Assessment of a Screening Questionnaire to Identify Exposure to Lead in Pregnant Women
Abstract
:1. Introduction
2. Materials and Methods
2.1. Study Design
2.2. Inclusion Criteria
2.3. Data Collection
2.4. Determining Blood Lead Levels
2.5. Statistical Analyses
2.6. Authorizations
3. Results
4. Discussion
4.1. Towards an Efficient and Simple Screening Lead Poisoning Questionnaire
4.2. A snapshot of Lead Poisoning in a Pregnant Population Consulted at University Hospital in Marseille
4.3. Implications for Health Professionals and Patients
4.4. Strengths and Weaknesses of the Study
5. Conclusions
Author Contributions
Funding
Acknowledgments
Conflicts of Interest
Appendix A. Lead Poisoning Screening Questionnaire
Q1: Have you ever had a personal health history with lead poisoning (acute and chronic absorption of lead into the body)? Or has someone in your surroundings? | YES ❑ NO ❑ |
Q2: Were you born in a country in Africa (including Comoros, Madagascar), the Middle East, Southeast Asia, the West Indies or Eastern Europe? | YES ❑ NO ❑ |
Q3: Do you live in an old and degraded apartment (built before 1975)? | YES ❑ NO ❑ |
Q4: Over the last 6 months, have you been in contact with someone working in construction, in an industrial site, or have you been living in an old apartment or in an apartment in construction (spread of dust, including stripping or sanding old paint)? | YES ❑ NO ❑ |
Q5: Do you ingest traditional food supplements (clays, medicinal herbs?) | YES ❑ NO ❑ |
Q6: Have you ever eaten non-food substances such as clay, soil, plaster, paint flakes? | YES ❑ NO ❑ |
Q7: Do you use traditional cosmetics? (kohl, surma)? | YES ❑ NO ❑ |
Q8: For the preparation/preservation of food, do you often use traditional containers (tajine dishes), enamelled ceramic pottery, pewter, or crystal dishes? | YES ❑ NO ❑ |
Q9: Do you drink tap water? | YES ❑ NO ❑ |
Q10: if yes, are there any lead pipes? | YES ❑ NO ❑ |
Q11: Do you smoke? | YES ❑ NO ❑ |
Q12 Are you passively exposed to the smoke of cigarettes? | YES ❑ NO ❑ |
Q13: Have you been drinking alcohol while pregnant? | YES ❑ NO ❑ |
Q14: Do you eat bread more than twice a day? | YES ❑ NO ❑ |
Q15: Do you eat vegetables grown close to an industrial site more than twice a day? | YES ❑ NO ❑ |
Q16: Have you been eating seafood while pregnant? | YES ❑ NO ❑ |
Q17: Do you live or spend much time in places close to an industrial site releasing lead into the atmosphere? | YES ❑ NO ❑ |
Q18: Do you practice (or have you practiced) shooting, hunting, fishing, pottery or a risky professional activity (in the industrial sector, construction work, metallurgy, in contact with objects containing lead)? Or is there in your surroundings someone practicing such leisure activities or working in those areas? | YES ❑ NO ❑ |
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YES Number of Patients (n) Frequency (%) | NO Number of Patients (n) Frequency (%) | I Don’t Know Number of Patients (n) Frequency (%) | |
---|---|---|---|
Tap water consumption (Q9) a | 598 75.5 | 193 24.4 | 1 0.1 |
Bread consumption > 2 times/day (Q14) | 406 51.3 | 384 48.5 | 2 0.3 |
Birth in a high-risk country b (Q2) | 344 43.4 | 448 56.6 | 0 0 |
Active or passive smoking (Q12) | 310 39.1 | 486 61.4 | 28 3.5 |
Vegetables consumption > 2 times/day (Q15) | 305 38.5 | 470 59.3 | 17 2.1 |
Living in an old and deteriorated dwelling (Q3) | 217 27.4 | 571 72.1 | 4 0.5 |
Use of traditional containers (tagine dish), handmade ceramic, tin or crystal containers (Q8) | 177 22.3 | 609 76.9 | 6 0.8 |
Exercise of a hobby or profession at risk c (Q18) | 155 19.6 | 634 80.1 | 3 0.4 |
Consumption of shellfish and crustaceans (Q16) | 152 19.2 | 639 80.7 | 1 0.1 |
Use of traditional cosmetics (kohl) (Q7) | 115 14.5 | 676 85.4 | 1 0.1 |
Carrying out recent renovation work in an old home (Q4) | 105 13.3 | 686 86.6 | 1 0.1 |
Consumption of traditional medicines or food supplements (Q5) | 53 6.7 | 736 92.9 | 3 0.4 |
Living close to an industrial site (Q17) | 33 4.2 | 740 93.4 | 3 0.4 |
Alcohol consumption (Q13) | 25 3.2 | 761 96.1 | 1 0.1 |
Pica behaviour (Q6) | 23 2.9 | 766 96.7 | 3 0.4 |
Personal or family history of lead poisoning (Q1) | 7 0.9 | 778 98.2 | 7 0.9 |
Blood Lead Level | pa | ||
---|---|---|---|
<25 µg/L (n = 572) | ≥25 µg/L (n = 24) | ||
n (%) | n (%) | ||
History of lead poisoning | 5 (0.9) | 1 (4.2) | 0.153 |
High-risk country of birth b | 250 (43.7) | 15 (62.5) | 0.076 |
Degraded old housing | 156 (27.3) | 12 (50) | 0.019 |
Renovation work in an old dwelling | 77 (13.5) | 5 (20.8) | 0.310 |
Use of traditional medicines or food supplements | 37 (6.5) | 2 (8.3) | 0.718 |
Pica behaviour | 16 (2.8) | 1 (4.2) | 0.695 |
Use of traditional cosmetics | 81 (14.2) | 10 (41.7) | 0.001 |
Use of traditional food containers (tagine dish), handmade ceramic, tin or crystal containers | 123 (21.5) | 5 (20.8) | 0.938 |
Tap water consumption | 430 (75.2) | 18 (75) | 0.985 |
Active or passive smoking | 230 (41.6) | 8 (34.8) | 0.530 |
Alcohol consumption | 20 (3.5) | 1 (4.2) | 0.862 |
Consumption of shellfish and crustaceans | 103 (18) | 5 (20.8) | 0.725 |
Bread consumption >2 times/day | 282 (49.3) | 17 (70.8) | 0.045 |
Vegetable consumption >2 times/day | 218 (38.1) | 9 (37.5) | 0.952 |
Living close to an industrial site | 14 (2.4) | 2 (8.3) | 0.102 |
Exercise of a hobby or profession at risk c | 99 (17.3) | 2 (8.3) | 0.264 |
Univariable Analysis | Multivariable Analysis | ||||
---|---|---|---|---|---|
Crude Odds Ratio | 95% CI | Adjusted Odds Ratio a | 95% CI | p | |
Living close to an industrial site | 3.62 | [0.78–16.92] | NE b | ||
High risk country of birth c | 2.15 | [0.92–4.99] | NE | ||
Consumption of bread more than twice per day | 2.50 | [1.02–6.11] | 2.40 | [0.96–5.99] | 0.060 |
Use of traditional cosmetics | 4.30 | [1.86–10.08] | 3.90 | [1.65–9.2] | 0.002 |
Degraded old housing | 2.67 | [1.17–6.06] | 2.76 | [1.19–6.38] | 0.018 |
History of lead poisoning | 4.93 | [0.55–43.9] | NE | ||
Renovation work in an old dwelling | 1.70 | [0.61–4.66] | NE | ||
Use of traditional medicines or food supplements | 1.31 | [0.30–5.81] | NE | ||
Pica behaviour | 1.51 | [0.19–11.88] | NE | ||
Use of traditional food containers (tagine dish), handmade ceramic, tin or crystal containers | 0.96 | [0.35–2.62] | NE | ||
Tap water consumption | 0.99 | [0.38–2.54] | NE | ||
Active or passive smoking | 0.62 | [0.18–2.12] | NE | ||
Alcohol consumption | 1.2 | [0.15–9.33] | NE | ||
Consumption of selfish or crustaceans | 1.20 | [0.43–3.29] | NE | ||
Vegetable consumption more than twice per day | 0.97 | [0.42–2.27] | NE | ||
Exercise of a hobby or profession at risk d | 0.43 | [0.10–1.87] | NE |
Blood Lead Level | pa | ||
---|---|---|---|
<25 µg/L (n = 572) | ≥25 µg/L (n = 24) | ||
n (%) | n (%) | ||
Age | |||
>35 years old | 112 (19.6) | 7 (29.2) | 0.294 |
Obstetrical history | |||
Spontaneous miscarriage | 134 (26.4) | 5 (21.7) | 0.617 |
Prematurity (<37 WG) | 24 (10.2) | 1 (4.3) | 0.451 |
IUGR | 19 (3.8) | 1 (4.3) | 0.596 |
Pregnancy hypertension | 22 (4.4) | 0 (0.0) | 1 |
Pregnancy course | |||
Anemia (Hb < 11 g/L) | 137 (32.6) | 7 (36.1) | 0.701 |
IUGR | 28 (7.4) | 3 (15.8) | 0.177 |
Pregnancy hypertension | 15 (4) | 0 (0) | 1 |
Prematurity (<37 WG) | 37 (9.8) | 1 (5.6) | 1 |
Low birth weight (<2500 g) | 48 (14) | 2 (14.3) | 1 |
Blood Lead Level ≥25 µg/L | ||
---|---|---|
Score Q3 + Q7 + Q14 a | N | % |
0 (n = 179) | 2 | 1.1 |
1 (n = 293) | 8 | 2.7 |
2 (n = 107) | 11 | 10.3 |
3 (n = 17) | 3 | 17.6 |
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Coiplet, E.; Freuchet, M.; Sunyach, C.; Mancini, J.; Perrin, J.; Courbiere, B.; Heckenroth, H.; Pissier, C.; Hamdaoui, N.; Bretelle, F. Assessment of a Screening Questionnaire to Identify Exposure to Lead in Pregnant Women. Int. J. Environ. Res. Public Health 2020, 17, 9220. https://doi.org/10.3390/ijerph17249220
Coiplet E, Freuchet M, Sunyach C, Mancini J, Perrin J, Courbiere B, Heckenroth H, Pissier C, Hamdaoui N, Bretelle F. Assessment of a Screening Questionnaire to Identify Exposure to Lead in Pregnant Women. International Journal of Environmental Research and Public Health. 2020; 17(24):9220. https://doi.org/10.3390/ijerph17249220
Chicago/Turabian StyleCoiplet, Eléna, Marine Freuchet, Claire Sunyach, Julien Mancini, Jeanne Perrin, Blandine Courbiere, Hélène Heckenroth, Christel Pissier, Naima Hamdaoui, and Florence Bretelle. 2020. "Assessment of a Screening Questionnaire to Identify Exposure to Lead in Pregnant Women" International Journal of Environmental Research and Public Health 17, no. 24: 9220. https://doi.org/10.3390/ijerph17249220