Early life blood lead levels and asthma diagnosis at age 4-6 years

The USA has a high burden of childhood asthma. Previous studies have observed associations between higher blood lead levels and greater hypersensitivity in children. The objective of the present study was to estimate the association between blood lead concentrations during early childhood and an asthma diagnosis between 48 and 72 months of age amongst a cohort with well-characterized blood lead concentrations. Blood lead concentrations were measured at 6, 12, 18, 24, 36, and 48 months of age in 222 children. The presence of an asthma diagnosis between 48 and 72 months was assessed using a questionnaire which asked parents or guardians whether they had been told by a physician, in the past 12 months, that their child had asthma. Crude and adjusted risk ratios (RR) of an asthma diagnosis were estimated for several parameterizations of blood lead exposure including lifetime average (6 to 48 months) and infancy average (6 to 24 months) concentrations. After adjustment for child sex, birthweight, daycare attendance, maternal race, education, parity, breastfeeding, income, and household smoking, age-specific or composite measures of blood lead were not associated with asthma diagnosis by 72 months of age in this cohort.

Estudio de metales urinarios y plomo en sangre: parámetros poblacionales en Antofagasta, 2018 / Urinary heavy metals and blood lead levels among residents of Antofagasta, Chile

Background: The presence of toxic metals in human populations is strongly associated with chronic diseases. Aim: To determine levels of lead, chromium, cadmium, mercury and inorganic arsenic (AsIn) in the general population aged over 5 years in Antofagasta, Chile. Material and Methods: People living in Urban Antofagasta for at least five years were considered eligible. Biological samples were obtained to measure heavy metals. Results: One thousand two hundred three participants with a median age of 43 years (656 women) were studied. Their mean time of residence in the city was 30 years, and 52% smoked. Eight percent of the adult population and 12% of children had AsIn values above 35 µg/L, while 75% of the population had levels below 21.9 µg/L. The other metals were below the risk levels defined by the health authority (10 µg/L for chromium, 10 µg/L for mercury, 2 µg/L for cadmium, 5 and 10 μg/dL for blood lead for children and adults, respectively). The factors associated with high levels of AsIn in adults were male sex, living more than 200 meters from monitoring points, and low schooling. In children, the associated variables were high intake of seafood products and having a caregiver with less than 8 years of schooling. Contrary to expectations, the greatest risk of presenting altered levels of the metals occurred in the population living more than 500 meters from the identified risk sources (90% of the population). Conclusions: The findings of this study suggest that all potential sources of exposure to AsIn should be evaluated, and surveillance actions should be established to reduce involuntary exposure to this metalloid.

Reporte nacional de niveles de plomo en sangre y uso de barro vidriado en población infantil vulnerable / National report of blood lead levels and lead-glazed ceramics use in vulnerable children

Resumen: Objetivo: Estimar la prevalencia de niveles elevados (≥5.0μg/dL) de plomo en sangre (PbS) y su asociación con el uso de loza de barro vidriado con plomo (LBVPb). Material y métodos: En 2018 se midió PbS capilar en una muestra representativa de niños de 1 a 4 años de edad residentes en localidades de México menores de 100 000 habitantes (Ensanut 100k). Se indagó sobre uso de LBVPb para consumo de alimentos. Para estimar su asociación con PbS, se generaron modelos logit multinomial estratificados por región. Resultados: La prevalencia de niveles elevados de PbS fue de 21.8%. En las regiones Norte, Centro y Sur las prevalencias fueron 9.8, 20.7 y 25.8%, respectivamente. La asociación con uso y frecuencia de LBVPb fue altamente significativa y diferencial por región. Conclusiones: La exposición a plomo permanece como un problema de salud pública en México, particularmente en el Centro y Sur, y está fuertemente asociada con el uso de LBVPb.

Abstract: Objective: To estimate the prevalence of elevated (≥5.0μg / dL) blood lead levels (BLL) and its association with the use of lead glazed ceramics (LGC). Materials and methods: In 2018, we measured capillary BLL in a representative sample of children 1 to 4 years old residing in Mexican localities under 100 000 inhabitants (Ensanut 100k). We inquired about use of LGC for food preparation and consumption. To estimate its association with BLL, multinomial logit models stratified by region were generated. Results: The prevalence of elevated BLL levels was 21.8%. For the North, Central and South regions, the prevalence were 9.8, 20.7 and 25.8%, respectively. The association with use and frequency of LGC was highly significant and differential by region. Conclusions: Lead exposure remains a public health problem in Mexico, particularly in the Central and South regions, and is strongly associated with the use of LGC.

A Comparison of Serum Lead Status among Elderly Osteopaenic Patients, Elderly Osteoporotic Patients and Healthy Controls / Comparación del estado de plomo sérico entre los pacientes osteopénicos mayores de edad, los pacientes osteoporóticos mayores de edad, y los controles sanos

ABSTRACT Objective: It is proposed that in some conditions such as pregnancy and osteoporosis where the bone turnover rate is high, there is mobilization of various minerals including lead (Pb) from bone to blood. This study aimed to determine if there were any differences in serum Pb levels among elderly osteopaenic patients, elderly osteoporotic persons and healthy controls. Methods: Fifty-four elderly persons (26 men and 28 women) from the Amirkola Health and Ageing Project, Iran, were included in this study. The diagnosis of osteopaenia and osteoporosis was based on spine and femur bone mineral density (BMD) measurements. After blood sampling, serum Pb levels were analysed by the method of atomic absorption spectrophotometry. Results: According to the BMD measurements, 19 persons had normal BMD, while 16 had osteopaenia and 19 suffered from osteoporosis. The differences in body mass index in these three groups were statistically significant (p < 0.001). The patients with osteoporosis had the highest levels of alkaline phosphatase and the highest rate of bone turnover. The mean ± standard deviation of the serum Pb levels in these groups were 236.8 ± 98.0, 270.0 ± 81.5 and 258.3 ± 57.5 μg/L, respectively, and the differences were not statistically significant (p = 0.467). Conclusion: No statistically significant differences in serum Pb levels were observed in healthy controls compared with osteopaenic persons and osteoporotic persons. This suggests that mobilization of Pb from bone to blood in this population of elderly osteopaenic patients and elderly osteoporotic patients was similar to that in the healthy controls.

RESUMEN Objetivo: Se postula que en algunas condiciones como el embarazo y la osteoporosis donde el índice de recambio óseo es alto, hay movilización de varios minerales - incluyendo plomo (Pb) - de los huesos a la sangre. Este estudio tuvo como objetivo determinar si hubo diferencias en los niveles de plomo sérico entre los pacientes osteopénicos mayores de edad, los pacientes osteoporóticos mayores de edad, y los controles sanos. Métodos: Se incluyeron en este estudio 54 personas de edad avanzada (26 hombres y 28 mujeres) del Proyecto Amirkola de Salud y Envejecimiento, Irán. La diagnosis de la osteopenia y la osteoporosis se basó en mediciones de la densidad mineral ósea (DMO) de la espina dorsal y del fémur (DMO). Después del muestreo de sangre, los niveles séricos de Pb fueron analizados por el método de espectrofotometría de absorción atómica. Resultados: Según las mediciones de la DMO, 19 personas tenían DMO normal, mientras que 16 tenían osteopenia y 19 padecían osteoporosis. Las diferencias en el índice de masa corporal en estos tres grupos fueron estadísticamente significativas (p < 0.001). Los pacientes con osteoporosis tenían los niveles más altos de fosfatasa alcalina y el índice más alto de recambio óseo. La media ± desviación estándar de los niveles séricos de Pb en estos grupos fue de 236.8 ± 98.0, 270.0 ± 81.5 y 258.3 ± 57.5 μg/L, respectivamente, y las diferencias no fueron estadísticamente significativas (p = 0.467). Conclusión: No se observaron diferencias estadísticamente significativas en los niveles séricos de Pb en los controles sanos en comparación con las personas osteopénicas y las osteoporóticas. Esto sugiere que la movilización de Pb del hueso a la sangre en esta población de pacientes osteopénicos mayores de edad y pacientes osteoporóticos mayores de edad, era similar a la encontrada en los controles sanos.

The maturation state of the auditory nerve and brainstem in rats exposed to lead acetate and supplemented with ferrous sulfate / Estado de maturação do nervo auditivo e tronco encefálico em ratos expostos a acetato de chumbo e suplementados com sulfato ferroso

Abstract Introduction The literature has reported the association between lead and auditory effects, based on clinical and experimental studies. However, there is no consensus regarding the effects of lead in the auditory system, or its correlation with the concentration of the metal in the blood. Objective To investigate the maturation state of the auditory system, specifically the auditory nerve and brainstem, in rats exposed to lead acetate and supplemented with ferrous sulfate. Methods 30 weanling male rats (Rattus norvegicus, Wistar) were distributed into six groups of five animals each and exposed to one of two concentrations of lead acetate (100 or 400 mg/L) and supplemented with ferrous sulfate (20 mg/kg). The maturation state of the auditory nerve and brainstem was analyzed using Brainstem Auditory Evoked Potential before and after lead exposure. The concentration of lead in blood and brainstem was analyzed using Inductively Coupled Plasma-Mass Spectrometry. Results We verified that the concentration of Pb in blood and in brainstem presented a high correlation (r = 0.951; p < 0.0001). Both concentrations of lead acetate affected the maturation state of the auditory system, being the maturation slower in the regions corresponding to portion of the auditory nerve (wave I) and cochlear nuclei (wave II). The ferrous sulfate supplementation reduced significantly the concentration of lead in blood and brainstem for the group exposed to the lowest concentration of lead (100 mg/L), but not for the group exposed to the higher concentration (400 mg/L). Conclusion This study indicate that the lead acetate can have deleterious effects on the maturation of the auditory nerve and brainstem (cochlear nucleus region), as detected by the Brainstem Auditory Evoked Potentials, and the ferrous sulphate can partially amend this effect.

Resumo Introdução A literatura relatou a associação entre o chumbo e os efeitos auditivos, com base em estudos clínicos e experimentais. No entanto, não há consenso em relação aos efeitos do chumbo no sistema auditivo, ou sua correlação com a concentração do metal no sangue. Objetivo Investigar o estado de maturação do sistema auditivo, especificamente do nervo auditivo e do tronco encefálico, em ratos expostos ao acetato de chumbo e suplementados com sulfato ferroso. Método 30 ratos machos desmamados (Rattus norvegicus, Wistar) foram distribuídos em seis grupos de cinco animais e expostos a uma de duas concentrações de acetato de chumbo (100 ou 400 mg/L) e suplementados com sulfato ferroso (20 mg/kg). O estado de maturação do nervo auditivo e do tronco encefálico foi analisado pelo Potencial Evocado Auditivo do Tronco Encefálico antes e após a exposição ao chumbo. A concentração de chumbo no sangue e tronco encefálico foi analisada utilizando-se Espectrometria de Massa com Plasma Indutivamente Acoplado. Resultados Verificamos que as concentrações de Pb no sangue e no tronco encefálico apresentaram alta correlação (r = 0,951, p < 0,0001). Ambas as concentrações de acetato de chumbo afetaram o estado de maturação do sistema auditivo, a maturação foi mais lenta nas regiões correspondentes à porção do nervo auditivo (onda I) e dos núcleos cocleares (onda II). A suplementação com sulfato ferroso reduziu significativamente a concentração de chumbo no sangue e no tronco encefálico no grupo exposto à menor concentração de chumbo (100 mg/L), mas não para o grupo exposto à maior concentração (400 mg/L). Conclusão Esse estudo indica que o acetato de chumbo pode ter efeitos deletérios na maturação do nervo auditivo e do tronco encefálico (região do núcleo coclear), como detectado pelos potenciais evocados auditivos do tronco encefálico, e que o sulfato ferroso pode diminuir parcialmente esse efeito.

Avaliação dos níveis de chumbo e mercúrio em população exposta ambientalmente na Região Centro-oeste do Brasil / Evaluación de los niveles de plomo y mercurio en población expuesta ambientalmente en la región centro-oeste de Brasil / Lead and mercury levels in an environmentally exposed population in the Central Brazil

O objetivo foi avaliar o nível de exposição ao chumbo e mercúrio em população do Pantanal Mato-grossense, Brasil. Chumbo no sangue (Pb-S) (n = 119) e mercúrio na urina (Hg-U) (n = 109) de moradores da região foram determinados por espectrometria de absorção atômica. A comparação de médias e correlação entre as variáveis utilizaram o teste ANOVA e a regressão linear, respectivamente, com 95% de confiança. Pb-S médio foi 2,82 ± 1,53µg dL-1. A comparação de Pb-S estratificado por local de coleta (p ≤ 0,01), atividade laboral (p ≤ 0,01) e consumo de leite produzido na região (p ≤ 0,05) mostrou diferenças estatisticamente significativas. Também houve associações positivas entre Pb-S e local de coleta (p ≤ 0,01), profissão dos participantes (p ≤ 0,05), consumo de leite da região (p ≤ 0,01) e origem da água de consumo (p ≤ 0,01). A média de Hg-U foi 1,41 ± 0,98µg L-1. Os teores mostraram diferenças significativas apenas quanto à profissão dos participantes (p ≤ 0,01), e associações positivas surgiram entre Hg-U e atividade profissional (p ≤ 0,01) assim como índice de massa corporal dos sujeitos de estudo (p ≤ 0,01). As amostras apresentaram baixos níveis de chumbo e mercúrio, semelhantes àqueles encontrados em populações também expostas ambientalmente. Apesar dessas baixas concentrações, o conhecimento atual sobre toxicidade desses metais mostra que efeitos à saúde já podem ser sentidos em níveis antes considerados seguros, o que caracteriza o perigo.

El objetivo fue evaluar el nivel de exposición al plomo y mercurio en una población del Pantanal Mato-grossense, Brasil. El plomo en sangre (Pb-S) (n = 119) y mercurio en la orina (Hg-U) (n = 109) de los habitantes de esa región se determinó por espectrometría de absorción atómica. La comparación de medias y la correlación entre las variables utilizaron el test ANOVA y la regresión lineal, respectivamente, con un 95% de confianza. Pb-S medio fue 2,82 ± 1,53µg dL-1. La comparación de Pb-S estratificado por lugar de recogida (p ≤ 0,01), actividad laboral (p ≤ 0,01) y consumo de leche que se produjo en la región (p ≤ 0,05) mostró diferencias estadísticamente significativas. También hubo asociaciones positivas entre Pb-S y el lugar de recogida (p ≤ 0,01), profesión de los participantes (p ≤ 0,05), consumo de leche de la región (p ≤ 0,01) y origen del agua de consumo (p ≤ 0,01). La media de Hg-U fue 1,41 ± 0,98µg L-1. Los porcentajes mostraron diferencias significativas sólo respecto a la profesión de los participantes (p ≤ 0,01), y las asociaciones positivas surgieron entre Hg-U y la actividad profesional (p ≤ 0,01), así como índice de masa corporal de los sujetos de estudio (p ≤ 0,01). Las muestras presentaron bajos niveles de plomo y mercurio, semejantes a aquellos encontrados en poblaciones también expuestas ambientalmente. A pesar de esas bajas concentraciones, el conocimiento actual sobre toxicidad de estos metales muestra que los efectos sobre la salud, ya pueden ser apreciados en niveles antes considerados seguros, lo que caracteriza el peligro.

The objective was to assess the level of exposure to lead and mercury in a population in the Pantanal region in Mato Grosso State, Brazil. Blood lead (PbB) (n = 119) and urinary mercury (HgU) (n = 109) in local residents were measured by atomic absorption spectrometry. Comparison of means and correlations between variables used analysis of variance (ANOVA) and linear regression, respectively, with 95% confidence intervals. Mean PbB was 2.82 ± 1.53µg dL-1. The comparison of PbB stratified by collection site (p ≤ 0.01), work activity (p ≤ 0.01), and consumption of locally produced cow's milk (p ≤ 0.05) showed statistically significant differences. There were also positive associations between PbB and collection site (p ≤ 0.01), participants' profession (p ≤ 0.05), local milk (p ≤ 0.01), and source of drinking water (p ≤ 0.01). Mean HgU was 1.41 ± 0.98µg L-1. The levels only showed significant differences for participants' profession (p ≤ 0.01), and positive associations emerged between HgU and work activity (p ≤ 0.01) and body mass index (p ≤ 0.01). The samples showed low lead and mercury levels, similar to those found in other environmentally exposed populations. Despite these low concentrations, current knowledge on the toxicity of these metals shows that health effects can already be felt at levels that were previously considered safe, thus characterizing a health hazard.

Blood lead levels in a group of children: the potential risk factors and health problems / Níveis de chumbo no sangue em um grupo de crianças: possíveis fatores de risco e problemas de saúde

Abstract Objective: To investigate blood lead levels in schoolchildren in two areas of Egypt to understand the current lead pollution exposure and its risk factors, aiming to improve prevention politicies. Subjects and method: This was a cross-sectional study in children (n = 400) aged 6-12 years recruited from two areas in Egypt (industrial and urban). Blood lead levels were measured using an atomic absorption method. Detailed questionnaires on sources of lead exposure and history of school performance and any behavioral changes were obtained. Results: The mean blood lead level in the urban area of Egypt (Dokki) was 5.45 ± 3.90 µg/dL, while that in the industrial area (Helwan) was 10.37 ± 7.94 µg/dL, with a statistically significant difference between both areas (p < 0.05). In Dokki, 20% of the studied group had blood lead levels ≥ 10 µg/dL, versus 42% of those in Helwan. A significant association was found between children with abnormal behavior and those with pallor with blood lead level ≥ 10 µg/dL, when compared with those with blood lead level < 10 µg/dL (p < 0.05). Those living in Helwan area, those with bad health habits, and those living in housing with increased exposure were at a statistically significantly higher risk of having blood lead level ≥ 10 µg/dL. Conclusion: Lead remains a public health problem in Egypt. High blood lead levels were significantly associated with bad health habits and housing with increased exposure, as well as abnormal behavior and pallor.

Resumo Objetivo: Investigar os níveis de chumbo no sangue (NCSs) em crianças em idade escolar em duas áreas do Egito para entender a atual exposição à poluição por chumbo e seus fatores de risco, para melhorar as políticas de prevenção. Indivíduos e método: Este foi um estudo transversal em crianças (400) entre 6-12 anos recrutadas de duas áreas no Egito (industrial e urbana). Os NCSs foram medidos por um método de absorção atômica. Foram obtidos questionários detalhados sobre as fontes de exposição ao chumbo e o histórico de desempenho escolar e quaisquer alterações comportamentais. Resultados: O NCS na área urbana do Egito (Dokki) foi de 5,45 ± 3,90 µg/dL, ao passo que na área industrial (Helwan) foi de 10,37 ± 7,94 µg/dL, com uma diferença significativa entre ambas as áreas (p < 0,05). Na área de Dokki, 20% do grupo estudado apresentaram NCSs ≥10 µg/dL, ao passo que na área de Helwan foi 42%. Foi encontrada uma associação significativa entre as crianças com comportamento anormal e aquelas com palidez com NCS ≥ 10 µg/dL, em comparação com aquelas com NCS < 10 µg/dL (p < 0,05). Aquelas que moram na área de Helwan, aquelas com hábitos de saúde ruins e aquelas que moram em moradias com maior exposição estiveram significativamente em alto risco de apresentar NCS ≥ 10 µg/dL. Conclusão: O chumbo ainda é um problema de saúde pública no Egito. Altos NCSs foram significativamente associados a hábitos de saúde ruins e moradia com maior exposição, bem como comportamento anormal e palidez.

Toxic metals in maternal blood, cord blood and meconium of newborn infants in Pakistan

Toxic metals and deficiency/excess of trace elements can have adverse effects on health. The aim of this study was to quantify toxic metals lead, cadmium and trace elements zinc, copper, aluminium [Al] and Iron [Fe] levels in pregnant women, cord blood and meconium of new-born infants from industrial zones of Karachi, Pakistan. Analytical research was performed from 2011–2012 in low socio-economic pregnant mothers and newborn infants from 20 towns near Sindh Industrial Trading Estates, Federal B industrial area and Korangi industrial areas, Karachi, where environmental pollution was anticipated. Blood samples of pregnant women [n = 416], cord blood [n = 309] and meconium [n = 309] were analyzed quantitatively for metals and trace elements. Results indicated that mothers residing in steel towns were found to have the highest levels of lead. Meconium contained high levels of toxic heavy metals and trace elements compared to cord blood and maternal blood. Maternal blood toxic metals were present in high quantities. Therefore, safety measures should be taken when industrial waste is disposed of in order to prevent population contamination

Heavy metals identification and exposure at workplace environment its extent of accumulation in blood of iron and steel recycling foundry workers of Lahore, Pakistan

The determination of heavy metals in blood is an important occupational environmental toxicology screening procedure. The aim of study was to determine the concentrations of Pb, Cd, Cr and Ni in blood samples of iron and steel foundry workplace exposed workers under routine clinical laboratory conditions. The method was employed for the quantitative determination of lead, cadmium, chromium and nickel in workplace environment particulate matter blood samples from iron and steel foundry workers and in unexposed controls. The results indicate that lead, chromium and nickel levels of the exposed workers are significantly higher those of the controls. Nickel Concentration [fig/L] in high P value=0.0306 and Chromium Concentration [microg/L] in P value=0.0295in worker population as compared to controls. Lead showed highest Absorption concentration in serum from particulate matter to Serum 47.3[microg/L]. Absorption concentration of nickel in serum 16.5[microg/L] was lower than lead observed in worker's population. Absorption concentration of cadmium and chromium in serum from particulate matter -152[microg/L] observed very low. The results also show the need for immediate improvements in workplace ventilation and industrial hygiene practices

Niveles de plombemia en niños de 1 a 6 años en la región de La Plata, Argentina: Identificación de factores de riesgo de exposición al plomo / Blood lead levels in children aged between 1 and 6 years old in La Plata, Argentina: Identification of risk factors for lead exposure

Introducción. El plomo es neurotóxico para los niños, aun en muy baja concentración sanguínea. Los factores de riesgo (FR) de exposición al plomo no están debidamente identificados en la región de La Plata. Los objetivos fueron determinar la media de plombemia e identificar los FR en niños de 1 a 6 años de la ciudad de La Plata y alrededores. Población y métodos. Se realizó un estudio de corte transversal en niños que concurrieron a controles de salud en centros de atención primaria. Se determinó la plombemia por absorción atómica y se realizó una encuesta socioambiental para relevar los FR. Se usó la prueba de Mann-Whitney para comparar medias. Se realizó un análisis estadístico multivariable para determinar los FR más relevantes. Resultados. Participaron 319 niños (51% de varones); la mediana y el rango intercuartílico de plombemia fue 2,2 (1,1-3,6) μg/dL. Se hallaron diferencias de media de plombemia significativas para edad ≤ 3 años, anemia, hábito de pica, hacinamiento, piso de tierra y escolaridad materna menor de 7 años. Los FR edad ≤ 3 años y hábito de pica tuvieron OR significativos. El OR ajustado por regresión logística fue significativo solo para edad ≤ 3 años. Conclusiones. La mediana de plombemia de la población estudiada fue de 2,2 μg/dL. Los principales FR de exposición al plomo identificados fueron edad ≤ 3 años y hábito de pica. Otros factores menos relevantes fueron anemia, escolaridad materna menor de 7 años, hacinamiento y piso de tierra.

Introduction. Lead has neurotoxic effects in children, even at a very low level in blood. The risk factors (RFs) for lead exposure have not been adequately identified in La Plata. The objectives of this study were to determine mean blood lead levels and identify RFs in children aged 1 to 6 years old living in La Plata and the outskirts. Population and methods. A cross-sectional study was conducted in children who attended primary health care centers for a health check-up. Blood lead levels were determined by atomic absorption spectroscopy, and a socioenvironmental survey was administered to outline RFs. The Mann-Whitney test was used to compare measurements. A multivariate statistical analysis was done to establish the most relevant RFs. Results. A total of 319 children participated (51% were boys); the median (interquartile range) blood lead level was 2.2 μg/dL (1.1-3.6 μg/dL). Significant mean differences in blood lead levels were observed for age ≤ 3 years old, anemia, pica behavior, overcrowding, dirt floors, and maternal education < 7 years. Age ≤ 3 years old and pica behavior were both RFs with significant odds ratios (ORs). The OR as adjusted by logistic regression was significant only for age ≤ 3 years old. Conclusions. The median blood lead level in the studied population was 2.2 μg/dL. The main RFs identified for lead exposure were age ≤ 3 years old and pica behavior. Other less relevant RFs included anemia, maternal education < 7 years, overcrowding, and dirt floors.

Plomo y nefropatía: biomarcadores urinarios en la detección de daño renal precoz / Blood lead levels and markers of renal dysfunction among mechanical workshop workers

The role of lead (Pb) as an environmental cause of nephropathy is difficult to ascertain due to the difficulty to determine clinically its exposure. Aim: To assess lead levels and renal function in a group of males working in mechanical workshops. Material and Methods: Blood and urine samples were obtained from 100 mechanical workshop workers aged 38 ± 16 years and 95 non-exposed office clerks aged 37 ± 17 years. Blood lead and creatinine levels were determined. In exposed workers, urinary excretion of intestinal alkaline phosphatases (IAP) and N-acetyl-glucosaminidase (NAG) were measured as early markers of renal failure. Results: Blood lead levels were 66.4 ± 43 and 33.6 ± 18 µg/L among mechanical workshop workers and non-exposed controls, respectively, p < 0.01. The figures for serum creatinine were 0.9 ± 0.1 and 0.9 ± 0.1 respectively, p = NS. Among exposed workers urinary excretion of IAP was 0.47 ± 0.6 U/L and of NAG, 0.92 ± 1.1 U/L. There was a positive correlation between blood lead levels and NAG excretion (r = 0.284) and IAP excretion (r = 0.346). Conclusions: Exposed workers had higher blood lead levels and there was a weak positive association between these levels and the urinary excretion of NAG and IAP.

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.

Severe abdominal pain caused by lead toxicity without response to oral chelators: a case report

A 19-year-old woman was referred to the Emergency Surgery Department with severe abdominal pain, icterus, and anemia. The patient's clinical and paraclinical findings in addition to her occupational and social history, convinced us to assay blood lead level [BLL], which was 41/5 microg/dL. Therefore toxicology consult was performed to treat lead toxicity. Recheck of the BLL showed the level as 53/7 microg/dL. So oral chelator with succimer was started. Despite consumption of oral chelator, there was no response and the pain continued. Because our repeated evaluations were negative, we decided to re-treat lead poisoning by intravenous and intramuscular chelators. Dimercaprol [BAL] + calcium EDTA was started, and after 5 days, the pain relieved dramatically and the patient was discharged. We recommend more liberal lead poisoning therapy in symptomatic patients, and also suggest parenteral chelator therapy, which is more potent, instead of oral chelators in patients with severe symptoms

Maternal Stress and Depressive Symptoms and Infant Development at Six Months: the Mothers and Children's Environmental Health (MOCEH) Prospective Study

Our objective is to evaluate the relationships between prenatal maternal stress and depressive symptoms, respectively, and infant neurodevelopment at 6 months, adjusted for heavy metals and oxidative stress. This research is a part of a multi-center birth cohort study in South Korea. Information on stress and depressive symptoms was collected during the first trimester using Psychosocial Well-Being Index Short Form (PWI-SF) and Center for Epidemiological Studies Depression Scale (CES-D). The Korean Bayley Scales of Infant Development-II assessment (BSID-II), which includes the standardized mental development index (MDI) and psychomotor developmental index (PDI), and Korean Ages & Stages Questionnaires (K-ASQ) were applied to infants at six months of age. A higher index score indicates better development. Among 641 babies, 320 were female (50%). Maternal PWI ≥ 29 (vs. PWI ≤ 18) during early pregnancy was associated with a decrease in MDI scores of 5.37 points (P = 0.02) after adjusting for socioeconomic factors. Maternal CES-D ≥ 26 (vs. CES-D ≤ 10) during early pregnancy was associated with a decrease in MDI scores of 8.18 points (P = 0.01). The associations remained significant even after adjustment for lead, cadmium, and MDA levels (P < 0.05). However, no association was found between maternal PWI/CES-D and PDI score. No interaction was observed between stress and lead exposure. We found an inverse association between prenatal maternal stress and depressive symptoms, and MDI scores in 6-month-old infants after adjustment for prenatal lead exposure, which is known to affect cognitive function negatively.

Physical Activity and Blood Lead Concentration in Korea: Study Using the Korea National Health and Nutrition Examination Survey (2008-2013)

Physical activity normally has a positive influence on health, however it can be detrimental in the presence of air pollution. Lead, a heavy metal with established adverse health effects, is a major air pollutant. We evaluated the correlation between blood lead concentration and physical activity using data collected from the Korea National Health and Nutrition Examination Survey. Multivariate logistic regression analysis was performed after dividing participants according to whether they were in the top 25% in the distribution of blood lead concentration (i.e., ≥ 2.76 µg/dL), with physical activity level as an independent variable and adjusting for factors such as age, sex, drinking, smoking, body mass index, region, and occupation. The high physical activity group had greater odds of having a blood lead concentration higher than 2.76 µg/dL (odds ratio 1.29, 95% CI 1.11-1.51) compared to the low physical activity group. Furthermore, blood lead concentration is correlated with increasing physical activity.

Environmental Exposure to Arsenic, Lead, and Cadmium in People Living near Janghang Copper Smelter in Korea

Concentrations of heavy metals exceed safety thresholds in the soil near Janghang Copper Refinery, a smelter in Korea that operated from 1936 to 1989. This study was conducted to evaluate the level of exposure to toxic metals and the potential effect on health in people living near the smelter. The study included 572 adults living within 4 km of the smelter and compared them with 413 controls group of people living similar lifestyles in a rural area approximately 15 km from the smelter. Urinary arsenic (As) level did not decrease according to the distance from the smelter, regardless of gender and working history in smelters and mines. However, in subjects who had no occupational exposure to toxic metals, blood lead (Pb) and cadmium (Cd) and urinary Cd decreased according to the distance from the smelter, both in men and women. Additionally, the distance from the smelter was a determinant factor for a decrease of As, Pb, and Cd in multiple regression models, respectively. On the other hands, urinary Cd was a risk factor for renal tubular dysfunction in populations living near the smelter. These results suggest that Janghang copper smelter was a main contamination source of As, Pb, and Cd, and populations living near the smelter suffered some adverse health effects as a consequence. The local population should be advised to make efforts to reduce exposure to environmental contaminants, in order to minimize potential health effects, and to pay close attention to any health problems possibly related to toxic metal exposure.

Occupational Lead Exposure from Indoor Firing Ranges in Korea

Military personnel often use ammunitions that contain lead. The present study aimed to identify the risks for lead exposure and lead poisoning among workers at indoor firing ranges. A special health examination, including blood lead level (BLL) testing, was performed for all 120 workers at the indoor firing ranges of the Republic of Korea's Air Force, Navy, and Armed Forces Athletic Corps. The overall mean BLL was 11.3 ± 9.4 µg/dL (range: 2.0-64.0 µg/dL). The arithmetic mean of the BLL for professional shooters belong to Armed Forces Athletic Corps was 14.0 ± 8.3 µg/dL, while those of shooting range managers and shooting range supervisors were 13.8 ± 11.1 µg/dL and 6.4 ± 3.1 µg/dL, respectively. One individual had a BLL of 64 µg/dL, and ultimately completed chelation treatment (with CaNa2-ethylenediaminetetraacetic acid) without any adverse effects. These findings indicate that indoor firing range workers are exposed to elevated levels of lead. Therefore, when constructing an indoor firing range, a specialist should be engaged to design and assess the ventilation system; and safety guidelines regarding ammunition and waste handling must be mandatory. Moreover, workplace environmental monitoring should be implemented for indoor firing ranges, and the workers should undergo regularly scheduled special health examinations.

Efectos genotóxicos asociados a metales pesados en una población humana de la región de La Mojana, Colombia, 2013 / Genotoxic effects in a human population exposed to heavy metals in the region of La Mojana, Colombia, 2013

Introducción. En Colombia, la minería es una actividad económica importante; sin embargo, genera grandes cantidades de residuos que contienen elementos potencialmente tóxicos, como los metales pesados, que contaminan los ecosistemas y ponen en riesgo la salud humana. La región de La Mojana es una de las zonas más ricas en biodiversidad del planeta y se ha visto sometida a procesos de contaminación muy relacionados con la minería de oro que se desarrolla en sus alrededores. Objetivo. Evaluar la genotoxicidad en una población expuesta a residuos de metales pesados en la región de La Mojana. Materiales y métodos. Se evaluaron los efectos genotóxicos y su relación con la concentración de metales pesados (mercurio, cadmio y plomo) en muestras de sangre de la población expuesta y el grupo de control. El grupo expuesto lo conformaron habitantes de los municipios de Guaranda, Sucre, Majagual y San Marcos; en el grupo de control se incluyó a habitantes del municipio de Montería. Se determinó el daño en el ADN mediante el ensayo cometa en condiciones alcalinas. Las concentraciones de mercurio se establecieron mediante espectrometría de absorción atómica con vapor frío, en tanto que las de cadmio y plomo se determinaron por espectrometría de absorción atómica en horno de grafito. Resultados. Las concentraciones de los metales sobrepasaron los límites permitidos por la Organización Mundial de la Salud. Se evidenciaron efectos genotóxicos posiblemente asociados a la presencia de los metales en la sangre. Se encontraron asociaciones significativas (p<0,05) entre la presencia de mercurio y de cadmio, y el daño en el ADN. Conclusión. Estos resultados sugieren que el daño genético registrado en pobladores de la región de La Mojana, Colombia, puede estar asociado a la presencia de los metales estudiados en las muestras de sangre.

Introduction: Mining is an economically important activity in Colombia which generates large quantities of residues containing potentially toxic elements such as heavy metals. These contaminate ecosystems and place human health at risk. La Mojana lies within one of the most biodiversity-rich zones on Earth and has been subjected to processes of contamination closely related to gold mining activities in the surrounding areas. Objective: To evaluate genotoxicity in the population of La Mojana region exposed to heavy metals. Materials and methods: Genotoxic effects and their relationship with concentrations of heavy metals (mercury, cadmium and lead) in blood were evaluated among an exposed population and a control group. The exposed group comprised inhabitants of the municipalities of Guaranda, Sucre, Majagual and San Marcos; inhabitants of the municipality of Montería were chosen as a control group. DNA damage was determined using the alkaline comet assay. Concentrations of mercury were determined by cold vapor atomic absorption spectrometry, and those of cadmium and lead by graphite furnace atomic absorption spectrometry. Results: Concentrations of the heavy metals exceeded the limits permitted by the World Health Organization. Genotoxic effects were found in the exposed population, possibly associated with the presence of these metals in blood. Significant associations (p<0.05) were found between mercury and cadmium levels and damage to DNA. Conclusion: These results suggest that the genetic damage recorded among inhabitants of the region of La Mojana, Colombia, may be associated with the presence of heavy metals in the blood.

Brainstem auditory evoked potentials in children with lead exposure / Potencial evocado auditivo de tronco encefálico em crianças com exposição ao chumbo

Introduction: Earlier studies have demonstrated an auditory effect of lead exposure in children, but information on the effects of low chronic exposures needs to be further elucidated. Objective: To investigate the effect of low chronic exposures of the auditory system in children with a history of low blood lead levels, using an auditory electrophysiological test. Methods: Contemporary cross-sectional cohort. Study participants underwent tympanometry, pure tone and speech audiometry, transient evoked otoacoustic emissions, and brainstem auditory evoked potentials, with blood lead monitoring over a period of 35.5 months. The study included 130 children, with ages ranging from 18 months to 14 years, 5 months (mean age 6 years, 8 months ± 3 years, 2 months). Results: The mean time-integrated cumulative blood lead index was 12 µg/dL (SD ± 5.7, range:2.433). All participants had hearing thresholds equal to or below 20 dBHL and normal amplitudes of transient evoked otoacoustic emissions. No association was found between the absolute latencies of waves I, III, and V, the interpeak latencies I-III, III-V, and I-V, and the cumulative lead values. Conclusion: No evidence of toxic effects from chronic low lead exposures was observed on the auditory function of children living in a lead contaminated area. .

Introdução: Estudos anteriores têm demonstrado efeitos da exposição ao chumbo no sistema auditivo em crianças, porém a exposição deste metal em níveis baixos ainda precisa ser investigada. Objetivo: Investigar os efeitos da exposição crônica ao chumbo no sistema auditivo de crianças com histórico de baixo nível sanguíneo de chumbo por meio de um teste eletrofisiológico. Método: Estudo de coorte transversal contemporânea. Foram realizados imitanciometria, audiometria tonal liminar e vocal, emissões otoacústicas evocadas transientes e potenciais evocados auditivos de tronco encefálico, com o monitoramento sanguíneo de chumbo durante um período de 35,5 meses. Participaram 130 crianças na faixa etária de 18 meses a 14 anos e 5 meses (6a8 m ± 3a2 m). Resultados: A média estimada do índice de pumblemia foi 12 mg/dL (DP ± 5,7). Todos os participantes apresentaram limiares auditivos iguais ou inferiores a 20 dBNA e amplitude normal das emissões otoacústicas evocadas transientes. Não foi encontrada associação entre as latências absolutas das ondas I, III e V e interpicos I-III, III-V e I-V e os valores cumulativos de chumbo. Conclusão: Não foi observada evidência de efeitos tóxicos em baixas exposições crônicas ao chumbo sobre a função auditiva de crianças que vivem em uma área contaminada por este metal. .

Environmental Heavy Metal Exposure and Chronic Kidney Disease in the General Population

Lead (Pb), mercury (Hg), and cadmium (Cd) are common heavy metal toxins and cause toxicological renal effects at high levels, but the relevance of low-level environmental exposures in the general population is controversial. A total of 1,797 adults who participated in the KNHANES (a cross-sectional nationally representative survey in Korea) were examined, and 128 of them (7.1%) had chronic kidney disease (CKD). Our study assessed the association between Pb, Hg, Cd exposure, and CKD. Blood Pb and Cd levels were correlated with CKD in univariate logistic regression model. However, these environmental heavy metals were not associated with CKD after adjustment for age, sex, BMI, smoking, hyperlipidemia, hypertension, diabetes, and these metals in multivariate logistic regression models. We stratified the analysis according to hypertension or diabetes. In the adults with hypertension or diabetes, CKD had a significant association with elevated blood Cd after adjustment, but no association was present with blood Pb and Hg. The corresponding odds ratio [OR] of Cd for CKD were 1.52 (95% confidence interval [CI], 1.05-2.19, P=0.026) in adults with hypertension and 1.92 (95% CI, 1.14-3.25, P=0.014) in adults with diabetes. Environmental low level of Pb, Hg, Cd exposure in the general population was not associated with CKD. However, Cd exposure was associated with CKD, especially in adults with hypertension or diabetes. This finding suggests that environmental low Cd exposure may be a contributor to the risk of CKD in adults with hypertension or diabetes.