Intoxicación por plomo y nivel de marginación en recién nacidos de Morelos, México / Lead poisoning and marginalization in newborns of Morelos, Mexico

Resumen: Objetivo: Determinar la prevalencia de intoxicación por plomo (IPb) al nacimiento en Morelos, analizar su distribución por nivel de marginación y estimar la asociación con el uso de barro vidriado (BV). Material y métodos: Se midió plomo en sangre (PbS) en cordón umbilical de una muestra representativa de 300 nacimientos seleccionados aleatoriamente de aquéllos atendidos por los Servicios de Salud de Morelos e IMSS estatal. Resultados: La prevalencia de IPb al nacimiento (PbS>5µg/dL) fue 14.7% (IC95%: 11.1, 19.3), y 22.2% (IC95%: 14.4, 32.5) en los municipios más marginados. 57.1% (IC95%: 51.3, 62.7) de las madres usaron BV durante el embarazo y la frecuencia de uso se asoció significativamente con PbS. Conclusión: Este es el primer estudio que documenta la proporción de recién nacidos con IPb que están en riesgo de sufrir los consecuentes efectos adversos. Se recomienda monitorear PbS al nacimiento y emprender acciones para reducir esta exposición, especialmente en poblaciones marginadas.

Abstract: Objective: To determine the prevalence of lead (Pb) poisoning at birth in Morelos, analyze its distribution by social marginalization level, and estimate the association with the use of lead glazed ceramics (LGC). Materials and methods: Blood lead level (BLL) in umbilical cord was measured in a representative sample of 300 randomly selected births at the Morelos Health Services and state IMSS. Results: The prevalence of Pb poisoning at birth (BLL> 5μg/dL) was 14.7% (95%CI: 11.1, 19.3) and 22.2% (95%CI: 14.4, 32.5) in the most socially marginalized municipalities. 57.1% (95%CI: 51.3, 62.7) of the mothers used LGC during pregnancy, and the frequency of use was significantly associated with BLL. Conclusion: This is the first study to document the proportion of newborns with Pb poisoning who are at risk of experiencing the related adverse effects. It is recommended to monitor BLL at birth and take action to reduce this exposure, especially in socially marginalized populations.

Proximity of residence to an old mineral storage site in Chile and blood lead levels in children / Proximidade residencial com um velho depósito mineral no Chile e nível de chumbo no sangue em crianças / Proximidad residencial con un viejo depósito mineral en Chile y el nivel de plomo en sangre de niños

Evidence suggests that an old mineral storage site removed in 1998 due to high lead content, remains as a source of exposure in the city of Antofagasta, Chile. The aim was to determine the association between blood lead levels in children and the residential proximity to the old mineral storage site. A cross sectional study was conducted with 185 children aged 7 to 16 years. The outcome variable was blood lead levels measured in 2005. The exposure variable was the distance between the current residence and the old mineral storage site. The distance was measured in meters by Geographic Information System (GIS). The median blood lead level in 2005 was 3.3μg/dL (interquartile range ‒ IQR: 2.0-4.3). A significant inverse association was found between the residential distance to the old mineral storage site and the blood lead levels in children, after adjusting by confounders (β: -0.04; 95%CI: -0.09; -0.01). This result suggests that the old mineral storage site continues to be a source of lead exposure for the children living nearby.

A evidência sugere que um depósito de minerais removido em 1998 por seu alto teor de chumbo ainda poderia ser uma fonte relevante de exposição a este metal, na cidade de Antofagasta, Chile. O objetivo deste trabalho foi determinar a associação entre a distância da residência até o antigo depósito e a concentração de chumbo no sangue. Estudo transversal com 185 crianças de 7-16 anos. A variável dependente foi a concentração de chumbo no sangue medido em 2005; a exposição foi a distância (metros) entre a residência atual e o antigo depósito de chumbo, obtida por meio do Sistema de Informação Geográfica (SIG). A concentração de chumbo no sangue foi de 3,3μg/dL (intervalo interquartil ‒IQR: 2,0-4.3). Constatou-se uma relação inversa entre a distância da casa para o antigo local de recolha e a concentração de chumbo no sangue (β: -0,04; IC95%: -0,09; -0,01). Esse resultado confirma que o antigo lugar de armazenagem do minério continua a ser uma fonte relevante de exposição ao chumbo.

Evidencia sugiere que un antiguo sitio de acopio de minerales removido en 1998 por el alto contenido de plomo, aún sería una fuente de exposición en la ciudad de Antofagasta, Chile. El objetivo fue determinar la asociación entre la concentración de plomo en sangre y la distancia entre la vivienda actual y el antiguo sitio de acopio. Se realizó un estudio de diseño transversal con 185 niños de 7 a 16 años. La variable dependiente fue la concentración de plomo sanguíneo, medida el 2005. La variable de exposición fue la distancia entre la vivienda actual y el antiguo sitio de acopio. Esta distancia fue medida en metros mediante Sistema de Información Geográfica (SIG). La concentración de plomo en sangre fue de 3,3μg/dL (rango intercuartil ‒ RIC: 2,0-4,3). Se encontró una relación inversa y significativa entre la distancia de la vivienda al antiguo sitio de acopio y la concentración de plomo sanguíneo (β: -0,04; IC95%: -0,09; -0,01). Este resultado sugiere que el antiguo sitio de acopio de minerales sigue siendo una fuente de exposición a plomo.

Prevalencia de mercurio y plomo en población general de Bogotá 2012/2013 / Mercury and lead prevalence in a sample of people living in Bogotá, 2012-2013

Objetivos Establecer la prevalencia de mercurio y plomo en población general de Bogotá, posibles efectos en salud y relación con zonas de exposición ambiental. Métodos Estudio transversal, muestra de 401 individuos de población general de Bogotá, distribuida aleatoria y proporcionalmente según localidad y zonas de exposición ambiental de alto, medio y bajo riesgo. Se realizó valoración médica y cuantificación de plomo (sangre) y mercurio (sangre, cabello, orina). Se realizó análisis descriptivo preliminar. Resultados Edad de los participantes: 3-91 años (media 46), ocupación más frecuente ama de casa (45,1 %, n=181); promedios de concentraciones: mercurio en cabello: 1,00 µg/g, sangre: 3,13 µg/L, y orina: 0,29 µg/L; plomo en sangre: 8,62 µg/dL. Individuos con concentraciones superiores a los valores de referencia internacionales: 54 (13,5 %) para mercurio (OMS); 10 (2,5 %) para plomo (CDC). Los hallazgos clínicos son inespecíficos, las zonas de exposición no parecen relacionarse con las concentraciones encontradas. Discusión Un porcentaje importante de individuos presentan concentraciones elevadas de los metales estudiados, lo que resalta la necesidad de identificar y controlar las fuentes ambientales de mercurio y plomo que están afectando a la población general de Bogotá, con posibles consecuencias en su salud.(AU)

Objectives Establishing mercury and lead prevalence in a sample of people living in Bogotá, potential effects on their health and the relationship with areas of environmental exposure. Methods This was a cross-sectional study involving a randomly and proportionally distributed sample of 401 people living in Bogotá, according to locality and their high, medium and low risk environmental exposure. A medical assessment was made and lead (in blood) and mercury levels (blood, hair, urine) quantified. A preliminary descriptive analysis was made. Results The participants were aged 3-91 years-old (mean 46), the most frequently occurring occupation was that of housewife (45.1%, n=181). Mean mercury concentration in hair was 1µg/g, 3.13 µg/L in blood and 0.29 µg/L in urine; lead in blood was found to be 8.62 µg/dL. Fifty-four people (13.5%) had higher concentrations than international reference values for mercury (WHO) and 10 (2.5%) for lead (CDC). Clinical findings were non-specific; exposure areas did not seem to relate to the concentrations found. Discussion A significant percentage of the study population had high mercury and/or lead levels and such high prevalence highlights the need for identifying and controlling sources of exposure to mercury and lead which could have adverse consequences regarding the health of Bogota’s general population.(AU)

Exposición a la contaminación con plomo en taller de ensamble de baterías / Exposure to lead contamination in battery assembly workshop

Introducción: Las consecuencias perjudiciales del plomo (Pb) en la salud de las personas, y los trabajadores en particular, han sido suficientemente demostradas desde hace mucho tiempo. No obstante ser un problema de tan larga data, llega hasta la actualidad; y los talleres de baterías constituyen una de las fuentes de contaminación. Objetivo General: Conocer el nivel de exposición al Pb de la totalidad de trabajadores directos de un taller de ensamble de baterías de la localidad de Boulogne, Buenos Aires. Objetivos Específicos: -Evaluar los registros sobre el nivel de Pb en sangre de los trabajadores entre 2007 y 2013. -Describir las condiciones de trabajo y las prácticas higiénicas de los empleados. -Medir la cantidad de Pb existente en el aire del establecimiento. Material y métodos: Es un estudio observacional descriptivo. El relevamiento general de riesgos se realizó mediante observación directa. Se analizaron las plombemias de los trabajadores. Las prácticas higiénico-laborales se estudiaron mediante un cuestionario semi-estructurado. Se llevó a cabo un estudio del aire. Resultados: El cumplimiento de las normas de seguridad e higiene laboral es parcial. Es una planta pequeña y mal ventilada, sin un adecuado sistema de extracción ni ventilación. No utiliza proceso húmedo o con aspiradores para la limpieza. No es sistemático el recambio de filtros de la campana de extracción ni de los respiradores personales. Las plombemias realizadas entre diciembre de 2007 y marzo de 2013 muestran valores superiores a los límites aceptables, alcanzando el promedio 19,23 ug/100ml (rango: 3 ug/100ml - 48,8 ug/100ml). Existen debilidades en cuanto a la utilización de la máscara de protección con filtros, a su higienización y a la forma en que esto se realiza. Resultados de las muestras del aire: en crisol: concentración de plomo (resultado analítico): 0,06 mg/m³; en intercelda: 0,92 mg/m3; en el sector de etiquetado: 0,03 mg/m³. Conclusiones principales: Se requiere el mejoramiento de las normas de seguridad e higiene laborales.

Introduction: The harmful effects of lead (Pb) on the health of people and workers in particular have long been sufficiently demonstrated. However being a problem as longstanding, arrives to present workshops and batteries are one of the sources of pollution. General Objective: To determine the level of exposure to Pb of all direct workers of a battery assembly workshop in the town of Boulogne, Buenos Aires. Specific Objectives: -Evaluate the records on the level of Pb in blood of workers between 2007 and 2013. -Describe the working conditions and hygiene practices of employees. -Measure the amount of Pb in the air existing in the establishment. Material and Methods: It is an observational descriptive study. The general risk survey-stage was conducted by direct observation. The lead levels of workers were analyzed. Hygiene and work practices were studied using a semi-structured questionnaire. It was made an air study. Results: Compliance with safety and hygiene is partial. It is a small and stuffy plant without adequate ventilation or exhaust system. It does not use wet or vacuum for cleaning process. No systematic replacement filters range hood or personal respirators. The lead levels between December 2007 and March 2013 show above acceptable limits values, reaching 19,23 ug/100ml average (range: 3 ug/100ml - 48,8 ug/100ml). There are weaknesses with regard to the use of the protective mask filters, to sanitize and the way this is done. Results of air samples: in pot: lead concentration (analytical result): 0,06 mg/ m3, in intercell 0,92 mg/m3; labeling sector: 0,03 mg/m3. Main conclusions: improving the safety and health at work is required.

Environmental lead poisoning among children in Porto Alegre state, Southern Brazil / Intoxicação ambiental por chumbo em crianças de Porto Alegre / Intoxicación ambiental por plomo en niños de Porto Alegre, Sur de Brasil

OBJECTIVE: To estimate the prevalence of lead poisoning in children and to identify associated factors, as well as possible local sources of contamination. METHODS: A cross-sectional prevalence study conducted in 2006 with a random sample of 97 children age zero to five years from a neighborhood in Porto Alegre, Southern Brazil. Blood lead levels were measured and a questionnaire administered to collect information on sociodemographics, recycling and dwelling. A preliminary environmental evaluation was carried out with direct analysis of soil and indirect analysis of air pollution with bioindicators to identify possible sources of contamination. To analyze lead concentrations from the different collection sites, for each type of material studied, ANOVA was performed with a Brown-Forsythe adjustment for heteroscedasticity and with Dunnett's T3 procedure for multiple comparisons of unequal variances. RESULTS: Blood lead levels > 10.0 µg/dL was found in 16.5 percent of children. Recycling of waste at home, low father's education level, and increased age of children were associated with increase blood lead levels. High lead levels were found in soil, and there was little indication of lead air pollution. CONCLUSIONS: A high prevalence of lead poisoning was identified, and the potential sources of contamination in this community appear related to waste recylcing activities. Studies should be conducted with other populations of Brazilian children and evaluate potential sources of local and general contamination, to accurately characterize this issue in Brazil.

OBJETIVO: Estimar a prevalência de intoxicação por chumbo em crianças e identificar fatores associados, bem como possíveis fontes de contaminação local. MÉTODOS: Estudo transversal de prevalência com amostra aleatória de 97 crianças de zero a cinco anos de uma vila em Porto Alegre, RS, em 2006. O nível de chumbo no sangue foi medido e foi aplicado questionário para coletar informações sociodemográficas, reciclagem e moradia. Foi realizada avaliação ambiental preliminar com análise direta do solo e indireta da poluição atmosférica utilizando bioindicadores para averiguar possíveis fontes de contaminação. Para avaliar diferenças significantes entre as concentrações encontradas nos pontos de coleta, para cada tipo de material estudado, foi realizada ANOVA com correção de Brown-Forsythe para heterocedasticidade com comparações múltiplas de Dunnett T3 para variâncias desiguais. RESULTADOS: O total de 16,5 por cento das crianças apresentou chumbo sanguíneo > 10,0µg/dL. Reciclagem de lixo no local de moradia, baixo nível educacional do pai e maior idade das crianças estiveram associados com maior concentração de chumbo no sangue. Foram encontrados níveis elevados de chumbo no solo e pouca indicação de poluição atmosférica por esse metal. CONCLUSÕES: Foi observada prevalência significativa de intoxicação por chumbo e as possíveis fontes de contaminação nessa comunidade parecem relacionar-se a atividades de reciclagem de lixo. Estudos devem ser conduzidos com outras populações infantis brasileiras, avaliando possíveis fontes de contaminação locais e gerais, para que se possa dimensionar corretamente essa questão no País.

OBJETIVO: Estimar la prevalencia de intoxicación por plomo en niños e identificar factores asociados, así como posibles fuentes de contaminación local. MÉTODOS: Estudio transversal de prevalencia con muestra aleatoria de 97 niños de cero a cinco años de una villa en Porto Alegre, Sur de Brasil, en 2006. El nivel de plomo en la sangre fue medido y se aplicó cuestionario para colectar informaciones sociodemográficas, reciclaje y vivienda. Se realizó evaluación ambiental preliminar con análisis directo del suelo e indirecto de la polución atmosférica utilizando bioindicadores para investigar posibles fuentes de contaminación. Para evaluar diferencias significativas entre las concentraciones encontradas en los puntos de colecta, para cada tipo de material estudiado, se realizó ANOVA con corrección de Brown-Forsythe para heterocedasticidad con comparaciones múltiples de Dunnett T3 para varianzas desiguales. RESULTADOS: Un total de 16,5 por ciento de los niños presentó plomo sanguíneo > 10,0µg/dL. Reciclaje de basura en el lugar de vivienda, bajo nivel educacional del padre y mayor edad de los niños estuvieron asociados con mayor concentración de plomo en la sangre. Se encontraron niveles elevados de plomo en el suelo y poca indicación de polución atmosférica por dicho metal. CONCLUSIONES: Se observó prevalencia significativa de intoxicación por plomo y las posibles fuentes de contaminación en la comunidad evaluada parecen relacionarse con actividades de reciclaje de basura. Estudios deben realizarse con otras poblaciones infantiles brasileñas, evaluando posibles fuentes de contaminación locales y generales, para que se pueda dimensionar correctamente este tema en el País.

Contenido de plomo sanguíneo y composición corporal en mujeres jóvenes expuestas a humo de madera en la ciudad de Temuco / Blood lead levels and body composition in young women exposed to wood smoke in the city of Temuco

One of the main concerns in the cities ofdeveloping countries is the coexistence of environmental pollution, malnutrition and overweight. The city of Temuco is highly polluted and the range of circulating lead of their inhabitants is unknown. The objective of this work was to study the potential association between blood lead concentration and body composition in young women (n=45) living in the city of Temuco, which were exposed permanently to wood smoke. Blood lead concentration was analyzed by atomic absorption spectrometry with graphite furnace (AAS-GF) and the body composition was determined by isotopic dilution (deuterium). All participants presented high percentage offat mass (FM) and 66.7% of them had blood lead levels over the accepted international limits (5µgldl; EPA; USA), although lower than the Chilean normative (40µgldl), which were not correlated with the % of FM. The high percentage of overweight and obesity together with the lead blood levels found in this study constitute risk factors that may affect health and life quality of the participants in the medium term.

Uno de los problemas más frecuentes en las ciudades de países en desarrollo es la coexistencia de polución ambiental, malnutrición y sobrepeso. La ciudad de Temuco posee una elevada contaminación ambiental y se desconoce el rango de las concentraciones de plomo circulante en la población. El objetivo de este trabajo fue estudiar la concentración de plomo sanguíneo en mujeres temuquenses expuestas a humo de leña doméstico en forma continua (n=45), y su posible asociación con la composición corporal. La concentración sanguínea de plomo fue analizada por espectrofotometría de absorción atómica con horno de grafito (AAS-GF), y la composición corporal se determinó por el método de dilución isotópica (deuterio). Todas las mujeres participantes registraron elevados porcentajes de masa grasa (MG) y un 66.7% de ellas registró concentraciones de plomo sanguíneo sobre los niveles aceptados internacionalmente (5 μg/dl; EPA; USA), aunque bajo la normativa chilena (40 μg/dl), los que no se correlacionaron con el % de MG. El elevado porcentaje de sobrepeso y obesidad junto a los niveles de plomo observados en este estudio constituyen factores de riesgo que afectarán en un mediano plazo la salud y calidad de vida de las participantes.

Niveles de plomo en sangre en niños venezolanos publicaciones en artículos científicos (1993-2006) / Blood lead levels in venezuelan children reported in scientific articles

El objetivo de esta investigación fue realizar una revisión de los níveles de plomo en sangre en niños venezolanos reportados en los artículos científicos publicados entre los años 1993-2996. El estudio fue del tipo documental y las bases de datos consultadas fueron PubMed/MEDLINE, EBDCO, ProQuest, Scielo, REVENCYT, FUNDACID BC UC, utilizando las palabras clave: niños, níveles de plomo en sangre, revisión, Venezuela. En total fueron recopilados 13 artículos, el 85% de estos fueron del tipo descriptivo. La mayor proporción (39%) de estudios revisados fueron clasificados como ambientales. La media de las medias de los níveles de plomo en sangre reportadas en los estudios fue de 12,61 ± 3,95% µg/dL, IC95%[10,23; 14,99 µg/dL]. En el 84,6% de las investigaciones realizadas se observaron medias de plomo en sangre en niños mayores a su límite permisible (10 µg/dL) Esta investigación podría servir de evidencia sobre los niveles de plomo observados en niños venezolanos, contribuyendo con el análisis y discusión de futuras investigaciones.

The objetive of this research was to conduct a review of blood lead levels in venezuelan children reported in the scientific articles published between the years 1993-2006. A documentary study was carried out, databases consulted were PubMed/MEDLINE, EBSCO, ProQuest, Scielo, REVENCYT; FUNDACID BC UC, using key word: children, levels of blood lead, review, Venezuela. Were collected in total 13 articles, 85% of these were descriptive. The largest proportion (39%) of studies reviewed were classified as environmental. The average of the average levels of blood lead reported in the studies was 12.61 ± 3.95 µg/dL, IC95% [10.23; 14.99 µg/dL]. In the 84.6% of investigations carried out in children whit blood lead were it was observed an average of blood lead higher to the allowable limit (10 µg/dL). This research could provide evidence on the blood lead levels observed in venezuelan children, helping with the analysis and discussion of future research.

Occupational lead poisoning in workers of traditional tile factories in Mashhad, northeast of Iran

Occupational lead poisoning is a health problem in Iran. It has not previously been studied in traditional tile makers. To determine the prevalence of lead poisoning and its complications in traditional tile workers in Mashhad, Northwest of Iran, We visited workers in two traditional tile factories and collected data by direct history taking and physical examination. Blood and urine lead concentrations were measured by heated graphite atomization technique. Overall, 108 men with mean +/- SD age of 37 +/- 7.8 years were studied. The mean +/- SD length of daily lead exposure was 9.8 +/- 6 years. The mean +/- SD blood lead concentration was 520.5 +/- 323, 2 M9/L. The main objective clinical findings were the presence of lead line [64.8%], peripheral neuropathy of the upper extremities [37%], depressed deep tendon reflexes in the upper extremities [25.7%], tremor [23.3%], peripheral neuropathy of the lower extremities [17%] and abdominal tenderness [15.1%]. The subjective findings were mainly attributed to the central nervous system and included loss of memory [57%], moodiness [56.1%], agitation [47.7%], drowsiness [36.4%] and headache [29.9%]. There was no statistically significant correlation between the blood lead concentration and glomerular filtration rate. However, there were significant correlations between the blood lead concentration and each of the urine lead concentration [p<0.001], diastolic blood pressure [p=0.04], serum triglyceride level [p=0.043], high density lipoprotein level [p=0.012], and basophilic stippling [p=0.048]. Blood lead level, however, did not have any significant correlation with the presence of lead line. In traditional tile workers, lead toxicity is not uncommon and the toxic effects of lead were found more often on the teeth [bone], central and peripheral nervous system, hematological and lipid profiles than on the renal function

Association of lead exposure, serum uric acid and parameters of renal function in Nigerian lead-exposed workers

The presence of hyperuricemia and renal function impairment, especially in the absence of urate stone formation is strongly suggestive of lead nephropathy. The evaluation of this association is essential in areas where lead exposure is still prevalent and uncontrolled. To determine the relationship between serum uric acid and renal function indices in lead-exposed workers. A cross-sectional study of 190 adults with occupational lead exposure and 80 adults [comparison group], matched for age and sex was performed in Port Harcourt, South-south Nigeria. Blood lead was used as the biomarker of lead exposure while serum urea, serum creatinine, urine albumin [using urine albumin:creatinine ratio], estimated glomerular filtration rate [GFR] and serum uric acid were the renal function indices measured. Occupationally lead-exposed subjects had a significantly [p = 0.008] higher mean_SD blood lead levels [50.37 +/- 24.58 M9/dL] than the comparison group [41.40 +/- 26.85]. The mean_SD serum urea [8.6 +/- 2.3 mg/dL], creatinine [1.0 +/- 0.2 mg/dL] and serum uric acid [4.6 +/- 1.2 mg/dL] were significantly [p < 0.01] higher in the study subjects than the comparison group [7.6 +/- 2.4, 0.9 +/- 0.2, and 3.9 +/- 1.1 mg/dL, respectively]. The mean +/- SD creatinine clearance was significantly [p = 0.002] lower in the study subjects than the comparison group [98.9 +/- 21.3 vs. 108.2 +/- 25.2 mL/min/1.72 m[2]]. Serum uric acid level correlated positively with serum creatinine [r = 0.134] and negatively with GFR [r = 0.151]. People with occupational lead exposure are at risk of developing hyperuricemia and renal impairment

Avaliação dos fatores de risco relacionados à exposição ao chumbo em crianças e adolescentes do Rio de Janeiro / Evaluation of risk factors related to lead exposure in children and adolescents from Rio de Janeiro

A importância do chumbo atmosférico na contaminação global do ambiente tem recebido crescente atenção científica. A principal forma de monitorização da exposição é biológica, mas a ambiental tem um papel importante, já que o ambiente é a principal fonte de exposição ao chumbo. O estudo transversal busca identificar fontes de contaminação e potenciais fatores de risco da exposição em 64 crianças de zero a dezesseis anos de uma comunidade economicamente desfavorecida do Rio de Janeiro. Foram determinadas as concentrações de chumbo em solo, água, poeira e ar e calculados os fatores de risco neurológico e carcinogênico de inalação e ingestão. O sangue coletado foi utilizado para análise de Pb-S, ALA-D por cento e genotipagem da ALA-D. O fator de risco neurológico observado foi 549 vezes superior à dose de referência para poeira e 554 vezes superior no caso de ingestão. O fator de risco carcinogênico para ingestão foi de quatro vezes. A média de Pb-S foi 5,6μg/dL e 40 por cento das crianças apresentaram valores de Pb-S acima do ponto de corte de 6μg/dL. A média de ALA-D por cento foi 40,3 por cento e foi observada correlação entre Pb-S e ALA-D por cento. O genótipo ALAD1-2 foi identificado em 10 por cento das crianças. Os resultados deste estudo permitirão o conhecimento da nossa realidade, subsidiando os órgãos de saúde pública e meio ambiente nas ações de controle e vigilância ambiental integrada

The importance of atmospheric lead in environmental global contamination is receiving increasing scientific attention. The main exposure monitoring approach is biological, but the environmental one has a key role, since the environment is the major source of exposure. The study aimed to identify the contamination sources and potential risk factors of the exposure in a 64 subject group formed by 0-16 years-old children from an economically deprived community in Rio de Janeiro. Lead concentrations in soil, water, dust and air were determined and neurological and carcinogenic risk factors for ingestion and inhalation were calculated. Blood samples were collected and used in the analysis of Pb-B, ALA-D percent and ALA-D genotyping. The observed neurological risk factor was 549 times higher than reference dose for dust and 554 times higher in the case of ingestion. The carcinogenic risk factor for ingestion was about 4 times. Mean Pb-B was 5.6μg/dL and 40 percent of the children presented Pb-B levels above the 6μg/dL cutoff value. Mean ALA-D percent was 40.3 percent and a correlation between Pb-B and ALA-D percent was observed. ALAD1-2 genotype was identified in 10 percent of the children. The results will allow the understanding of our reality, supporting public health and environment organizations to carry out control actions and all-encompassing environmental surveillance.

Plumbemia em trabalhadores da indústria de reciclagem de baterias automotivas da Grande Porto Alegre, RS / Blood lead levels in the battery recycling industry of the metropolitan region of Porto Alegre, RS

A reciclagem de baterias pode contaminar o ar, o solo e a água, não só no lugar de processamento, mas também nas regiões circunvizinhas, sendo que os resíduos permanecem no local mesmo após o término da atividade. No presente artigo descrevemos os resultados da avaliação da plumbemia em 53 operários que trabalhavam com reciclagem de baterias automotivas e em 53 indivíduos sem história de exposição. Os dados obtidos foram comparados e discutidos em relação às normas do Ministério do Trabalho (MT) e da Occupational Safety and Health Administration (OSHA). A plumbemia no sangue do grupo controle foi de 2,44±1,15 µg/dl e, no grupo exposto, de 59,43±28,34 µg/dl, sendo que 79,2 por cento dos indivíduos mostraram níveis acima do valor de referência (até 40 µg/dl). Estudos recentes recomendam estratégias para prevenir a intoxicação com chumbo: identificação, eliminação ou controle da fonte, monitoração da exposição e respectivos danos e um programa de recompra de baterias usadas das por parte da indústria de origem.

Battery recycling may contaminate soil, air and water not only at the processing site but also in the neighboring areas, inasmuch as the residues remain at the site even after the end of the activity. In the present article, we describe the results of plumbism evaluation in 53 individuals that work with car battery recycling and 53 individuals without history of lead exposure. The obtained data were compared and discussed according to the regulations of Brazilian Ministry of Labor and OSHA (Occupational Safety and Health Administration). Blood lead levels in the control group were 2.44 ± 1.15 µg/dl and 59.43 ± 28.34 µg/dl in the exposed group. 79.2 percent of the individuals presented levels above the reference value (40 µg/dl). Recent studies recommend strategies to prevent lead intoxication: source identification, control or elimination, monitoring of environmental exposure and hazards and a buy-back program of used batteries by the industry of origin.

Uso do chumbo em urina como indicador de exposição e sua relação com chumbo no sangue / Use of urine lead level as an exposure indicator and its relationship to blood lead

O objetivo deste trabalho foi verificar se há correlação estatisticamente significativa entre as concentrações de chumbo no sangue (Pb-S) e urina (Pb-U). A espectrometria de absorção atômica eletrotérmica foi utilizada na determinação da concentração de chumbo no material biológico. As amostras de sangue e de urina foram coletadas entre trabalhadores expostos ocupacionalmente (95) e entre adultos (130) e crianças até 15 anos (22) expostos ambientalmente. Após um teste que mostrou diferenças significativas entre Pb-U e as três categorias previamente determinadas, pontos de corte em Pb-U puderam ser fixados para a predição dos valores de Pb-S pela curva ROC. Assim, para Pb-U até 0,55 µg.dL-1, pode-se esperar que Pb-S seja menor do que 10 µg.dL-1, ao passo que níveis de chumbo no sangue até 27,6 µg.dL-1 são esperados quando o teor do metal na urina é menor do que 2,05 µg.dL-1. Logo, a urina pode ser utilizada em substituição ao sangue para avaliação da exposição ocupacional ao chumbo. Contudo, recomenda-se cautela no caso da exposição ambiental, devendo-se utilizar o chumbo urinário como uma estimativa do conteúdo do metal no sangue.

The aim of this work was to verify whether there are statistically significant correlation between the concentrations of lead in blood (Pb-B) and urine (Pb-U). Electrothermal atomic absorption spectrometry was used in the determination of lead concentration in biological material. Venous blood and spot urine were collected from workers occupationally exposed (95), adults (130) and children up to 15 years old (22) environmentally exposed. After a test showing significant differences between Pb-U and the three categories previously determined, cutting points for Pb-U were established to predict Pb-B values by the ROC curve. Thus, it is expected that Pb-B is lower than 10 µg.dL-¹ with Pb-U up to 0.55 µg. dL-¹, whereas lead levels in blood below 27.6 µg. dL-¹ are expected when the amount of the metal in urine is lower than 2.05 µg.dL-¹. So, urine can be used to replace blood for the assessment of the occupational exposure to lead. However, caution is advised in the case of environmental exposure, since urinary lead should be used just as an estimation of the metal content in blood.

N-acetil-β-D-glicosaminidase como biomarcador precoce de disfunção renal para a exposição ocupacional ao chumbo inorgânico / N-acetyl-β-D-glucosaminidase as an early biomarker of renal dysfunction due to occupational exposure to inorganic lead

OBJETIVO: Este estudo teve como objetivo averiguar a atividade enzimática da N-acetil-β-D-glicosaminidase (NAG) como possível biomarcador precoce de disfunção renal para a exposição ocupacional ao chumbo inorgânico. MATERIAIS E MÉTODOS: Foi selecionado um grupo de 30 pessoas do sexo masculino expostas ao chumbo inorgânico em uma fábrica de baterias localizada no estado do Paraná. Fizeram parte do grupo os funcionários que mostraram valores de chumbo sanguíneo inferiores a 40 mg/dl. O grupo controle foi representado por 15 adultos saudáveis com similaridade em relação à idade e ao gênero do grupo exposto. Foram determinados os níveis de plumbemia, do ácido d-aminolevulínico urinário e a atividade da NAG urinária. RESULTADOS E DISCUSSÃO: Foi evidenciado que a atividade urinária da NAG foi significativamente maior (p < 0,05; teste U de Mann-Whitney) no grupo exposto ao chumbo inorgânico quando comparado ao grupo controle, e houve uma correlação negativa com significância (p < 0,05; correlação de Spearman Rank Order) entre o indicador biológico de exposição plúmbica e a atividade urinária da NAG. CONCLUSÃO: Os resultados demonstraram que o aumento da atividade urinária da NAG pode ser utilizado como um biomarcador precoce da exposição ao chumbo inorgânico.

OBJECTIVE: This study aimed to verify the enzymatic activity of N-acetyl-β-D-glucosaminidase (NAG) as a possible early biomarker of renal dysfunction due to occupational exposure to inorganic lead. MATERIALS AND METHODS: We selected a group of 30 males that had been exposed to inorganic lead in a battery factory in the state of Paraná. This group comprised those employees whose blood lead levels were below 40 mg/dl. The control group consisted of 15 healthy adults of similar age and gender compared with the exposed group. Blood lead concentrations, d-aminolevulinic acid levels and urinary NAG activity were measured. RESULTS AND DISCUSSION: It was shown that urinary NAG activity was significantly higher (p < 0.05, U test of Mann-Whitney) in the exposed group in comparison to the control group, and there was a significant negative correlation (p < 0.05, Spearman Rank Order correlation) between the biological indicator of lead exposure and urinary NAG activity. CONCLUSION: The results showed that the increase of urinary NAG activity may be used as an early biomarker of the exposure to inorganic lead.

Caracterização das alterações de linguagem em crianças com histórico de intoxicação por chumbo / Characterization of language disorders in children with lead poisoning

TEMA: a intoxicação por chumbo pode causar deficiências neuropsicológicas, que incluem a linguagem, devido aos danos provocados no desenvolvimento do SNC. OBJETIVO: verificar a ocorrência de alterações de linguagem em crianças com histórico de intoxicação por chumbo e a correlação entre o índice de chumbo sangüíneo e as alterações de linguagem apresentadas pelas crianças. MÉTODO: avaliação da linguagem de 20 crianças em idade pré-escolar, com índice de chumbo sangüíneo acima de 10 µg/dl. RESULTADOS: 13 crianças apresentaram distúrbio de linguagem envolvendo somente a Fonologia ou mais de um subsistema lingüístico. A análise estatistica revelou não existir correlação entre a gravidade das alterações e os índices de chumbo apresentado. CONCLUSÃO: a ocorrência de crianças com distúrbio de linguagem aponta a contaminação por chumbo como um fator de risco para as alterações apresentadas, mesmo tendo sido encontrados outros fatores que levem à defasagem no desenvolvimento da linguagem e ausência de correlação entre as referidas variavéis.

BACKGROUND: lead poisoning can have a negative impact on the neuropsychological functions, including language, due to the damage it causes to the development of the Central Nervous System. AIM: to verify the occurrence of language disorders in children who suffered from led poisoning and to verify the correlation between the lead concentration level in the blood and the language disorders presented by the children. METHOD: language evaluation of 20 preschoolers, with lead concentration level in the blood above 10µg/dl. RESULTS: 13 children presented language impairment involving only phonology or more than one language subsystem. The statistical analysis indicated that no correlation exists between the severity of the language impairment and the concentration levels of lead. CONCLUSION: the number of children with language impairment indicates lead poisoning as a risk factor for the present alterations, even though other risk factors for language disorders were found and the absence of correlation between the investigated variables.

Plomo en sangre: estado nutricional y estratificacion socioeconómica, en niños de una comunidad de Valencia / Blood lead: nutritional state and socioeconomic status: in children of a community of Valencia

El plomo (Pb), un metal versátil, usado desde tiempos prehistóricos, se ha distribuido ampliamente en el medio ambiente convirtiéndose en un riesgo de exposición humana. El presente estudio Analítico–Ecológico. El muestreo fue el aleatorio simple; el tamaño de la muestra se calculó con una confiabilidad de 95 por ciento y un error máximo de de 10 por ciento, se seleccionaron 60 niños entre 4–9 años en el sector Michelena, municipio Valencia, en el 2004. El objetivo fue evaluar la relación entre los valores de Pb-S, el estado nutricional y la estratificación socioeconómica en un grupo de niños. Se midió Plomo en sangre, Hemoglobina, Hematocrito y se realizó la evaluación antropométrica. La media de Pb-S en varones (11,1 ± 3,1 μg/dL) fue significativamente superior p≤ 0.05 a la encontrada en las hembras (9,5 ± 2,7 μg/dL). La media de Plomo fue de 10,5±3 μg/dL, observándose el valor más alto no significativo en el estrato socioeconómico III (10,6 ± 2,9 μg/dL). Las hembras presentaron mayores porcentajes bajo la norma en el estado nutricional En el estrato socioeconómico IV se encontró el porcentaje mas alto de niños con estado nutricional bajo la norma se presentó. Los valores de Hemoglobina y Hematocrito estuvieron dentro de límites permisibles. El mayor porcentaje de la población estudiada presentó estado nutricional normal, con niveles de Plomo en sangre no críticos. Los niveles de Pb-S no constituyen un nivel alarmante “critico” de exposición. Se sugiere realizar actividades de prevención primaria para disminuir los niveles de Plomo en sangre observados en los niños.

Lead is a versatile metal used since prehistoric times and has been distributed widely in the environment becoming a risk factor for human exposure. The present analytical-ecological study was performed in a sample size with a confidence of 95% and a maximal error of 10%; 60 children between 4 and 9 years of age belonging to Michelena sector in Valencia District in 2004. The objective was to relate blood level values to nutritional and socioeconomic status. Blood levels, Hemoglobin and Hematocrit values were determined and nutritional evaluation was performed. Mean Blood Lead in boys (11.1 ± 3.1 μg/dL) was significantly higher in boys with regard to girlsat a p <- 0.05 than in girls (9.5 ± 2.7 μg/dL). Mean Blood Lead was 10.5 ± 3 μg/dL. Girls showed a higher % of low nutritional status. Also in stratum IV, the highest prevalence was found. Hemoglobin and Hematocrit values were inside permissible limits. and levels of Lead were found at a non-critical level. It is suggested that activities of primary prevention should be carried out to diminish the levels of Blood Lead observed in children.

Determinación y estandarización de plomo en sangre en operarios de estaciones de servicio del Estado Mérida / Blood lead determination and standardization in petrol station workers in the State of Merida

En este trabajo se ha determinado el contenido de plomo (Pb) en sangre en operarios de estaciones de servicio de la ciudad de Mérida (Venezuela) y en un grupo de personas no expuestas ocupacionalmente. Las muestras de sangre provenientes de sujetos de ambos sexos n=21 (controles) y n=65 (personal expuesto) fueron procesadas por absorción atómica con atomización electrotérmica (ETAAS). Las concentraciones obtenidas de 15,27±9,62 y 83,74±28,95 µg/L para los grupos denominados como control y expuesto respectivamente, muestran diferencias altamente significativas que evidencian una exposición directa al Pb, por cuanto los valores del grupo expuesto ocupacional son más de 5 veces superiores a los del grupo control. Los resultados obtenidos también muestran que valores iguales o superiores a 54,79 µg/L son indicadores de exposición directa al Pb, permitiendo establecer valores de tolerancia entre los intervalos de 24,89 y 112,69 µg/L. Estos valores de referencia se encuentran por debajo de lo descripto por Burguera y cols. (1997), lo cual podría atribuirse al reemplazo gradual de la gasolina con plomo, en los últimos años, que ha llevado a una disminución de un 27% en los niveles de plomo en sangre, en comparación con un estudio similar realizado en esta misma ciudad en el año 1997.

In this work the lead (Pb) content in blood was determined in petrol station workers in the city of Merida-Venezuela and in a group of people not occupationally exposed. The blood samples coming from subjects of both sexes n=21 controls and n=65 exposed workers were processed by atomic absorption with electrothermal atomization (ETAAS). The 15.27±9.62 and 83.74±28.95 µg/L concentrations obtained for the group referred to as control and exposed respectively show highly significant differences that evidence a direct exposure to Pb, since the values of the occupationally exposed group are more than 5 times higher than those of the control group. The results obtained also show that values equal to or higher than 54.79 µg/L are indicative of direct exposure to Pb, making it possible to establish tolerance values between the 24.89 and 112.69 µg/L intervals. These reference values are below what was reported by Burguera et al (1997) which could be attributed to the gradual substitution of gasoline for lead that has originated a 27% decrease in lead levels in blood, if compared with a similar study carried out in the same city in 1997.

Retinal lead toxicity.

A 35-year-old female who had suffered from acute lead poisoning when she was 22 years old, presented 13 years later with loss of vision in the right eye and normal vision in the left eye. She had a pale disc, narrowed arterioles and mid-peripheral heavy pigmentation, right eye being more affected than the left eye. Electrodiagnostic tests identified marked asymmetry of visual function. We would postulate lead retinal toxicity as the cause of the asymmetric findings.