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Lead: Risk Assessment and Health Effects

A special issue of International Journal of Environmental Research and Public Health (ISSN 1660-4601).

Deadline for manuscript submissions: closed (31 December 2015) | Viewed by 143667

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Guest Editor
Department of Pharmacology, Tulane University School of Medicine, 1430 Tulane Ave-SL-8683, New Orleans, LA 70112, USA
Interests: urban geochemistry and health; children; primary prevention; environmental signalling; lead poisoning
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Sometime in the near future it probably will be shown that the older urban areas of the United States have been rendered more or less uninhabitable by the millions of tons of poisonous industrial lead residues that have accumulated in cities during the past century.
Clair C. Patterson, 1980, Lead in the Human Environment, National Academy of Sciences.

Dear Colleagues,

As a result of rapid population growth and the transition from a rural to urban society, cities have become the major human habitat on the Earth. Historically, people lived on the land and relied directly on local ecosystem services. The transition to cities increased the duration, intensity, and spatial extent of contact between humans and their predominantly urban environments. Urban societies continue to rely on ecosystem services but they now accentuate their reliance on socioeconomic instead of ecosystem services. The synergistic processes of population growth, urbanization, and technological change contribute to an artificial environment and have profound effects on the human population. The legacy of the lead (Pb) is an important artifact of human activities. The toxic effects of lead on humans and other organisms are one of the best-studied topics known to science. We now live in the near future that Patterson was referring to. The purpose of this volume is to explore the status of scientific evidence regarding Dr. Patterson’s statement about the habitability of cities?

The massiveness of lead mining and lead use in commerce is an especially important topic for understanding health effects. Multiple advances in science serve to refine our understanding about the quality of urban environments. What is currently known about the sources and quantities of lead dispersed and their impacts on cities? What are recent advances concerning the health outcomes of lead exposure? Measurement techniques are critical for addressing lead in the environment and human exposure and numerous developments have in instrumentation? What advances have been made to evaluate the urban disparities of lead exposure? Are there other metals that show similar urban patterns in cities? Who are the most vulnerable individuals to lead exposure? What are advances in statistical tools for evaluating lead and health effects? What is known about the long-term health outcomes from early life lead exposure? Are there adequate interventions available to prevent exposure to toxic metals?

This Special Issue will synthesize what is known urban contamination levels, exposures, vulnerabilities, and the capacities to manage lead contamination. Given the importance of cities to the human population these topics have far ranging implication for human society’s future.

Prof. Dr. Howard W. Mielke
Guest Editor

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Keywords

  • lead
  • urban environments
  • environmental statistics
  • exposure disparities
  • fetal and child exposure
  • bone lead
  • latent health outcomes
  • interventions
  • ethics
  • national clean soil program

Published Papers (20 papers)

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Editorial

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228 KiB  
Editorial
Editorial: Lead Risk Assessment and Health Effects
by Howard W. Mielke
Int. J. Environ. Res. Public Health 2016, 13(6), 587; https://doi.org/10.3390/ijerph13060587 - 14 Jun 2016
Cited by 3 | Viewed by 4535
Abstract
In 1980, Clair C. Patterson stated: “Sometime in the near future it probably will be shown that the older urban areas of the United States have been rendered more or less uninhabitable by the millions of tons of poisonous industrial lead residues that [...] Read more.
In 1980, Clair C. Patterson stated: “Sometime in the near future it probably will be shown that the older urban areas of the United States have been rendered more or less uninhabitable by the millions of tons of poisonous industrial lead residues that have accumulated in cities during the past century”. We live in the near future about which this quote expressed concern. This special volume of 19 papers explores the status of scientific evidence regarding Dr. Patterson’s statement on the habitability of the environments of communities. Authors from 10 countries describe a variety of lead issues in the context of large and small communities, smelter sites, lead industries, lead-based painted houses, and vehicle fuel treated with lead additives dispersed by traffic. These articles represent the microcosm of the larger health issues associated with lead. The challenges of lead risk require a concerted global action for primary prevention. Full article
(This article belongs to the Special Issue Lead: Risk Assessment and Health Effects)

Research

Jump to: Editorial

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Article
Preliminary Assessment of Health Risks of Potentially Toxic Elements in Settled Dust over Beijing Urban Area
by Dejun Wan, Changlin Zhan, Guanglin Yang, Xingqi Liu and Jinsong Yang
Int. J. Environ. Res. Public Health 2016, 13(5), 491; https://doi.org/10.3390/ijerph13050491 - 11 May 2016
Cited by 35 | Viewed by 5233
Abstract
To examine levels, health risks, sources, and spatial distributions of potentially toxic elements in settled dust over Beijing urban area, 62 samples were collected mostly from residential building outdoor surfaces, and their <63 μm fractions were measured for 12 potentially toxic elements. The [...] Read more.
To examine levels, health risks, sources, and spatial distributions of potentially toxic elements in settled dust over Beijing urban area, 62 samples were collected mostly from residential building outdoor surfaces, and their <63 μm fractions were measured for 12 potentially toxic elements. The results show that V, Cr, Mn, Co, Ni, and Ba in dust are from predominantly natural sources, whereas Cu, Zn, As, Cd, Sb, and Pb mostly originate from anthropogenic sources. Exposure to these elements in dust has significant non-cancer risks to children but insignificant to adults. Cancer risks of Cr, Co, Ni, As, and Cd via inhalation and dermal contact are below the threshold of 10−6–10−4 but As via dust ingestion shows a tolerable risk. The non-cancer risks to children are contributed mainly (75%) by As, Pb, and Sb, and dominantly (92%) via dust ingestion, with relatively higher risks mainly occurring in the eastern and northeastern Beijing urban areas. Although Cd, Zn, and Cu in dust are heavily affected by anthropogenic sources, their health risks are insignificant. Source appointments suggest that coal burning emissions, the dominant source of As, are likely the largest contributors to the health risk, and traffic-related and industrial emissions are also important because they contribute most of the Pb and Sb in dust. Full article
(This article belongs to the Special Issue Lead: Risk Assessment and Health Effects)
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Children’s Blood Lead Seasonality in Flint, Michigan (USA), and Soil-Sourced Lead Hazard Risks
by Mark A.S. Laidlaw, Gabriel M. Filippelli, Richard C. Sadler, Christopher R. Gonzales, Andrew S. Ball and Howard W. Mielke
Int. J. Environ. Res. Public Health 2016, 13(4), 358; https://doi.org/10.3390/ijerph13040358 - 25 Mar 2016
Cited by 95 | Viewed by 26147
Abstract
In Flint; MI; USA; a public health crisis resulted from the switching of the water supply from Lake Huron to a more corrosive source from the Flint River in April 2014; which caused lead to leach from water lines. Between 2010 and 2015; [...] Read more.
In Flint; MI; USA; a public health crisis resulted from the switching of the water supply from Lake Huron to a more corrosive source from the Flint River in April 2014; which caused lead to leach from water lines. Between 2010 and 2015; Flint area children’s average blood lead patterns display consistent peaks in the third quarter of the year. The third quarter blood lead peaks displayed a declining trend between 2010 and 2013; then rose abruptly between the third quarters of 2013 from 3.6% blood lead levels ≥5 µg/dL to a peak of about 7% in the third quarter of 2014; an increase of approximately 50%. The percentage of blood lead level ≥5 µg/dL in the first quarter of 2015 then dropped to 2.3%; which was the same percentage as the first quarter of 2014 (prior to the Flint River water source change). The Flint quarterly blood lead level peak then rose to about 6% blood lead levels ≥ 5 µg/dL in the third quarter of 2015; and then declined to about 2.5% in the fourth quarter of 2015. Soil lead data collected by Edible Flint food collaborative reveal generally higher soil lead values in the metropolitan center for Flint; with lower values in the outskirts of the city. The questions that are not being asked is why did children’s blood lead levels display a seasonal blood lead pattern before the introduction of the new water supply in Flint; and what are the implications of these seasonal blood lead patterns? Based upon previous findings in Detroit and other North American cities we infer that resuspension to the air of lead in the form of dust from lead contaminated soils in Flint appears to be a persistent contribution to lead exposure of Flint children even before the change in the water supply from Lake Huron to the Flint River. Full article
(This article belongs to the Special Issue Lead: Risk Assessment and Health Effects)
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Article
Dose-Response Relationship between Cumulative Occupational Lead Exposure and the Associated Health Damages: A 20-Year Cohort Study of a Smelter in China
by Yue Wu, Jun-Ming Gu, Yun Huang, Yan-Ying Duan, Rui-Xue Huang and Jian-An Hu
Int. J. Environ. Res. Public Health 2016, 13(3), 328; https://doi.org/10.3390/ijerph13030328 - 16 Mar 2016
Cited by 23 | Viewed by 8077
Abstract
Long-term airborne lead exposure, even below official occupational limits, has been found to cause lead poisoning at higher frequencies than expected, which suggests that China’s existing occupational exposure limits should be reexamined. A retrospective cohort study was conducted on 1832 smelting workers from [...] Read more.
Long-term airborne lead exposure, even below official occupational limits, has been found to cause lead poisoning at higher frequencies than expected, which suggests that China’s existing occupational exposure limits should be reexamined. A retrospective cohort study was conducted on 1832 smelting workers from 1988 to 2008 in China. These were individuals who entered the plant and came into continuous contact with lead at work for longer than 3 months. The dose-response relationship between occupational cumulative lead exposure and lead poisoning, abnormal blood lead, urinary lead and erythrocyte zinc protoporphyrin (ZPP) were analyzed and the benchmark dose lower bound confidence limits (BMDLs) were calculated. Statistically significant positive correlations were found between cumulative lead dust and lead fumes exposures and workplace seniority, blood lead, urinary lead and ZPP values. A dose-response relationship was observed between cumulative lead dust or lead fumes exposure and lead poisoning (p < 0.01). The BMDLs of the cumulative occupational lead dust and fumes doses were 0.68 mg-year/m3 and 0.30 mg-year/m3 for lead poisoning, respectively. The BMDLs of workplace airborne lead concentrations associated with lead poisoning were 0.02 mg/m3 and 0.01 mg/m3 for occupational exposure lead dust and lead fume, respectively. In conclusion, BMDLs for airborne lead were lower than occupational exposure limits, suggesting that the occupational lead exposure limits need re-examination and adjustment. Occupational cumulative exposure limits (OCELs) should be established to better prevent occupational lead poisoning. Full article
(This article belongs to the Special Issue Lead: Risk Assessment and Health Effects)
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Elevated Blood Lead Levels in Infants and Mothers in Benin and Potential Sources of Exposure
by Florence Bodeau-Livinec, Philippe Glorennec, Michel Cot, Pierre Dumas, Séverine Durand, Achille Massougbodji, Pierre Ayotte and Barbara Le Bot
Int. J. Environ. Res. Public Health 2016, 13(3), 316; https://doi.org/10.3390/ijerph13030316 - 11 Mar 2016
Cited by 35 | Viewed by 6477
Abstract
Lead in childhood is well known to be associated with poor neurodevelopment. As part of a study on maternal anemia and offspring neurodevelopment, we analyzed blood lead level (BLL) with no prior knowledge of lead exposure in 225 mothers and 685 offspring 1 [...] Read more.
Lead in childhood is well known to be associated with poor neurodevelopment. As part of a study on maternal anemia and offspring neurodevelopment, we analyzed blood lead level (BLL) with no prior knowledge of lead exposure in 225 mothers and 685 offspring 1 to 2 years old from Allada, a semi-rural area in Benin, sub-Saharan Africa, between May 2011 and May 2013. Blood samples were analyzed by inductively coupled plasma mass spectrometry. Environmental assessments in households and isotopic ratio measurements were performed for eight children with BLL > 100 µg/L. High lead levels (BLL > 50 µg/L) were found in 44% of mothers and 58% of children. The median BLL was 55.1 (interquartile range 39.2–85.0) and 46.6 (36.5–60.1) µg/L, respectively. Maternal BLL was associated with offspring’s consumption of piped water and animals killed by ammunition. Children’s BLL was associated with presence of paint chips in the house and consumption of animals killed by ammunition. In this population, with 98% of children still breastfed, children’s BLL was highly associated with maternal BLL on multivariate analyses. Environmental measures and isotopic ratios supported these findings. Offspring may be highly exposed to lead in utero and probably via breastfeeding in addition to lead paint exposure. Full article
(This article belongs to the Special Issue Lead: Risk Assessment and Health Effects)
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Article
The Risk Factors of Child Lead Poisoning in China: A Meta-Analysis
by You Li, Jian Qin, Xiao Wei, Chunhong Li, Jian Wang, Meiyu Jiang, Xue Liang, Tianlong Xia and Zhiyong Zhang
Int. J. Environ. Res. Public Health 2016, 13(3), 296; https://doi.org/10.3390/ijerph13030296 - 08 Mar 2016
Cited by 20 | Viewed by 5669
Abstract
Background: To investigate the risk factors of child lead poisoning in China. Methods: A document retrieval was performed using MeSH (Medical subject heading terms) and key words. The Newcastle-Ottawa Scale (NOS) was used to assess the quality of the studies, and the pooled [...] Read more.
Background: To investigate the risk factors of child lead poisoning in China. Methods: A document retrieval was performed using MeSH (Medical subject heading terms) and key words. The Newcastle-Ottawa Scale (NOS) was used to assess the quality of the studies, and the pooled odd ratios with a 95% confidence interval were used to identify the risk factors. We employed Review Manager 5.2 and Stata 10.0 to analyze the data. Heterogeneity was assessed by both the Chi-square and I2 tests, and publication bias was evaluated using a funnel plot and Egger’s test. Results: Thirty-four articles reporting 13,587 lead-poisoned children met the inclusion criteria. Unhealthy lifestyle and behaviors, environmental pollution around the home and potential for parents’ occupational exposure to lead were risk factors of child lead poisoning in the pooled analyses. Our assessments yielded no severe publication biases. Conclusions: Seventeen risk factors are associated with child lead poisoning, which can be used to identify high-risk children. Health education and promotion campaigns should be designed in order to minimize or prevent child lead poisoning in China. Full article
(This article belongs to the Special Issue Lead: Risk Assessment and Health Effects)
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Article
Evaluation of Lead Release in a Simulated Lead-Free Premise Plumbing System Using a Sequential Sampling Approach
by Ding-Quan Ng and Yi-Pin Lin
Int. J. Environ. Res. Public Health 2016, 13(3), 266; https://doi.org/10.3390/ijerph13030266 - 27 Feb 2016
Cited by 27 | Viewed by 6772
Abstract
In this pilot study, a modified sampling protocol was evaluated for the detection of lead contamination and locating the source of lead release in a simulated premise plumbing system with one-, three- and seven-day stagnation for a total period of 475 days. Copper [...] Read more.
In this pilot study, a modified sampling protocol was evaluated for the detection of lead contamination and locating the source of lead release in a simulated premise plumbing system with one-, three- and seven-day stagnation for a total period of 475 days. Copper pipes, stainless steel taps and brass fittings were used to assemble the “lead-free” system. Sequential sampling using 100 mL was used to detect lead contamination while that using 50 mL was used to locate the lead source. Elevated lead levels, far exceeding the World Health Organization (WHO) guideline value of 10 µg·L−1, persisted for as long as five months in the system. “Lead-free” brass fittings were identified as the source of lead contamination. Physical disturbances, such as renovation works, could cause short-term spikes in lead release. Orthophosphate was able to suppress total lead levels below 10 µg·L−1, but caused “blue water” problems. When orthophosphate addition was ceased, total lead levels began to spike within one week, implying that a continuous supply of orthophosphate was required to control total lead levels. Occasional total lead spikes were observed in one-day stagnation samples throughout the course of the experiments. Full article
(This article belongs to the Special Issue Lead: Risk Assessment and Health Effects)
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Article
Impact of Dust from Ore Processing Facilities on Rain Water Collection Tanks in a Tropical Environment—The Obvious Source “Ain’t Necessarily So”
by Brian Gulson, Michael Korsch and Anthony Bradshaw
Int. J. Environ. Res. Public Health 2016, 13(2), 243; https://doi.org/10.3390/ijerph13020243 - 22 Feb 2016
Cited by 9 | Viewed by 4535
Abstract
Concerns have been expressed that dust from the minerals processing facilities at Karumba Queensland Australia have resulted in elevated lead (Pb) concentrations in rain water tanks. The ores derived from the Century mine some 304 km from the port. High precision Pb isotopic [...] Read more.
Concerns have been expressed that dust from the minerals processing facilities at Karumba Queensland Australia have resulted in elevated lead (Pb) concentrations in rain water tanks. The ores derived from the Century mine some 304 km from the port. High precision Pb isotopic measurements on environmental samples have been undertaken to evaluate the source of Pb in rainwaters and acid digests from roof wipes and gutter wipes. There does not appear to be any relationship between sample location and the processing facility but samples from the area subject to the prevailing winds show the highest contribution of Century Pb. All gutter wipes (82 to 1270 µg Pb/wipe) have contributions of Century ore ranging from 87% to 96%. The contribution of Century ore to five roof wipes (22 to 88 µg Pb/wipe) ranges from 89% to 97% and in the other two samples there is a mix of Century and Broken Hill Pb. Three of the seven rainwater have contributions of Century ore Pb ranging from 33% to 75%. Two of the other four rainwater samples have the highest water Pb concentrations of 88 and 100 µg/L and their isotopic data show Broken Hill Pb contributions ranging from 77% to 80%. The source of the Broken Hill Pb is probably from the galvanized roofing material and/or brass fittings in the rainwater tanks. The discrimination between various sources is only detectable using high precision 204Pb-based isotopic ratios and not the now common inductively coupled plasma mass spectrometry (ICP-MS ) data presentations of the higher abundance isotopes 208Pb, 207Pb and 206Pb. Isotopic results for the waters demonstrate that apportioning blame where there is an obvious point source may not always be the correct conclusion. Nevertheless the isotopic data for the gutter wipes indicates that there was widespread contamination from the processing facilities throughout the town. Full article
(This article belongs to the Special Issue Lead: Risk Assessment and Health Effects)
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Article
Appropriate LDL-C-to-HDL-C Ratio Cutoffs for Categorization of Cardiovascular Disease Risk Factors among Uygur Adults in Xinjiang, China
by Qing-Jie Chen, Hong-Mei Lai, Bang-Dang Chen, Xiao-Mei Li, Hui Zhai, Chun-Hui He, Shuo Pan, Jun-Yi Luo, Jing Gao, Fen Liu, Yi-Tong Ma and Yi-Ning Yang
Int. J. Environ. Res. Public Health 2016, 13(2), 235; https://doi.org/10.3390/ijerph13020235 - 19 Feb 2016
Cited by 31 | Viewed by 6249
Abstract
Elevated LDL-C/HDL-C ratio has been shown to be a marker of lipid metabolism as well as a good predictor of coronary artery disease (CAD). Thus, the aim of this study was to investigate whether the LDL-C/HDL-C ratio is useful for detecting cardiovascular disease [...] Read more.
Elevated LDL-C/HDL-C ratio has been shown to be a marker of lipid metabolism as well as a good predictor of coronary artery disease (CAD). Thus, the aim of this study was to investigate whether the LDL-C/HDL-C ratio is useful for detecting cardiovascular disease (CVD) risk factors in general healthy Uygur adults in Xinjiang. A total of 4047 Uygur subjects aged ≥35 years were selected from the Cardiovascular Risk Survey (CRS) study which was carried out from October 2007 to March 2010. Anthropometric data, blood pressure, lipid profile and fasting glucose were measured in all participants. The prevalence, sensitivity, specificity and distance on the receiver operating characteristic (ROC) curve of each LDL-C/HDL-C ratio were calculated. The prevalence of high LDL-C and low HDL-C cholesterol was high and positively correlated with higher LDL-C/HDL-C ratio in the Uygur population. In both men and women, we detected a slight apparent trend of high prevalence of hypertension and hypercholesterolemia with higher LDL-C/HDL-C ratio. Our study also demonstrated that the discriminatory power of the LDL-C/HDL-C ratio for CVD risk factors was slightly stronger in men than in women. Analysis of the shortest distance in the ROC curves for hypertension, dyslipidemia, diabetes, or ≥two of these risk factors suggested a LDL-C/HDL-C ratio cutoff of 2.5 for both men and women. The results of this study showed that a LDL-C/HDL-C ratio cut-off of 2.5 might be used as the predictive marker to detect CVD risk factors among Uygur adults in Xinjiang. Full article
(This article belongs to the Special Issue Lead: Risk Assessment and Health Effects)
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Article
Pollution and Oral Bioaccessibility of Pb in Soils of Villages and Cities with a Long Habitation History
by Nikolaj Walraven, Martine Bakker, Bertil Van Os, Gerard Klaver, Jack Jacobus Middelburg and Gareth Davies
Int. J. Environ. Res. Public Health 2016, 13(2), 221; https://doi.org/10.3390/ijerph13020221 - 17 Feb 2016
Cited by 17 | Viewed by 5949
Abstract
The Dutch cities Utrecht and Wijk bij Duurstede were founded by the Romans around 50 B.C. and the village Fijnaart and Graft-De Rijp around 1600 A.D. The soils of these villages are polluted with Pb (up to ~5000 mg/kg). Lead isotope ratios were [...] Read more.
The Dutch cities Utrecht and Wijk bij Duurstede were founded by the Romans around 50 B.C. and the village Fijnaart and Graft-De Rijp around 1600 A.D. The soils of these villages are polluted with Pb (up to ~5000 mg/kg). Lead isotope ratios were used to trace the sources of Pb pollution in the urban soils. In ~75% of the urban soils the source of the Pb pollution was a mixture of glazed potsherd, sherds of glazed roof tiles, building remnants (Pb sheets), metal slag, Pb-based paint flakes and coal ashes. These anthropogenic Pb sources most likely entered the urban soils due to historical smelting activities, renovation and demolition of houses, disposal of coal ashes and raising and fertilization of land with city waste. Since many houses still contain Pb-based building materials, careless renovation or demolition can cause new or more extensive Pb pollution in urban soils. In ~25% of the studied urban topsoils, Pb isotope compositions suggest Pb pollution was caused by incinerator ash and/or gasoline Pb suggesting atmospheric deposition as the major source. The bioaccessible Pb fraction of 14 selected urban soils was determined with an in vitro test and varied from 16% to 82% of total Pb. The bioaccessibility appears related to the chemical composition and grain size of the primary Pb phases and pollution age. Risk assessment based on the in vitro test results imply that risk to children may be underestimated in ~90% of the studied sample sites (13 out of 14). Full article
(This article belongs to the Special Issue Lead: Risk Assessment and Health Effects)
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Article
Exposure to PM2.5 and Blood Lead Level in Two Populations in Ulaanbaatar, Mongolia
by Undarmaa Enkhbat, Ana M. Rule, Carol Resnick, Chimedsuren Ochir, Purevdorj Olkhanud and D’Ann L. Williams
Int. J. Environ. Res. Public Health 2016, 13(2), 214; https://doi.org/10.3390/ijerph13020214 - 15 Feb 2016
Cited by 15 | Viewed by 5788
Abstract
Approximately 60% of the households in Ulaanbaatar live in gers (a traditional Mongolian dwelling) in districts outside the legal limits of the city, without access to basic infrastructure, such as water, sewage systems, central heating, and paved roads, in contrast to apartment residents. [...] Read more.
Approximately 60% of the households in Ulaanbaatar live in gers (a traditional Mongolian dwelling) in districts outside the legal limits of the city, without access to basic infrastructure, such as water, sewage systems, central heating, and paved roads, in contrast to apartment residents. This stark difference in living conditions creates different public health challenges for Ulaanbaatar residents. Through this research study we aim to test our hypothesis that women living in gers burning coal in traditional stoves for cooking and heating during the winter are exposed to higher concentrations of airborne PM2.5 than women living in apartments in Ulaanbaatar, Mongolia, and this exposure may include exposures to lead in coal with effects on blood lead levels. This cross-sectional study recruited a total of 50 women, 40–60 years of age, from these two settings. Air sampling was carried out during peak cooking and heating times, 5:00 p.m.–11:00 p.m., using a direct-reading instrument (TSI SidePak™) and integrated polytetrafluoroethylene (PTFE) filters using the SKC Personal Environmental Monitor. Blood lead level (BLL) was measured using a LeadCare II rapid field test method. In our study population, measured PM2.5 geometric mean (GM) concentrations using the SidePak™ in the apartment group was 31.5 (95% CI:17–99) μg/m3, and 100 (95% CI: 67–187) μg/m3 in ger households (p < 0.001). The GM integrated gravimetric PM2.5 concentrations in the apartment group were 52.8 (95% CI: 39–297) μg/m3 and 127.8 (95% CI: 86–190) μg/m3 in ger households (p = 0.004). The correlation coefficient for the SidePak™ PM2.5 concentrations and filter based PM2.5 concentrations was r = 0.72 (p < 0.001). Blood Lead Levels were not statistically significant different between apartment residents and ger residents (p = 0.15). The BLL is statistically significant different (p = 0.01) when stratified by length of exposures outside of the home. This statistically significant difference in increased BLL could be due to occupational or frequent exposure to other sources of indoor or outdoor air pollution that were not measured. Blood lead levels from our study population are the first study measurements published on women aged 40–60 years of age in Mongolia. Full article
(This article belongs to the Special Issue Lead: Risk Assessment and Health Effects)
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Article
Legacies of Lead in Charm City’s Soil: Lessons from the Baltimore Ecosystem Study
by Kirsten Schwarz, Richard V. Pouyat and Ian Yesilonis
Int. J. Environ. Res. Public Health 2016, 13(2), 209; https://doi.org/10.3390/ijerph13020209 - 06 Feb 2016
Cited by 27 | Viewed by 6587
Abstract
Understanding the spatial distribution of soil lead has been a focus of the Baltimore Ecosystem Study since its inception in 1997. Through multiple research projects that span spatial scales and use different methodologies, three overarching patterns have been identified: (1) soil lead concentrations [...] Read more.
Understanding the spatial distribution of soil lead has been a focus of the Baltimore Ecosystem Study since its inception in 1997. Through multiple research projects that span spatial scales and use different methodologies, three overarching patterns have been identified: (1) soil lead concentrations often exceed state and federal regulatory limits; (2) the variability of soil lead concentrations is high; and (3) despite multiple sources and the highly heterogeneous and patchy nature of soil lead, discernable patterns do exist. Specifically, housing age, the distance to built structures, and the distance to a major roadway are strong predictors of soil lead concentrations. Understanding what drives the spatial distribution of soil lead can inform the transition of underutilized urban space into gardens and other desirable land uses while protecting human health. A framework for management is proposed that considers three factors: (1) the level of contamination; (2) the desired land use; and (3) the community’s preference in implementing the desired land use. The goal of the framework is to promote dialogue and resultant policy changes that support consistent and clear regulatory guidelines for soil lead, without which urban communities will continue to be subject to the potential for lead exposure. Full article
(This article belongs to the Special Issue Lead: Risk Assessment and Health Effects)
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Article
A Temporal Association between Accumulated Petrol (Gasoline) Lead Emissions and Motor Neuron Disease in Australia
by Mark A. S. Laidlaw, Dominic B. Rowe, Andrew S. Ball and Howard W. Mielke
Int. J. Environ. Res. Public Health 2015, 12(12), 16124-16135; https://doi.org/10.3390/ijerph121215047 - 19 Dec 2015
Cited by 8 | Viewed by 8940
Abstract
Background: The age standardised death rate from motor neuron disease (MND) has increased from 1.29 to 2.74 per 100,000, an increase of 112.4% between 1959 and 2013. It is clear that genetics could not have played a causal role in the increased rate [...] Read more.
Background: The age standardised death rate from motor neuron disease (MND) has increased from 1.29 to 2.74 per 100,000, an increase of 112.4% between 1959 and 2013. It is clear that genetics could not have played a causal role in the increased rate of MND deaths over such a short time span. We postulate that environmental factors are responsible for this rate increase. We focus on lead additives in Australian petrol as a possible contributing environmental factor. Methods: The associations between historical petrol lead emissions and MND death trends in Australia between 1962 and 2013 were examined using linear regressions. Results: Regression results indicate best fit correlations between a 20 year lag of petrol lead emissions and age-standardised female death rate (R2 = 0.86, p = 4.88 × 10−23), male age standardised death rate (R2 = 0.86, p = 9.4 × 10−23) and percent all cause death attributed to MND (R2 = 0.98, p = 2.6 × 10−44). Conclusion: Legacy petrol lead emissions are associated with increased MND death trends in Australia. Further examination of the 20 year lag between exposure to petrol lead and the onset of MND is warranted. Full article
(This article belongs to the Special Issue Lead: Risk Assessment and Health Effects)
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Article
Screening for Elevated Blood Lead Levels in Children: Assessment of Criteria and a Proposal for New Ones in France
by Anne Etchevers, Philippe Glorennec, Yann Le Strat, Camille Lecoffre, Philippe Bretin and Alain Le Tertre
Int. J. Environ. Res. Public Health 2015, 12(12), 15366-15378; https://doi.org/10.3390/ijerph121214989 - 03 Dec 2015
Cited by 16 | Viewed by 5162
Abstract
The decline in children’s Blood Lead Levels (BLL) raises questions about the ability of current lead poisoning screening criteria to identify those children most exposed. The objectives of the study were to evaluate the performance of current screening criteria in identifying children with [...] Read more.
The decline in children’s Blood Lead Levels (BLL) raises questions about the ability of current lead poisoning screening criteria to identify those children most exposed. The objectives of the study were to evaluate the performance of current screening criteria in identifying children with blood lead levels higher than 50 µg/L in France, and to propose new criteria. Data from a national French survey, conducted among 3831 children aged 6 months to 6 years in 2008–2009 were used. The sensitivity and specificity of the current criteria in predicting blood lead levels higher than or equal to 50 µg/L were evaluated. Two predictive models of BLL above 44 µg/L (for lack of sufficient sample size at 50 µg/L) were built: the first using current criteria, and the second using newly identified risk factors. For each model, performance was studied by calculating the area under the ROC (Receiver Operating Characteristic) curve. The sensitivity of current criteria for detecting BLL higher than or equal to 50 µg/L was 0.51 (0.26; 0.75) and specificity was 0.66 (0.62; 0.70). The new model included the following criteria: foreign child newly arrived in France, mother born abroad, consumption of tap water in the presence of lead pipes, pre-1949 housing, period of construction of housing unknown, presence of peeling paint, parental smoking at home, occupancy rates for housing and child’s address in a cadastral municipality or census block comprising more than 6% of housing that is potentially unfit and built pre-1949. The area under the ROC curve was 0.86 for the new model, versus 0.76 for the current one. The lead poisoning screening criteria should be updated. The risk of industrial, occupational and hobby-related exposure could not be assessed in this study, but should be kept as screening criteria. Full article
(This article belongs to the Special Issue Lead: Risk Assessment and Health Effects)
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180 KiB  
Article
Low Levels of Awareness of Lead Hazards among Pregnant Women in a High Risk—Johannesburg Neighbourhood
by Tanya Haman, Angela Mathee and Andre Swart
Int. J. Environ. Res. Public Health 2015, 12(12), 15022-15027; https://doi.org/10.3390/ijerph121214968 - 27 Nov 2015
Cited by 9 | Viewed by 4686
Abstract
Background: The widespread use of lead and elevated risk of lead exposure in South African children justifies a need for high levels of awareness of the sources, exposure pathways, and measures to reduce this risk in children. This study aimed to determine the [...] Read more.
Background: The widespread use of lead and elevated risk of lead exposure in South African children justifies a need for high levels of awareness of the sources, exposure pathways, and measures to reduce this risk in children. This study aimed to determine the levels of knowledge of lead hazards among pregnant women in an area where children had already been established to be at a high risk of lead exposure and poisoning. Methods: Following informed consent, a structured questionnaire was administered to 119 pregnant women attending antenatal clinic services at Rahima Moosa Mother and Child Hospital, west of central Johannesburg. Questions were asked about social, demographic and residential characteristics, as well as knowledge, perceptions, behaviours and practices in relation to child lead hazards. Conclusion: Overall awareness of the dangers of lead in pregnancy was low (11%). Amongst those who had heard of it, only 15% thought that lead could cause detrimental health effects. A consequence of this low level of awareness of lead hazards is a high potential for the participants and their children to unwittingly be exposed to environmental lead from various sources, thereby undermining preventative approaches. Full article
(This article belongs to the Special Issue Lead: Risk Assessment and Health Effects)
666 KiB  
Article
Health-Related Quality of Life of Former Lead Workers in Brazil
by Martha Carvalho Pereira Teixeira, Fernando Martins Carvalho and Liliane Lins
Int. J. Environ. Res. Public Health 2015, 12(11), 14084-14093; https://doi.org/10.3390/ijerph121114084 - 03 Nov 2015
Cited by 8 | Viewed by 4840
Abstract
Little is known about the health-related quality of life of former lead workers. Using the Short-Form 36 Questionnaire (SF-36), a cross-section design study evaluated the health-related quality of life of 186 former workers of a lead smelter that operated in Santo Amaro da [...] Read more.
Little is known about the health-related quality of life of former lead workers. Using the Short-Form 36 Questionnaire (SF-36), a cross-section design study evaluated the health-related quality of life of 186 former workers of a lead smelter that operated in Santo Amaro da Purificação, Brazil, from 1960 to 1993, when it closed down. The smelter had very poor occupational and environmental hygiene standards. The health-related quality of life of former lead workers was low, compared to population-based and other nosological groups from Brazil. Former lead workers who indicated metal poisoning, difficulty getting another job and who could not get another job after dismissal by the smelter presented poorer health-related quality of life. Former lead workers with poor health-related quality of life form part of the huge occupational liability left by the Santo Amaro lead smelter. Full article
(This article belongs to the Special Issue Lead: Risk Assessment and Health Effects)
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Article
The Effects of Lead Exposure on Serum Uric Acid and Hyperuricemia in Chinese Adults: A Cross-Sectional Study
by Haijiang Dai, Zhijun Huang, Qihong Deng, Ying Li, Ting Xiao, Xingping Ning, Yao Lu and Hong Yuan
Int. J. Environ. Res. Public Health 2015, 12(8), 9672-9682; https://doi.org/10.3390/ijerph120809672 - 18 Aug 2015
Cited by 34 | Viewed by 6094
Abstract
The aim of this study was to assess the correlation between blood lead levels and both serum uric acid and hyperuricemia in adult residents living within an area of China with lead pollution. We conducted a cross-sectional analysis of 2120 subjects (1180 of [...] Read more.
The aim of this study was to assess the correlation between blood lead levels and both serum uric acid and hyperuricemia in adult residents living within an area of China with lead pollution. We conducted a cross-sectional analysis of 2120 subjects (1180 of whom were male) between the ages of 20 and 75 years who had undergone health examinations at the Centers for Disease Control and Prevention (CDC) in a lead-polluted area of China between June 2013 and September 2014. Blood lead was positively correlated with serum uric acid in both males (r = 0.095, p = 0.001) and females (r = 0.134, p < 0.001). Multivariate linear regression analysis demonstrated that for males, blood lead (p = 0.006), age (p = 0.001), current smoking (p = 0.012), education (p = 0.001), triglycerides (TG) (p < 0.001), and serum creatinine (p < 0.001) were independently associated with serum uric acid. For females, blood lead (p < 0.001), body mass index (BMI) (p = 0.009), and TG (p < 0.001) were independently associated with serum uric acid. After multiple adjustments, blood lead was significantly associated with a higher prevalence of hyperuricemia when female subjects were categorized into quartiles (for the highest quartile vs. the lowest quartile, odds ratio (OR) = 2.190; 95% confidence interval (CI): 1.106–4.338; p = 0.025); however, no such association was observed for male subjects. Continuous lead exposure has an independent impact on serum uric acid for both males and females, although this impact is more pronounced for females than for males. Lead exposure is significantly associated with hyperuricemia for females but not for males. Full article
(This article belongs to the Special Issue Lead: Risk Assessment and Health Effects)
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701 KiB  
Article
Retrospective Investigation of a Lead Poisoning Outbreak from the Consumption of an Ayurvedic Medicine: Durban, South Africa
by Angela Mathee, Nisha Naicker and June Teare
Int. J. Environ. Res. Public Health 2015, 12(7), 7804-7813; https://doi.org/10.3390/ijerph120707804 - 10 Jul 2015
Cited by 25 | Viewed by 7168
Abstract
Ayurvedic medicines have been gaining in popularity around the world in recent decades, but have also been associated with lead contamination and poisoning. In 2012 in Durban, South Africa, a lead poisoning outbreak among adolescents was associated with the consumption of an Ayurvedic [...] Read more.
Ayurvedic medicines have been gaining in popularity around the world in recent decades, but have also been associated with lead contamination and poisoning. In 2012 in Durban, South Africa, a lead poisoning outbreak among adolescents was associated with the consumption of an Ayurvedic medicine for the treatment of skin conditions. In 2014 eight individuals (out of 12 affected) were traced and interviewed. Questionnaires were administered; blood samples were taken for lead content analysis; and medical records were reviewed. Samples of the implicated medicines were analyzed to determine lead levels. Blood lead levels during the acute phase ranged from 34 to 116 µg/dL; and during the current study (two years later) from 13 to 34 µg/dL. The implicated lead capsules had a lead content of 125,235 µg/g. Participants suffered a wide range of non-specific ill health symptoms; and there was a significant delay in the diagnosis of lead poisoning. This study highlights the potential for lead poisoning outbreaks from the consumption of Ayurvedic medicines in African settings. There were weaknesses with regard to the diagnosis of and response to the outbreak, for which measures need to be put in place to ensure greater awareness of the role of Ayurvedic medicine in lead poisoning, and prompt diagnosis and treatment of future cases. Full article
(This article belongs to the Special Issue Lead: Risk Assessment and Health Effects)
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4738 KiB  
Article
Ninety Day Toxicity and Toxicokinetics of Fluorochloridone after Oral Administration in Rats
by Suhui Zhang, Xiaoqin Cheng, Yu Wang, Junpei Fan, Rui Li, Su Zhou, Shihong Liu, Jingmin Shi, Jie Sun, Yue Hu, Chaojin Xu, Chunhua Wu, Xiuli Chang, Liming Tang and Zhijun Zhou
Int. J. Environ. Res. Public Health 2015, 12(5), 4942-4966; https://doi.org/10.3390/ijerph120504942 - 06 May 2015
Cited by 19 | Viewed by 6120
Abstract
The ninety day toxicity and toxicokinetics of fluorochloridone (FLC) were accessed in Wistar rats. Animals were gavaged with FLC at doses of 31.25 mg/kg, 125 mg/kg and 500 mg/kg for ninety days, followed by thirty days for recovery. On the 1st, 60th, 75th [...] Read more.
The ninety day toxicity and toxicokinetics of fluorochloridone (FLC) were accessed in Wistar rats. Animals were gavaged with FLC at doses of 31.25 mg/kg, 125 mg/kg and 500 mg/kg for ninety days, followed by thirty days for recovery. On the 1st, 60th, 75th and 90th days of the dosing phase, plasma of ten animals of all groups treated with FLC was collected for toxicokinetic analysis of FLC by an UPLC-MS/MS method. Numerous changes in body weight, hematology, serum chemistry, and organ weight ratios were observed by the 45th and 90th dosing day. Most changes in groups treated with FLC were absent on the last recovery day. Testis and epididymis lesions were consistently seen in histopathological observations on the 45th, 90th dosing day and the last recovery day. Repeated administration of FLC increased the level of testosterone in serum in male rats on the 90th dosing day. FLC plasma concentrations could be detected in all animal drug-treated groups during the dosing phase, and a dose proportional relationship was seen between FLC dose and AUC or Cmax. This study will support future studies on the mechanism of FLC-induced toxicity. Full article
(This article belongs to the Special Issue Lead: Risk Assessment and Health Effects)
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1634 KiB  
Article
Lead Isotope Characterization of Petroleum Fuels in Taipei, Taiwan
by Pei-Hsuan Yao, Guey-Shin Shyu, Ying-Fang Chang, Yu-Chen Chou, Chuan-Chou Shen, Chi-Su Chou and Tsun-Kuo Chang
Int. J. Environ. Res. Public Health 2015, 12(5), 4602-4616; https://doi.org/10.3390/ijerph120504602 - 24 Apr 2015
Cited by 42 | Viewed by 7140
Abstract
Leaded gasoline in Taiwan was gradually phased out from 1983 to 2000. However, it is unclear whether unleaded gasoline still contributes to atmospheric lead (Pb) exposure in urban areas. In this study, Pb isotopic compositions of unleaded gasolines, with octane numbers of 92, [...] Read more.
Leaded gasoline in Taiwan was gradually phased out from 1983 to 2000. However, it is unclear whether unleaded gasoline still contributes to atmospheric lead (Pb) exposure in urban areas. In this study, Pb isotopic compositions of unleaded gasolines, with octane numbers of 92, 95, 98, and diesel from two local suppliers in Taipei were determined by multi-collector inductively coupled plasma mass spectrometry with a two-sigma uncertainty of ± 0.02 %. Lead isotopic ratios of vehicle exhaust (208Pb/207Pb: 2.427, 206Pb/207Pb: 1.148, as estimated from petroleum fuels) overlap with the reported aerosol data. This agreement indicates that local unleaded petroleum fuels, containing 10–45 ng·Pb·g−1, are merely one contributor among various sources to urban aerosol Pb. Additionally, the distinction between the products of the two companies is statistically significant in their individual 208Pb/206Pb ratios (p-value < 0.001, t test). Lead isotopic characterization appears to be applicable as a “fingerprinting” tool for tracing the sources of Pb pollution. Full article
(This article belongs to the Special Issue Lead: Risk Assessment and Health Effects)
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