multivariate logistic regression analysis was performed to calculate the effects of each variable on sleep disorders. Causal effects of blood lead levels and hypertension on sleep disorders were assessed using MR analysis. RESULTS In total, 3660 individuals were enrolled in the study. The prevalence of self-reported sleep disorders was 26.21%. Serum lead level, serum mercury level, serum retinol level, prevalence of hypertension, and daily vigorous work duration were significantly higher for those in the sleep disorders group than the control group. After adjusting for various covariates, the effects of serum lead and hypertension on sleep disorders were stable from logistic regression models 1-4. MR analysis showed that blood lead levels were causally related to the risk of sleep disorders (odds ratio (OR) = 1.09, 95% confidence interval (CI) 1.01-1.17, P = 0.030). There was no causal link between elevated blood pressure and sleep disorders (OR = 0.99, 95% CI 0.94-1.04, P = 0.757). Goodness-of-fit tests and sensitivity analyses were used to verify the reliability of the results. CONCLUSIONS Blood lead is positively and causally associated with an increased risk of sleep disorders. These findings provide a novel perspective regarding sleep protection. Taking effective measures to reduce lead exposure may significantly improve sleep health.
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Affiliation(s)
- Shengnan Chen
- Department of Joint Surgery, HongHui Hospital, Xi'an Jiaotong University, Xi'an, 710054, Shaanxi, China
- Medical Department, Xi'an Jiaotong University, Xi'an, 710048, Shaanxi, China
| | - Ming Zhang
- Department of General Practice, Honghui Hospital, Xi'an Jiaotong University, Xi'an, 710054, Shaanxi, China
| | - Weisong Zhang
- Department of Joint Surgery, HongHui Hospital, Xi'an Jiaotong University, Xi'an, 710054, Shaanxi, China
| | - Xiaolong Shao
- Department of Joint Surgery, HongHui Hospital, Xi'an Jiaotong University, Xi'an, 710054, Shaanxi, China
| | - Xiaobin Yang
- Hongdong County Hospital of Traditional Chinese Medicine, Hongdong, 041600, Shaanxi, China
| | - Zhi Yang
- Department of Joint Surgery, HongHui Hospital, Xi'an Jiaotong University, Xi'an, 710054, Shaanxi, China.
| | - Kai Nan
- Department of Joint Surgery, HongHui Hospital, Xi'an Jiaotong University, Xi'an, 710054, Shaanxi, China.
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Queirolo EI, Kordas K, Martínez G, Ahmed Z, Barg G, Mañay N. Secular trends in blood lead concentrations of school-age children in Montevideo, Uruguay from 2009 to 2019. Environ Pollut 2024; 343:123160. [PMID: 38104764 PMCID: PMC10922799 DOI: 10.1016/j.envpol.2023.123160] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/22/2023] [Revised: 11/16/2023] [Accepted: 12/12/2023] [Indexed: 12/19/2023]
Abstract
Lead exposure continues to be a public health problem globally, yet very few countries perform systematic biomonitoring or surveillance of children's blood lead levels (BLLs). Secular trends in children's BLLs have not been well characterized outside North America and Europe. In 2009-19, we conducted a series of non-representative cross-sectional surveys in Montevideo, Uruguay, enrolling children living in areas of the city with known or suspected lead contamination. Lead was measured with atomic absorption spectrometry on fasting venous blood samples. Of the 856 children representing independent (non-sibling) observations, 759 had BLL measures. Other missing data were imputed. Using linear and logistic regression models, we estimated the covariate-adjusted year to year difference in mean BLL and the likelihood of having BLL ≥5 and BLL ≥3.5 μg/dL. At the start of the study, mean ± SD BLL was 4.8 ± 2.6 μg/dL, and at the end 1.4 ± 1.4 μg/dL. The prevalence of BLL ≥5 and BLL ≥3.5 μg/dL also differed markedly between 2009 and 2019 (30.8% vs. 2.7% and 53.8% vs. 5.8%). Similarly, where 80.8% of children had BLL ≥2 μg/dL in 2011, in 2019 that number was 19.3%. The estimated year to year difference in BLL was ∼0.3 μg/dL. Despite this progress, pediatric lead exposure remains a problem in Montevideo. In years 2015-19, between 19 and 48% of school children had BLL ≥2 μg/dL, a level at which adverse neurobehavioral outcomes continue to be reported in the literature. Continued prevention and risk-reduction efforts are needed in Montevideo, including systematic surveillance of BLLs in all children.
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Affiliation(s)
- Elena I Queirolo
- Department of Neuroscience and Learning, Faculty of Health Sciences, Catholic University of Uruguay, Montevideo, Uruguay.
| | - Katarzyna Kordas
- Department of Epidemiology and Environmental Health, University at Buffalo, Buffalo, NY, USA.
| | - Gabriela Martínez
- Department of Toxicology, Faculty of Chemistry, University of the Republic of Uruguay (UDELAR), Montevideo, Uruguay
| | - Zia Ahmed
- RENEW Institute, University at Buffalo, 106 Cooke Hall, Buffalo NY, USA.
| | - Gabriel Barg
- Department of Neuroscience and Learning, Faculty of Health Sciences, Catholic University of Uruguay, Montevideo, Uruguay.
| | - Nelly Mañay
- Department of Toxicology, Faculty of Chemistry, University of the Republic of Uruguay (UDELAR), Montevideo, Uruguay
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Zhang Y, Gong X, Li R, Gao W, Hu D, Yi X, Liu Y, Fang J, Shao J, Ma Y, Jin L. Exposure to cadmium and lead is associated with diabetic kidney disease in diabetic patients. Environ Health 2024; 23:1. [PMID: 38166936 PMCID: PMC10763104 DOI: 10.1186/s12940-023-01045-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/19/2023] [Accepted: 12/20/2023] [Indexed: 01/05/2024]
Abstract
BACKGROUND Cadmium (Cd) and lead (Pb) exhibit nephrotoxic activity and may accelerate kidney disease complications in diabetic patients, but studies investigating the relation to diabetic kidney disease (DKD) have been limited. We aimed to examine the associations of Cd and Pb with DKD in diabetic patients. METHODS 3763 adults with blood metal measurements and 1604 adults with urinary ones who were diabetic from National Health and Nutrition Examination Survey (NHANES) 2007-2016 were involved. Multivariate logistic regression models were used to analyze the associations of blood Cd (BCd), blood Pb (BPb), urinary Cd (UCd), and urinary Pb (UPb) with DKD. RESULTS BPb, BCd, and UCd levels were higher among participants with DKD than diabetics without nephropathy, but UPb performed the opposite result. BPb and UCd were significantly associated with DKD in the adjusted models (aOR, 1.17 (1.06, 1.29);1.52 (1.06, 2.02)). Participants in the 2nd and 3rd tertiles of BPb and BCd levels had higher odds of DKD, with a significant trend across tertiles, respectively (all P-trend < 0.005). Multiplication interaction was also identified for BPb and BCd (P for interaction = 0.044). CONCLUSION BPb, BCd, and UCd were positively associated with the risk of DKD among diabetic patients. Furthermore, there were the dose-response relationship and multiplication interaction in the associations of BPb, BCd with DKD.
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Affiliation(s)
- Yuan Zhang
- Department of Epidemiology and Biostatistics, School of Public Health, Jilin University, No.1163 Xinmin Street, Changchun, Jilin, 130021, P.R. China
| | - Xiaoyu Gong
- Department of Biostatistics and Epidemiology, School of Public Health, China Medical University, No. 77 Puhe Road, Shenyang North New Area, Shenyang, Liaoning Province, 110122, P.R. China
| | - Runhong Li
- Department of Epidemiology and Biostatistics, School of Public Health, Jilin University, No.1163 Xinmin Street, Changchun, Jilin, 130021, P.R. China
| | - Wenhui Gao
- Department of Epidemiology and Biostatistics, School of Public Health, Jilin University, No.1163 Xinmin Street, Changchun, Jilin, 130021, P.R. China
| | - Daibao Hu
- Department of Biostatistics and Epidemiology, School of Public Health, China Medical University, No. 77 Puhe Road, Shenyang North New Area, Shenyang, Liaoning Province, 110122, P.R. China
| | - Xiaoting Yi
- Department of Public Health, Xinjiang Medical University, Urumqi, 830011, P.R. China
| | - Yang Liu
- Department of Biostatistics and Epidemiology, School of Public Health, China Medical University, No. 77 Puhe Road, Shenyang North New Area, Shenyang, Liaoning Province, 110122, P.R. China
| | - Jiaxin Fang
- Department of Epidemiology and Biostatistics, School of Public Health, Jilin University, No.1163 Xinmin Street, Changchun, Jilin, 130021, P.R. China
| | - Jinang Shao
- Department of Biostatistics and Epidemiology, School of Public Health, China Medical University, No. 77 Puhe Road, Shenyang North New Area, Shenyang, Liaoning Province, 110122, P.R. China
| | - Yanan Ma
- Department of Biostatistics and Epidemiology, School of Public Health, China Medical University, No. 77 Puhe Road, Shenyang North New Area, Shenyang, Liaoning Province, 110122, P.R. China.
| | - Lina Jin
- Department of Epidemiology and Biostatistics, School of Public Health, Jilin University, No.1163 Xinmin Street, Changchun, Jilin, 130021, P.R. China.
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Stanek LW, Grokhowsky N, George BJ, Thomas KW. Assessing lead exposure in U.S. pregnant women using biological and residential measurements. Sci Total Environ 2023; 905:167135. [PMID: 37739076 DOI: 10.1016/j.scitotenv.2023.167135] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/20/2023] [Revised: 09/14/2023] [Accepted: 09/14/2023] [Indexed: 09/24/2023]
Abstract
There is strong scientific evidence for multiple pathways of human exposure to lead (Pb) in residential settings, particularly for young children; however, less is known about maternal exposure during pregnancy and children's exposure during early lifestages. A robust, multi-faceted secondary analysis was conducted using data collected by the National Institute of Child Health and Human Development in the 2009-2014 National Children's Study Vanguard Studies. Descriptive statistics summarized Pb concentrations of maternal blood, maternal urine, and house dust vacuum samples collected during pregnancy and residence surface wipes collected both during pregnancy and six months post-partum. The maternal blood Pb level geometric mean was 0.44 μg/dL (n = 426), with no women having values ≥ 5 μg/dL; creatinine-adjusted maternal urinary Pb geometric mean was 0.43 μg/g (n = 366). These blood and urine concentrations are similar to those observed for females in the general U.S. population in the National Health and Nutrition Examination Survey 2010-2011 cycle. A modest correlation between maternal blood Pb and surface wipe measurements during pregnancy was observed (Spearman r = 0.35, p < 0.0001). Surface wipe Pb loadings obtained in mother's homes during pregnancy (n = 640) and from areas where children spent the most time at roughly 6 months of age (n = 99) ranged from 0.02 to 71.8 ng/cm2, with geometric means of 0.47 and 0.49 ng/cm2, respectively, which were relatively low compared to other national studies. Survey responses of demographic, lifestyle, and residence characteristics were assessed for associations with blood concentration and surface wipe loading. Demographic (e.g., race/ethnicity, income, education, marital status) and housing characteristics (e.g., year home built, paint condition, own or rent home, attached garage) were associated with both maternal blood and surface wipe loadings during pregnancy. The availability of residential environmental media and extensive survey data provided enhanced understanding of Pb exposure during pregnancy and early life.
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Affiliation(s)
- Lindsay W Stanek
- U.S. Environmental Protection Agency (EPA), Office of Research and Development (ORD), Research Triangle Park, NC, USA.
| | - Nicholas Grokhowsky
- Formerly of Oak Ridge Institute for Science and Education, Research Triangle Park, NC, USA
| | - Barbara J George
- U.S. Environmental Protection Agency (EPA), Office of Research and Development (ORD), Research Triangle Park, NC, USA
| | - Kent W Thomas
- U.S. Environmental Protection Agency (EPA), Office of Research and Development (ORD), Research Triangle Park, NC, USA
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Rogers GP, Twum F, Zhang J, Wei Y. Covariation between serum cotinine and blood lead levels among US pediatric populations: Trends from 1999 to 2018. J Trace Elem Med Biol 2023; 80:127283. [PMID: 37586164 DOI: 10.1016/j.jtemb.2023.127283] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/24/2023] [Revised: 08/04/2023] [Accepted: 08/10/2023] [Indexed: 08/18/2023]
Abstract
BACKGROUND Tobacco smoke, including both active and passive smoke, can be an important source of lead exposure. However, the relationship between passive tobacco smoke exposure (PTSE) and blood lead levels (BLL), especially in vulnerable populations, needs to be further explored. The present study was to assess the covariation between serum cotinine, a measure of PTSE, and BLL in a pediatric population during 1999-2018. METHODS Data on 21,817 children, aged 3-19 years, was extracted from the biennial nationally representative surveys. The trends of the prevalence of lead exposure (BLL ≥ 3.5 µg/dL) and PTSE (cotinine ≥ 1 ng/mL but < 10 ng/mL) were determined, and the covariation between BLL and cotinine was assessed. The population attributable fraction (PAF) of PTSE to the BLL was proxied using the partial R2 of the hierarchical linear regression. The association between PTSE and lead exposure was estimated using multivariate logistic regression. RESULTS A parallel decreasing trend in the prevalence of lead exposure and PTSE was observed. Similarly, the means of both BLL and cotinine declined simultaneously. Overall, the PAF from PTSE towards blood lead was 7 %, doubling the PAF from race/ethnicity and family income combined. Stratified by race/ethnicity, PAF from PTSE was 8 % in Blacks and Whites and 4 % for Hispanics. The odds ratio of PTSE with lead exposure was 2.45 (95 % CI, 1.75, 3.44), 2.00 (1.21, 3.33), and 1.16 (0.64, 2.13) for Black, White, and Hispanic children, respectively. Cotinine mean remained two times higher in Blacks than non-Black children at the end of the study period. CONCLUSION Serum cotinine and BLL may have a significant association in children that persists even as both have been steadily declining in recent years. The contribution from PTSE to blood lead variations could be greater than that from socioeconomic factors. Further reducing lead exposure might be achieved by eliminating PTSE, particularly for the Black pediatric population.
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Affiliation(s)
| | - Felix Twum
- School of Health Professions, The University of Southern Mississippi, Hattiesburg, MS, USA
| | - Jian Zhang
- Department of Biostatistics, Epidemiology, and Environmental Health Sciences, Jiann-Ping Hsu College of Public Health, Georgia Southern University, Statesboro, GA, USA.
| | - Yudan Wei
- Department of Community Medicine, Mercer University School of Medicine, Macon, GA, USA.
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Zhuo S, Zhang B, Zhang J, Yang M, Yu Z. Effects of dietary inflammatory index, blood lead levels, and flavonoid intake on stroke risk in older Americans: A cross-sectional study. J Stroke Cerebrovasc Dis 2023; 32:107336. [PMID: 37677899 DOI: 10.1016/j.jstrokecerebrovasdis.2023.107336] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/23/2023] [Revised: 08/25/2023] [Accepted: 08/30/2023] [Indexed: 09/09/2023] Open
Abstract
OBJECTIVES We aimed to investigate the relationship between dietary flavonoids, the dietary inflammatory index (DII), blood lead levels, and stroke and evaluate how these factors interact with one another in relation to stroke. MATERIALS AND METHODS We analyzed data from 3675 older American adults aged ≥60 years, obtained from the National Health and Nutrition Examination Survey. Since this database does not specifically differentiate between hemorrhagic and ischemic strokes, our data include both types. We utilized the DII to assess the inflammatory potential of the diet, calculated using 24 h dietary recalls. To determine the association between dietary flavonoids, blood lead levels, DII, and stroke, we performed multivariate logistic regression, subgroup analysis, and restricted cubic splines. We modeled additive interactions to assess the relationship between blood lead levels and DII. RESULTS A high intake of flavonols, flavan-3-ols, and total flavonoids correlated negatively with stroke risk, whereas blood lead levels had a positive association. After adjusting for confounders, stroke risk was found to increase with higher DII. Restricted cubic splines analysis revealed that flavan-3-ols, total flavonoids, blood lead levels, and DII were linearly related to stroke, while the relationships with flavonoids and flavonols were nonlinear. Additionally, a significant interaction was detected between high DII and elevated blood lead levels in relation to stroke risk. CONCLUSIONS Intake of flavan-3-ol, flavanols, and total flavonoids is negatively associated with stroke risk, while higher blood lead levels and DII are positively related to it. High DII and elevated blood lead levels interact synergistically to influence stroke risk.
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Affiliation(s)
- Shitu Zhuo
- Department of Neurology, The Second Affiliated Hospital of Fujian Medical University, Quanzhou, Fujian Province 362000, China; Translational Medicine Immunology Laboratory, Clinical Research Center, The Second Affiliated Hospital of Fujian Medical University, Quanzhou, Fujian Province 362000, China
| | - Biyue Zhang
- Department of Neurology, The Second Affiliated Hospital of Fujian Medical University, Quanzhou, Fujian Province 362000, China
| | - Jingying Zhang
- Department of Neurology, The Second Affiliated Hospital of Fujian Medical University, Quanzhou, Fujian Province 362000, China
| | - Meili Yang
- Department of Neurology, The Second Affiliated Hospital of Fujian Medical University, Quanzhou, Fujian Province 362000, China; Translational Medicine Immunology Laboratory, Clinical Research Center, The Second Affiliated Hospital of Fujian Medical University, Quanzhou, Fujian Province 362000, China
| | - Zheng Yu
- Department of Neurology, The Second Affiliated Hospital of Fujian Medical University, Quanzhou, Fujian Province 362000, China; Translational Medicine Immunology Laboratory, Clinical Research Center, The Second Affiliated Hospital of Fujian Medical University, Quanzhou, Fujian Province 362000, China.
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Bunch D, Pyle-Eilola AL. Lead poisoning: Clinical and laboratory considerations. Adv Clin Chem 2023; 117:209-222. [PMID: 37973320 DOI: 10.1016/bs.acc.2023.08.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2023]
Abstract
Lead has been a known source of toxicity for millennia due to widespread use until the 20th century. Consequently, there remains significant, though decreasing, exposure to lead throughout the world. Clinical signs and symptoms of lead toxicity are well-documented but is particularly concerning for children six years of age and under, as brain development is rapid and therefore, is likely to be affected by even low levels of lead. Therefore, in the United States, it is recommended that young children to be routinely screened for blood lead levels. Blood lead levels can be measured by various methods in laboratories with blood collection greatly impacting possible lead contamination of samples. The history, presentation, and laboratory testing methodologies will be discussed.
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Affiliation(s)
- Dustin Bunch
- Department of Pathology and Laboratory Medicine, Nationwide Children's Hospital, Columbus, OH, United States; Department of Clinical Pathology, Wexner Medical Center, The Ohio State University, Columbus, OH, United States
| | - Amy L Pyle-Eilola
- Department of Pathology and Laboratory Medicine, Nationwide Children's Hospital, Columbus, OH, United States; Department of Clinical Pathology, Wexner Medical Center, The Ohio State University, Columbus, OH, United States.
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Tian W, Zhang Y, Han X, Li Y, Liu J, Wang H, Zhang Q, Ma Y, Yan G. Development and validation of a predictive model for depression risk in the U.S. adult population: Evidence from the 2007-2014 NHANES. BMC Psychol 2023; 11:244. [PMID: 37620859 PMCID: PMC10463541 DOI: 10.1186/s40359-023-01278-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/14/2022] [Accepted: 08/09/2023] [Indexed: 08/26/2023] Open
Abstract
BACKGROUND Depression is a prevalent mental health disorder with a complex etiology and substantial public health implications. Early identification of individuals at risk for depression is crucial for effective intervention and prevention efforts. This study aimed to develop a predictive model for depression by integrating demographic factors (age, race, marital status, income), lifestyle factors (sleep duration, physical activity), and physiological measures (hypertension, blood lead levels). A key objective was to explore the role of physical activity and blood lead levels as predictors of current depression risk. METHODS Data were extracted from the 2007-2014 National Health and Nutrition Examination Survey (NHANES). We applied a logistic regression analysis to these data to assess the predictive value of the above eight factors for depression to create the predictive model. RESULTS The predictive model had bootstrap-corrected c-indexes of 0.68 (95% CI, 0.67-0.70) and 0.66 (95% CI, 0.64-0.68) for the training and validation cohorts, respectively, and well-calibrated curves. As the risk of depression increased, the proportion of participants with 1.76 ~ 68.90 µg/L blood lead gradually increased, and the proportion of participants with 0.05 ~ 0.66 µg/L blood lead gradually decreased. In addition, the proportion of sedentary participants increased as the risk of depression increased. CONCLUSIONS This study developed a depression risk assessment model that incorporates physical activity and blood lead factors. This model is a promising tool for screening, assessing, and treating depression in the general population. However, because the corrected c-indices of the predictive model have not yet reached an acceptable threshold of 0.70, caution should be exercised when drawing conclusions. Further research is required to improve the performance of this model.
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Affiliation(s)
- Wei Tian
- Department of Biostatistics, School of Public Health, Harbin Medical University, Harbin, China
- Department of Cell Biology, Harbin Medical University, Harbin, China
| | - Yafeng Zhang
- Institute for Hospital Management of Henan Province, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, China
| | - Xinhao Han
- Department of Biostatistics, School of Public Health, Harbin Medical University, Harbin, China
| | - Yan Li
- Department of Biostatistics, School of Public Health, Harbin Medical University, Harbin, China
| | - Junping Liu
- Department of Social Medicine, School of Health Management, Harbin Medical University, Harbin, China
| | - Hongying Wang
- Department of Biostatistics, School of Public Health, Harbin Medical University, Harbin, China
| | - Qiuju Zhang
- Department of Biostatistics, School of Public Health, Harbin Medical University, Harbin, China.
| | - Yujie Ma
- Department of Biostatistics, School of Public Health, Harbin Medical University, Harbin, China.
| | - Guangcan Yan
- Department of Biostatistics, School of Public Health, Harbin Medical University, Harbin, China.
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Wang L, Wang C, Liu T, Xuan H, Li X, Shi X, Dai F, Chen J, Li D, Xu T. Association of low-level lead exposure with all-cause and cardiovascular disease mortality in US adults with hypertension: evidence from the National Health and Nutrition Examination Survey 2003-2010. Arch Public Health 2023; 81:146. [PMID: 37574566 PMCID: PMC10424362 DOI: 10.1186/s13690-023-01148-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/28/2022] [Accepted: 07/07/2023] [Indexed: 08/15/2023] Open
Abstract
BACKGROUND To explore the association of low-level lead exposure with all-cause mortality and cardiovascular disease (CVD) mortality among hypertensive patients. METHODS This cohort study enrolled 6453 adults with hypertension from the National Health and Nutrition Examination Survey 2003-2010 and followed mortality information through December 31, 2019. The baseline population were divided into four groups based on quartiles of blood lead levels (Q1: < 1.2 μg/dL, Q2: 1.2-1.6 μg/dL, Q3: 1.7-2.4 μg/dL, Q4: 2.5-4.9 μg/dL). The correlation of blood lead levels to mortality was investigated by Kaplan-Meier survival curves, restricted cubic spline (RCS), proportional hazard regression model, and subgroup analysis. RESULTS During a median follow-up period of 136 (interquartile range 113, 164) months, a total of 1943 (30.1%) deaths were documented, among which 553 (28.5%) were due to CVD. Blood lead showed a linear dose-response relationship with all-cause and CVD mortality. After adequate adjusting for confounders, the risk of all-cause death rose by 23% for each unit increase in continuous variable blood lead (hazard ratio (HR): 1.23; 95% confidence interval (CI):1.16-1.30). When blood lead was a quartile group variable, participants in the Q 4 group had a 73% higher risk of death than those in the Q 1 group (HR:1.73; 95% CI: 1.43-2.10; P for trend < 0.001). The association for CVD mortality was analogous. The concordant results were achieved in the subgroup analysis. CONCLUSION Elevated blood lead levels were strongly associated with an increased all-cause and CVD mortality in adults with hypertension, even at the reference range of blood lead.
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Affiliation(s)
- Lili Wang
- Department of Cardiology, The Affiliated Hospital of Xuzhou Medical University, Xuzhou, 221000, China
| | - Chaofan Wang
- Department of Cardiology, The Affiliated Hospital of Xuzhou Medical University, Xuzhou, 221000, China
| | - Tao Liu
- Department of Cardiology, Jinshan Branch of Shanghai Sixth People's Hospital, Shanghai, 201500, China
| | - Haochen Xuan
- Department of Cardiology, The Affiliated Hospital of Xuzhou Medical University, Xuzhou, 221000, China
| | - Xiaoqun Li
- Department of General Practice, The Affiliated Hospital of Xuzhou Medical University, Xuzhou, 221000, China
| | - Xiangxiang Shi
- Department of General Practice, The Affiliated Hospital of Xuzhou Medical University, Xuzhou, 221000, China
| | - Feng Dai
- Department of Cardiology, The Affiliated Hospital of Xuzhou Medical University, Xuzhou, 221000, China
| | - Junhong Chen
- Department of Cardiology, The Affiliated Hospital of Xuzhou Medical University, Xuzhou, 221000, China
| | - Dongye Li
- Department of Cardiology, The Affiliated Hospital of Xuzhou Medical University, Xuzhou, 221000, China.
| | - Tongda Xu
- Department of Cardiology, The Affiliated Hospital of Xuzhou Medical University, Xuzhou, 221000, China.
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Sun W, Dai B, Hong L, Zhang H. The risk of dental restoration-related lead exposure on renal function. Chemosphere 2023; 337:139405. [PMID: 37399997 DOI: 10.1016/j.chemosphere.2023.139405] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/22/2023] [Revised: 06/14/2023] [Accepted: 06/30/2023] [Indexed: 07/05/2023]
Abstract
OBJECTIVE To explore the relationship between oral restoration count, blood lead (PbB) level, and renal function as potential heavy metal releases, and the related toxicity of dental restorative materials. METHODS A total of 3682 participants from the National Health and Nutrition Examination Survey (January 2017 to March 2020) were included in this cross-sectional analysis. We utilized multivariable linear regression models to investigate the associations between the number of oral restorations and PbB levels or renal function. The mediating effect of PbB on renal function indicators was analyzed using the R mediation package. RESULTS Based on the indicators of 3682 participants, we found that the elderly, females, and whites were fit with more oral restoration, which was accompanied by increased PbB levels and decreased renal function. Meanwhile, oral restoration count was positively associated with PbB level (β = 0.023, 95% CI: -0.020 to 0.027), renal function-related urine albumin creatinine ratio (β = 1.541, 95% CI: 0.615-2.468), serum uric acid level (β = 0.012, 95% CI: 0.007 to 0.017), and serum creatinine level, and negatively associated with estimated glomerular filtration rate (eGFR) (β = -0.804, 95% CI: -0.880 to -0.728). Furthermore, the mediation effect test confirmed that PbB played a mediating role in the relationship between restoration count and serum uric acid or eGFR, with mediation effects accounting for 98.0% and 71.0%, respectively. CONCLUSIONS Oral restoration negatively affects renal function. Oral restoration-related PbB level is a potential mediating factor.
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Affiliation(s)
- Wansu Sun
- Department of Stomatology, The First Affiliated Hospital of Anhui Medical University, Hefei, 230032, China; Anhui Public Health Clinical Center, Hefei, 230032, China
| | - Bichong Dai
- Key Laboratory of Oral Diseases Research of Anhui Province, College & Hospital of Stomatology, Anhui Medical University, Hefei, 230032, China
| | - Lilin Hong
- Department of Stomatology, The First Affiliated Hospital of Anhui Medical University, Hefei, 230032, China; Anhui Public Health Clinical Center, Hefei, 230032, China
| | - Hengguo Zhang
- Key Laboratory of Oral Diseases Research of Anhui Province, College & Hospital of Stomatology, Anhui Medical University, Hefei, 230032, China; Department of Dental Implantology, College & Hospital of Stomatology, Anhui Medical University, Hefei, 230032, China.
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13
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Yau WH, Chen SC, Wu DW, Chen HC, Lin HH, Wang CW, Hung CH, Kuo CH. Blood lead (Pb) is associated with lung fibrotic changes in non-smokers living in the vicinity of petrochemical complex: a population-based study. Environ Sci Pollut Res Int 2023:10.1007/s11356-023-27784-7. [PMID: 37213022 DOI: 10.1007/s11356-023-27784-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Received: 11/21/2022] [Accepted: 05/16/2023] [Indexed: 05/23/2023]
Abstract
Lead (Pb) is a toxic metal that has been extensively used in various industrial processes, and it persists in the environment, posing a continuous risk of exposure to humans. This study investigated blood lead levels in participants aged 20 years and older, who resided in Dalinpu for more than two years between 2016 to 2018, at Kaohsiung Municipal Siaogang Hospital. Graphite furnace atomic absorption spectrometry was used to analyze the blood samples for lead levels, and the LDCT (Low-Dose computed tomography) scans were interpreted by experienced radiologists. The blood lead levels were divided into quartiles, with Q1 representing levels of ≤1.10 μg/dL, Q2 representing levels of >1.11 and ≤1.60 μg/dL, Q3 representing levels of >1.61 and ≤2.30 μg/dL, and Q4 representing levels of >2.31 μg/dL. Individuals with lung fibrotic changes had significantly higher (mean ± SD) blood lead levels (1.88±1.27vs. 1.72±1.53 μg/dl, p< 0.001) than those with non-lung fibrotic changes. In multivariate analysis, we found that the highest quartile (Q4: >2.31 μg/dL) lead levels (OR: 1.36, 95% CI: 1.01-1.82; p= 0.043) and the higher quartile (Q3: >1.61 and ≤2.30 μg/dL) (OR: 1.33, 95% CI: 1.01-1.75; p= 0.041) was significantly associated with lung fibrotic changes compared with the lowest quartile (Q1: ≤1.10 μg/dL) (Cox and Snell R2, 6.1 %; Nagelkerke R2, 8.5 %). The dose-response trend was significant (Ptrend= 0.030). Blood lead exposure was significantly associated lung fibrotic change. To prevent lung toxicity, it is recommended to maintain blood lead levels lower than the current reference value.
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Affiliation(s)
- Wei-Hoong Yau
- Division of Pulmonary and Critical Care Medicine, Department of Internal Medicine, Kaohsiung Veterans General Hospital Tainan Branch, Tainan, Taiwan
| | - Szu-Chia Chen
- Department of Internal Medicine, Kaohsiung Municipal Siaogang Hospital, Kaohsiung Medical University, 482, Shan-Ming Rd., Hsiao-Kang Dist, 812, Kaohsiung, Taiwan, Republic of China
- Division of Nephrology, Department of Internal Medicine, Kaohsiung Medical University Hospital, Kaohsiung Medical University, Kaohsiung, Taiwan
- Research Center for Precision Environmental Medicine, Kaohsiung Medical University, Kaohsiung, Taiwan
| | - Da-Wei Wu
- Department of Internal Medicine, Kaohsiung Municipal Siaogang Hospital, Kaohsiung Medical University, 482, Shan-Ming Rd., Hsiao-Kang Dist, 812, Kaohsiung, Taiwan, Republic of China
- Division of Pulmonary and Critical Care Medicine, Department of Internal Medicine, Kaohsiung Medical University Hospital, Kaohsiung Medical University, Kaohsiung, Taiwan
| | - Huang-Chi Chen
- Department of Internal Medicine, Kaohsiung Municipal Siaogang Hospital, Kaohsiung Medical University, 482, Shan-Ming Rd., Hsiao-Kang Dist, 812, Kaohsiung, Taiwan, Republic of China
- Division of Pulmonary and Critical Care Medicine, Department of Internal Medicine, Kaohsiung Medical University Hospital, Kaohsiung Medical University, Kaohsiung, Taiwan
| | - Hung-Hsun Lin
- Department of Laboratory Technology, Kaohsiung Municipal Siaogang Hospital, Kaohsiung, Taiwan
| | - Chih-Wen Wang
- Department of Internal Medicine, Kaohsiung Municipal Siaogang Hospital, Kaohsiung Medical University, 482, Shan-Ming Rd., Hsiao-Kang Dist, 812, Kaohsiung, Taiwan, Republic of China.
- Research Center for Precision Environmental Medicine, Kaohsiung Medical University, Kaohsiung, Taiwan.
- Division of Hepatobiliary, Department of Internal Medicine, Kaohsiung Medical University Hospital, Kaohsiung Medical University, Kaohsiung, Taiwan.
| | - Chih-Hsing Hung
- Research Center for Precision Environmental Medicine, Kaohsiung Medical University, Kaohsiung, Taiwan
- Department of Pediatrics, Kaohsiung Medical University Hospital, Kaohsiung Medical University, Kaohsiung, Taiwan
- Department of Pediatrics, Kaohsiung Municipal Siaogang Hospital, Kaohsiung Medical University, Kaohsiung, Taiwan
| | - Chao-Hung Kuo
- Department of Internal Medicine, Kaohsiung Municipal Siaogang Hospital, Kaohsiung Medical University, 482, Shan-Ming Rd., Hsiao-Kang Dist, 812, Kaohsiung, Taiwan, Republic of China
- Division of Gastroenterology, Department of Internal Medicine, Kaohsiung Medical University Hospital, Kaohsiung Medical University, Kaohsiung, Taiwan
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Lacerda D, Pestana IA, Santos Vergilio CD, de Rezende CE. Global decrease in blood lead concentrations due to the removal of leaded gasoline. Chemosphere 2023; 324:138207. [PMID: 36822521 DOI: 10.1016/j.chemosphere.2023.138207] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/06/2022] [Revised: 01/31/2023] [Accepted: 02/20/2023] [Indexed: 06/18/2023]
Abstract
Lead (Pb) is a chemical element with extreme toxicity that is classified as one of the ten chemicals of most significant concern to human health. The main problem involving Pb is its use as a fuel additive (tetraethyllead - TEL) at a global level, which raised the atmospheric Pb concentrations. It is estimated that between 80 and 90% of the atmospheric Pb in large cities came from the use of TEL, and as a consequence, it was also the main source responsible for human exposure to the element. Therefore, this work aimed to evaluate, through a systematic review, the blood concentrations of Pb in scientific articles published in the first two decades of the 2000s to compare the global and regional trends of each continent over time. Our data show the importance of removing TEL in decreasing human exposure to Pb worldwide. We observed exponentially decreasing blood Pb concentrations over the years after additive removal on all continents, resulting in a global trend which TEL's use was the major process governing human exposure worldwide. In addition, the results also showed that, despite the removal of Pb additives lowering levels of human blood Pb, the general population remains exposed to the element through exogenous and endogenous sources. The exhaust Pb particles were deposited into the environment in proportion to the traffic flows, and the legacy of Pb in the environment requires novel primary prevention remedy to curtail exposure.
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Affiliation(s)
- Diego Lacerda
- Laboratório de Ciências Ambientais, Centro de Biociências e Biotecnologia, Universidade Estadual Do Norte Fluminense Darcy Ribeiro. Avenida Alberto Lamego, 2000, Parque Califórnia, Campos Dos Goytacazes, Rio de Janeiro, CEP: 28.013-602, Brazil.
| | - Inácio Abreu Pestana
- Laboratório de Ciências Ambientais, Centro de Biociências e Biotecnologia, Universidade Estadual Do Norte Fluminense Darcy Ribeiro. Avenida Alberto Lamego, 2000, Parque Califórnia, Campos Dos Goytacazes, Rio de Janeiro, CEP: 28.013-602, Brazil
| | - Cristiane Dos Santos Vergilio
- Laboratório de Ecotoxicologia, Departamento de Biologia, Centro de Ciências Exatas Naturais e da Saúde, Universidade Federal Do Espírito Santo - Campus Alegre. Alto Universitário, S/N, Guararema, Alegre, Espírito Santo, CEP: 29.500-000, Brazil
| | - Carlos Eduardo de Rezende
- Laboratório de Ciências Ambientais, Centro de Biociências e Biotecnologia, Universidade Estadual Do Norte Fluminense Darcy Ribeiro. Avenida Alberto Lamego, 2000, Parque Califórnia, Campos Dos Goytacazes, Rio de Janeiro, CEP: 28.013-602, Brazil
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15
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Huang YQ, He GD, Feng YQ. The association of lead exposure with blood pressure and hypertension: a mediation analyses of estimated glomerular filtration rate. Environ Sci Pollut Res Int 2023; 30:59689-59700. [PMID: 37014600 DOI: 10.1007/s11356-023-26734-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/10/2022] [Accepted: 03/27/2023] [Indexed: 05/10/2023]
Abstract
The link between lead and blood pressure was debatable, and whether it was mediated by renal function was unknown. The purpose was to investigate the relationship between blood lead concentrations and blood pressure and hypertension, as well as the mediating role of estimated glomerular filtration rate (eGFR) in this relationship. Participants aged 18 were recruited from the National Health and Nutrition Examination Survey (1999-2014) and provided with lead and blood pressure data. Multivariate linear and logistic regression, stratification, interaction tests, and a restricted cubic spline curve were used to assess the association of blood lead with systolic/diastolic blood pressure (SBP/DBP) and hypertension, and mediation effect analysis was used to investigate the role of eGFR in this relationship. A total of 20,073 subjects were enrolled, and among them, 9837 (49.01%) were male and 7800 (38.86%) were hypertensive patients. Multivariate linear and logistic regression analysis showed that blood lead levels were significantly associated with SBP (β = 3.14, 95%CI: 2.03, 4.25; P < 0.001), DBP (β = 3.50, 95%CI: 2.69, 4.30; P < 0.001), and hypertension (OR = 1.29, 95%CI: 1.09, 1.52; P = 0.0026). In comparison to the lowest blood lead quartile, the highest lead group was significantly associated with SBP (= 2.55, 95%CI: 1.66, 3.44; P = 0.0001), DBP (= 2.60, 95%CI: 1.95, 3.24; P = 0.0001), and hypertension (OR = 1.26, 95%CI: 1.10, 1.45; P = 0.0007). Mediation analysis showed that the proportion of blood lead mediated for SBP, DBP, and hypertension was 3.56% (95%CI: 0.42%, 7.96%; P = 0.0320), 6.21% (95%CI: 4.02%, 9.32%; P < 0.0001), and 17.39% (95%CI: 9.34%, 42.71%; P < 0.0001), respectively. Adjusted restricted cubic spline curves presented a non-linear correlation of blood lead levels with DBP (P-non-linearity < 0.001), linear with SBP (P-non-linearity = 0.203), and hypertension (P-non-linearity = 0.763). Our findings demonstrated that blood lead levels were non-linear with DBP, but linear with SBP and hypertension, and this relationship was mediated by eGFR.
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Affiliation(s)
- Yu-Qing Huang
- Hypertension Research Laboratory, Guangdong Provincial People's Hospital, Guangdong Academy of Medical Sciences, No. 106, Zhongshan Two Road, Yuexiu District, Guangzhou, 510080, China
- Department of Cardiology, Guangdong Provincial People's Hospital, Guangdong Academy of Medical Sciences, Guangzhou, China
| | - Guo-Dong He
- Research Department of Medical Sciences, Guangdong Provincial People's Hospital, Guangdong Academy of Medical Sciences, Guangzhou, China
| | - Ying-Qing Feng
- Hypertension Research Laboratory, Guangdong Provincial People's Hospital, Guangdong Academy of Medical Sciences, No. 106, Zhongshan Two Road, Yuexiu District, Guangzhou, 510080, China.
- Department of Cardiology, Guangdong Provincial People's Hospital, Guangdong Academy of Medical Sciences, Guangzhou, China.
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Shi L, Zhou J, Dong J, Gao F, Zhao W. Association of low-level blood lead with plasma homocysteine in US children and adolescents. Environ Geochem Health 2023:10.1007/s10653-023-01526-7. [PMID: 37029846 DOI: 10.1007/s10653-023-01526-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/04/2022] [Accepted: 02/28/2023] [Indexed: 06/19/2023]
Abstract
Although research in adults has revealed a positive relationship between blood lead levels (BLLs) and homocysteine (Hcy) levels in adults, few studies have investigated this relationship in children and adolescents. We evaluated the relationship between lowlevel blood lead and Hcy levels in US children and adolescents. A total of 8,313 children and adolescents aged 8-19 participated in this study via the National Health and Nutrition Examination Survey 1999-2006. Multivariable linear regression analyses were performed to examine the association between continuous BLLs and Hcy levels. The dose-dependent relationship between continuous BLLs and Hcy levels was analyzed using smooth curve fitting. The average age of participants was 14.1 ± 3.3 years (50.3% male). The mean values of BLLs and Hcy levels were 1.45 μg/dL and 5.77 μmol/L, respectively. In a multivariable adjusted model, an increase in 1.0 μg/dL of BLLs was associated with an elevation of 0.06 μmol/L in Hcy levels (β = 0.06, 95%CI:0.02-0.10, P = 0.001). A linear relationship between BLLs and Hcy levels was discovered using smooth curve fitting (P non-linearity = 0.464). The relationship between low-level blood lead and Hcy levels was stronger on participants with lower serum folate levels (P for interaction = 0.002). Low BLLs were positively associated with plasma Hcy levels in children and adolescents, which varies depending on the levels of folate, vitamin B, and dietary supplements involved in Hcy metabolism.
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Affiliation(s)
- Lingfei Shi
- Department of Geriatrics and Psychiatry, Zhejiang Provincial People's Hospital (Affiliated People's Hospital, Hangzhou Medical College), Hangzhou, 310014, Zhejiang, China
| | - Jia Zhou
- Cancer Center, Gamma Knife Treatment Center, Zhejiang Provincial People's Hospital (Affiliated People's Hospital, Hangzhou Medical College), Hangzhou, 310014, Zhejiang, China
| | - Jinjiang Dong
- Department of Neurosurgery, First People's Hospital of Chun'an City, Hangzhou, 311700, Zhejiang, China
| | - Faliang Gao
- Center for Rehabilitation Medicine, Department of Neurosurgery, Zhejiang Provincial People's Hospital (Affiliated People's Hospital, Hangzhou Medical College), Hangzhou, 310014, Zhejiang, China.
- Key Laboratory of Endocrine Gland Diseases of Zhejiang Province, Hangzhou, China.
| | - Wenyan Zhao
- Center for General Practice Medicine, Department of General Practice Medicine, Zhejiang Provincial People's Hospital (Affiliated People's Hospital, Hangzhou Medical College), Hangzhou, 310014, Zhejiang, China.
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Zhang C, Yan Y, Zeng J, Liu J, Dong N, Zhang C. Evaluation of blood lead measurements by the 6-year external quality assessment program in China. Clin Chim Acta 2023; 544:117331. [PMID: 37031783 DOI: 10.1016/j.cca.2023.117331] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/02/2023] [Revised: 03/15/2023] [Accepted: 04/03/2023] [Indexed: 04/11/2023]
Abstract
BACKGROUND Blood lead is an important clinical indicator. A typical tool for promoting standardisation or harmonisation is external quality assessment (EQA). Therefore, the National Centre for Clinical Laboratories (NCCL) in China launched the EQA Program for blood lead measurement in 2006 to assess its standardisation process. METHODS Blood lead EQA samples tested for homogeneity and stability were sent to participating laboratories. The return data were grouped according to the detection method. The robust mean value, robust coefficient of variation (CV) and standard uncertainty were calculated according to ISO 13528. The evaluation criteria were determined based on a thorough analysis of the previous pass rate and the current detection level. Overall trends in the blood lead EQA program over 6 years were investigated by calculating the pass rates of participating laboratories. We compared the pass rates and current issues of different detection methods and analysed the target values, bias and CV results of mainstream detection methods. RESULTS A total of 4,283 laboratories participated in EQA programs from 2017 to 2022. The pass rates were generally increasing while the inter-laboratory mean CVs were decreasing. For samples with varying concentrations, the higher the concentration, the smaller the CV. According to the evaluation criteria, the most used measurement methods, Graphite Furnace Atomic Absorption Spectrometry (GFAAS) and Tungsten Ship Atomic Absorption Spectrometry (TSAAS) demonstrated better performances than Differential Potentiometric Stripping (DPS), Inductively Coupled Plasma Mass Spectrometry (ICP-MS) and Flame Atomic Absorption Spectrometry (FAAS). Furthermore, DPS, ICP-MS and FAAS outperformed Anodic Stripping Voltammetry (ASV). CONCLUSION Our study provides reliable information on the standardisation of blood lead measurement procedures for manufacturers and clinical laboratories. Further improvements for standardisation are still required to make laboratories more patient-centred.
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Affiliation(s)
- Chao Zhang
- National Center for Clinical Laboratories, Beijing Hospital, National Center of Gerontology, Institute of Geriatric Medicine, Chinese Academy of Medical Sciences, PR China; Peking Union Medical College, Beijing, PR China.
| | - Ying Yan
- National Center for Clinical Laboratories, Beijing Hospital, National Center of Gerontology, Institute of Geriatric Medicine, Chinese Academy of Medical Sciences, PR China
| | - Jie Zeng
- National Center for Clinical Laboratories, Beijing Hospital, National Center of Gerontology, Institute of Geriatric Medicine, Chinese Academy of Medical Sciences, PR China; Peking Union Medical College, Beijing, PR China
| | - Jiali Liu
- National Center for Clinical Laboratories, Beijing Hospital, National Center of Gerontology, Institute of Geriatric Medicine, Chinese Academy of Medical Sciences, PR China
| | - Na Dong
- National Center for Clinical Laboratories, Beijing Hospital, National Center of Gerontology, Institute of Geriatric Medicine, Chinese Academy of Medical Sciences, PR China
| | - Chuanbao Zhang
- National Center for Clinical Laboratories, Beijing Hospital, National Center of Gerontology, Institute of Geriatric Medicine, Chinese Academy of Medical Sciences, PR China.
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Imagawa M, Rushing M, Carter A, Schott R, Berman JD. Using blood lead concentrations of wildlife sentinels to identify environmental risk factors of lead exposure for public health and wildlife rehabilitation efforts. Ecotoxicology 2023; 32:357-369. [PMID: 36964298 DOI: 10.1007/s10646-023-02642-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 03/03/2023] [Indexed: 06/18/2023]
Abstract
Lead poisoning remains a persistent health issue for both humans and wildlife, despite strides to reduce lead contamination in the environment. Using Geographic Information Systems (GIS), this study explores the associations between blood lead levels (BLLs) in wildlife sentinels and possible built environment lead exposure risk factors in the Minneapolis-Saint Paul, Minnesota urban area. Results show a high-level of heterogeneity in animal BLLs (n = 472) across our urban environment and suggest that each kilometer increase in road density is associated with a 17.07% (95% CI: 1.48%, 35.05%) increase in BLL in our study species of Virginia opossums and Eastern gray squirrels, and a 14.28% (95% CI: 1.16%, 29.09%) increase in BLL of rock pigeons. For squirrels and opossums, we see an additional 5.72% (95% CI: 0.59%, 10.85%) increased risk of BLL for every 1000 people per square-mile. The relationship between animal sentinels and environmental hazards can give us an insight into the potential lead exposure risks for humans. The use of wildlife sentinel data to explore environmental risk factors supports a One Health approach to better address public health questions and aid in wildlife rehabilitation related to residual lead poisoning from ambient environmental exposures.
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Affiliation(s)
- Mito Imagawa
- University of Minnesota School of Public Health, Division of Environmental Health Sciences, Minneapolis, MN, USA
| | - Marcus Rushing
- University of Minnesota School of Public Health, Occupational and Environmental Medicine, Minneapolis, MN, USA
| | | | - Renee Schott
- Wildlife Rehabilitation Center, Roseville, MN, USA
| | - Jesse D Berman
- University of Minnesota School of Public Health, Division of Environmental Health Sciences, Minneapolis, MN, USA.
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Chagonda S, Chitungo IJB, Musarurwa C, Nyamayaro T. Blood lead levels in children residing in a 115-year old urban settlement in Harare, Zimbabwe: a cross sectional study. BMC Pediatr 2023; 23:72. [PMID: 36765303 PMCID: PMC9912585 DOI: 10.1186/s12887-023-03886-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/05/2022] [Accepted: 02/03/2023] [Indexed: 02/12/2023] Open
Abstract
BACKGROUND Elemental lead (Pb) toxicity in children, irreversibly affects their growth and development. We assessed the prevalence of high blood Pb levels (BLL) in children living in a potentially high risk residential area and also assessed Pb levels in environmental specimens. METHODS This cross sectional study measured blood lead levels (BLL) in 86children living in Mbare, a densely populated suburb in Harare, Zimbabwe, characterised by dwellings progressively constructed from 1907 through to the 1940s, before the ban of leaded paint. Study participants of both genders were under 6 years of age. Potential risk factors of Pb poisoning were assessed. Pb levels were also assessed in soil, water and paint chip specimens from the study area. RESULTS The mean (standard deviation) BLL was 4.3 ± 0.75 g/dL. Twelve (13.95%) participants had BLL of > 5.0ug/dL. Our results showed no significant association between BLL and household income, participant behaviour/habits/activities, sources of drinking water, and the types of cookware used to prepare meals in their households. CONCLUSION Mean BLL observed in the current study were higher compared to those of children of similar age groups in the United States, suggesting that Pb contamination may be more ubiquitous in the Mbare flats area, potentially predisposing these children to impaired development.
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Affiliation(s)
- Svitsai Chagonda
- grid.13001.330000 0004 0572 0760Department of Laboratory Diagnostic and Investigative Sciences, Faculty of Medicine and Health Sciences, Chemical Pathology Unit, University of Zimbabwe, Harare, Zimbabwe
| | - Itai James Blessing Chitungo
- grid.13001.330000 0004 0572 0760Department of Laboratory Diagnostic and Investigative Sciences, Faculty of Medicine and Health Sciences, Chemical Pathology Unit, University of Zimbabwe, Harare, Zimbabwe
| | - Cuthbert Musarurwa
- Department of Biomedical Laboratory Sciences, School of Health Sciences, College of Medicine and Health Sciences, University of Rwanda, Kigali, Rwanda.
| | - Terence Nyamayaro
- grid.13001.330000 0004 0572 0760Department of Laboratory Diagnostic and Investigative Sciences, Faculty of Medicine and Health Sciences, Chemical Pathology Unit, University of Zimbabwe, Harare, Zimbabwe
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20
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Fan X, Li Q, Fang H, Ju Y, Jin Z, Li H, Zhang X. Development and application of a high accuracy method for measuring Pb in blood. Clin Chim Acta 2023; 538:164-168. [PMID: 36423701 DOI: 10.1016/j.cca.2022.11.014] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/05/2022] [Revised: 10/17/2022] [Accepted: 11/08/2022] [Indexed: 11/23/2022]
Abstract
BACKGROUND Lead (Pb) is an environmental pollutant, and human exposure is assessed by measuring blood Pb concentrations. Today, the use of Pb-based products is restricted, but the health effects of low Pb concentrations require investigation. For this, a high-accuracy method is needed. Here, we report a new inductively coupled plasma mass spectrometry (ICP-MS) method for quantifying Pb in blood. METHODS Blood samples and calibrators were gravimetrically spiked with bismuth as an internal standard, digested with ultrapure nitric acid, and diluted 100 times. The calibrators were made from high-purity reference materials supplied by the National Institute of Standards and Technology, and the sample concentration was measured using the calibration bracketing method. The analytical performance and application of the new method were investigated. RESULTS The method had good specificity and a negligible matrix effect. The intra- and inter-assay coefficients of variation (CVs) were <1.34 % and <1.88 %, respectively, and the total CV was <1.74 %. The range of recovery was 98.9 %-99.4 %. SRM955d, BCR-635, and BCR-636 were within the certified intervals, with mean relative bias values of 0.93 %, -0.13 %, and -0.56 %, respectively. The limit of quantification was 1.1 µg/l. The method was used to assign target values to external quality assessment samples and to assess routine methods, showing good results at high concentrations. However, at low concentrations, two laboratories did not pass. CONCLUSIONS This ICP-MS method is a simple, accurate method and can be a candidate reference method for blood Pb measurement. But more research will be needed to verify this.
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Affiliation(s)
- Xiaoyu Fan
- Shanghai Center for Clinical Laboratory, Shanghai, PR China
| | - Qing Li
- Shanghai Center for Clinical Laboratory, Shanghai, PR China
| | - Huiling Fang
- Shanghai Center for Clinical Laboratory, Shanghai, PR China
| | - Yi Ju
- Shanghai Center for Clinical Laboratory, Shanghai, PR China.
| | - Zhonggan Jin
- Shanghai Center for Clinical Laboratory, Shanghai, PR China
| | - Huaiyuan Li
- Shanghai Children's Medical Center Affiliated to Shanghai Jiaotong University School of Medicine, Shanghai, PR China
| | - Xiaoqi Zhang
- Shanghai Children's Medical Center Affiliated to Shanghai Jiaotong University School of Medicine, Shanghai, PR China
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21
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Wang X, Bakulski KM, Mukherjee B, Hu H, Park SK. Predicting cumulative lead (Pb) exposure using the Super Learner algorithm. Chemosphere 2023; 311:137125. [PMID: 36347347 PMCID: PMC10160242 DOI: 10.1016/j.chemosphere.2022.137125] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/13/2022] [Revised: 09/08/2022] [Accepted: 10/31/2022] [Indexed: 05/06/2023]
Abstract
Chronic lead (Pb) exposure causes long term health effects. While recent exposure can be assessed by measuring blood lead (half-life 30 days), chronic exposures can be assessed by measuring lead in bone (half-life of many years to decades). Bone lead measurements, in turn, have been measured non-invasively in large population-based studies using x-ray fluorescence techniques, but the method remains limited due to technical availability, expense, and the need for licensing radioactive materials used by the instruments. Thus, we developed prediction models for bone lead concentrations using a flexible machine learning approach--Super Learner, which combines the predictions from a set of machine learning algorithms for better prediction performance. The study population included 695 men in the Normative Aging Study, aged 48 years and older, whose bone (patella and tibia) lead concentrations were directly measured using K-shell-X-ray fluorescence. Ten predictors (blood lead, age, education, job type, weight, height, body mass index, waist circumference, cumulative cigarette smoking (pack-year), and smoking status) were selected for patella lead and 11 (the same 10 predictors plus serum phosphorus) for tibia lead using the Boruta algorithm. We implemented Super Learner to predict bone lead concentrations by calculating a weighted combination of predictions from 8 algorithms. In the nested cross-validation, the correlation coefficients between measured and predicted bone lead concentrations were 0.58 for patella lead and 0.52 for tibia lead, which has improved the correlations obtained in previously-published linear regression-based prediction models. We evaluated the applicability of these prediction models to the National Health and Nutrition Examination Survey for the associations between predicted bone lead concentrations and blood pressure, and positive associations were observed. These bone lead prediction models provide reasonable accuracy and can be used to evaluate health effects of cumulative lead exposure in studies where bone lead is not measured.
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Affiliation(s)
- Xin Wang
- Department of Epidemiology, School of Public Health, University of Michigan, Ann Arbor, MI, USA
| | - Kelly M Bakulski
- Department of Epidemiology, School of Public Health, University of Michigan, Ann Arbor, MI, USA
| | - Bhramar Mukherjee
- Department of Biostatistics, School of Public Health, University of Michigan, Ann Arbor, MI, USA
| | - Howard Hu
- Department of Preventive Medicine, Keck School of Medicine, University of Southern California, Los Angeles, CA, USA
| | - Sung Kyun Park
- Department of Epidemiology, School of Public Health, University of Michigan, Ann Arbor, MI, USA; Department of Environmental Health Sciences, School of Public Health, University of Michigan, Ann Arbor, MI, USA.
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22
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Zou X, Zhao Z, Huang W, Chen Y, Zhang W, Luo J, Zhao T, Wu L, Ma X, Guo X. High-density lipoprotein cholesterol modifies the association between blood lead and uric acid: results from NHANES 2005-2016. Int Arch Occup Environ Health 2022; 96:497-506. [PMID: 36550371 DOI: 10.1007/s00420-022-01944-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/20/2022] [Accepted: 12/06/2022] [Indexed: 12/24/2022]
Abstract
BACKGROUND The association between blood lead (PbB) and uric acid (SUA) remains unclear in US adults without a high level of lead exposure. Additionally, the effects of high-density lipoprotein cholesterol (HDL-C) modifying this association are still unclear. Therefore, this study aims to assess the effect of modification of high-density lipoprotein cholesterol on the association between PbB and SUA. METHOD This research analyzed National Health and Nutrition Examination Survey (NHANES) data from 2005 to 2016. Through several screenings, 18,578 participants over the age of 20 were eligible for the analysis. Multivariable linear regression was used to evaluate the association between PbB and SUA. By having stratified participants based on the HDL-C intake category (low HDL-C intake < 50 mg/dl; high HDL-C intake ≥ 50 mg/dl), effect modification by HDL-C was assessed through a likelihood ratio test between PbB and SUA. RESULT Multivariable linear regression indicated that PbB positively affects SUA (β = 0.19, 95% CI 0.16-0.22). The relationship between PbB and SUA was different in the low and high HDL-C intake group (β 0.12 95% Cl 0.08-0.16 vs. β 0.26 95% Cl 0.22 ~ - 0.30). Furthermore, high-density lipoprotein cholesterol significantly modified the relationship between PbB and SUA in all models which indicates that the interaction of lead exposure and HDL-C is more dangerous than the sum of the individual effects. CONCLUSIONS Our study shows that high-density lipoprotein cholesterol and blood lead have an interactive effect on increasing uric acid, which may have great importance for clinical medication.
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Affiliation(s)
- Xiaoting Zou
- Department of Clinical Laboratory Medicine, The Third Affiliated Hospital of Guangzhou Medical University, Guangzhou, 510150, China.,Department of Clinical Medicine, The Third Clinical School of Guangzhou Medical University, Guangzhou, 511436, China
| | - Zifan Zhao
- Department of Clinical Laboratory Medicine, The Third Affiliated Hospital of Guangzhou Medical University, Guangzhou, 510150, China.,Nanshan College, Guangzhou Medical University, Guangzhou, 510180, Guangdong, China
| | - Weichao Huang
- Department of Clinical Laboratory Medicine, The Third Affiliated Hospital of Guangzhou Medical University, Guangzhou, 510150, China.,Department of Clinical Medicine, The Second Clinical School of Guangzhou Medical University, Guangzhou, 511436, China
| | - Yue Chen
- Department of Clinical Laboratory Medicine, The Third Affiliated Hospital of Guangzhou Medical University, Guangzhou, 510150, China.,Department of Clinical Medicine, The Second Clinical School of Guangzhou Medical University, Guangzhou, 511436, China
| | - Wanlin Zhang
- Department of Clinical Laboratory Medicine, The Third Affiliated Hospital of Guangzhou Medical University, Guangzhou, 510150, China.,Department of Clinical Medicine, The First Clinical School of Guangzhou Medical University, Guangzhou, 511436, China
| | - Jing Luo
- Department of Clinical Laboratory Medicine, The Third Affiliated Hospital of Guangzhou Medical University, Guangzhou, 510150, China.,Department of Clinical Medicine, The Third Clinical School of Guangzhou Medical University, Guangzhou, 511436, China
| | - Tianyi Zhao
- Department of Clinical Laboratory Medicine, The Third Affiliated Hospital of Guangzhou Medical University, Guangzhou, 510150, China.,Department of Clinical Medicine, The Third Clinical School of Guangzhou Medical University, Guangzhou, 511436, China
| | - Luying Wu
- Department of Clinical Laboratory Medicine, The Third Affiliated Hospital of Guangzhou Medical University, Guangzhou, 510150, China.,Department of Clinical Medicine, The Third Clinical School of Guangzhou Medical University, Guangzhou, 511436, China
| | - Xiaoman Ma
- Department of Clinical Laboratory Medicine, The Third Affiliated Hospital of Guangzhou Medical University, Guangzhou, 510150, China.,Department of Clinical Medicine, The Third Clinical School of Guangzhou Medical University, Guangzhou, 511436, China
| | - Xuguang Guo
- Department of Clinical Laboratory Medicine, The Third Affiliated Hospital of Guangzhou Medical University, Guangzhou, 510150, China. .,Department of Clinical Medicine, The Third Clinical School of Guangzhou Medical University, Guangzhou, 511436, China. .,Guangdong Provincial Key Laboratory of Major Obstetric Diseases, The Third Affiliated Hospital of Guangzhou Medical University, Guangzhou, China. .,Key Laboratory of Reproduction and Genetics of Guangdong Higher Education Institutes, The Third Affiliated Hospital of Guangzhou Medical University, Guangzhou, 510150, China.
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23
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Yohannes YB, Nakayama SM, Yabe J, Toyomaki H, Kataba A, Nakata H, Muzandu K, Miyashita C, Ikenaka Y, Choongo K, Ishizuka M. Methylation profiles of global LINE-1 DNA and the GSTP1 promoter region in children exposed to lead (Pb). Epigenetics 2022; 17:2377-2388. [PMID: 36131534 PMCID: PMC9665151 DOI: 10.1080/15592294.2022.2123924] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/29/2022] [Revised: 07/12/2022] [Accepted: 09/05/2022] [Indexed: 11/03/2022] Open
Abstract
Lead (Pb) exposure has adverse health effects and altered DNA methylation may contribute to Pb toxicity. LINE-1 is an interspersed repeated DNA that is used as a surrogate marker for estimating genomic DNA methylation levels, and GSTP1 is an isozyme that detoxifies xenobiotics like Pb, and its expression is inhibited by methylation. Thus, to assess the effects of Pb exposure on global hypomethylation and gene-specific promoter hypermethylation, we examined DNA methylation at LINE-1 repetitive elements and the GSTP1 promoter region. Blood samples were obtained from children (N = 123) living in Pb-polluted areas (as exposed children) and children (N = 63) living in Pb-unpolluted areas (as control children) in Kabwe, Zambia. ICP-MS was used to determine blood lead levels (BLLs), and pyrosequencing and a fluorescence-based polymerase chain reaction assay were used to determine levels of LINE-1 methylation and GSTP1 promoter methylation, respectively. Inverse association was found between BLLs and LINE-1 methylation (β = - 0.046, p = 0.006). The highest quartile of BLL had significant hypomethylation of LINE-1 (p for trend = 0.03), suggesting the higher the BLL, the lower LINE-1 methylation. GSTP1 methylation levels did not differ significantly between the two areas (p = 0.504), nor was it associated with Pb poisoning risk (OR = 1.03, p = 0.476), indicating GSTP1 methylation may not be a reliable biomarker of Pb exposure in healthy people. Therefore, Pb-related health problems could result from global DNA methylation changes due to high BLLs.
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Affiliation(s)
- Yared Beyene Yohannes
- Laboratory of Toxicology, Department of Environmental Veterinary Sciences, Faculty of Veterinary Medicine, Hokkaido University, Sapporo, Japan
- Department of Chemistry, College of Natural and Computational Science, University of Gondar, Gondar, Ethiopia
| | - Shouta M.M. Nakayama
- Laboratory of Toxicology, Department of Environmental Veterinary Sciences, Faculty of Veterinary Medicine, Hokkaido University, Sapporo, Japan
- School of Veterinary Medicine, The University of Zambia, Lusaka, Zambia
| | - John Yabe
- School of Veterinary Medicine, The University of Zambia, Lusaka, Zambia
- Department of Veterinary Para-Clinical Studies, School of Veterinary Medicine, University of Namibia, Windhoek, Namibia
| | - Haruya Toyomaki
- Laboratory of Toxicology, Department of Environmental Veterinary Sciences, Faculty of Veterinary Medicine, Hokkaido University, Sapporo, Japan
| | - Andrew Kataba
- School of Veterinary Medicine, The University of Zambia, Lusaka, Zambia
| | - Hokuto Nakata
- Laboratory of Toxicology, Department of Environmental Veterinary Sciences, Faculty of Veterinary Medicine, Hokkaido University, Sapporo, Japan
| | - Kaampwe Muzandu
- School of Veterinary Medicine, The University of Zambia, Lusaka, Zambia
| | - Chihiro Miyashita
- Center for Environmental and Health Sciences, Hokkaido University, Sapporo, Japan
| | - Yoshinori Ikenaka
- Laboratory of Toxicology, Department of Environmental Veterinary Sciences, Faculty of Veterinary Medicine, Hokkaido University, Sapporo, Japan
- Water Research Group, Unit for Environmental Sciences and Management, Potchefstroom Campus, North-West University, Potchefstroom, South Africa
- Translational Research Unit, Veterinary Teaching Hospital, Faculty of Veterinary Medicine, Hokkaido University, Sapporo, Japan
- One Health Research Center, Hokkaido University, Sapporo, Japan
| | - Kennedy Choongo
- School of Veterinary Medicine, The University of Zambia, Lusaka, Zambia
- College of Agriculture, Fisheries & Forestry, School of Animal and Veterinary Sciences, Fiji National University, Koronivia Campus, Suva, Fiji
| | - Mayumi Ishizuka
- Laboratory of Toxicology, Department of Environmental Veterinary Sciences, Faculty of Veterinary Medicine, Hokkaido University, Sapporo, Japan
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Axelrad DA, Coffman E, Kirrane EF, Klemick H. The relationship between childhood blood lead levels below 5 µg/dL and childhood intelligence quotient (IQ): Protocol for a systematic review and meta-analysis. Environ Int 2022; 169:107475. [PMID: 36162279 PMCID: PMC9896788 DOI: 10.1016/j.envint.2022.107475] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/08/2021] [Revised: 08/10/2022] [Accepted: 08/12/2022] [Indexed: 05/10/2023]
Abstract
BACKGROUND The causal association between childhood lead (Pb) exposure and decrements in intelligence quotient (IQ) is well-established, and no safe blood lead level (BLL) in children has been identified. An international pooled analysis of seven prospective studies published by Lanphear et al. in 2005 quantified the relationship between childhood BLL and IQ. Further studies of Pb and IQ have been published more recently with mean BLLs generally lower than in the studies analyzed by Lanphear et al. In this article, we present the protocol for a systematic review to estimate an updated Pb-IQ relationship focusing on BLLs below 5 µg per deciliter (µg/dL). STUDY QUESTION What is the quantitative relationship between childhood BLLs and IQ at ages 3-17 years at BLLs below 5 μg/dL? DATA SOURCES A comprehensive search of the scientific literature will utilize citation mapping and key word searching. In the citation mapping approach, we will identify seed references that are relevant to our study question, and will then identify more recent references that have cited at least one of the seed references. The key word search will be conducted in the PubMed, Biosis Previews, Scopus, and Web of Science databases. We will also search electronic grey literature databases for conference proceedings, dissertations, and preprints. STUDY ELIGIBILITY CRITERIA, STUDY SCREENING AND DATA EXTRACTION We will include studies that measured BLL in children at any age, assessed full-scale IQ of the same children (concurrent with or subsequent to BLL sample collection) at ages 3-17, and estimated a continuous quantitative relationship between BLL and IQ. We will consider only studies with a central tendency BLL < 10 µg/dL. The title and abstract of each record will be reviewed independently by two authors to determine whether the study in question satisfies the inclusion criteria. The full text of each article remaining after title-abstract screening will be reviewed independently by two authors to determine whether the study in question satisfies the inclusion criteria. Two authors will independently extract study characteristics and data from each included study. RISK OF BIAS ASSESSMENT Studies meeting inclusion criteria will be evaluated for risk of bias (RoB) using the Navigation Guide method applied in a previous systematic review of neurodevelopmental effects (Lam et al., 2017), with adaptation to our study question. Each study will be independently evaluated by two review authors. DATA ANALYSIS AND SYNTHESIS We intend to conduct a random-effects meta-analysis to summarize the effects of children's exposure to Pb on IQ scores. Additionally, we plan to perform sensitivity analyses using sub-group analyses and/or meta-regression techniques to assess the impact of study design and study population characteristics to examine potential heterogeneity of results across studies. We will assign a confidence level rating (high, moderate, low, or very low) to the effect estimate from the meta-analyses/meta-regressions.
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Affiliation(s)
| | - Evan Coffman
- U.S. Environmental Protection Agency, Office of Research and Development, Center for Public Health and Environmental Assessment, Research Triangle Park, NC, USA.
| | - Ellen F Kirrane
- U.S. Environmental Protection Agency, Office of Research and Development, Center for Public Health and Environmental Assessment, Research Triangle Park, NC, USA.
| | - Heather Klemick
- U.S. Environmental Protection Agency, Office of Policy, National Center for Environmental Economics, Washington, DC, USA.
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Bramwell L, Morton J, Harding AH, Lin N, Entwistle J. Determinants of blood and saliva lead concentrations in adult gardeners on urban agricultural sites. Environ Geochem Health 2022; 44:3493-3513. [PMID: 34622415 PMCID: PMC9522656 DOI: 10.1007/s10653-021-01095-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 04/19/2021] [Accepted: 09/03/2021] [Indexed: 06/13/2023]
Abstract
Soil Pb concentrations at urban agriculture sites (UAS) commonly exceed recommended safe levels. There is a lack of evidence regarding uptake of Pb by gardeners using such sites for food crops. Our study aimed to elucidate whether gardening in soil with raised Pb levels results in Pb body burdens of concern to health, and to assess confounding factors influencing Pb body burden. Our cross-sectional case study measured Pb in saliva and blood of UAS gardeners (n = 43), soil and produce samples from their UAS, and home tap water. Blood and saliva Pb concentrations were compared with those from non-UAS gardener controls (n = 29). A health risk threshold of 5 µg dL-1 blood Pb level (BLL) was selected in keeping with international guidance. Detailed surveys investigated individuals' anthropometrics and potential Pb exposures from diet, and historic and everyday activities. Saliva was not found to be a suitable biomarker of adult Pb exposure in this context. Predictors of higher BLLs were being older, being male and eating more root vegetables and shrub fruit. Eating more green vegetables predicted a lower BLL, suggesting a protective effect against Pb uptake. UAS gardeners' BLLs (geometric mean 1.53; range 0.6-4.1 µg dL-1) were not significantly higher (p = 0.39) than the control group (geometric mean 1.43; range 0.7-2.9 µg dL-1). All BLLs were below 5 µg dL-1 except one resulting from occupational exposure. Having paired the UAS gardeners with closely matched controls, we found Pb in UAS soils (with range 62-1300 mg kg-1from common urban sources) unlikely to pose an additional risk to adult health compared to their neighbours who did not access UAS. As such, other Pb sources may be the dominant factor controlling BLL.
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Affiliation(s)
- Lindsay Bramwell
- Population Health Sciences Institute, Newcastle University, Newcastle upon Tyne, NE2 4AX Tyne and Wear UK
- Present Address: Department of Geography and Environmental Sciences, Northumbria University, Ellison Building, Newcastle Upon Tyne, NE1 8ST Tyne and Wear UK
| | - Jackie Morton
- Health and Safety Executive Science and Research Centre, Buxton, SK17 9JN Derbyshire UK
| | - Anne-Helen Harding
- Health and Safety Executive Science and Research Centre, Buxton, SK17 9JN Derbyshire UK
| | - Nan Lin
- Department of Mathematics, Physics and Electrical Engineering, Northumbria University, Ellison Building, Newcastle Upon Tyne, NE1 8ST Tyne and Wear UK
| | - Jane Entwistle
- Present Address: Department of Geography and Environmental Sciences, Northumbria University, Ellison Building, Newcastle Upon Tyne, NE1 8ST Tyne and Wear UK
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26
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Moonga G, Chisola MN, Berger U, Nowak D, Yabe J, Nakata H, Nakayama S, Ishizuka M, Bose-O'Reilly S. Geospatial approach to investigate spatial clustering and hotspots of blood lead levels in children within Kabwe, Zambia. Environ Res 2022; 207:112646. [PMID: 34979123 DOI: 10.1016/j.envres.2021.112646] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/14/2021] [Revised: 12/26/2021] [Accepted: 12/28/2021] [Indexed: 06/14/2023]
Abstract
BACKGROUND Communities around Kabwe, Zambia are exposed to lead due to deposits from an old lead (Pb) and zinc (Zn) mining site. Children are particularly more vulnerable than adults, presenting with greatest risk of health complications. They have increased oral uptake due to their hand to mouth activities. Spatial analysis of childhood lead exposure is useful in identifying specific areas with highest risk of pollution. The objective of the current study was to use a geospatial approach to investigate spatial clustering and hotspots of blood lead levels in children within Kabwe. METHODS We analysed existing data on blood lead levels (BLL) for 362 children below the age of 15 from Kabwe town. We used spatial autocorrelation methods involving the global Moran's I and local Getis-Ord Gi*statistic in ArcMap 10.5.1, to test for spatial dependency among the blood lead levels in children using the household geolocations. RESULTS BLL in children from Kabwe are spatially autocorrelated with a Moran's Index of 0.62 (p < 0.001). We found distinct hotspots (mean 51.9 μg/dL) in communities close to the old lead and zinc-mining site, lying on its western side. Whereas coldspots (mean 7 μg/dL) where observed in areas distant to the mine and traced on the eastern side. This pattern suggests a possible association between observed BLL and distance from the abandoned lead and zinc mine, and prevailing winds. CONCLUSION Using geocoded data for households, we found clustering of childhood blood lead and identified distinct hotspot areas with high lead levels for Kabwe town. The geospatial approach used is especially valuable in resource-constrained settings like Zambia, where the precise identification of high risk locations allows for the initiation of targeted remedial and treatment programs.
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Affiliation(s)
- Given Moonga
- Institute and Clinic for Occupational-, Social- and Environmental Medicine, LMU University Hospital Munich, Ziemssenstr. 1, D-80336, Munich, Germany; CIH(LMU) Center for International Health, LMU University Hospital, Munich, Germany; Department of Epidemiology and Biostatistics, University of Zambia, Lusaka, Zambia; Institute of Public Health, Medical Decision Making and Health Technology Assessment, Department of Public Health, Health Services Research and Health Technology Assessment, UMIT (Private University for Health Sciences, Medical Informatics and Technology), Hall i.T, Austria.
| | - Moses N Chisola
- Department of Geography and Environmental Studies, University of Zambia, Lusaka, Zambia
| | - Ursula Berger
- Institute for Medical Information Processing, Biometry and Epidemiology, Ludwig Maximilian University Munich, Munich, Germany
| | - Dennis Nowak
- Institute and Clinic for Occupational-, Social- and Environmental Medicine, LMU University Hospital Munich, Ziemssenstr. 1, D-80336, Munich, Germany
| | - John Yabe
- School of Veterinary Medicine, University of Zambia, Lusaka, Zambia
| | - Hokuto Nakata
- Laboratory of Toxicology, Department of Environmental Veterinary Sciences, Faculty of Veterinary Medicine, Hokkaido University, Sapporo, Japan
| | - Shouta Nakayama
- Laboratory of Toxicology, Department of Environmental Veterinary Sciences, Faculty of Veterinary Medicine, Hokkaido University, Sapporo, Japan
| | - Mayumi Ishizuka
- Laboratory of Toxicology, Department of Environmental Veterinary Sciences, Faculty of Veterinary Medicine, Hokkaido University, Sapporo, Japan
| | - Stephan Bose-O'Reilly
- Institute and Clinic for Occupational-, Social- and Environmental Medicine, LMU University Hospital Munich, Ziemssenstr. 1, D-80336, Munich, Germany; Institute of Public Health, Medical Decision Making and Health Technology Assessment, Department of Public Health, Health Services Research and Health Technology Assessment, UMIT (Private University for Health Sciences, Medical Informatics and Technology), Hall i.T, Austria; University Children's Hospital Regensburg (KUNO-Clinics), University of Regensburg, Clinic St. Hedwig, Regensburg, Germany
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Ramesh RM, Khiratkar AG, Sindhu KN, Rose A, John SM, Bhagat PR, Kang G, Mohan VR. Risk Factors and Hazards in the Household Environment for Elevated Blood Lead Levels in Urban Preschool Children of Vellore: A Case-Control Approach in the MAL-ED Birth Cohort. Indian J Pediatr 2022; 89:125-132. [PMID: 34018129 DOI: 10.1007/s12098-021-03738-0] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/06/2020] [Accepted: 03/12/2021] [Indexed: 11/30/2022]
Abstract
OBJECTIVES To study the household environmental risk factors and hazards associated with elevated blood lead levels (EBLLs) in preschool children in an urban setting of Vellore, South India. METHODS A case-control study within the MAL-ED (Etiology, Risk Factors and Interactions of Enteric Infections and Malnutrition and the Consequences for Child Health and Development) birth cohort was conducted between January 2014 and January 2015. The study included 153 pre-school children: 87 cases and 66 controls with elevated and normal BLLs, respectively. A structured questionnaire was used to assess the sociodemographic profile, household environment, breastfeeding practices, children's habits, and the use of cosmetics in them. Household environmental samples of wall and door paint, floor dust, drinking water, and cosmetics were estimated for lead levels using gas flame atomic absorption spectrometry (FAAS). RESULTS Children born with low birth weight, those living in houses painted at least once in the last five years and those residing in houses older than ten years had a higher odds of EBLLs [OR (95% CI) = 3.79 (1.24-11.1); 4.84 (1.42-16.53); 5.07 (2.06-12.46), and 2.58 (0.99-6.69)], respectively. Drinking water samples from both cases (88%) and controls (95%) had lead levels more than the Environmental Protection Agency (EPA), USA recommendation of 0.015 ppm. CONCLUSIONS Low birth weight and the household environment pose important risk factors/hazards for elevated blood lead levels in urban preschool children. Multipronged interventions that include government legislations, household environmental modification, safe water supply, and community education are pivotal in reducing lead exposure in young children.
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Affiliation(s)
- Rohan Michael Ramesh
- Wellcome Trust Research Laboratory, Division of Gastrointestinal Sciences, Christian Medical College, Vellore, Tamil Nadu, India
| | - Avinash Ganesh Khiratkar
- Department of Chemistry, School of Advanced Sciences, Vellore Institute of Technology, Vellore, Tamil Nadu, India
| | - Kulandaipalayam Natarajan Sindhu
- Wellcome Trust Research Laboratory, Division of Gastrointestinal Sciences, Christian Medical College, Vellore, Tamil Nadu, India
| | - Anuradha Rose
- Department of Community Health, Christian Medical College, Vellore, Tamil Nadu, 632 002, India
| | - Sushil Mathew John
- Low Cost Effective Care Unit, Christian Medical College, Vellore, Tamil Nadu, India
| | - Pundlik Rambhau Bhagat
- Department of Chemistry, School of Advanced Sciences, Vellore Institute of Technology, Vellore, Tamil Nadu, India
| | - Gagandeep Kang
- Wellcome Trust Research Laboratory, Division of Gastrointestinal Sciences, Christian Medical College, Vellore, Tamil Nadu, India
| | - Venkata Raghava Mohan
- Department of Community Health, Christian Medical College, Vellore, Tamil Nadu, 632 002, India.
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Mazidi M, Kirwan R, Davies IG. Genetically determined blood lead is associated with reduced renal function amongst individuals with type 2 diabetes mellitus: insight from Mendelian Randomisation. J Mol Med (Berl) 2022; 100:125-134. [PMID: 34661687 PMCID: PMC8724171 DOI: 10.1007/s00109-021-02152-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/05/2021] [Revised: 09/21/2021] [Accepted: 10/11/2021] [Indexed: 11/29/2022]
Abstract
Some observational studies indicate a link between blood lead and kidney function although results remain controversial. In this study, Mendelian randomisation (MR) analysis was applied to obtain unconfounded estimates of the casual association of genetically determined blood lead with estimated glomerular filtration rate (eGFR) and the risk of chronic kidney disease (CKD). Data from the largest genome-wide association studies (GWAS) on blood lead, eGFR and CKD, from predominantly ethnically European populations, were analysed in total, as well as separately in individuals with or without type 2 diabetes mellitus. Inverse variance weighted (IVW) method, weighted median (WM)-based method, MR-Egger, MR-Pleiotropy RESidual Sum and Outlier (PRESSO) as well as the leave-one-out method were applied. In a general population, lifetime blood lead levels had no significant effect on risk of CKD (IVW: p = 0.652) and eGFR (IVW: p = 0.668). After grouping by type 2 diabetes status (no diabetes vs. diabetes), genetically higher levels of blood lead had a significant negative impact among subjects with type 2 diabetes (IVW = Beta: -0.03416, p = 0.0132) but not in subjects without (IVW: p = 0.823), with low likelihood of heterogeneity for any estimates (IVW p > 0.158). MR-PRESSO did not highlight any outliers. Pleiotropy test, with very negligible intercept and insignificant p-value, indicated a low likelihood of pleiotropy for all estimations. The leave-one-out method demonstrated that links were not driven by a single SNP. Our results show, for the first time, that among subjects with type 2 diabetes, higher blood lead levels are potentially related to less favourable renal function. Further studies are needed to confirm our results. KEY MESSAGES: What is already known about this subject? Chronic kidney disease is associated with unfavourable lifestyle behaviours and conditions such as type 2 diabetes. Observational studies have reported an association between blood lead and reduced estimated glomerular filtration rate, but the relationship between lead exposure and renal function remains controversial. What is the key question? Using Mendelian randomisation with data from 5433 individuals from the UK and Australian populations, does genetically determined blood lead have a potentially causal effect on estimated glomerular filtration rate and the risk of chronic kidney disease? What are the new findings? Blood lead levels have a potentially causal effect on reduced renal function in individuals with type 2 diabetes. In subjects without diabetes, no such causal relationship was identified. How might this impact on clinical practice in the foreseeable future? This highlights the risk of elevated blood lead, for example, due to environmental exposure, amongst those with type 2 diabetes, which may predispose them to impaired renal function.
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Affiliation(s)
- Mohsen Mazidi
- Department of Twin Research and Genetic Epidemiology, King's College London, London, UK
| | - Richard Kirwan
- School of Biological and Environmental Sciences, Liverpool John Moores University, Liverpool, UK.
| | - Ian G Davies
- Research Institute of Sport and Exercise Science, Liverpool John Moores University, Liverpool, UK
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Słota M, Wąsik M, Stołtny T, Machoń-Grecka A, Kasperczyk A, Bellanti F, Dobrakowski M, Chwalba A, Kasperczyk S. Relationship between lead absorption and iron status and its association with oxidative stress markers in lead-exposed workers. J Trace Elem Med Biol 2021; 68:126841. [PMID: 34438315 DOI: 10.1016/j.jtemb.2021.126841] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/11/2021] [Revised: 07/26/2021] [Accepted: 08/10/2021] [Indexed: 02/08/2023]
Abstract
BACKGROUND The emission of lead (Pb) occurring during the extraction, processing and industrial applications of this element remains a significant environmental risk factor. The absorbability of lead in humans is strongly associated with the general health status of exposed individuals. Existing mineral deficiencies are considered being a predisposition to an increased Pb uptake. Both, iron deficiency and lead poisoning are the major causative factors responsible for the prevalence of anemia within the vulnerable population, especially in children. Although some of the intervention programs of counteracting lead poisoning by iron supplementation proved to be effective in the Pb-exposed population, the exact mechanisms of this interaction still require further studies. The objective of the presented study was to examine the association of iron level on oxidative stress measures and its effects on the severity of lead toxicity in the exposed population. METHODS The analyzed population consisted of 270 male workers from the lead-zinc smelter. The studied population was divided into two sub-groups based on the serum iron concentration: low iron level group (L-Fe; Fe < median value) and high iron level group (H-Fe; Fe > median value). Measured traits comprised of blood lead (PbB), serum Fe and zinc protoporphyrin (ZPP) levels as well as a blood count and oxidative stress markers. RESULTS No significant correlation between serum iron concentration and PbB in the tested cohort was found. On the contrary, the analysis of ZPP levels (long-term marker related to a hematologic toxic effect of Pb) within the subgroups differing in serum Fe level shown that ZPP was 12.3 % lower (p = 0.043) in subjects classified within the H-Fe group. A positive correlation of serum Fe and total antioxidant capacity (TAC) was found (R = 0.1999). The conducted 3-D PCA analysis showed that individuals classified within the H-Fe group were characterized by the co-occurrence of higher Fe levels, lower ZPP, and higher TAC value. CONCLUSION These results support the existing evidence providing that maintaining the optimal status of Fe may play a significant role in preventing the lead poisoning and alleviating harmful effects of Pb on the oxidative balance in humans.
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Affiliation(s)
- Michał Słota
- ARKOP Sp. z o.o., Kolejowa 34a, 32-332, Bukowno, Poland
| | - Marta Wąsik
- Department of Clinical Biochemistry and Laboratory Diagnostics, Institute of Medicine, University of Opole, Oleska 48, 45-052, Opole, Poland
| | - Tomasz Stołtny
- District Hospital of Orthopaedics and Trauma Surgery in Piekary Śląskie, Bytomska 62, 41-940, Piekary Śląskie, Poland
| | - Anna Machoń-Grecka
- Department of Biochemistry, Faculty of Medical Sciences in Zabrze, Medical University of Silesia in Katowice, Poniatowskiego 15, 40-055, Katowice, Poland
| | - Aleksandra Kasperczyk
- Department of Biochemistry, Faculty of Medical Sciences in Zabrze, Medical University of Silesia in Katowice, Poniatowskiego 15, 40-055, Katowice, Poland
| | - Francesco Bellanti
- Department of Medical and Surgical Sciences, University of Foggia, Viale Pinto 1, 71122, Foggia, Italy
| | - Michał Dobrakowski
- Department of Biochemistry, Faculty of Medical Sciences in Zabrze, Medical University of Silesia in Katowice, Poniatowskiego 15, 40-055, Katowice, Poland
| | - Artur Chwalba
- Department of Pharmacology, Faculty of Medical Sciences in Zabrze, Medical University of Silesia in Katowice, Poniatowskiego 15, 40-055, Katowice, Poland
| | - Sławomir Kasperczyk
- Department of Biochemistry, Faculty of Medical Sciences in Zabrze, Medical University of Silesia in Katowice, Poniatowskiego 15, 40-055, Katowice, Poland.
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Chen J, Wang N, Yuan Y, Zhang W, Xia F, Chen B, Dong R, Lu Y. Blood lead, nutrient intake, and renal function among type 2 diabetic patients. Environ Sci Pollut Res Int 2021; 28:49063-49073. [PMID: 33939087 DOI: 10.1007/s11356-021-13623-0] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/30/2021] [Accepted: 03/18/2021] [Indexed: 06/12/2023]
Abstract
Lead (Pb) exposure has been reported to have nephrotoxicity. However, such an effect has not been well investigated in type 2 diabetes (T2D) patients, especially when taking into account the nutrition status of the patients. Therefore, we explore the association between blood lead levels (BLLs), dietary intake of nutrients, and impaired renal function among patients with T2D. We measured BLLs and biochemical parameters of renal injury in 780 patients. Dietary nutrients intake was assessed by a food frequency questionnaire in 420 of 780 participants. We found high BLLs were significantly associated with certain parameters of renal injury, and dietary intake of specific nutrients (mainly micronutrients) was associated with reduced BLLs at high percentile distribution of concentration. BLLs were also found to have moderation effects on the association between specific dietary nutrients and specific renal function parameters.
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Affiliation(s)
- JingSi Chen
- Department of Nutrition and Food Hygiene, School of Public Health, Soochow University, Suzhou, China
- Key Laboratory of Public Health Safety of Ministry of Education, Collaborative Innovation Center of Social Risks Governance in Health, School of Public Health, Fudan University, Shanghai, 200032, China
| | - NingJian Wang
- Institute and Department of Endocrinology and Metabolism, Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, 200011, China
| | - Yaqun Yuan
- Key Laboratory of Public Health Safety of Ministry of Education, Collaborative Innovation Center of Social Risks Governance in Health, School of Public Health, Fudan University, Shanghai, 200032, China
| | - Wen Zhang
- Institute and Department of Endocrinology and Metabolism, Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, 200011, China
| | - FangZhen Xia
- Institute and Department of Endocrinology and Metabolism, Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, 200011, China
| | - Bo Chen
- Key Laboratory of Public Health Safety of Ministry of Education, Collaborative Innovation Center of Social Risks Governance in Health, School of Public Health, Fudan University, Shanghai, 200032, China
| | - RuiHua Dong
- Key Laboratory of Public Health Safety of Ministry of Education, Collaborative Innovation Center of Social Risks Governance in Health, School of Public Health, Fudan University, Shanghai, 200032, China.
| | - YingLi Lu
- Institute and Department of Endocrinology and Metabolism, Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, 200011, China.
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Wang H, Huang P, Zhang R, Feng X, Tang Q, Liu S, Wen F, Zeng L, Liu Y, Wang T, Ma L. Effect of lead exposure from electronic waste on haemoglobin synthesis in children. Int Arch Occup Environ Health 2021; 94:911-918. [PMID: 33474627 PMCID: PMC8238723 DOI: 10.1007/s00420-020-01619-1] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/15/2020] [Accepted: 11/20/2020] [Indexed: 02/05/2023]
Abstract
BACKGROUND Primitive electronic waste (e-waste) recycling is ongoing in Guiyu, so toxic heavy metals may continue to threaten the health of children in the area. OBJECTIVE This study primarily aimed to evaluate the effect of e-waste exposure on haemoglobin (Hb) synthesis in preschool children. METHODS Medical examinations were conducted with the permission of children's guardians and the approval of the Ethics Committee of the Medical College of Shantou University. This study recruited 224 children (aged 3-6 years, exposed group) who lived in Guiyu and 204 children (aged 3-6 years, control group) who lived in a town free of e-waste pollution. Blood levels of lead, Hb, ferritin, folate and vitamin B12 were tested in all children. Furthermore, all children were assessed for thalassemia, and their parents were asked to fill in questionnaires. RESULTS There were no significant differences in the level of ferritin, folate, or vitamin B12 between the exposed and control groups (P > 0.05). No children were identified as having thalassemia in all study participants. Blood lead level (BLL) and the risk of children with BLL ≥ 10 µg/dL in the exposed group were significantly higher than those in the control group (all P < 0.01). Three subgroups of each group were created according to BLL (Group A: < 5.0 µg/dL; Group B: 5.0-9.9 µg/dL; Group C: ≥ 10.0 µg/dL). Hb level decreased with elevated BLL in the exposed group (P = 0.03), but not in the control group (P = 0.14). Hb levels in group B and group C were also significantly lower in the exposed group than in the control group (Group B: 122.6 ± 9.5 g/L versus 125.8 ± 8.2 g/L, P = 0.01; Group C: 120.3 ± 7.3 g/L versus 123.6 ± 8.3 g/L, P = 0.03). In addition, the prevalence of anaemia associated with BLLs above 10 µg/dL and between 5.0 and 9.9 µg/dL were both significantly higher in the exposed group than in the control group (4.0% vs. 0.5%, 5.4% vs. 1.5%, respectively, both P < 0.05). CONCLUSION Lead exposure more significantly inhibits Hb synthesis in children who live in e-waste dismantling areas than in those who live in non-e-waste dismantling areas. Other toxins released from e-waste may also contribute to the inhibition of Hb synthesis and may lead to anaemia in local children. Further investigations are needed to provide evidence for the development of relevant protective measures.
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Affiliation(s)
- Hongwu Wang
- Department of Hematology and Oncology, Shenzhen Children's Hospital of China Medical University, Shenzhen, 518038, China
- Department of Pediatrics, The Second Affiliated Hospital of Shantou University Medical College, Shantou, 515041, China
| | - Peng Huang
- Department of Hematology and Oncology, Shenzhen Children's Hospital of China Medical University, Shenzhen, 518038, China
| | - Ruibiao Zhang
- Department of Pediatrics, Third People's Hospital of Huizhou, Affiliated Huizhou Hospital of Guangzhou Medical University, Guangdong, 516002, China
| | - Xueyong Feng
- Department of Pediatrics, The Second Affiliated Hospital of Shantou University Medical College, Shantou, 515041, China
| | - Qiulin Tang
- Department of Pediatrics, The Second Affiliated Hospital of Shantou University Medical College, Shantou, 515041, China
| | - Sixi Liu
- Department of Hematology and Oncology, Shenzhen Children's Hospital of China Medical University, Shenzhen, 518038, China
| | - Feiqiu Wen
- Department of Hematology and Oncology, Shenzhen Children's Hospital of China Medical University, Shenzhen, 518038, China
| | - Li Zeng
- Department of Clinical Laboratory of the First Affiliated Hospital of Zhengzhou University, Zhengzhou, 450000, China
| | - Yufeng Liu
- Children's Hospital of the First Affiliated Hospital of Zhengzhou University, Zhengzhou, 450000, China.
| | - Tianyou Wang
- Beijing Children's Hospital, Beijing, 100045, China.
| | - Lian Ma
- Department of Hematology and Oncology, Shenzhen Children's Hospital of China Medical University, Shenzhen, 518038, China.
- Department of Pediatrics, The Second Affiliated Hospital of Shantou University Medical College, Shantou, 515041, China.
- Shenzhen Public Service Platform of Molecular Medicine in Pediatric Hematology and Oncology, Shenzhen, 518000, China.
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Liu Y, Liu F, Dong KF, Wu Y, Yang X, Yang J, Tan H, Niu X, Zhao X, Xiao G, Zhou S. Regional characteristics of children's blood lead levels in China: A systematic synthesis of national and subnational population data. Sci Total Environ 2021; 769:144649. [PMID: 33493913 DOI: 10.1016/j.scitotenv.2020.144649] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/08/2020] [Revised: 12/16/2020] [Accepted: 12/17/2020] [Indexed: 06/12/2023]
Abstract
The blood lead levels (BLLs) of children in China remain notably high in many areas. We aimed to summarise the relevant regional characteristics, identifying problematic areas and the causes of lead pollution. We searched the databases of PubMed, China National Knowledge Infrastructure (CNKI), and Wanfang Data, systematically reviewing 219 articles published from January 2010 to September 2020. In doing so, we assessed the BLLs noted in 220 prefectures across China. Data were organised using Geographic Information Systems (GIS) mapping. Out of a total of 629,627 children sampled, we found that the average blood lead level (BLL) of children included in our study is 50.61 ± 13.63 μg/L, which slightly exceeds the 50.00 μg/L US standard. Within the sample, 8.75% had BLLs higher than 100.00 μg/L. Children living in Liaoning, Hebei, Shanxi, Jiangxi, Anhui, Fujian, Guizhou, Yunnan, and Guangxi had notably high BLLs, at more than 60.00 μg/L. A total of 112 municipalities had an average children's BLL above 50.00 μg/L. Furthermore, Chenzhou, Linfen, Yuncheng, and Hechi had the highest children's BLLs, with average values above 100.00 μg/L. The leading contributors to lead pollution are lead mining, lead recovery and the smelting industry. Nonetheless, the lead-acid battery industry needs more attention. Although data suggest that BLLs are decreasing in China, many areas still have high BLLs that need to be monitored. Moreover, national standards must improve to decrease acceptable BLL thresholds for children.
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Affiliation(s)
- Yang Liu
- Guizhou Academy of Sciences, Guiyang 550001, China; School of Environment and Energy, South China University of Technology, Guangzhou 510006, China; National Institute of Hospital Administration, Beijing 100044, China; Southern Medical University, Guangzhou 510515, China
| | - Feiyan Liu
- Institute of Complexity Science & Big Data Technology, Guangxi University, Nanning 530004, China
| | - Kylie Fei Dong
- National Institute of Hospital Administration, Beijing 100044, China
| | - Yongning Wu
- China National Center for Food Safety Risk Assessment, Beijing 100022, China; Southern Medical University, Guangzhou 510515, China
| | - Xingfen Yang
- Southern Medical University, Guangzhou 510515, China
| | - Jintao Yang
- Institute of Geographic Sciences and Natural Resources Research, Chinese Academy of Sciences, Beijing 100101, China
| | - Hong Tan
- Guizhou Academy of Sciences, Guiyang 550001, China
| | - Xiaojun Niu
- School of Environment and Energy, South China University of Technology, Guangzhou 510006, China
| | - Xinyuan Zhao
- Capital University of Economics and business, Beijing 100070, China; National Institute of Hospital Administration, Beijing 100044, China
| | - Gexin Xiao
- National Institute of Hospital Administration, Beijing 100044, China; Guizhou Academy of Sciences, Guiyang 550001, China.
| | - Shaoqi Zhou
- School of Environment and Energy, South China University of Technology, Guangzhou 510006, China; Guizhou Academy of Sciences, Guiyang 550001, China.
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Liang J, Cai J, Guo J, Mai J, Zhou L, Zhang J, Liu Y, Wang Z. The lead burden of occupational lead-exposed workers in Guangzhou, China: 2006-2019. Arch Environ Occup Health 2021; 77:403-414. [PMID: 33978559 DOI: 10.1080/19338244.2021.1916421] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/12/2023]
Abstract
We analyzed the lead levels in blood and urine from lead-exposed workers in Guangzhou and assessed the influencing factors. The data were analyzed by descriptive statistics, and the time-dependent changes were mapped via analytical statistics. Although the lead burden showed a clear downward trend over time, it remained high among the exposed workers. The highest lead burden was detected in workers of the electrical equipment manufacturing industry, especially among those in lead-acid battery factories where we did field studies. Hazardous as the working conditions of the original lead-acid battery factories were, there were improvements in the applications of occupational disease prevention measures after the relocation of factories, but the lead burdens were still above the average levels of lead-related industries. Improvements are needed in the management and regulations on occupational safety and health to further decrease the lead burden to acceptable levels.
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Affiliation(s)
- Jiabin Liang
- Guangzhou Occupational Disease Prevention and Treatment Hospital, Guangzhou, China
- Guangzhou Twelfth People's Hospital, Guangzhou Medical University, Guangzhou, China
- Key Laboratory of Occupational Environment and Health, Guangzhou Twelfth People's Hospital, Guangzhou, China
| | - Jieyan Cai
- Guangzhou Occupational Disease Prevention and Treatment Hospital, Guangzhou, China
- School of Basic Medical Sciences, Jinan University, Guangzhou, China
| | - Jiaming Guo
- Guangzhou Occupational Disease Prevention and Treatment Hospital, Guangzhou, China
- Guangzhou Twelfth People's Hospital, Guangzhou Medical University, Guangzhou, China
- Key Laboratory of Occupational Environment and Health, Guangzhou Twelfth People's Hospital, Guangzhou, China
| | - Jianping Mai
- Guangzhou Occupational Disease Prevention and Treatment Hospital, Guangzhou, China
- Guangzhou Twelfth People's Hospital, Guangzhou Medical University, Guangzhou, China
- Key Laboratory of Occupational Environment and Health, Guangzhou Twelfth People's Hospital, Guangzhou, China
| | - Liping Zhou
- Guangzhou Occupational Disease Prevention and Treatment Hospital, Guangzhou, China
- Guangzhou Twelfth People's Hospital, Guangzhou Medical University, Guangzhou, China
- Key Laboratory of Occupational Environment and Health, Guangzhou Twelfth People's Hospital, Guangzhou, China
| | - Jinwei Zhang
- Guangzhou Occupational Disease Prevention and Treatment Hospital, Guangzhou, China
- Guangzhou Twelfth People's Hospital, Guangzhou Medical University, Guangzhou, China
- Key Laboratory of Occupational Environment and Health, Guangzhou Twelfth People's Hospital, Guangzhou, China
| | - Yimin Liu
- Guangzhou Occupational Disease Prevention and Treatment Hospital, Guangzhou, China
- Guangzhou Twelfth People's Hospital, Guangzhou Medical University, Guangzhou, China
- Key Laboratory of Occupational Environment and Health, Guangzhou Twelfth People's Hospital, Guangzhou, China
| | - Zhi Wang
- Guangzhou Occupational Disease Prevention and Treatment Hospital, Guangzhou, China
- Guangzhou Twelfth People's Hospital, Guangzhou Medical University, Guangzhou, China
- Key Laboratory of Occupational Environment and Health, Guangzhou Twelfth People's Hospital, Guangzhou, China
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Wang B, Wan H, Cheng J, Chen Y, Wang Y, Chen Y, Chen C, Zhang W, Xia F, Wang N, Wang L, Lu Y. Blood lead, vitamin D status, and albuminuria in patients with type 2 diabetes. Environ Pollut 2021; 276:116653. [PMID: 33607353 DOI: 10.1016/j.envpol.2021.116653] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/22/2020] [Revised: 01/18/2021] [Accepted: 01/31/2021] [Indexed: 05/26/2023]
Abstract
Environmental lead exposure has been linked with reduced kidney function. However, evidence about its role in diabetic kidney damage, especially when considering the nutritional status of vitamin D, is sparse. In this observational study, we investigated the association between low-level lead exposure and urinary albumin-to-creatinine ratio (UACR) and assessed potential impact of vitamin D among 4033 diabetic patients in Shanghai, China. Whole blood lead was measured by graphite furnace atomic absorption spectrometry. Serum 25-hydroxyvitamin D [25(OH)D] was tested using a chemiluminescence immunoassay. The associations of blood lead with UACR and albuminuria, defined as UACR ≥30 mg/g, according to 25(OH)D levels were analyzed using linear and Poisson regression models. A doubling of blood lead level was associated with a 10.7% higher UACR (95% CI, 6.19%-15.5%) in diabetic patients with 25(OH)D < 50 nmol/L, whereas the association was attenuated toward null (2.03%; 95% CI, -5.18% to 9.78%) in those with 25(OH)D ≥ 50 nmol/L. Similarly, the risk ratios of prevalent albuminuria per doubling of blood lead level between the two groups were 1.09 (95% CI, 1.03-1.15) and 0.99 (95% CI, 0.86-1.14), respectively. Joint analysis demonstrated that a combination of high blood lead and low 25(OH)D corresponded to significantly higher UACR. Among diabetic patients with 25(OH)D < 50 nmol/L, the increment of UACR relative to blood lead was more remarkable in those with reduced estimated glomerular filtration rate (<60 mL/min/1.73 m2). These results suggested that higher blood lead levels were associated with increased urinary albumin excretion in diabetic patients with vitamin D deficiency. Further prospective studies are needed to validate our findings and to determine whether vitamin D supplementation yields a benefit.
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Affiliation(s)
- Bin Wang
- Institute and Department of Endocrinology and Metabolism, Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Heng Wan
- Institute and Department of Endocrinology and Metabolism, Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Jing Cheng
- Institute and Department of Endocrinology and Metabolism, Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Yingchao Chen
- Institute and Department of Endocrinology and Metabolism, Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Yuying Wang
- Institute and Department of Endocrinology and Metabolism, Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Yi Chen
- Institute and Department of Endocrinology and Metabolism, Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Chi Chen
- Institute and Department of Endocrinology and Metabolism, Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Wen Zhang
- Institute and Department of Endocrinology and Metabolism, Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Fangzhen Xia
- Institute and Department of Endocrinology and Metabolism, Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Ningjian Wang
- Institute and Department of Endocrinology and Metabolism, Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Li Wang
- Department of Nephrology, Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Yingli Lu
- Institute and Department of Endocrinology and Metabolism, Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China.
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Guo Y, Deng YH, Ke HJ, Wu JL. Iron Status in Relation to Low-Level Lead Exposure in a Large Population of Children Aged 0-5 Years. Biol Trace Elem Res 2021; 199:1253-1258. [PMID: 32562239 DOI: 10.1007/s12011-020-02253-1] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/21/2020] [Accepted: 06/15/2020] [Indexed: 10/24/2022]
Abstract
There are limited data regarding low lead exposure and iron status in Chinese children. This study aimed to examine the association between low-level lead exposure and iron status in a large population of children aged 0-5 years. We reviewed the records of children aged 0-5 years who had blood lead, iron, ferritin, and hemoglobin measurements during 2014-2017 at the Guangdong Women and Children Hospital. We identified 17,486 children with a blood lead level < 100 μg/L. Multiple linear and logistic regression analyses were performed to estimate the associations between blood lead levels and blood iron, serum ferritin, and hemoglobin. The mean concentrations of blood lead, iron, ferritin, and hemoglobin were 31.50 μg/L, 7.50 mmol/L, 46.98 ng/mL, and 120.41 g/L, respectively. Adjusting for age and sex, blood lead was negatively correlated with iron (r = - 0.073, p < 0.05), ferritin (r = - 0.043, p < 0.05), and hemoglobin (r = - 0.047, p < 0.05). Compared with the 1st quintile of lead exposure, the 5th quintile of lead exposure was associated with a 0.146 mmol/L decrease in blood iron, a 4.678 ng/mL decrease in serum ferritin, and a 1.245 g/L decrease in hemoglobin. Adjusted odds ratios (95% confidence interval) for the 5th quintile of blood lead were 1.39 (1.25-1.55) for iron deficiency and 1.45 (1.26-1.67) for anemia, relative to the 1st quintile. Our study findings confirmed the previously established association of blood lead levels with decreasing iron status and extended previous findings to even low-level lead exposure in Chinese children.
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Affiliation(s)
- Yong Guo
- Department of Children's Health Care, Guangdong Women and Children Hospital, Guangzhou Medical University, Guangzhou, 511400, China
| | - Yu-Hong Deng
- Department of Children's Health Care, Guangdong Women and Children Hospital, Guangzhou Medical University, Guangzhou, 511400, China
| | - Hai-Jin Ke
- Department of Children's Health Care, Guangdong Women and Children Hospital, Guangzhou Medical University, Guangzhou, 511400, China
| | - Jie-Ling Wu
- Department of Children's Health Care, Guangdong Women and Children Hospital, Guangzhou Medical University, Guangzhou, 511400, China.
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Abstract
In China, the first and also the latest version of national childhood lead exposure control guidelines was issued by the National Health Commission in 2006, when the reference value of high blood lead exposure was set at 100 μg/L and lead poisoning was set at 200 μg/L. Lead exposure levels have been decreasing in China over the last few decades, with almost all blood lead concentrations in children under 7 years of age being under 100 μg/L in non-industrial areas. However, lead concentrations lower than 100 μg/L in blood in children are associated with neurodevelopmental deficits. Thus, if the reference value remains at a high level, a large percent of children with exposure levels that are high but lower than the current reference value will be diagnosed as 'safe' and be ignored. Thus, we appeal that the reference value should be lowered according to local actual exposure level. A more stringent reference value would give care givers, doctors, communities, and officials more opportunities to take action earlier.
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Affiliation(s)
- Tao Li
- Child Health Big Data Research Center, Capital Institute of Pediatrics, NO. 2, Yabao Road, Chaoyang District, Beijing, China.
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Farnia V, Pirsaheb M, Azadi NA, Mansouri B, Radmehr F. Blood lead concentration among oral/inhaled opium users: systematic review and meta-analysis. Crit Rev Toxicol 2021; 51:24-35. [PMID: 33528296 DOI: 10.1080/10408444.2020.1864722] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/01/2023]
Abstract
Lead is a poisonous heavy metal with various known side effects. The effect of opium on raising blood lead concentration (BLC) has been investigated with no general agreement. In Iran, the number of lead poisoning cases has raised among the opium-addicted population. This systematic review and meta-analysis aim to combine the results of previous studies with the Iranian population to investigate the effect of opium on BLC. In this systematic review, PubMed/Medline, Web of Sciences, Embase, and Scopus were searched for studies using the Iranian population to compare the BLC of opium-addicted cases and non-addicted controls till January 2020. A random-effects model was used to pool the results. I-square test was used to assess the heterogeneity of the studies. The effect sizes were standardized mean differences (proxied by Hedges' g) followed by a 95% confidence interval. Of 417 initial articles, 13 studies met the inclusion criteria to be considered in the meta-analysis. The sample size of eligible studies ranged from 40 to 131 (mean 81.83, SD 27.6). All studies were focused on adults with mean age ranged from 33.5 to 65.15 years old (overall mean 49.0, SD 7.66). There were 13 studies included with 18 Hedges' g effect sizes. Using a random effect model, the pooled effect size was gw = 2.48 (95% CI: 1.58-3.39) and statistically significant in favor of opium-addicted participants. Moreover, heterogeneity was 96.6% (I2=96.6, Q(17) = 504.95, p < 0.001). For studies with large Hedges' g effect sizes (> 4) identified as outliers and removed from meta-analysis. The pooled Hedges' g effect size reduced to 1.39 (95% CI: 0.94-1.85), still highly significant in favor of higher levels of lead in the opium-addicted group. The funnel plot appeared symmetrical confirmed by Egger's test (t = 1.87, p = 0.088), indicating no publication bias present.
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Affiliation(s)
- Vahid Farnia
- Substance Abuse Prevention Research Center, Health Institute, Kermanshah University of Medical Sciences, Kermanshah, Iran
| | - Maghdad Pirsaheb
- Research Center for Environmental Determinants of Health, Health Institute, Kermanshah University of Medical Sciences, Kermanshah, Iran
| | - Namam Ali Azadi
- Department of Biostatistics, School of Public Health, Iran University of Medical Sciences, Tehran, Iran
| | - Borhan Mansouri
- Substance Abuse Prevention Research Center, Health Institute, Kermanshah University of Medical Sciences, Kermanshah, Iran
| | - Farnaz Radmehr
- Substance Abuse Prevention Research Center, Health Institute, Kermanshah University of Medical Sciences, Kermanshah, Iran
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Patil JA, Kshirsagar MS, Patil AJ. Activated Carbon Fabric Mask Reduces Lead Absorption and Improves the Heme Biosynthesis and Hematological Parameters of Battery Manufacturing Workers. Indian J Clin Biochem 2021; 36:94-99. [PMID: 33505133 DOI: 10.1007/s12291-019-00868-3] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/09/2019] [Accepted: 12/06/2019] [Indexed: 11/26/2022]
Abstract
Activated carbon fabrics (ACF) mask prevents the absorption of lead and reduce its adverse effects of human health. Aim of this study to know the blood lead level and its effects on heme biosynthesis and hematological parameters after using 2 months activated carbon fabric mask of battery manufacturing workers (BMW). Blood lead level, heme biosynthesis and hematological parameters were measured by using standard method. Blood lead level (P < 0.001, - 13.5%) was significantly decreased, activated δ-aminolevulinic acid dehydratase (P < 0.001, 11.97%) and non-activated δ- aminolevulinic acid dehydratase (P < 0.001, 23.17%) enzyme activity were significantly increased, however, the ratio of activated to Non-activated δ- ALAD (P < 0.001, - 10.13%) was significantly decreased, urinary excretion of δ- aminolevulinic acid (P < 0.001, - 10.49%) and porphobilinogen (P < 0.001, - 7.38%) were significantly decreased after using 2 months ACF mask as compared to before using mask of BMW. Hematological parameters i.e Hb (P < 0.05, 13.42%), PCV (P < 0.05, 7.23%), MCV (P < 0.05, 1.9%) were significantly increased and total WBC count (P < 0.05, - 5.18%) was significantly decreased after using 2 months ACF mask as compared to before using mask of BMW. Two months using ACF mask reduces the blood lead level and improves the δ-ALDH activity and hematological parameters, decreases the urinary excretion of δ-ALA, PBG of battery manufacturing workers. Therefore, the regular using of ACF mask is beneficial to prevent the lead absorption and its adverse effects on human health.
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Affiliation(s)
- Jyotsna A Patil
- Department of Biochemistry, Krishna Institute of Medical Sciences, Karad, Maharashtra 415539 India
| | - Mandakini S Kshirsagar
- Department of Biochemistry, Krishna Institute of Medical Sciences, Karad, Maharashtra 415539 India
| | - Arun J Patil
- Department of Biochemistry, Krishna Institute of Medical Sciences, Karad, Maharashtra 415539 India
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Sezavar AH, Pourhassan B, Kakavandi NR, Hooshangi Shayeste MR, Abyadeh M. Association of maternal blood lead concentration with the risk of small for gestational age: A dose-response meta-analysis. Arch Environ Occup Health 2021; 77:293-300. [PMID: 33492189 DOI: 10.1080/19338244.2021.1874857] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/12/2023]
Abstract
In spite of growing evidence for the negative effect of lead, knowledge about the dose-response relationship of maternal blood lead level (BLL) and the risk of small for gestational age (SGA) is limited. We performed this meta-analysis to evaluate the dose-response relation between maternal BLL and the risk of SGA. A systematic search through Embase and PubMed was performed. Odds ratios (ORs) and 95% confidence intervals (95% CI) were calculated. The nonlinear and linear relationships between maternal BLL and the risk of SGA were also investigated. Results from 51,065 patients showed a significant association between maternal BLL and risk of SGA in highest versus lowest analysis (OR: 1.54; 95% CI: 1.12-2.10, p = 0.007). While there was no association in linear dose-response (OR: 1.02; 95% CI: 1.00-1.04, p = 0.021) meta-analysis, a direct relationship was observed in the nonlinear model (nonlinearity p < 0.001). Results of this dose-response meta-analysis showed that maternal BLL higher than ∼ 0.3 µg/dL is directly associated with the risk of SGA.
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Affiliation(s)
- Ahmad Habibian Sezavar
- Department of Toxicology and Pharmacology, Faculty of Pharmacy, Tehran University of Medical Sciences (TUMS), Tehran, Iran
| | - Bahman Pourhassan
- Department of Occupational Health Engineering, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran
| | - Nader Rahimi Kakavandi
- Department of Toxicology and Pharmacology, Faculty of Pharmacy, Tehran University of Medical Sciences (TUMS), Tehran, Iran
| | | | - Morteza Abyadeh
- Department of Molecular Systems Biology, Cell Science Research Center, Royan Institute for Stem Cell Biology and Technology, ACECR, Tehran, Iran
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Chang CW, Wang CW, Wu DW, Lee WH, Chen YC, Liu YH, Li CH, Tsai CC, Lin WY, Chen SC, Hung CH, Kuo CH, Su HM. Significant association between blood lead (Pb) level and haemoglobin A1c in non-diabetic population. Diabetes Metab 2021; 47:101233. [PMID: 33497800 DOI: 10.1016/j.diabet.2021.101233] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/06/2020] [Revised: 12/27/2020] [Accepted: 01/08/2021] [Indexed: 12/19/2022]
Abstract
Although many heavy metals are necessary for normal biological function, a subset of heavy metals have no role in human physiology, such as lead (Pb) and arsenic (As). Such elements have deleterious effects on physiology and be associated with the incidence of diabetes and related metabolic syndromes. Haemoglobin A1c (HbA1c) is not only a useful diagnostic and prognostic parameter in patients with diabetes, but it is also helpful in prediction of future diabetic risk in non-diabetic patients. However, no studies have evaluated the relationship between heavy metal concentration and HbA1c in non-diabetic patients. Therefore, the present study was designed to address this issue. We performed surveys for general populations living in southern Taiwan from June 2016 to September 2018. All participants received face-to-face interviews, laboratory tests, and measurements of weight and height, waist circumference, heart rate, and systolic and diastolic blood pressures. HbA1c was positively associated with Log blood Pb, after adjustments for age, body mass index, fasting blood glucose, total cholesterol, and triglyceride. Additionally, a Log 1 μg/dL increase in Pb was associated with a small (0.819 mmol/mol, 95% confidence interval = 0.072-1.566) increase in HbA1c (P = 0.032). No association with HbA1c was observed for urine nickel, chromium, manganese, As, copper, and cadmium in the multivariable analysis. In conclusion, after adjusting for important clinical parameters, Log blood Pb was positively associated with HbA1c in our non-diabetic population. This finding implies that high blood Pb might have the potential to predict future diabetic risk in non-diabetic populations. Further prospective studies are necessary to validate this issue.
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Affiliation(s)
- Chien-Wei Chang
- Department of Internal Medicine, Kaohsiung Municipal Siaogang Hospital, Kaohsiung Medical University, Kaohsiung, Taiwan; Graduate Institute of Clinical Medicine, College of Medicine, Kaohsiung Medical University, Kaohsiung, Taiwan; Division of Cardiology, Department of Internal Medicine, Kaohsiung Medical University Hospital, Kaohsiung Medical University, Kaohsiung, Taiwan
| | - Chih-Wen Wang
- Department of Internal Medicine, Kaohsiung Municipal Siaogang Hospital, Kaohsiung Medical University, Kaohsiung, Taiwan
| | - Da-Wei Wu
- Department of Internal Medicine, Kaohsiung Municipal Siaogang Hospital, Kaohsiung Medical University, Kaohsiung, Taiwan
| | - Wen-Hsien Lee
- Department of Internal Medicine, Kaohsiung Municipal Siaogang Hospital, Kaohsiung Medical University, Kaohsiung, Taiwan; Graduate Institute of Clinical Medicine, College of Medicine, Kaohsiung Medical University, Kaohsiung, Taiwan; Division of Cardiology, Department of Internal Medicine, Kaohsiung Medical University Hospital, Kaohsiung Medical University, Kaohsiung, Taiwan; Faculty of Medicine, College of Medicine, Kaohsiung Medical University, Kaohsiung, Taiwan
| | - Ying-Chih Chen
- Department of Internal Medicine, Kaohsiung Municipal Siaogang Hospital, Kaohsiung Medical University, Kaohsiung, Taiwan; Division of Cardiology, Department of Internal Medicine, Kaohsiung Medical University Hospital, Kaohsiung Medical University, Kaohsiung, Taiwan
| | - Yi-Hsueh Liu
- Department of Internal Medicine, Kaohsiung Municipal Siaogang Hospital, Kaohsiung Medical University, Kaohsiung, Taiwan; Division of Cardiology, Department of Internal Medicine, Kaohsiung Medical University Hospital, Kaohsiung Medical University, Kaohsiung, Taiwan
| | - Chiu-Hui Li
- Health Management and Occupational Safety Health Centre, Kaohsiung Municipal Siaogang Hospital, Kaohsiung Medical University, Kaohsiung, Taiwan
| | - Chun-Chi Tsai
- Health Management and Occupational Safety Health Centre, Kaohsiung Municipal Siaogang Hospital, Kaohsiung Medical University, Kaohsiung, Taiwan
| | - Wen-Yi Lin
- Research Centre for Environmental Medicine, Kaohsiung Medical University, Kaohsiung, Taiwan; Health Management and Occupational Safety Health Centre, Kaohsiung Municipal Siaogang Hospital, Kaohsiung Medical University, Kaohsiung, Taiwan
| | - Szu-Chia Chen
- Department of Internal Medicine, Kaohsiung Municipal Siaogang Hospital, Kaohsiung Medical University, Kaohsiung, Taiwan; Division of Cardiology, Department of Internal Medicine, Kaohsiung Medical University Hospital, Kaohsiung Medical University, Kaohsiung, Taiwan; Faculty of Medicine, College of Medicine, Kaohsiung Medical University, Kaohsiung, Taiwan; Research Centre for Environmental Medicine, Kaohsiung Medical University, Kaohsiung, Taiwan
| | - Chih-Hsing Hung
- Research Centre for Environmental Medicine, Kaohsiung Medical University, Kaohsiung, Taiwan
| | - Chao-Hung Kuo
- Department of Internal Medicine, Kaohsiung Municipal Siaogang Hospital, Kaohsiung Medical University, Kaohsiung, Taiwan; Faculty of Medicine, College of Medicine, Kaohsiung Medical University, Kaohsiung, Taiwan; Research Centre for Environmental Medicine, Kaohsiung Medical University, Kaohsiung, Taiwan
| | - Ho-Ming Su
- Department of Internal Medicine, Kaohsiung Municipal Siaogang Hospital, Kaohsiung Medical University, Kaohsiung, Taiwan; Division of Cardiology, Department of Internal Medicine, Kaohsiung Medical University Hospital, Kaohsiung Medical University, Kaohsiung, Taiwan; Faculty of Medicine, College of Medicine, Kaohsiung Medical University, Kaohsiung, Taiwan; Research Centre for Environmental Medicine, Kaohsiung Medical University, Kaohsiung, Taiwan.
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Gleason KM, Valeri L, Shankar AH, Obrycki JF, Ibne Hasan MOS, Mostofa G, Quamruzzaman Q, Wright RO, Christiani DC, Bellinger DC, Mazumdar M. Stunting and lead: using causal mediation analysis to better understand how environmental lead exposure affects cognitive outcomes in children. J Neurodev Disord 2020; 12:39. [PMID: 33327931 PMCID: PMC7745460 DOI: 10.1186/s11689-020-09346-x] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/06/2020] [Accepted: 11/18/2020] [Indexed: 11/10/2022] Open
Abstract
Background Many children in Bangladesh experience poor nutritional status and environmental lead exposure, both of which are associated with lower scores on neurodevelopmental assessments. Recent studies have suggested that part of lead’s adverse effects on neurodevelopment are caused in part by lead’s effect on growth. New statistical methods are now available to evaluate potential causal pathways in observational studies. This study used a novel statistical method to test the hypothesis that stunting, a measure of linear growth related to poor nutrition, is a mediator and/or an effect modifier of the lead exposure’s adverse effect on cognitive development. Methods Participants were 734 children from a longitudinal birth cohort established in rural Bangladesh to study the health effects of prenatal and early childhood environmental metal exposures. Lead exposure was estimated using umbilical cord blood samples obtained at birth and blood obtained via venipuncture at age 20–40 months. Stunting was determined using the World Health Organization’s standards. Neurodevelopment was assessed at age 20–40 months years using the Bayley Scales of Infant and Toddler Development, Third Edition (BSID-III). We evaluated the effect of lead on stunting and whether the effect of lead on cognitive scores is modified by stunting status in multivariable regression analyses. We then conducted a novel 4-way mediation analysis that allows for exposure-mediator interaction to assess how much of the effect of lead on cognitive scores is explained by the pathway through stunting (mediation) and how much is explained by the interaction between lead and stunt (effect modification). Results Stunting was not a mediator of the effect of lead in our analyses. Results suggested effect modification by stunting. In an area of Bangladesh with lower lead exposures (median umbilical cord blood lead concentration, 1.7 μg/dL), stunting modified the relationship between prenatal blood lead concentrations and cognitive score at age 2–3 years. A 1-unit increase in natural log cord blood lead concentration in the presence of stunting was associated with a 2.1-unit decrease in cognitive scores (β = − 2.10, SE = 0.71, P = 0.003). This interaction was not found in a second study site where lead exposures were higher (median umbilical cord blood lead concentration, 6.1 μg/dL, β = − 0.45, SE = 0.49, P = 0.360). Conclusions We used a novel method of mediation analysis to test whether stunting mediated the adverse effect of prenatal lead exposure on cognitive outcomes in Bangladesh. While we did not find that stunting acted as mediator of lead’s effect on cognitive development, we found significant effect modification by stunting. Our results suggest that children with stunting are more vulnerable to the adverse effects of low-level lead exposure.
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Affiliation(s)
- Kelsey M Gleason
- Department of Medicine, Robert Larner M.D. College of Medicine, Burlington, VT, USA
| | - Linda Valeri
- Department of Biostatistics, Columbia Mailman School of Public Health, New York, NY, USA
| | - Anuraj H Shankar
- Department of Nutrition, Harvard T.H. Chan School of Public Health, Boston, MA, USA
| | - John F Obrycki
- Department of Neurology, Boston Children's Hospital, 300 Longwood Avenue, Boston, MA, 02115, USA
| | | | | | | | - Robert O Wright
- Department of Preventive Medicine, Icahn School of Medicine at Mt. Sinai, New York, NY, USA.,Department of Environmental Medicine and Public Health, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - David C Christiani
- Department of Environmental Health, Harvard T.H. Chan School of Public Health, Boston, MA, USA
| | - David C Bellinger
- Department of Neurology, Boston Children's Hospital, 300 Longwood Avenue, Boston, MA, 02115, USA.,Department of Environmental Health, Harvard T.H. Chan School of Public Health, Boston, MA, USA
| | - Maitreyi Mazumdar
- Department of Neurology, Boston Children's Hospital, 300 Longwood Avenue, Boston, MA, 02115, USA. .,Department of Environmental Health, Harvard T.H. Chan School of Public Health, Boston, MA, USA.
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Abstract
Methods proposed to address confounding variables frequently do not adequately distinguish confounding from covariation. A confounder is a variable that correlates both with the outcome and the major exposure variable. Accurate treatment of confounding is crucial to low dose extrapolation of the effects of chemical exposures based on epidemiology studies. This study explores the limitations of current regression models in extrapolation to the low dose region of the dose-response curve due to the existence of unrecognized and uncontrolled confounding, using epidemiological data for lead. Based on the reported data in analyses by Lanphear and colleagues and Crump and colleagues, and drawing on other studies, Wilson and Wilson considered maternal IQ, HOME score, SES, parental education, birthweight, smoking, and race as characteristic variables which may have interaction effects. This analysis identifies confounding variables based on the seven longitudinal cohorts in analyses conducted by Lanphear and colleagues and by Crump and colleagues and confirms maternal IQ, HOME score, maternal education and maternal marital status at birth are "Highly Likely" confounders, while race is a "Likely" confounder. The cohort data were reanalyzed using the methods presented by Crump and colleagues while also considering the interaction among the identified confounding variables. This analysis determined that confounders influence IQ estimates in a quantifiable way that may exceed or at least obscure previously-reported effects of blood lead on IQ with blood lead levels below 5 µg/dL; however, limitations in the datasets make predictions of the low dose dose-response analysis questionable.
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Teye SO, Yanosky JD, Cuffee Y, Weng X, Luquis R, Farace E, Wang L. Association between blood lead levels and blood pressure in American adults: results from NHANES 1999-2016. Environ Sci Pollut Res Int 2020; 27:45836-45843. [PMID: 32803607 DOI: 10.1007/s11356-020-10381-3] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/28/2020] [Accepted: 08/03/2020] [Indexed: 06/11/2023]
Abstract
The aim of this study was to investigate the association between blood lead level (BLL) and hypertension in adults when lead exposure for the general population is low. The study used data from the US National Health and Nutrition Examination Survey (NHANES) 1999-2016. Participants aged 20 to 79 years were included in our study. Weighted multiple linear regression and logistic regression were conducted to test the association between BLL and systolic/diastolic blood pressure and hypertension status, respectively, while controlling for age, gender, race/ethnicity, body mass index, income level, and education. A total of 30,467 participants were included in this study. There was no association between BLL and hypertension status for the overall sample. Among those who were not taking antihypertensive medication, after adjusting for covariates, systolic blood pressure was positively correlated with BLL in non-Hispanic Whites (P = 0.004) and non-Hispanic Blacks (P = 0.0005), but not Hispanics (P = 0.07) nor Others (P = 0.37). The relationship between diastolic blood pressure and lead levels was also significant in non-Hispanic Whites and non-Hispanic Blacks. This study showed that higher BLL was associated with higher systolic and diastolic blood pressure in some population groups, but not associated with hypertension status.
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Affiliation(s)
- Simisola O Teye
- Department of Public Health Sciences, Penn State College of Medicine, Hershey, PA, USA.
| | - Jeff D Yanosky
- Department of Public Health Sciences, Penn State College of Medicine, Hershey, PA, USA
| | - Yendelela Cuffee
- Department of Public Health Sciences, Penn State College of Medicine, Hershey, PA, USA
| | - Xingran Weng
- Department of Public Health Sciences, Penn State College of Medicine, Hershey, PA, USA
| | - Raffy Luquis
- School of Behavioral Sciences and Education, Penn State Harrisburg, Middletown, PA, USA
| | - Elana Farace
- Department of Public Health Sciences, Penn State College of Medicine, Hershey, PA, USA
- Department of Neurosurgery, Penn State College of Medicine, Hershey, PA, USA
| | - Li Wang
- Department of Public Health Sciences, Penn State College of Medicine, Hershey, PA, USA
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Weber AK, Bannon DI, Abraham JH, Seymour RB, Passman PH, Lilley PH, Parks KK, Braybrooke G, Cook ND, Belden AL. Reduction in lead exposures with lead-free ammunition in an advanced urban assault course. J Occup Environ Hyg 2020; 17:598-610. [PMID: 33201787 DOI: 10.1080/15459624.2020.1836375] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/11/2023]
Abstract
The training of soldiers for urban conflict involves marksmanship instruction on outdoor flat ranges and the teaching of close-quarter battle techniques in indoor facilities, referred to as shoot houses, where intense firing exercises can generate high air lead levels from small arms ammunition, flash bang grenades, and explosive devices. Levels of lead and copper in air were evaluated during five training activities of a 45-day training course using both stationary general area and breathing zone sampling over a 2-year period. Individual blood lead values were determined prior to and at course completion. Mean breathing zone lead concentrations for the five training activities ranged from 0.014 on the outdoor flat range to 0.064 mg/m3 inside shoot houses; with a change to lead-free ammunition the values were reduced to a range of 0.006-0.022 mg/m3. Isolated flash bang grenades generated very high general area lead concentrations (2.0 mg/m3), which in training were associated with the highest measured breathing zone concentration (0.16 mg/m3). For copper, mean breathing zone concentrations increased from 0.010 to 0.037 mg/m3 with the change to lead-free frangible ammunition on the outdoor range, but remained below the permissible exposure limit for copper fume. Inside shoot houses, mean breathing zone copper concentrations exceeded the permissible exposure limit with ball and lead-free frangible ammunition, ranging from 0.077-0.13 mg/m3. With the introduction of lead-free ammunition, when comparing the blood lead differences between start and finish of the course, there was a significant reduction in the mean blood lead difference from 13.3 µg/dL to 5.4 µg/dL. Options for mitigation of potentially high exposure areas using improved ventilation designs are discussed. These results advocate for improved designs for shoot house training facilities, stress the importance of removing lead from ammunition and explosive devices for training, and promote the continued need for implementation of controls to mitigate and manage metal exposures during training.
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Affiliation(s)
- Alice K Weber
- Army Public Health Center, Occupational Health Sciences, Aberdeen Proving Ground, Maryland
| | - Desmond I Bannon
- Army Public Health Center, Toxicology Directorate, Aberdeen Proving Ground, Maryland
| | - Joseph H Abraham
- Army Public Health Center, Clinical Public Health and Epidemiology, Aberdeen Proving Ground, Maryland
| | - Rachel B Seymour
- Army Public Health Center, Occupational Health Sciences, Aberdeen Proving Ground, Maryland
| | | | - Paul H Lilley
- Army Public Health Center, Occupational Health Sciences, Aberdeen Proving Ground, Maryland
| | - Kimberly K Parks
- Army Public Health Center, Occupational Health Sciences, Aberdeen Proving Ground, Maryland
| | | | - Nathan D Cook
- Army Public Health Center, Occupational Health Sciences, Aberdeen Proving Ground, Maryland
| | - Arthur L Belden
- Army Public Health Center, Occupational Health Sciences, Aberdeen Proving Ground, Maryland
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Balachandar R, Bagepally BS, Kalahasthi R, Haridoss M. Blood lead levels and male reproductive hormones: A systematic review and meta-analysis. Toxicology 2020; 443:152574. [PMID: 32860866 DOI: 10.1016/j.tox.2020.152574] [Citation(s) in RCA: 22] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/15/2020] [Revised: 08/18/2020] [Accepted: 08/24/2020] [Indexed: 12/14/2022]
Abstract
Present study aimed to systematically review and synthesise quantitative evidence on association between occupational Lead (Pb) exposure and male reproductive hormones (MRH) and sperm quality from the existing literature. Observational studies investigating the effects of Pb exposure on MRH, sperm-count and sperm motility are systematically searched in PubMed, Scopus and EMBASE databases since inception to May 2019. The PRISMA guidelines are adhered during the entire study procedure and details such as participant characteristics, occupational Pb exposure, MRH, sperm-count and sperm motility from individual articles are extracted to the perform meta-analysis. Sub-group analysis and sensitivity analysis are additionally explored. Further, meta-regression is executed to investigate the influence of participant's age, duration of workplace Pb exposure on the individual outcome parameters. We observed that otherwise normal (fertile) male participants from all studies were within the age range of 25-45 years. Male employees occupationally exposed to Pb exhibited significantly higher blood Pb, lower sperm-count, poor sperm motility and higher serum prolactin levels as compared to the Pb unexposed males. The testosterone, follicle stimulating hormone and luteinising hormone levels of the occupationally Pb exposed participants are comparable to that of unexposed comparators. Studies included for synthesising quantitative evidence had unacceptable levels of heterogeneity. Explorative subgroup or meta-regression analysis had no additional results to the study. Lastly, included studies were driven by publication bias (positive results) and low powered (small sample size) studies. Thus, Pb exposure at workplaces is detrimental to male reproductive function, with lower sperm-count and higher prolactin levels. However, to enumerate the precise quantity of Pb exposure detrimental on male reproductive functions, high quality longitudinal studies with large cohorts are needed.
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Dong C, Taylor MP, Gulson B. A 25-year record of childhood blood lead exposure and its relationship to environmental sources. Environ Res 2020; 186:109357. [PMID: 32330765 DOI: 10.1016/j.envres.2020.109357] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/17/2019] [Revised: 03/05/2020] [Accepted: 03/05/2020] [Indexed: 06/11/2023]
Abstract
Broken Hill, the oldest silver (Ag)-zinc (Zn)-lead (Pb) mining community in Australia, has a legacy and ongoing problem of environmental Pb exposure that was identified as early as 1893. To reduce Pb exposure risks, identifying potential exposure pathways and related factors is a critical first step. This study examined blood lead (PbB) levels of children ≤60 months old (n = 24,106 samples), along with Pb concentrations in corresponding soil (n = 10,160 samples), petri-dish dust (n = 106 houses) and ceiling dust (n = 80 houses) over a 25-year period from 1991 to 2015. Regression analysis was used to examine the relationships between environmental Pb sources and children's blood lead (PbB) outcomes. Analysis of the dataset showed Aboriginal children in Broken Hill had a geometric mean PbB of 7.4 μg/dL (95% CI: 6.7-7.4) being significantly higher (p < 0.01) than non-Aboriginal children (PbB 6.2 μg/dL, 95% CI: 6.2-6.3) for all years between 1991 and 2015. Children at the age of 24-36 months had a higher PbB compared with other age groups. Higher PbB levels were also statistically associated with lower socio-economic status and children living in houses built before 1940 (p < 0.01). Blood Pb was also significantly correlated with both soil Pb and indoor petri-dish dust Pb loadings, confirming that these are important pathways for exposure in Broken Hill. A 100 mg/kg increase in soil Pb was associated with a 0.12 μg/dL increase in childhood PbB. In addition, PbB concentrations increased with indoor petri-dish dust Pb loadings (i.e., 0.08 μg/dL per 100 μg/m2/30 days). The 25-year data show that the risk of exposure at ≥ 10 μg/dL was seemingly unavoidable irrespective of residential address (i.e., children of all ages presenting with a ≥10 μg/dL across the whole city area). In terms of moving forward and mitigating harmful early-life Pb exposures, all children aged 24-36 months should be prioritised for feasible and effective intervention practices. Primary intervention must focus on mitigating contemporary ongoing dust emissions from the mining operations and the associated mine-lease areas along with household soil remediation, to help prevent recontamination of homes. Additional practices of dust cleaning using wet mopping and wiping techniques, vacuuming of carpets and furnishings, ongoing monitoring of children and household dust remain important but short-lived abatement strategies. Overall, the key goal should be to eliminate risk by removing contamination in the wider environment as well as in individual homes.
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Affiliation(s)
- Chenyin Dong
- Department of Earth and Environmental Sciences, Faculty of Science and Engineering, Macquarie University, Sydney, NSW, 2109, Australia; Ministry of Education-Shanghai Key Laboratory of Children's Environmental Health, Xinhua Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, 200092, PR China.
| | - Mark Patrick Taylor
- Department of Earth and Environmental Sciences, Faculty of Science and Engineering, Macquarie University, Sydney, NSW, 2109, Australia.
| | - Brian Gulson
- Department of Earth and Environmental Sciences, Faculty of Science and Engineering, Macquarie University, Sydney, NSW, 2109, Australia; CSIRO Land and Water, Lucas Heights, NSW, 2234, Australia
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Muñoz MP, Rubilar P, Valdés M, Muñoz-Quezada MT, Gómez A, Saavedra M, Iglesias V. Attention deficit hyperactivity disorder and its association with heavy metals in children from northern Chile. Int J Hyg Environ Health 2020; 226:113483. [PMID: 32106053 DOI: 10.1016/j.ijheh.2020.113483] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/18/2019] [Revised: 12/24/2019] [Accepted: 02/04/2020] [Indexed: 12/09/2022]
Abstract
INTRODUCTION Exposure to lead and arsenic has been associated with child behavior problems. In Arica, a northern city of Chile, the natural presence of arsenic in water has been registered. Also, the city has a history of heavy metals contamination of anthropogenic origin. The purpose of this study was to explore the association between the concentration of blood lead and urinary inorganic arsenic with attention deficit hyperactivity disorder (ADHD) as reported by parents. METHODS Cross-sectional design with data analysis of 2656 children between the ages of 3 and 17 enrolled at the Environmental Health Center of Arica between 2009 and 2015. The diagnosis of ADHD was made based on the parents' response to questions about health history. Multiple logistic regression models were used to adjust for confounding variables. RESULTS The prevalence of ADHD was 6.4%. The means urinary inorganic arsenic and blood lead were 21 μg/L and 1.5 μg/dl, respectively. In the lead model adjusted for sex, age, housing material quality and exposure to secondhand tobacco smoke report; children with blood lead concentrations ≥5 μg/dl were more likely to develop ADHD [Odds Ratio (OR): 2.33 95% confidence intervals (CI) 1.32-4.12)]. Regarding arsenic, the adjusted model revealed a higher chance of developing ADHD in the fifth quintile of exposure (OR = 2.02 IC 95% 1.12-3.61). CONCLUSION The findings of this study suggest that exposure of children to lead and inorganic arsenic was associated with ADHD. This study provides additional evidence to existing literature regarding the potential role of toxic metals such as lead and arsenic in children's behavior. However, our findings should be interpreted with caution due to the limitations of the study.
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Affiliation(s)
- María Pía Muñoz
- Escuela de Salud Pública, Facultad de Medicina, Universidad de Chile, Santiago, Chile
| | - Paola Rubilar
- Escuela de Salud Pública, Facultad de Medicina, Universidad de Chile, Santiago, Chile.; Centro de Epidemiología y Políticas de Salud Pública, Facultad de Medicina, Universidad del Desarrollo, Santiago, Chile
| | - Macarena Valdés
- Escuela de Salud Pública, Facultad de Medicina, Universidad de Chile, Santiago, Chile
| | - María Teresa Muñoz-Quezada
- Centro de Investigación en Neuropsicología y Neurociencias Cognitivas, Facultad de Ciencias de la Salud, Universidad Católica del Maule, Talca, Chile
| | - Andrea Gómez
- Escuela de Salud Pública, Facultad de Medicina, Universidad de Chile, Santiago, Chile
| | - Marta Saavedra
- Departamento de Salud Pública, Secretaria Regional Ministerial de Salud Arica y Parinacota, Arica, Chile
| | - Verónica Iglesias
- Escuela de Salud Pública, Facultad de Medicina, Universidad de Chile, Santiago, Chile..
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Mannetje A', Coakley J, Douwes J. Where are we at with lead? Current levels, time trend, and determinants of blood lead in New Zealand children and adults. Int J Hyg Environ Health 2020; 225:113468. [PMID: 32007778 DOI: 10.1016/j.ijheh.2020.113468] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/31/2019] [Revised: 01/22/2020] [Accepted: 01/24/2020] [Indexed: 10/25/2022]
Abstract
AIMS A national biomonitoring survey was conducted in 2014-2016, to determine current blood lead levels (BLL) in New Zealand children and adults and identify determinants of BLL. METHODS Blood samples were provided by 191 children (age 5-18) and 304 adults (age 20-65) and analysed for BLL using inductively coupled mass spectroscopy. Linear regression on log-transformed BLL was used to assess associations between BLL and demographic and lifestyle factors collected via questionnaire. RESULTS The geometric mean (GM) BLL was 0.86 μg/dl (95%CI 0.80-0.92) for children and 1.31 μg/dl (1.23-1.39) for adults, representing a 90% reduction in BLL over the past 36 years. For children, shellfish consumption was associated with 20% higher BLL. Adult BLLs were positively associated with age, beer consumption, spirits consumption, having roof water as the home's water supply, and having worked in glass manufacturing. Determinants of reduced BLL were tofu and canned food consumption. For women, menopause was associated with 34% higher BLL. CONCLUSIONS Although significant reductions in New Zealanders' BLL have been achieved in the past decades, this study identified several additional opportunities to reduce further background exposure to lead. In particular, consideration needs to be given to reducing lead levels in New Zealand roof water supplies.
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Affiliation(s)
- Andrea 't Mannetje
- Centre for Public Health Research, Massey University. PO Box 756, Wellington, 6140, New Zealand.
| | - Jonathan Coakley
- Centre for Public Health Research, Massey University. PO Box 756, Wellington, 6140, New Zealand
| | - Jeroen Douwes
- Centre for Public Health Research, Massey University. PO Box 756, Wellington, 6140, New Zealand
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Emer LR, Kalkbrenner AE, O'Brien M, Yan A, Cisler RA, Weinhardt L. Association of childhood blood lead levels with firearm violence perpetration and victimization in Milwaukee. Environ Res 2020; 180:108822. [PMID: 31654907 DOI: 10.1016/j.envres.2019.108822] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/02/2019] [Revised: 10/10/2019] [Accepted: 10/10/2019] [Indexed: 06/10/2023]
Abstract
Childhood lead exposure impairs future decision-making and may influence criminal behavior, but its role in future firearm violence is unclear. Using public health, education, and criminal justice datasets linked at the individual level, we studied a population-based cohort of all persons born between June 1, 1986 and December 31, 2003 with a valid blood lead test before age 6 years and stable Milwaukee residency (n = 89,129). We estimated associations with firearm violence perpetration (n = 553) and victimization (n = 983) using logistic regression, adjusting for temporal trends, child sex, race, and neighborhood socioeconomic status. Increasing risks for firearm violence perpetration and victimization were found in each higher category of blood lead compared to the lowest, after adjusting for confounding. For perpetration, risk ratios (RR) for increasing comparisons of mean blood lead in categories of ≥5 < 10, ≥10 < 20, and ≥20 μg/dL compared to persons with mean blood lead < 5 μg/dL, were: RR 2.3 (95% CI 1.6, 3.3), RR 2.5 (95% CI 1.7, 3.9), and RR 2.8 (95% CI 1.8, 4.4). For victimization, the same increasing categoric comparisons were: RR 1.8 (95% CI 1.4, 2.3), RR 2.4 (95% CI 1.8, 3.2), RR 3.3 (95% CI 2.4, 4.5). The proportion of firearm violence attributable to blood lead ≥5 μg/dL was 56% for perpetration and 51% for victimization. In Milwaukee, during a period of high lead exposures, childhood levels may have substantially contributed to adult firearm violence. While we cannot definitively conclude causality, the possibility that over half of firearm violence among this sample might be due to lead exposure suggests the potential importance of lead exposure reduction in firearm violence prevention efforts.
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Affiliation(s)
- Lindsay R Emer
- University of Wisconsin-Milwaukee, Joseph J. Zilber School of Public Health, 1240 North 10th Street, Milwaukee, WI, 53205, USA; Medical College of Wisconsin, Institute for Health and Equity, 8701 Watertown Plank, Milwaukee, WI, 53226, USA; National Center for State Courts, 300 Newport Avenue, Williamsburg, VA, 23185, USA.
| | - Amy E Kalkbrenner
- University of Wisconsin-Milwaukee, Joseph J. Zilber School of Public Health, 1240 North 10th Street, Milwaukee, WI, 53205, USA
| | - Mallory O'Brien
- Medical College of Wisconsin, Institute for Health and Equity, 8701 Watertown Plank, Milwaukee, WI, 53226, USA
| | - Alice Yan
- University of Wisconsin-Milwaukee, Joseph J. Zilber School of Public Health, 1240 North 10th Street, Milwaukee, WI, 53205, USA
| | - Ron A Cisler
- Western Michigan University, College of Health and Human Services, 1200 Oakland Drive, Kalamazoo, MI, 49008, USA
| | - Lance Weinhardt
- University of Wisconsin-Milwaukee, Joseph J. Zilber School of Public Health, 1240 North 10th Street, Milwaukee, WI, 53205, USA
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Barry V, Steenland K. Lead exposure and mortality among U.S. workers in a surveillance program: Results from 10 additional years of follow-up. Environ Res 2019; 177:108625. [PMID: 31401374 DOI: 10.1016/j.envres.2019.108625] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/30/2019] [Revised: 08/01/2019] [Accepted: 08/02/2019] [Indexed: 06/10/2023]
Abstract
BACKGROUND A cohort of male lead-exposed workers with past blood lead levels, previously followed for mortality over 12 years, has now been followed for an additional 10 years. This has doubled the number of deaths and allowed for examination of mortality outcomes across a wide range of blood lead levels. OBJECTIVE Evaluate association between lead exposure and 16 causes of death. METHODS The cohort included male workers from 11 U.S. states enrolled in a U.S. lead surveillance program. Maximum blood lead level for each worker was abstracted from surveillance records. Mortality was assessed using the National Death Index. We conducted internal analyses via Cox regression adjusting for age, calendar time, and race. External analyses compared cohort mortality rates with those of the U.S. POPULATION Blood lead categories were defined as 0-<5, 5-<25, 25-<40, and ≥40 μg/dL with the two lower categories combined for outcomes with <5 deaths in the 0-<5 group. RESULTS The cohort (n = 58,368) was followed for a median of 19 years and experienced 6,527 deaths. Average maximum blood lead was 25.9 μg/dL and mean year of first blood lead test was 1997. Strong associations were found between blood lead level with larynx and lung cancer mortality. For these outcomes, hazard ratios and 95% confidence intervals across blood lead categories were 1.0 (ref), 1.1 (0.4-3.2), 3.4 (1.3-9.1) for larynx and 1.0 (ref), 1.6 (1.0-2.5), 2.0 (1.3-3.1), 2.9 (1.9-4.5) for lung (trend p-values = 0.08 and < 0.01, respectively). Positive significant trends were also seen for mortality from brain cancer, chronic obstructive pulmonary disease, ischemic heart disease, and non-hodgkin's lymphoma. Findings suggested associations with chronic renal disease and rectal cancer mortality, although trends were not statistically significant. CONCLUSIONS The additional follow up confirmed previous relationships between lead and mortality and also detected new associations.
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Affiliation(s)
- Vaughn Barry
- Department of Environmental Health, Rollins School of Public Health at Emory University, Atlanta, GA, USA.
| | - Kyle Steenland
- Department of Environmental Health, Rollins School of Public Health at Emory University, Atlanta, GA, USA
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