Difference in concentration of lead (Pb) in meat from pheasants killed using lead and iron (Fe) shotgun ammunition

The use of lead shotgun ammunition for hunting has been banned in a few jurisdictions and habitats, principally to protect wild birds from poisoning by ingestion of spent lead shot. The EU and UK REACH processes have recently considered bans on lead ammunition throughout the European Union and United Kingdom, including assessments of possible health benefits from reduced human dietary exposure to lead from game meat. Comparisons of the mean lead concentrations in meat from gamebirds killed using lead and non‑lead shotgun ammunition have not been published. We compared lead concentrations in meat from wild-shot pheasants from which lead shotgun pellets were recovered (n = 27) with those from which iron pellets were recovered (n = 20), having removed all pellets from the meat before analysis. The mean concentration of lead in meat from pheasants killed using lead shot was 2.10 mg/kg w.w., which is >20 times the European Union's maximum permitted level for the lead concentration in meat from domesticated animals. For pheasants killed using iron shot the mean was 0.07 mg/kg w.w., which is below the maximum permitted level.

Influence of lead-induced toxicity on the inflammatory cytokines

Lead (Pb2+) is a hazardous heavy metal that is pervasive in the human environment as a result of anthropogenic activity, and poses serious health risks, particularly in children. Due to its innumerable unique physical and chemical properties, it has various applications; therefore, it has become a common environmental pollutant. Lead may cause oxidative stress, and accumulating evidence indicates that oxidative stress influences the pathophysiology of lead poisoning, also called plumbism. The immune system is continually exposed to various environmental pathogens and xenobiotics, including heavy metals such as lead, and appears to be one of the most vulnerable targets. After being exposed to lead, cells are subjected to oxidative stress as a result of reactive oxygen species (ROS) production. When the generation and consumption of ROS are out of equilibrium, various cell structures, particularly phospholipids are disrupted leading to lipid peroxidation. Various inflammatory signalling pathways are activated as a consequence, along with reduced disease resistance, inflammation, autoimmunity, sensitization and disruption of the cell-mediated and humoral immune systems. Lead negatively affects the metabolism of cytokines, including the interleukins IL-2, IL-1b, IL-6, IL-4, IL-8, tumor necrosis factor-alpha (TNF-α), and interferon-gamma (IFN), as well as the expression and functioning of inflammatory enzymes such as cyclooxygenases. However, the cause of toxicity depends on the kind of lead, dosage, route of entry, exposure period, age, host and genetic predisposition.

Integral trends in research of lead exposure and child health from 2012 to 2022: a bibliometric analysis

Lead poisoning in children is a non-negligible and ongoing threat to children's health and optimal development worldwide. There is no sufficient scientometric analysis available on this subject, though. Aiming to uncover the research development, hotspots, and possible future orientation, we performed a scientometric analysis of related publications from 2012 to 2022. Initial information was accessed using the "Analysis Results" and "Create Citation Report" sections of the Web of Science core collection database, which were utilized to find original publications in this field of research. Biblioshiny and VOSviewer software were applied to further analyze and visualize the data. The research addressed a range of topics, including yearly publications, highly cited articles, co-cited references, journals, authors, nations, organizations, and keywords. A total of 883 articles were retrieved. From 2018 to 2021, the annual publication output was abundant and peaked in 2019. Among 111 countries, the USA obtained the highest number of documents issued, total citations, and total link strength. Meanwhile, most of the top 15 institutions, including the top four, are located in the USA. Further, we spotted greater scopes with development potential, including enhancing records to lessen exposure to harmful risks, improving methods for observing lead sources, and elucidating the gradient link between lead poisoning symptoms and concentrations. We anticipate that our research will assist researchers in summarizing previous research and providing perspectives for workable prospective study topics.

A Case of Severe Lead Encephalopathy with Cardiac Arrest Managed During a Chelation Shortage

INTRODUCTION

For many years, the standard of care in the USA has been to treat acute lead encephalopathy with a combination parenteral dimercaprol (BAL) and CaNa2EDTA. We present a case of a pediatric patient with severe lead encephalopathy, complicated by cardiac arrest, who was treated with an alternative regimen when CaNa2EDTA was unavailable.

CASE REPORT

A 24-month-old male was brought by ambulance to an emergency department (ED) with new onset seizures and sustained a cardiac arrest. An initial blood lead concentration returned at 263 mcg/dl. The hospital was unable to obtain CaNa2EDTA due to the nationwide shortage. For this reason, the patient was chelated with BAL IM for 12 days and dimercaptosuccinic acid (DMSA) for 28 days. He received a second 5-day course of BAL due to rebounding blood lead concentrations. Eight days after cardiac arrest, he was extubated; however, despite ongoing therapy, subsequent follow-up 2 months later demonstrated persistent cognitive deficits.

DISCUSSION

The combination of DMSA and BAL was effective in rapidly decreasing whole blood lead concentrations. Drug shortages continue to have implications for the management of poisoned patients. This case highlights how shortages of chelating agents complicate patient care.

Reductions in Children's Blood Lead Levels from a Drinking-Water Intervention in Madagascar, Sub-Saharan Africa

One in three children globally is estimated to have blood lead levels (BLL) at or above the BLL reference value of 5 μg/dL with increased burden falling on low- and middle-income countries (LMIC). Within developed countries, aqueous lead is the predominant exposure route. However, aqueous lead exposure is rarely examined in the LMIC, leaving a gap in the literature that ignores a potentially significant route of exposure. Furthermore, limited lead-based remediation efforts around consumer products have been examined. This study investigates the importance of lead exposure from the water supply through a case study in Toamasina, Madagascar. The project measured aqueous lead and BLL of children pre- and postremediation efforts (i.e., removal of leaded pump components in hand pumps) to verify the impact of aqueous lead exposure within this community. Removal of the leaded pump components (i.e., piston and foot valves) and replacement with nonleaded components decreased aqueous lead levels below the World Health Organization provisional guideline of 10 μg/L in all but 4% of pumps tested. Measured BLL concentrations indicated a statistically significant decrease in BLL from pre- to postremediation. Furthermore, the remediation resulted in a decrease in BLL for 87% of children with the greatest changes in BLL observed for children with the highest preremediation concentrations. These findings point to a need for greater consideration of lead in drinking and cooking waters as an important exposure route in LMIC.

Melanonychia as a manifestation of chronic lead poisoning

First-contact clinicians and dermatologists should be aware of melanonychia as an atypical presentation of chronic lead poisoning in high-risk groups.

Stability of blood lead levels in children with low-level lead absorption

Current child blood lead (Pb) screening guidelines assume that blood lead levels (BLLs) are relatively stable over time, and that only youngest children are vulnerable to the damaging effects of lower-range BLLs. This study aimed to test the stability of lower-range (≤ 10 μg/dL) child BLLs over time, and whether lower-range BLLs diminished with age among children aged 6 months to 16 years living in a lower-income neighborhood with a density of pre-1986 housing and legacy contamination. Age, sex, family income, age of residence, and/or residence proximity to point sources of Pb, were tested as potential additional factors. Capillary blood samples from 193 children were analyzed by inductively coupled plasma mass spectrometry (ICPMS). Multiple imputation was used to simulate missing data for 3 blood tests for each child. Integrated Growth Curve models with Test Wave as a random effect were used to test BLL variability over time. Among N = 193 children tested, at Time 1 testing, 8.7% had the BLLs ≥ 5 μg/dL (CDC "elevated" BLL reference value at the time of data collection) and 16.8% had BLLs ≥ 3.5 μg/dL (2021 CDC "elevated" BLL reference value). Modeling with time as a random effect showed that the variability of BLLs were attributable to changes within children. Moreover, time was not a significant predictor of child BLLs over 18 months. A sex by age interaction suggested that BLLs diminished with age only among males. Of the additional environmental factors tested, only proximity to a major source of industrial or vehicle exhaust pollution predicted child BLL variability, and was associated with a small, but significant BLL increase (0.22 μg/dL). These findings suggest that one or two BLL tests for only infants or toddlers are insufficient for identifying children with Pb poisoning.

Association between Chronic Environmental Lead (Pb) Exposure and Cytokines in Males and Females of Reproductive Age from Kabwe, Zambia

Lead (Pb) poisoning remains a great public health challenge globally known to induce a wide range of ailments in both children and adults. The current study investigated the association of chronic environmental Pb exposure and immunomodulatory cytokines tumor necrosis factor alpha (TNF-α) and interleukin-8 (IL-8) in adult males and females living in Kabwe, Zambia. The standard human cytokine/chemokine Milliplex assay was used to quantify plasma cytokines from four groups categorized as low (<10 μg/dL) and high (>10 μg/dL) blood lead level (BLL) groups, namely, low BLL female (n = 47; BLL = 3.76 μg/dL), low BLL Male (n = 43; BLL = 4.13 μg/dL), high BLL female (n = 21; BLL = 23.5 μg/dL), and high BLL male (n = 18; BLL = 23.7 μg/dL), respectively. The low BLL group was associated with increased TNF-α levels, and the high BLL group was associated with reduced TNF-α levels in female subjects. No associations between BLL and the levels of IL-8 and TNF-α cytokines were observed in either females or males, respectively. A negative correlation between BLL and TNF-α was found in female subjects, suggesting that an increase in BLL accompanied by a reduction in TNF-α. The reduced levels of circulating TNF-α in female subjects suggest that chronic Pb exposure could predispose females to immune and inflammation-related disorders than their male counterparts. Further studies are recommended to ascertain the impact of chronic Pb exposure on immunomodulatory cytokines, especially in females.

Lead contamination in Australian game meat

Lead-based ammunition (gunshot and bullets) frequently leaves small lead fragments embedded in the meat of wild-shot game animals. Australia produces several commercial game meat products from wild animals harvested with lead-based ammunition and has a growing population of recreational hunters. However, no studies have previously investigated the frequency of lead fragments or lead concentrations in Australian game meat. We examined 133 Australian minced game meat items of four types for evidence of lead contamination. Samples were meat from kangaroos (Macropus and Osphranter spp.; n=36) and Bennett's wallabies (Notamacropus rufogriseus; n=28) sold for human consumption, and deer ('venison'; multiple spp.; n=32) and stubble quail (Coturnix pectoralis; n=37) harvested for private consumption by recreational hunters. All packages were studied by digital radiography to detect the presence of radio-dense fragments, assumed to be lead fragments from ammunition. Visible fragments were absent in commercially available kangaroo products, but were present in 4%, 28% and 35% of wallaby, venison and quail, respectively. Mean meat lead concentrations (mg/kg wet weight) were 0.01 ± 0.01 for kangaroo, 0.02 ± 0.01 for wallaby, 0.12 ± 0.07 for venison, and 1.76 ± 3.76 for quail. The Australian food standards threshold for livestock meat (0.1 mg/kg w.w.) was not exceeded by any kangaroo or wallaby products but was exceeded by 53% and 86% of venison and quail, respectively. Radiography only detected 35% of samples that were above the food safety threshold. While average lead concentrations in commercially available macropod (kangaroo and wallaby) meat were low, those in recreationally harvested game meat may pose health risks for hunters and associated consumers.

Evaluation of the integrated exposure uptake biokinetic (IEUBK) model for lead in children

BACKGROUND

The Integrated Exposure Uptake Biokinetic Model for Lead in Children (IEUBK model) was developed by the U.S. Environmental Protection Agency to support assessments of health risks to children from exposures to lead (Pb).

OBJECTIVE

This study evaluated performance of IEUBK model (v2.0) as it would be typically applied at Superfund sites to predict blood Pb levels (BLLs) in populations of children.

METHODS

The model was evaluated by comparing model predictions of BLLs to 1144 observed BLLs in a population of children at the Bunker Hill Superfund Site for which there were paired estimates of environmental Pb concentrations.

RESULTS

Predicted population geometric mean (GM) BLLs (GM: 3.4 µg/dL, 95% CI: 3.3, 3.5) were within 0.3 µg/dL of observed (GM: 3.6 µg/dL, 95% CI: 3.5, 3.8). The model predicted the observed age trend in GM BLLs and explained ~90% of the variance in the observed age-stratified GM BLLs. The mean predicted probability of exceeding 5 µg/dL (P5) was 27% (95% CI: 24, 29) and observed P5 was 32% (95% CI: 29, 35), a difference of 5%. Differences between geographic area stratified mean P5 (predicted minus observed) ranged from -11 to 14% (mean difference: 2.3%).

SIGNIFICANCE

Although the more general applicability of these findings to other populations remains to be determined in future studies, our results support applications of the IEUBK model (v2.0) for informing risk-based decisions regarding remediation of soils and mitigation of exposures at Superfund sites where the majority of the exposure unit GM BLLs are expected to be ≤5 µg/dL and where it is desired to limit the predicted probability of exceeding 5 µg/dL to <5%.

Lead exposure in childhood and historical land use: a geostatistical analysis of soil lead concentrations in South Philadelphia parks

Elevated soil lead (Pb) concentrations in public parks and outdoor spaces continue to have a significant impact on the public health of urban communities. This study evaluated the geospatial and statistical relationships between soil Pb concentrations, the urban environment, and child blood lead levels (BLLs) in the neighborhood of South Philadelphia, PA. Soil samples (n = 240) were collected from forty (40) public parks and analyzed for Pb using a field portable X-ray fluorescence (XRF) analyzer. Geospatial mapping was used to investigate historical land use of each park, vehicular traffic on adjacent roadways, and density of residential/commercial development. Predicted child BLLs and BLL "high-risk areas" were identified using interpolation and biokinetic modeling. Childhood BLL data for South Philadelphia (n = 10,379) was provided by the Philadelphia Department of Public Health (2013-2015). Of the two hundred forty (240) soil samples collected, Pb levels for 10.8% of samples were ≥ 400 ppm. Two hundred sixty-nine of 10,379 children screened were identified with BLLs ≥ 5 µg/dL. Historical land use of each park was shown to be significantly correlated (p = 0.01) with soil Pb concentrations and child BLLs ≥ 5 µg/dL. Approximately 13.3% of the variance in child BLLs ≥ 5 µg/dL was attributed to historical site land use. Overall, undeveloped/greenspace historical land use exhibited the highest soil Pb concentrations in the study. Geospatial relationships were identified between census tracts with higher percentages of children with BLLs ≥ 5 µg/dL and interpolated BLL "high-risk" areas (≥ 3.5 µg/dL). The results of this study suggest soil accumulation time and historical land use may influence soil Pb concentrations and child BLLs in urban communities. Measured soil Pb concentrations were determined to effectively model community-wide contamination and childhood Pb exposure.

Identifying the origin of lead poisoning in white-backed vulture (Gyps africanus) chicks at an important South African breeding colony: a stable lead isotope approach

Elevated lead levels in scavenging raptors can originate from a variety of environmental and anthropogenic sources, including soil, water, mining activities and legacy lead from leaded fuel, but has mostly been attributed to fragments of lead-based ammunition embedded in the tissues of carcasses. To identify the origins of lead in the tissues of white-backed vulture (Gyps africanus) chicks at Dronfield Nature Reserve, South Africa, we used MC-ICP-MS to compare the isotopic composition of lead in blood samples to those of soil in the chicks' immediate environment, different mining activities in South Africa and lead ammunition commonly used in hunting and game management practices. The isotopic ratios in vulture blood samples ranged widely (207Pb/206Pb: 0.827-0.911), but fell within those measured for ammunition (0.761-0.938). Dronfield water can be excluded as a significant source, as the lead concentration for water was below detection limits. Uranium, coal, atmospheric Pb, legacy Pb from fuel and Pb mining can also be excluded as significant sources, based on the limited overlap with Pb isotopic ratios measured in vulture blood. Whereas 55% of chicks we sampled displayed isotopic ratios consistent with Dronfield soil, the low local Pb concentration and the low extractable Pb levels in South African soil in general, imply that soil Pb is unlikely the major source of Pb in WBV chicks, especially in birds with elevated blood Pb levels, i.e. > 20 µg/dL. Our results, when considered in the context of vulture feeding ecology and low Pb levels in non-scavenging birds in South Africa, imply the major source of elevated Pb levels in WBV chicks to be fragments of lead-based ammunition embedded in the carrion fed to them by their parents.

Relation of blood lead levels and lead in gasoline: an updated systematic review

BACKGROUND

Millions of tons of lead were added to gasoline worldwide beginning in 1922, and leaded gasoline has been a major source of population lead exposure. In 1960s, lead began to be removed from automotive gasoline. Removal was completed in 2021.

OBJECTIVES

To determine whether removal of lead from automotive gasoline is associated with declines in population mean blood lead levels (BPb).

METHODS

We examined published studies that reported population blood leaded levels for two or more years, and we calculated average concentrations of lead in gasoline corresponding to the years and locations of the blood lead level measurements.

RESULTS

Removal of lead from gasoline is associated with declines in BPb in all countries examined. In some countries, BPb continues to fall after lead has been eliminated from gasoline. Following elimination of lead from gasoline, BPb less than 1 μg/dL have been observed in several European and North American countries, and BPb less than 3 μg/dL have been documented in several studies from South America.

DISCUSSION

There remain many countries for which no multi-year studies of populations BPb have been identified, including all of Central America, high population countries including Pakistan and Indonesia, and major lead producers including Australia and Russia.

CONCLUSION

Removal of lead from gasoline has been a public health success. Elimination of lead from gasoline has enabled many countries to achieve population mean BPb levels of 1 μg/dL or lower. These actions have saved lives, increased children's intelligence and created great economic benefit in countries worldwide.

Childhood lead exposure and sex-based neurobehavioral functioning in adolescence

It is well documented that childhood lead exposure is associated with long-term decreases in intelligence quotients (IQ). Lesser known is the relationship with neurobehavioral domains, especially in adolescence. This study sought to identify cross-sectional and longitudinal associations between lead exposure and adolescent executive and visual-motor functioning and examine sex-based differences. Participants were 681 children from Jintan, China who had their blood lead levels (BLLs) assessed at age 3-5 years and 12 years old and neurobehavioral functioning assessed through the University of Pennsylvania Computerized Neurocognitive Battery (PennCNB) platform http://www.med.upenn.edu/bbl at 12 years old. Mean BLLs were 6.41 mcg/dl at age 3-5 years and 3.10 mcg/dl at 12. BLLs at 3-5 years and 12 years were used as predictors for the individual neurobehavioral domains in general linear models while controlling for father and mother occupation and education, residence location, age, and adolescent IQ. Models were run separately for males and females. In adjusted models, males BLLs at 3-5 years were associated with increased time to correctly complete tasks in multiple domains including abstraction/flexibility (β = 19.90, 95% CI( 4.26, 35.54) and spatial processing (β = 96.00, 95% CI 6.18, 185.82) at 12 years. For females in adjusted models, BLLs at 3-5 years were associated with increasing time to correctly complete tasks on the episodic memory domain task (β = 34.59, 95% CI 5.33, 63.84) at 12 years. Two adolescent cross-sectional relationships remained in the adjusted models for males only, suggesting a positive association between BLLs and increasing time for correct responses on the attentional domain task (β = 15.08, 95% CI 0.65, 29.51) and decreasing time for correct responses on the episodic memory task (β = -73.49, 95% CI -138.91, -8.06) in males at 12 years. These associations remained with and without controlling for IQ. These results suggest that lead exposure is associated with overall deficits in male and female neurobehavioral functioning, though in different domains and different timing of exposure.

Lead poisoning of backyard chickens: Implications for urban gardening and food production

Increased interest in backyard food production has drawn attention to the risks associated with urban trace element contamination, in particular lead (Pb) that was used in abundance in Pb-based paints and gasoline. Here we examine the sources, pathways and risks associated with environmental Pb in urban gardens, domestic chickens and their eggs. A suite of other trace element concentrations (including As, Cd, Cr, Cu, Hg, Mn, Ni, Pb, Zn) are reported from the sampled matrices. Sixty-nine domestic chickens from 55 Sydney urban gardens were sampled along with potential sources (feed, soil, water), blood Pb concentrations and corresponding concentrations in eggs. Age of the sampled chickens and house age was also collected. Commercial eggs (n = 9) from free range farms were analysed for comparative purposes. Study outcomes were modelled using the large Australian VegeSafe garden soil database (>20,000 samples) to predict which areas of inner-city Sydney, Melbourne and Brisbane are likely to have soil Pb concentrations unsuitable for keeping backyard chickens. Soil Pb concentrations was a strong predictor of chicken blood and egg Pb (p=<0.00001). Almost 1 in 2 (n = 31/69) chickens had blood Pb levels >20 μg/dL, the level at which adverse effects may be observed. Older homes were correlated with higher chicken blood Pb (p = 0.00002) and egg Pb (p = 0.005), and younger chickens (<12 months old) had greater Pb concentrations, likely due to increased Pb uptake during early life development. Two key findings arose from the study data: (i) in order to retain chicken blood Pb below 20 μg/dL, soil Pb needs to be < 166 mg/kg; (ii) to retain egg Pb < 100 μg/kg (i.e. a food safety benchmark value), soil Pb needs to be < 117 mg/kg. These concentrations are significantly lower than the soil Pb guideline of 300 mg/kg for residential gardens. This research supports the conclusion that a large number of inner-city homes may not be suitable for keeping chickens and that further work regarding production and consumption of domestic food is warranted.

Childhood blood lead levels and environmental risk factors in Madagascar

One-third of children globally have blood lead levels (BLLs) exceeding the (former) US CDC reference value of 5 µg/dL; this value may be as high as one-half for children in low- and middle-income countries (LMICs). Lead exposure occurs through a variety of routes (e.g., water, dust, air), and in LMICs specifically, informal economies (e.g., battery recycling) can drive lead exposures due, in part, to absent regulation. Previous work by our team identified a ubiquitous source of lead (Pb), in the form of Pb-containing components used in manually operated pumps, in Toamasina, Madagascar. Characterization of BLLs of children exposed to this drinking water, and identification of additional exposure routes were needed. BLLs were measured for 362 children (aged 6 months to 6 years) in parallel with surveying to assess 14 risk factors related to demographics/socioeconomics, diet, use of pitcher pumps, and parental occupations. BLL data were also compared against a recent meta-review of BLLs for LMICs. Median childhood BLL (7.1 µg/dL) was consistent with those of other Sub-Saharan African LMICs (6.8 µg/dL) and generally higher than LMICs in other continents. Risk factors significantly associated (p < 0.05, univariate logistic regression) with elevated BLL (at ≥ 5 µg/dL) included male gender, living near a railway or major roadway (owing potentially to legacy lead pollution), having lower-cost flooring, daily consumption of foods (beans, vegetables, rice) commonly cooked in recycled aluminum pots (a previously identified lead source for this community), and a maternal occupation (laundry-person) associated with lower socioeconomic status (SES). Findings were similar at the ≥ 10 µg/dL BLL status. Our methods and findings may be appropriate in identifying and reducing lead exposures for children in other urbanizing cities, particularly in Sub-Saharan Africa, where lead exposure routes are complex and varied owing to informal economics and substantial legacy pollution.

Use of historical mapping to understand sources of soil-lead contamination: Case study of Santa Ana, CA

This paper investigates the historical sources of soil-lead contamination in Santa Ana, California. Even though dangerous levels of soil-lead have been found in a wide variety of communities across the United States, public health institutions lack clarity on the historical origins of these crises. This study uses geo-spatial data collected through archival research to estimate the impact of two potential sources of lead contamination in the past -- lead-paint and leaded gasoline. It examines, through a combination of statistical and historical methods, the association between lead concentrations in contemporary soil samples and patterns in the evolution of the city's physical features, such as the growth of urbanized areas and the historical flow of traffic. We emphasize the value of historical data collected through archival research for understanding the sources of environmental lead, particularly leaded gasoline, which our study found to be the most likely and most prominent contributor to soil-lead in Santa Ana's environment. This research contributes to environmental-justice advocacy efforts to reframe lead poisoning as a systemic environmental issue and outlines the path forward to community-level remediation strategies.

Implications for food safety of the size and location of fragments of lead shotgun pellets embedded in hunted carcasses of small game animals intended for human consumption

Carcasses of common pheasants (Phasianus colchicus) killed by hunters using shotguns are widely used or sold in the United Kingdom and elsewhere for human consumption. Almost all of the birds are shot using shotgun pellets composed principally of lead (Pb). Lead shotgun pellets often fragment on impact within the bodies of gamebirds, leaving small lead particles in the meat that are difficult for consumers to detect and remove and from which a greater proportion of lead is likely to be absorbed. Chronic exposure to even low levels of lead is associated with negative health effects in humans and especially in groups particularly vulnerable to the effects of lead, which include young children and pregnant women. Our study used a high-resolution computerised tomography X-ray scanner to locate, in three dimensions, metal fragments embedded within carcasses of eight pheasants sold for human consumption in the UK. Small radio-dense fragments (<2 mm diameter), assumed to be metallic lead, were present in all of the pheasant carcasses examined (mean number: 39 per carcass) and many were too small (<0.1 mm diameter) and too distant from the nearest large shotgun pellet for it to be practical for consumers to detect and remove them without discarding a large proportion of otherwise usable meat. Consumers of carcasses of pheasants killed using lead shotgun ammunition are likely to be exposed to elevated levels of dietary lead, even if careful food preparation is practiced to remove shotgun pellets and the most damaged tissue.

Dose-dependent effects of chronic lead toxicity in vivo: Focusing on trace elements and gut microbiota

Dose-dependent effects of chronic Pb exposure-induced injuries, especially on the trace elements and gut microbiota in mice, have not been explored. In the present study, we investigated these aspects using C57BL/6 mouse models that were exposed to Pb via drinking water with Pb concentrations of 0.1, 0.5, and 1.0 g/L for 8 weeks. The results showed that with the increase in chronic Pb exposure dose, the Pb levels in the blood and tissues, Zn levels in the kidney and brain were elevated, and the levels of bone Zn, kidney Fe, brain Mg, Ca, and Fe, renal catalase activity, and glutathione levels, as well as the expression of colonic zonula occludens-1 and occludin, decreased with a strong linear correlation. Moreover, the relative abundance of Marvinbryantia and Ruminococcus 1 increased, while that of Lactobacillus and Roseburia decreased linearly with the Pb exposure dose. PICRUSt analysis revealed that chronic Pb exposure had a greater impact on the metabolism of macronutrients, trace elements, and neurodegenerative injury. These findings suggest that chronic Pb exposure disrupts trace element levels in tissues, especially in the brain, and induces gut dysbiosis in a dose-dependent manner, which is different from the dose-effect of acute Pb toxicity.

Comparison of Thyroid Function in Lead-Poisoned Patients and Healthy Individuals in Eastern Iran

Lead (Pb) is a prevalent environmental toxic metal that may harmfully affect the function of the thyroid gland. Our information about the effects of lead on thyroid function in lead poisoning is limited. The present study aimed to evaluate thyroid function in lead-poisoned patients compared with the healthy group. In this study, two groups of lead poisoning subjects (lead concentrations ≥ 25 μg/dL) (n = 56) (HBLC group) and randomly selected age and gender-matched healthy individuals with lower blood lead concentrations (BLC < 10 μg/dL) (n = 58) (LBLC group) were included. Thyroid function tests, including thyroxine (T4), triiodothyronine (T3), and thyroid-stimulating hormone (TSH) concentration, were measured for each patient in both groups (for the HBLC group, it was taken on admission). The linear regression model was used to investigate the effects of lead poisoning on thyroid function tests. A p-value of less than 0.05 was considered significant. Our study showed no significant difference between the two groups in terms of age and gender. The mean concentration of T3 and TSH in the HBLC group was significantly lower than the LBLC group, but the mean levels of T4 were significantly higher in the HBLC group (p < 0.05). Based on the linear regression model results, the T3 and TSH levels in the LBLC group were significantly higher by 13.86 and 0.43 units than the HBLC group, respectively. The current study results showed that lead poisoning affects thyroid function, reduces TSH, and increases T4.

Environmental lead exposure and its correlation with intelligence quotient level in children

BACKGROUND

Lead (Pb) is ubiquitous, naturally occurring heavy metal that has a neurotoxic effect on the CNS and causes a range of health problems in humans, including cognitive impairment. Its toxicity remains a worldwide health issue, especially in developing countries. In this study, we tend to investigate the relationship between Pb poisoning and sociodemographic status, intellectual and neurobehavioral capabilities of children.

METHODS

The background characteristics of the research subjects were collected via questionnaire. The study involved 43 children, aged from 4 to 12 years. Blood lead (BL) levels were analysed by using anodic stripping voltammeter (ASV). Intelligence quotient (IQ) was another parameter that was assessed via using the Goodenough draw-A-person test in Pb exposed as well as control children. Although sociodemographic information was obtained in a questionnaire pattern from the parents.

RESULTS

The mean of BL level was 19.93 ± 9.22 μg/dL. BL levels were considerably higher with low social status (p < 0.05), maternal employment (p < 0.001) and the maximum time spent outdoors (p < 0.001). Source of water, age of subjects, type of house and kohl used by children was observed to be significantly correlated with BL levels i.e. (p < 0.05). IQ levels were decreased in a concentration dependent manner (p < 0.01). Negative correlations were found between BL levels and IQ levels (r = -0.963, <0.01). Girls were found to be higher IQ level than boys (p < 0.05). Moreover, higher socioeconomic status had a higher IQ level (p < 0.01) as compared to low.

CONCLUSION

BL levels were significantly associated with IQ levels. Sociodemographic characteristic was also found to be one of the risk factors that influenced the BL levels of children. Our investigations have demonstrated that the exposure of Pb severely affected the learning with memory, and the intelligence quotient of children, that is found inversely proportional in respect to BL levels.

Lead Toxicity and Environmental Health Justice Stories in Black and White Woodcut Portraits

BACKGROUND

Omaha, Nebraska, has a lead-contaminated superfund site and substandard housing that pose risks for childhood lead exposure. Healthy Housing Omaha (formerly, Omaha Healthy Kids Alliance), an environmental health nonprofit, partnered with the fourth author, an artist, and a newspaper to raise awareness about lead poisoning by publishing portraits and stories of affected community members.

METHODS

The authors analyzed an interview with the artist, photographs of portraits published in a local newspaper, and quotations from portrait sitters.

RESULTS

Shared stories of lead exposure and poisoning conveyed in the portraiture and printmaking processes revealed structural racism as an emergent theme.

CONCLUSIONS

Arts-based research methods, such as portraiture, can be scaled and applied to support national and international community engagement efforts to advocate for environmental justice and public health.

Role of Ape1 in Impaired DNA Repair Capacity in Battery Recycling Plant Workers Exposed to Lead

Exposure to lead in environmental and occupational settings continues to be a serious public health problem. At environmentally relevant doses, two mechanisms may underlie lead exposition-induced genotoxicity, disruption of the redox balance and an interference with DNA repair systems. The aim of the study was to evaluate the ability of lead exposition to induce impaired function of Ape1 and its impact on DNA repair capacity of workers chronically exposed to lead in a battery recycling plant. Our study included 53 participants, 37 lead exposed workers and 16 non-lead exposed workers. Lead intoxication was characterized by high blood lead concentration, high lipid peroxidation and low activity of delta-aminolevulinic acid dehydratase (δ-ALAD). Relevantly, we found a loss of DNA repair capacity related with down-regulation of a set of specific DNA repair genes, showing specifically, for the first time, the role of Ape1 down regulation at transcriptional and protein levels in workers exposed to lead. Additionally, using a functional assay we found an impaired function of Ape1 that correlates with high blood lead concentration and lipid peroxidation. Taken together, these data suggest that occupational exposure to lead could decrease DNA repair capacity, inhibiting the function of Ape1, as well other repair genes through the regulation of the ZF-transcription factor, promoting the genomic instability.

Comparative efficacy of silibinin and nano-silibinin on lead poisoning in Male Wistar rats

Lead (Pb) is an environmental neurotoxin that can lead to toxicity. It has shown that tissues can be exposed to oxidative stress in lead poisoning. Since silymarin is a natural agent with antioxidant effects, this study aimed to investigate the antioxidant and chelation effects of silibinin and nano-silibinin on the oxidative stress status in lead-poisoned rats. Sixty male Wistar rats randomly divided into ten groups (n = 6). Control and Pb groups treated with or without silibinin and nano-silibinin for six days. Following measuring of weight and blood lead levels, biochemical antioxidant parameters evaluated. Finally, a histopathological examination of the liver performed. In this experiment, silibinin and more efficiently nano-silibinin prevented weight loss and blood lead level elevation induced by lead. Also, they increased the attenuated levels of superoxide dismutase (SOD) activity, catalase (CAT), total thiol molecules (TTM), glutathione (GSH), and total antioxidant capacity (TAC). Lead-induced elevation of lipid peroxidation products (MDA) and nitric oxide (NO) normalized to the standard level in silibinin and especially nano-silibinin groups. These data suggested that silibinin and especially nano-silibinin can decrease blood lead levels and prevent weight loss and oxidative stress in the lead-poisoned rat's model.

Lead poisoning among asymptomatic individuals with a long-term history of opiate use in Golestan Cohort Study

BACKGROUND

Recent reports of lead poisoning suggest that people who use opium may be exposed to high amounts of lead. Here, we investigate the association between opium use and blood lead levels (BLL) in a population-based cohort study.

METHODS

In 2017, we studied a random sample of 410 people who currently (both within the past year and the past month) used opium and 104 who did not from participants of the Golestan Cohort Study in northeast Iran. Participants were stratified by sex and tobacco use history, completed a comprehensive opiate and tobacco use questionnaire and provided blood. BLL was measured by Lead Care® II Blood Lead Test Kit, validated by inductively coupled plasma triple quadrupole mass spectrometry. BLL was categorized as "<5 µg/dL", "elevated" (5-10 µg/dL), "high" (10-50 µg/dL), and "very high" (above 50 µg/dL). To assess the association between BLL categories and opiate use, route of consumption and weekly use, we used ordered logistic regression models, and report OR (odds ratio) and 95% CI (confidence interval) adjusted for age, sex, place of residence, education, occupation, household fuel type, and tobacco use.

RESULTS

In the cohort, participants used only raw (teriak) or refined (shireh) opium, which were smoked (45%, n = 184), taken orally (46%, n = 189), or both (9%, n = 37), for a mean duration of 24.2 (standard deviation: 11.6) years. The median BLL was significantly higher in people who currently used opium (11.4 µg/dL; IQR: 5.2-23.4) compared with those who did not (2.3 µg/dL; IQR: 2.3-4.2), and the highest median BLL was seen in oral use (21.7 µg/dL; IQR: 12.1-34.1). The BLL was <5 µg/dL among 79.8% of people with no opiate use, compared with only 22.7% in those using opium. BLL was elevated in 21.7%, high in 50.5% and very high in 5.1% of people using opium. About 95% of those with oral (180/189) or dual use (35/37) and 55% (102/184) of those who smoked opium had levels of blood lead above 5 µg/dL. The OR for the association between any opium use and each unit of increase in BLL category was 10.5 (95%CI: 5.8-19.1), and oral use of opium was a very strong predictor of increasing BLL category (OR=74.1; 95%CI: 35.1-156.3). This odds ratio was 38.8 (95%CI: 15.9-95.1) for dual use and 4.9 (95%CI: 2.6-9.1) for opium smoking. There was an independent dose-response association between average weekly dose and BLL among people using opium, overall and when stratified by route of use.

CONCLUSION

Our results indicate that regular use of lead-adulterated opium can expose individuals to high levels of lead, which may contribute to mortality and cancer risks associated with long-term opium use.

Association between lead source exposure and blood lead levels in some lead manufacturing countries: A systematic review and meta-analysis

Lead is one of the 10 most toxic chemicals of greatest concern for its effects on public health. Predominantly, in undeveloped countries, high blood lead levels (BLLs) persist in the population. To develop intervention strategies that may reduce lead exposure in populations, it is a priority to know the sources of lead pollution. The objective of this critical review and meta-analysis is to assess whether there is an association between different sources of lead exposure and the mean difference in blood lead levels in people exposed. To identify the major lead source exposure, a statistical analysis was performed on selection studies. This investigation reveals the limited information available on the sources of lead in Mexico and other lead producer countries, such as Croatia, Ecuador, Brazil, South Korea, India, Nigeria, Turkey, and China. Meta-analysis could be performed only in battery, smelting mining, and glazed ceramic workers. Battery manufacturing workers have the highest mean difference level of lead in their blood worldwide. Mexico has the second highest mean difference BLL in battery workers in the world. An interesting difference between the mean difference in BLL in mining workers from uncontrolled industry (-39.38) and controlled industry (-5.68) was found. This difference highlighted the success of applying strict control of lead sources and community education to reduce BLL and its potential harmful effects on human health and the environment. Children living near mining sites have the highest mean difference BLL (-11.1). This analysis may aid in assessing the source of lead exposure associated with a range of BLLs in people. Furthermore, this review highlights several social and cultural patterns associated with lead exposure and lead levels in control populations. These results could help to develop international lead regulations and appropriate public health guidelines to protect people around the world.

[Analysis on incidence of occupational diseases in Guangzhou from 2010 to 2020]

Objective: To analyze the incidence characteristics of occupational diseases in Guangzhou from 2010 to 2020, provide scientific basis for formulating occupational disease prevention and control policies. Methods: In January 2021, based on the data of occupational diseases in Guangzhou reported in the Information Monitoring System of Occupational Diseases and Occupational Health, descriptive epidemiological method was used to analyze the types and characteristics of occupational diseases in Guangzhou from 2010 to 2020. Results: A total of 1341 cases of 38 kinds of occupational diseases in 9 categories were reported in the past 11 years. The incidence of occupational pneumoconiosis, occupational otolaryngology and oral diseases and occupational chemical poisoning ranked the top three, accounting for 38.1% (511/1341) , 30.5% (409/1341) and 16.2% (217/1341) of the total cases respectively. The cases of pneumoconiosis in welders and silicosis accounted for 47.7% (244/511) and 34.4% (176/511) of the cases of occupational pneumoconiosis respectively. The cases of noise deafness accounted for 99.8% (408/409) of occupational otorhinolaryngology oral diseases. Acute occupational chemical poisoning cases accounted for 26.7% (58/217) of the occupational chemical poisoning cases, in which dichloroethane poisoning cases ranked the first, accounting for 79.3% (46/58) . Chronic occupational chemical poisoning cases accounted for 73.3% (159/217) of the occupational poisoning cases, in which benzene and lead poisoning cases ranked the top two, accounting for 79.2% (126/159) and 17.6% (28/159) respectively. Conclusion: Pneumoconiosis, silicosis, noise deafness, benzene poisoning, lead poisoning, dichloroethane poisoning should be supervised and managed as key occupational diseases in Guangzhou.

Estimating the Effects of Soil Remediation on Children's Blood Lead near a Former Lead Smelter in Omaha, Nebraska, USA

BACKGROUND

Lead exposures from legacy sources threaten children's health. Soil in Omaha, Nebraska, was contaminated by emissions from a lead smelter and refinery. The U.S. Environmental Protection Agency excavated and replaced contaminated soil at the Omaha Lead Superfund Site between 1999 and 2016.

OBJECTIVES

The goal of this study was to assess the association of soil lead level (SLL) and soil remediation status with blood lead levels (BLLs) in children living near or on the site.

METHODS

We linked information on SLL at residential properties with children's BLLs and assigned remediation status to children's BLL measurements based on whether their measurements occurred during residence at remediated or unremediated properties. We examined the association of SLL and remediation status with elevated BLL (EBLL). We distinguished the roles of temporal trend and the intervention with time-by-intervention-status interaction contrasts. All analyses estimated odds ratios (ORs) with a generalized estimating equations approach to ensure robustness under the complex correlations among BLL measurements. All analyses controlled for relevant covariates including children's characteristics.

RESULTS

EBLL (>5μg/dL) was associated with both residential SLL [e.g., OR=2.00; 95% confidence interval (CI): 1.83, 2.19; >400-800 vs. ≤200 ppm] and neighborhood SLL [e.g., OR=1.85 (95% CI: 1.62, 2.11; >400-800 vs. ≤200 ppm)] before remediation but only with neighborhood SLL after remediation. The odds of EBLL were higher before remediation [OR 1.52 (95% CI: 1.34, 1.72)]. Similarly, EBLL was positively associated with preremediation status in our interaction analysis [interaction OR=1.18 (95%CI: 1.02, 1.37)].

DISCUSSION

Residential and neighborhood SLLs were important predictors of EBLLs in children residing near or on this Superfund site. Neighborhood SLL remained a strong predictor following remediation. Our data analyses showed the benefit of soil remediation. Results from the interaction analyses should be interpreted cautiously due to imperfect correspondence of remediation times between remediation and comparison groups. https://doi.org/10.1289/EHP8657.

Mapping blood lead levels in French children due to environmental contamination using a modeling approach

The decrease in levels of lead in air and drinking water over the last 40 years has resulted in an overall decrease in blood lead levels (BLLs). However, there is no known safe level of lead regarding developmental effects in children. This paper maps predicted BLLs of children in France, resulting from a simulated chronic exposure in two steps, with the aim of identifying areas with environmentally overexposed populations. Probabilistic estimates of BLLs based on environmental contamination were obtained and compared to biomonitoring data. First, the contribution of various environmental exposure pathways was estimated using a multimedia exposure model: spatialized data on soil, drinking water and air contamination, together with data on food contamination and ingestion, was joined using geostatistical approaches. In a second step, a Physiologically Based Toxicokinetic (PBTK) model provided estimates of BLLs. Probabilistic estimates of BLLs were obtained by simulating uncertainty and variability of exposure levels, physiological characteristics and lead-specific parameters in the PBTK model. The median and 95th percentile of predicted BLLs in children aged 1 to 11 were compared to recent biomonitoring data obtained in France in young children (SATURNINF study): median predictions were overestimated in infants and in agreement with median observed BLLs in children aged 3 to 6. Upper bounds of predicted BLLs were protective due to uncertainties in exposure estimates. The main source of exposure appeared to be drinking water in children over 2 years old, and vegetal food and milk in children under 2 years old. Although elevated drinking water lead levels were not related to large geographical areas, the relatively fine resolution map also pinpointed geographical areas of concern due to elevated soil lead levels.

Effectiveness of interventions for the remediation of lead-contaminated soil to prevent or reduce lead exposure - A systematic review

OBJECTIVE

To summarize the evidence on the effectiveness of soil remediation to prevent or reduce lead exposure.

METHODS

We systematically searched MEDLINE, the Agricultural & Environmental Science Database, Web of Science, and Scopus from 1980 to February 15, 2021. We also performed reference list checking, hand-searched websites, and contacted experts. Eligible studies evaluated the effect of soil remediation to prevent or reduce lead exposure in humans of any age. We screened all records dually; one investigator performed the data extraction; a second checked for completeness and accuracy. Two investigators independently rated the risk of bias of included studies and graded the certainty of evidence. We synthesized findings narratively.

RESULTS

We identified 6614 potentially relevant publications, all focused on children, of which five studies (six records) fulfilled our prespecified inclusion criteria. The number of evaluated participants ranged from 31 to 1425, with follow-up periods of 11 months to one year. The primary soil remediation method was the replacement of the upper layer with clean soil. Outcomes were limited to blood lead levels (BLL), dust lead levels, and soil lead levels. The largest study, a controlled before- after study (n = 1425) reported favorable effects of soil remediation compared to no intervention. This finding was consistent with results from two cross-sectional studies and one uncontrolled before-after study. One year post-remediation, the mean reduction in BLL was 2.1 μg/dL (p < 0.0001) greater in the intervention group than in the control group. Two randomized controlled trials with a total of 511 participants showed no statistically significant incremental effect of soil remediation when combined with paint and/or dust abatement. The certainty of evidence for all outcomes was low.

CONCLUSION

Soil remediation appears to reduce BLL in children when used as a single intervention. The incremental benefit of soil remediation when part of other interventions is limited.

Lead, Soils, and Children: An Ecological Analysis of Lead Contamination in Parks and Elevated Blood Lead Levels in Brooklyn, New York

Although the prevalence of elevated childhood blood lead levels (BLLs) has been declining, there are still an estimated 500,000 children (1 to 5 years) with BLLs above the CDC's reference value (≥ 5 μg/dL). The objective of this study was to evaluate the ecological association between soil lead (Pb) concentrations in greenspaces in Brooklyn, NY and elevated BLLs of children aged 1 to 5 years old. Soil samples (n = 1504) were collected from a wide variety of parks within 43 neighborhood tabulation areas (NTAs) located in Brooklyn, NY, analyzed with a portable XRF with a subset (n = 350), and also analyzed by ICP-MS. Lead concentrations were right skewed with a mean of 160.4 ppm and a median of 113.1 ppm. The Pb concentration range spanned three orders of magnitude with most samples (66.7%) ≥ 80 ppm and 6.7% of samples ≥ 400 ppm. Elevated BLL (≥ 5ug/dL) data on children 1 to 5 years were obtained from the New York City Department of Health and Mental Hygiene (2011-2015). Weighted median soil Pb concentrations were calculated for each NTA and stratified into quartiles. The overall median rate of children from 1 to 5 years old with BLLs ≥ 5 µg/dL was 28.6 per 1000; the median rate was highest (p = 0.070) in the fourth quartile (Pb concentrations ≥ 150 ppm) compared to the first quartile (Pb concentrations < 88 ppm), 37.2 vs. 28.3 per 1000, respectively. We then used multivariable linear regression to determine the ecological association between BLL rates and soil Pb concentrations. In the final stepwise multivariable regression model, controlling for known risk factors, there was a significant positive association between soil Pb concentrations and increased childhood BLL rates (beta = 0.0008; p = 0.004). Our findings suggest that there is an ecological association between high soil Pb levels and increased rates of elevated childhood BLLs.

Relationship between lead absorption and iron status and its association with oxidative stress markers in lead-exposed workers

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.

Childhood lead exposure of Amerindian communities in French Guiana: an isotopic approach to tracing sources

In French Guiana were detected high lead (Pb) levels in blood of Amerindian people. Lead exposure is a serious hazard that can affect the cognitive and behavior development. People can be exposed to Pb through occupational and environmental sources. Fingerprinting based on stable Pb isotopes in environmental media is often used to trace natural and anthropogenic sources but is rarely paired with blood data. The objective of this study was to determine the main factors associated with high Blood Lead Levels (BLL). Soil, manioc tubers, food bowls, beverages, wild games, lead pellets and children blood were sampled in small villages along the Oyapock River. children BLL ranged between 5.7 and 35 µg dL^-1, all exceeding 5 µg dL^-1, the reference value proposed in epidemiologic studies for lead poisoning. Among the different dietary sources, manioc tubers and large game contained elevated Pb concentrations while manioc-based dishes were diluted. The isotopes ratios (²⁰⁷Pb/²⁰⁶Pb and ²⁰⁸Pb/²⁰⁶Pb) of children blood overlapped these of lead shots and meals. These first results confirm for the first time, the diary consumption of manioc-based food as the main contributor to Amerindian children's BLL in French Guiana, but don't exclude the occasional exposure to lead bullets by hunting activities. This is a specific health concern, since previous studies have shown that these same villagers present high levels of mercury (Hg). These communities are indeed subject to a double exposure to neurotoxic metals, Hg and Pb, both through their diet. The farming activity is based on manioc growing, and explaining that this ancestral practice can induce serious health risks for the child's development may seriously affect their food balance and cultural cohesion.

Novel Application of Machine Learning Algorithms and Model-Agnostic Methods to Identify Factors Influencing Childhood Blood Lead Levels

Blood lead (Pb) poisoning remains a global concern, particularly for children in their early developmental years. Broken Hill is Australia's oldest operating silver-zinc-lead mine. In this study, we utilized recent advances in machine learning to assess multiple algorithms and identify the most optimal model for predicting childhood blood Pb levels (BLL) using Broken Hill children's (<5 years of age) data (n = 23,749) from 1991 to 2015, combined with demographic, socio-economic, and environmental influencing factors. We applied model-agnostic methods to interpret the most optimal model, investigating different environmental and human factors influencing childhood BLL. Algorithm assessment showed that stacked ensemble, a method for automatically and optimally combining multiple prediction algorithms, enhanced predictive performance by 1.1% with respect to mean absolute error (p < 0.01) and 2.6% for root-mean-squared error (p < 0.01) compared to the best performing constituent algorithm (random forest). By interpreting the model, the following information was acquired: children had higher BLL if they resided within 1.0 km to the central mine area or 1.37 km to the railroad; year of testing had the greatest interactive strength with all other factors; BLL increased faster in Aboriginal than in non-Aboriginal children at 9-10 and 12-18 months of age. This "stacked ensemble + model-agnostic interpretation" framework achieved both prediction accuracy and model interpretability, identifying previously unconnected variables associated with elevated childhood BLL, offering a marked advantage over previous works. Thus, this approach has a clear value and potential for application to other environmental health issues.

A Systematic Review and Meta-analysis on Blood Lead Level in Opium Addicts: an Emerging Health Threat

This meta-analysis was conducted aiming to summarize the results obtained from the previous studies so that the effect of opium on blood lead levels (BLLs) can be investigated. Scopus, Embase, PubMed, and Web of Science (ISI) were systematically searched up to June 2020. Heterogeneity of the included studies was evaluated using Cochrane's Q test and the I² statistic. A random-effects model was used to pool the weighted mean differences (WMDs) and their 95% confidence intervals (CIs). Out of a total of 2372 citations, eleven articles with 916 participants (487 opium addicts and 429 controls) were included in the study. The meta-analysis results showed that there were higher lead levels (WMD = 14.59 μg/dL, 95% CI = 11.59 to 17.92, Z = 8.60, P < 0.001) in opium addicts than in the control group. The degree of heterogeneity observed (P < 0.001, I² = 98.1%) might be mainly the result of the type of sampling and of consumption. Moreover, the findings of meta-regression analyses indicated that publication year (β = 1.23, P = 0.287), total sample size (β = 0.05, P = 0.728), and quality scores (β = - 2.91, P = 0.546) had no effects on lead levels in opium addicts. In the sensitivity analysis, it was found that the pooled WMDs remained stable after excluding one by one study. Oral opium consumption increased the amount of lead in the bloodstream, and the measurement of lead levels in opium addicts' blood may be regarded as a useful test to diagnosis and prognosis of disorders that may lead poisoning causes.

Small-Mammal Shooting as a Conduit for Lead Exposure in Avian Scavengers

Lead (Pb) exposure is a widespread wildlife conservation threat. Although commonly associated with Pb-based ammunition from big-game hunting, small mammals (e.g., ground squirrels) shot for recreational or pest-management purposes represent a potentially important Pb vector in agricultural regions. We measured the responses of avian scavengers to pest-shooting events and examined their Pb exposure through consumption of shot mammals. There were 3.4-fold more avian scavengers at shooting fields relative to those at fields with no recent shooting, and avian scavengers spent 1.8-fold more time feeding after recent shooting events. We isotopically labeled shot ground squirrels in the field with an enriched ¹⁵N isotope tracer; 6% of avian scavengers sampled within a 39 km radius reflected this tracer in their blood. However, 33% of the avian scavengers within the average foraging dispersal distance of nests (0.6-3.7 km) were labeled, demonstrating the importance of these shooting fields as a source of food for birds nesting in close proximity. Additionally, Pb concentrations in 48% of avian scavengers exceeded subclinical poisoning benchmarks for sensitive species (0.03-0.20 μg/g w/w), and those birds exhibited reduced δ-aminolevulinic acid dehydratase activity, indicating a biochemical effect of Pb. The use of shooting to manage small mammal pests is a common practice globally. Efforts that can reduce the use of Pb-based ammunition may lessen the negative physiological effects of Pb exposure on avian scavengers.

Blood lead levels in indigenous peoples living close to oil extraction areas in the Peruvian Amazon

BACKGROUND

High blood lead levels (BLLs) have been previously reported in indigenous people living in communities in the northern Peruvian Amazon. Oil extraction activities have been conducted in the area since the 1970s and have been identified as a source of lead exposure.

OBJECTIVE

Measure BLL and assess risk factors associated with BLL among indigenous populations from four river basins of the northern Peruvian Amazon.

METHODS

Participants from 39 communities were selected using a two-stage stratified random selection strategy and were visited between May and June 2016. Information on risk factors was collected using structured questionnaires and blood samples were taken. Overall, complete information was available from 1047 individuals (309 < 12 years old, 738 ≥ 12 years). BLL was determined using atomic absorption spectrophotometry in a graphite chamber. Weighted linear logistic regression models were used to study the association between socio-demographic variables, self-reported life-style factors, environmental, geographical and occupational exposures and BLLs.

RESULTS

Geometric mean (95% CI) BLL was 4.9 (4.5, 5.4) µg/dL in participants <12 years and 5.7 (5.4, 6.0) µg/dL in older participants. There were marked differences in BLL between river basins with the highest levels observed in the Corrientes river basin [8.1 (7.2, 9.1) µg/dL <12 years and 8.8 (8.0, 9.6) µg/dL older participants]. High BLL was associated with older age, being male, living in the Pastaza, Tigre or Corrientes river basins and consumption of fish offal in children and adults. Increased Euclidean distance between residence and oil production facilities was associated with a small reduction in BLL.

CONCLUSION

BLLs that pose a health risk were detected in the study population of a non-industrialized and remote area of the Amazon. The highest BLLs were observed in those river basins where relative oil extraction activity and environmental levels of contaminants have been reported to be greatest.

The impact of elevated blood lead levels in children on maternal health-related quality of life

Kabwe is a mining town in Zambia that has been ranked among "the ten most polluted places in the world" with previous findings of serious lead (Pb) pollution. In this study, we aim to examine the impact of childhood Pb poisoning on the health-related quality of life (HRQoL) of mothers in Kabwe. The HRQoL was assessed using the Short-Form 36 survey for 404 mothers coming from residences in 40 randomly selected standard enumeration areas (SEAs). Blood lead levels (BLLs) of the household members including the mothers themselves were measured. We found a significant positive correlation between the BLLs of the mothers and their children (R = 0.6385, p < 0.0001), while the BLLs of preschool-aged and school-aged children were significantly higher than those of their mothers and fathers. Using the data sets containing the BLLs of the household members, the age of the mothers, the household income, and the household SEA, we performed stepwise multiple linear regression analyses. The results showed significant negative associations between the representative BLL of household children and the BLL of preschool-aged children with the vitality and mental health scores of their mothers. Additionally, the BLL of school-aged children was only significantly associated with the mental health score of their mothers. By contrast, there was a significant negative association between the BLLs of the mothers with the social role functioning score. This suggests that elevated BLLs in children have a negative impact on the mental health conditions of their mothers regardless of the mothers' BLL.

Lead contamination in tissues of large avian scavengers in south-central Europe

Lead poisoning from spent ammunition is known to affect many avian species. Birds of prey ingest lead when feeding on game shot with lead gunshot or bullets. Raptors with scavenging habits are particularly vulnerable to ingesting lead in areas with intensive hunting and are good indicators of the risk of poisoning from lead ammunition. To assess how much facultative and obligate avian scavengers suffer lead contamination in south-central Europe, between 2005 and 2019 we collected and analysed 595 tissue samples from 252 carcasses of 4 species (golden eagle, bearded vulture, griffon vulture, cinereous vulture). Lead concentrations in organs showed a similar pattern across species with long and small bones revealing the highest median values (5.56 and 6.8 mg/kg w.w., respectively), the brain the lowest (0.12), and the liver and kidney the intermediate (0.47 and 0.284). Overall, 111 individuals (44.0%) had lead concentrations above background thresholds in at least one tissue (i.e. >2 mg/kg w.w. in soft tissues, >8.33 in bone) and 66 (26.2%) had values indicating clinical poisoning (>6 mg/kg w.w. in liver, >4 in kidney, >16.6 in bone). Tissue lead concentrations and incidence of clinical and sub-clinical poisoning were higher in golden eagles and griffon vultures than in bearded and cinereous vultures, likely due to different feeding habits. In all species we found a rapid increase in lead values with age, but differences between age classes were significant only in the golden eagle. Birds with lead fragments in their digestive tract, as detected by X-rays, had higher median lead concentrations, suggesting that hunting ammunition is the main source of lead poisoning. Our results imply that lead impacts the demography of these long-lived species with delayed sexual maturity and low reproduction rate. A rapid transition towards lead-free bullets and gunshot is therefore required across Europe.

Health and Economic Consequences of Lead Exposure Associated with Products and Services Provided by the Informal Economy

In low- and middle-income countries (LMICs), the presence of an informal economy can lead to human exposure to toxic metals such as lead (Pb). This paper demonstrates the local health and economic benefits of modifying practices within the informal economic sector in Madagascar. Specifically, leaded components in 504 locally manufactured household water pumps were replaced with unleaded components. Prior to the intervention, 32% of the household systems exhibited lead concentrations above the World Health Organization (WHO) provisional drinking water guideline of 10 μg/L, but after the intervention, fewer than 3% of the systems were in exceedance. The reduction of lead concentration is modeled to reduce the fraction of children with elevated BLLs (>5 μg/dL) from 34 to 13%. The reduction in BLLs is estimated to provide an average economic benefit of US$11 800 per child based on predicted increases in lifetime productivity. This corresponds to a total benefit of US$8.7 million for the 730 children aged 1-5 associated with the pumps, representing a return on investment of greater than 1000-to-1. Results demonstrate how the formation of partnerships between public, private, and civil society entities, as suggested by UN Sustainable Development Goal 17, can realize important local economic and health benefits in LMICs.

Blood lead levels of Chinese children from 1991 to 2020: Based on Monte Carlo simulation

Chinese children have been exposed to high level of lead due to polluted air, dust, contaminated foods and water, etc. In this research, we investigated published blood lead levels (BLLs) reflecting 1,057,832 Chinese children aged at 0-12 and teenagers aged at 13-18 in the past 30 years (1991-2020). The data mining and estimation were performed innovatively by Monte Carlo simulation to remedy the skewed distribution-induced bias. The temporal trend of Chinese children's BLLs showed an obvious decrease in the past decades from 88.74 μg/L (Geometric SD = 4.09) during 1991-1995 to 27.32 μg/L (Geometric SD = 4.18) during 2016-2020. This study also indicated that children's BLLs of Yunnan, Guizhou, Shanxi were at relatively high levels and most provinces showed a downward trend. Chinese boys aged at 1-18 years old had higher BLLs (GM: 44.03 μg/L) compared to girls (GM: 41.32 μg/L) (p < 0.001). At different age groups, Chinese children's BLLs were 42.04 μg/L (1-3 years old), 52.88 μg/L (4-6 years old), 50.49 μg/L (7 and above years old), respectively. Although the BLLs of Chinese children exhibited a continuous declined trend in the past 30 years, it was still higher than that in developed countries, which indicated that more efforts are needed in children's BLLs control.

Assessment of LeadCare® II analysis for testing of a wide range of blood lead levels in comparison with ICP-MS analysis

The LeadCare® testing system, which utilizes anodic stripping voltammetry (ASV) methodology, has been widely used worldwide for cost-effective blood lead level (BLL) screening. However, some concerns have recently been issued regarding inaccurate results obtained using LeadCare®. Hence, we aimed to evaluate the accuracy of BLL measured by LeadCare® II (BLL_LC) by comparison with ICP-MS (BLL_IM) by the Passing-Bablok regression, Deming regression, and Bland-Altman analyses by using 994 venous blood samples. BLL_LC ranged from 3.3 to 162.3 μg/dL, while BLL_IM ranged from 0.8 to 154.8 μg/dL. Although BLL_LC and BLL_IM exhibited a strong and positive correlation, BLL_LC values were generally greater than BLL_IM values, indicative of the overestimation of the LeadCare® analysis. A large positive bias of 19.15 ± 8.26 μg/dL and 29.25 ± 14.04 μg/dL for BLL_LC compared with BLL_IM were recorded in the BLL_LC range of 45.0-64.9 μg/dL and for ≥65.0 μg/dL, respectively. In contrast, a bias of ≤0.3 μg/dL was observed at a BLL_LC of less than 10.0 μg/dL. Blood copper, cadmium, and iron levels did not exhibit an effect on the bias of BLL_LC, indicative of the minimal potential interferences of the metals; these interferences are a cause for concern with the ASV method. In conclusion, LeadCare® analysis is thought to be a good tool for screening purposes at a lower BLL around the reference level of 5 μg/dL in the initial stage; however, conversion or retesting using a laboratory analyzer is recommended at a higher BLL for appropriate clinical evaluation and research.

Blood Lead Level and Renal Impairment among Adults: A Meta-Analysis

Background: The adult population in lead-related occupations or environmentally exposed to lead may be at risk for renal impairment and lead nephropathy. This meta-analysis aims to determine the impact of blood lead level (BLL) on renal function among middle-aged participants. Methods: Cross-sectional, longitudinal, or cohort studies that reported BLL and renal function tests among adult participants were retrieved from PubMed, Scopus, and ISI Web of Science. Relevant studies were included and assessed for quality using the Newcastle-Ottawa Scale (NOS). The pooled mean BLL of participants with a high BLL (≥30 µg/dL), moderate BLL (20-30 µg/dL), and low BLL (<20 µg/dL) was estimated using the random effects model. The pooled mean differences in BLL, blood urea nitrogen (BUN), creatinine, uric acid, and creatinine clearance between the exposed and non-exposed participants were estimated using the random effects model. Meta-regression was performed to demonstrate the association between the effect size (ES) of the pooled mean BLL and renal function. Heterogeneity among the included studies was assessed using the Cochrane Q and I2 statistics. Cochrane Q with a p value less than 0.05 and I2 more than 50% demonstrated substantial heterogeneity among the studies included. Publication bias was assessed using the funnel plot between the effect size and standard error of the effect size. Results: Out of 1657 articles, 43 were included in the meta-analysis. The meta-analysis demonstrated that the pooled mean BLL in the participants with a high BLL, moderate BLL, and low BLL was 42.41 µg/dL (95% confidence interval (CI): 42.14-42.67, I2: 99.1%), 22.18 µg/dL (95% CI: 21.68-22.68, I2: 60.4%), and 2.9 µg/dL (95% CI: 2.9-2.9, I2: 100%), respectively. The mean BLL of the exposed participants was higher than that of the non-exposed participants (weighted mean difference (WMD): 25.5, p < 0.0001, 95% CI: 18.59-32.45, I2: 99.8%, 17 studies). The mean BUN (WMD: 1.66, p < 0.0001, 95% CI: 0.76-2.55, I2: 76%, 10 studies) and mean creatinine (WMD: 0.05, p = 0.007, 95% CI: 0.01-0.08, I2: 76.8%, 15 studies) in the exposed participants were higher than those in the non-exposed participants. The mean creatinine clearance in the exposed participants was lower than that in the non-exposed participants (standard mean difference (SMD): -0.544, p = 0.03, 95% CI: -1.035-(-0.054), I2: 96.2%). The meta-regression demonstrated a significant positive effect of BLL on BUN (p = 0.022, coefficient: 0.75, constant: -3.7, 10 studies). Conclusions: BLL was observed to be associated with abnormal renal function test parameters, including high BUN, high creatinine, and low creatinine clearance. Moreover, BUN seemed to be the most valuable prognostic marker for lead-induced renal impairment. Therefore, regular checks for renal function among lead-exposed workers should be a priority and publicly promoted.

Blood Lead Levels in U.S. Children Ages 1-11 Years, 1976-2016

BACKGROUND

Lead can adversely affect child health across a wide range of exposure levels. We describe the distribution of blood lead levels (BLLs) in U.S. children ages 1-11 y by selected sociodemographic and housing characteristics over a 40-y period.

METHODS

Data from the National Health and Nutrition Examination Survey (NHANES) II (1976-1980), NHANES III (Phase 1: 1988-1991 and Phase II: 1991-1994), and Continuous NHANES (1999-2016) were used to describe the distribution of BLLs (in micrograms per deciliter; 1 μ g / dL = 0.0483 μ mol / L ) in U.S. children ages 1-11 y from 1976 to 2016. For all children with valid BLLs (n = 27,122 ), geometric mean (GM) BLLs [95% confidence intervals (CI)] and estimated prevalence ≥ 5 μ g / dL (95% CI) were calculated overall and by selected characteristics, stratified by age group (1-5 y and 6-11 y).

RESULTS

The GM BLL in U.S. children ages 1-5 y declined from 15.2 μ g / dL (95% CI: 14.3, 16.1) in 1976-1980 to 0.83 μ g / dL (95% CI: 0.78, 0.88) in 2011-2016, representing a 94.5% decrease over time. For children ages 6-11 y, GM BLL declined from 12.7 μ g / dL (95% CI: 11.9, 13.4) in 1976-1980 to 0.60 μ g / dL (95% CI: 0.58, 0.63) in 2011-2016, representing a 95.3% decrease over time. Even so, for the most recent period (2011-2016), estimates indicate that approximately 385,775 children ages 1-11 y had BLLs greater than or equal to the CDC blood lead reference value of 5 μ g / dL . Higher GM BLLs were associated with non-Hispanic Black race/ethnicity, lower family income-to-poverty-ratio, and older housing age.

DISCUSSION

Overall, BLLs in U.S. children ages 1-11 y have decreased substantially over the past 40 y. Despite these notable declines in population exposures to lead over time, higher GM BLLs are consistently associated with risk factors such as race/ethnicity, poverty, and housing age that can be used to target blood lead screening efforts. https://doi.org/10.1289/EHP7932.

Time for a change in blood lead reference value for Chinese children

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.

Biomonitoring of Lead Exposure in Children from Two Fishing Communities at Northern Colombia

Lead (Pb) exposure is a growing concern in developing countries, especially in vulnerable children. The objective of this study was to evaluate blood lead levels (BLL) in children from two fishing populations at Northern Colombia, Loma de Arena and Tierrabomba, as well as their association with morphometric parameters, markers of hematological status, liver function, and mRNA expression of genes related to Pb toxicity. A total of 198 blood samples were collected from participants aged 5-16 years old. The mean (± standard error) BLL for the studied sample was 3.6 ± 0.3 μg/dL, and the 97.5th percentile was 21.0 μg/dL. The participants of Loma de Arena and Tierrabomba presented BLL of 3.9 ± 0.5 and 2.9 ± 0.3 μg/dL, respectively. Children born preterm had greater BLL than those born at full term. Boys had greater BLL than girls, which also occurred for participants between 12 and 16 years old, compared with those aged 5-11 years old. The BLL were negatively correlated with body mass index in children from Loma de Arena, but an opposite behavior was observed for Tierrabomba. In Loma de Arena, the mRNA expression of interferon gamma, a pro-inflammatory cytokine, increased with the BLL, but that of δ-aminolevulinic acid dehydrogenase, a sensor for Pb poisoning, decreased. In Tierrabomba, gene expression did not change with BLL. These results show that in fishing communities, lead exposure promotes different health impacts depending on age, sex, and other site-specific factors. In any case, appropriate educational and intervention programs should be carried out to minimize Pb exposure in children.

Blood Lead Level in a Paediatric Population of South-Eastern Spain and Associated Risk Factors

Objective: To determine blood lead levels (BLL) in a healthy paediatric population and to analyse related sociodemographic, dietary and haematological factors. Methods: A cross-sectional study was made of 1427 healthy subjects aged 1–16 years from the city of Almería (south-eastern Spain). BLL, iron parameters and erythropoietin were determined, and sociodemographic and dietary data obtained. The study paramateters was analyses in BLL toxic and BLL no toxic group by multiple logistic regression. Results: The mean BLL was 1.98 ± 1.1 µg/dL (95% CI:1.91–2.04). For 5.7% of the population, mean BLL was 2–5 µg/dL, for 2.1% it was >5 µg/dL and for 0.15% it was >10 µg/dL. Multivariate analysis showed that immigrant origin (OR:11.9; p < 0.0001), low level of parental education (OR:4.6; p < 0.02) and low dietary iron bioavailability (OR: 3.2; p < 0.02) were all risk factors for toxic BLL. Subjects with toxic and non-toxic BLL presented similar iron and erythropoiesis-related parameters, except erythrocyte protoporphyrin, which was significantly higher in the BLL >5 µg/dL group. Conclusions: BLL and the prevalence of toxic BLL in healthy subjects aged 1–16 years living in south-eastern Spain are low and similar to those found in other developed countries. The factors associated with toxic BLL are immigrant origin, low level of parental education and dietary iron deficiency. The toxicity of BLL was not related to changes in the analytical parameters studied.

Blood Magnesium Level and Selected Oxidative Stress Indices in Lead-Exposed Workers

Occupational exposure to lead is one of the important hazards to human global population. Lead interferes with divalent cations, such as calcium, magnesium, and iron. Magnesium is the fourth most common mineral in the human body and a cofactor in more than 325 enzymes. There are many disorders associated with magnesium deficiency. It has been postulated that hypomagnesemia promotes oxidative stress. Study population included 232 male employees of lead-zinc works and was divided into two sub-groups based on the median of magnesium serum level: low magnesium level (L-Mg) group and high magnesium level (H-Mg) group. Magnesium level was significantly higher in the H-Mg group than in the L-Mg group due to the study design. The level of zinc protoporphyrin was significantly higher in the L-Mg group than in the H-Mg group by 13%, while the blood lead levels were similar in the examined groups. The serum level of MDA was significantly higher in the L-Mg group than in the H-Mg group by 12%, while the serum levels of thiol groups, TAC, and bilirubin were significantly lower in that group by 6%, 3%, and 27%, respectively. Similarly, the erythrocyte SOD activity was lower in the L-Mg group than in the H-Mg group by 5%. Low serum magnesium levels contribute to lead-induced oxidative stress, result in unfavorable modification of antioxidant system function, and promote lead-induced impairment of heme synthesis. Obtained results indicate that prevention of hypomagnesemia should be regarded as an important step in ensuring adequate prophylaxis of chronic lead poisoning.