Crianças e adolescentes intoxicados por chumbo: práticas maternas e problemas de comportamento / Children and adolescents with lead poisoning: Childrearing practices and behavioral problems / Los niños y adolescentes envenenados por plomo: las prácticas maternas y trastornos de conducta

Este estudo teve por objetivo avaliar as práticas educativas maternas em crianças e adolescentes intoxicados por chumbo, bem como sua correlação com problemas de comportamento nos filhos. Foi utilizada uma versão reduzida do IEP para avaliar as práticas maternas e o SSRS-BR, versão professor, para problemas de comportamento. Participaram 155 estudantes, com idade média de 13 anos, pertencentes a três grupos: alta plumbemia (GAP), baixa plumbemia (GBP) e grupo de comparação (GC) e suas respectivas mães e professores. Os resultados indicaram que as mães das crianças do grupo GBP utilizavam mais práticas indutivas, menos coerção e mais negligência que os outros dois grupos. A análise de correlação indicou também que estratégias parentais inconsistentes estão associadas a maior probabilidade de emissão de problemas de comportamento pelos filhos. Os resultados sugerem uma associação entre as práticas educativas adotadas pelas mães e as condições de contaminação por chumbo dos filhos.

This study aimed to investigate childrearing practices as related to children and adolescents poisoned by lead, and their correlation with behavioral problems. The authors used a reduced version of the Inventory of Parental Styles (IEP) to assess parenting practices and the SSRS-BR for behavioral problems. Participants included 155 children and adolescents with an average age of 13 years who belonged to three groups: high blood-lead (GAP), low blood-lead (GBP) and a comparison group (GC); and their respective mothers and teachers. The results show GBP’s mothers used more inductive practices, less coercion and more neglect than the other two groups. The correlation analysis also indicated that inconsistent parenting strategies are associated with higher probability of emission of behavioral problems in the children. The results suggest an association between the childrearing practices adopted by mothers and lead contamination conditions of the children.

El presente estudio tuvo como objetivo evaluar prácticas parentales con niños intoxicados por plomo y su correlación con los trastornos de conducta. Se utilizó una versión reducida del IEP (Inventario de Estilos Parentales) para evaluar las prácticas maternas y la versión maestro del SSRS-BR (Sistema de evaluación de habilidades sociales) para evaluar trastornos de conducta. Participaron 155 estudiantes, con edad media de 13 años y junto a sus madres y maestros, pertenecientes a tres grupos: plomo elevado en la sangre (GAP), bajos niveles de plomo (GBP) y grupos de comparación (GC). Los resultados indicaron que las madres de GBP utilizan prácticas más inductivas, con menos coacción y más negligentes que en los otros grupos. El análisis de correlación también indica que las prácticas parentales inconsistentes se asocian con una mayor probabilidad de emisión de los niños trastornos de conducta. Los resultados sugieren una asociación entre las prácticas adoptadas por las madres y las condiciones de contaminación de plomo de los niños.

Neurotoxicity and aggressiveness triggered by low-level lead in children: a review / Neurotoxicidad y agresividad desencadenadas por bajos niveles de plomo en niños: una revisión

Lead-induced neurotoxicity acquired by low-level long-term exposure has special relevance for children. A plethora of recent reports has demonstrated a direct link between low-level lead exposure and deficits in the neurobehavioral-cognitive performance manifested from childhood through adolescence. In many studies, aggressiveness and delinquency have also been suggested as symptoms of lead poisoning. Several environmental, occupational and domestic sources of contaminant lead and consequent health risks are largely identified and understood, but the occurrences of lead poisoning remain numerous. There is an urgent need for public health policies to prevent lead poisoning so as to reduce individual and societal damages and losses. In this paper we describe unsuspected sources of contaminant lead, discuss the economic losses and urban violence possibly associated with lead contamination and review the molecular basis of lead-induced neurotoxicity, emphasizing its effects on the social behavior, delinquency and IQ of children and adolescents.

La neurotoxicidad adquirida inducida por la exposición prolongada a bajos niveles de plomo tiene una importancia especial en los niños. Una plétora de publicaciones recientes ha demostrado el vínculo directo existente entre la exposición a bajos niveles de plomo y el déficit en el desempeño neuroconductual-cognitivo manifestado desde la infancia hasta el final de la adolescencia. En numerosos estudios, la agresividad y la delincuencia juvenil también se han considerado síntomas de la intoxicación por plomo. Se han identificado y explicado ampliamente varias fuentes ambientales, laborales y domésticas de contaminación por plomo y los riesgos resultantes para la salud, pero aún son numerosos los casos de intoxicación por plomo. Se necesitan urgentes políticas de salud pública para prevenir la intoxicación por plomo de manera de reducir los daños y las pérdidas, tanto individuales como para la sociedad. En este artículo se describen algunas fuentes no sospechadas de contaminación por plomo y se discuten las pérdidas económicas y la violencia urbana posiblemente asociada con este tipo de contaminación. Además, se hace una revisión de las bases moleculares de la neurotoxicidad inducida por plomo, con énfasis en sus efectos sobre el comportamiento social, la delincuencia juvenil y el coeficiente intelectual de los niños y los adolescentes.

Indicadores de comprometimento emocional avaliados pelo DFHem crianças contaminadas e não contaminadas por chumbo / HFDT-evaluated indicators of emotional impairment in lead-contaminatedand noncontaminated children

Uma fábrica de baterias chumbo-ácidas contaminou bairros populares em Bauru - Estado de São Paulo, afetando 314 crianças, conforme inquérito epidemiológico. Nesse estudo, foram avaliadas 50 crianças contaminadas por chumbo, com índices sanguíneos superiores a 10 μgPb/dl sangue e 50 crianças com níveis inferiores ao do grupo exposto (d” 0,5 μgPb/dl sangue), de ambos os sexos, de 6 a 12 anos e 11 meses de idade, por meio do Teste da Figura Humana (DFH) de Koppitz, que avalia os conflitos e motivações subjetivas dos indicadores emocionais infantis, fornecendo dados objetivos e subjetivos. Por meio do teste estatístico Qui-quadrado, não se encontrou diferenças significativas entre os dois grupos na freqüência de indicadores de comprometimento emocional, ou na análise intra-grupos, quanto aos índices de contaminação, indicadores emocionais, sexo e faixa etária. Porém, o indicador 7, um dos critérios de prognóstico de problemática emocional, capaz de diferenciar grupos clínicos e controles quando acima de 16%, apareceu em 18% no grupo de crianças contaminadas, sugerindo sinais de conflitos nesse grupo. Indica-se a realização de pesquisas transversais com o uso do DFH, outros instrumentos e maior controle de outras variáveis, além de estudos longitudinais com crianças contaminadas por chumbo com utilização de instrumentos diagnósticos complementares.

Some years ago, certain popular suburban areas in the city of Bauru, SP (Brazil) were contaminated by a leakage from a lead battery factory. According to data from an epidemiological inquiry, the incident affected 314 children. In this study, two groups of children were evaluated: 50 lead-contaminated children with blood indices above 10 μgPb/dl, and 50 children with indices below the exposed group (d” 0.5 μgPb/dl). They were both male and female, ranging from 6 to 12 years old and 11 months old. The evaluation was performed by the Koppitz’s Human Figure Drawing Test (HFDT), which assesses the subjective conflicts and motivations of the infant emotional indicators, thus providing objective and subjective data as well. According to the Chi-square test, there were no statistically significant differences between the two groups regarding the frequency of the emotional impairment indicators. Also, there were no significant differences in the intragroup analysis, regarding the contamination indices, emotional indicators, sex and age range. However, the indicator 7 - one of the emotional prognostic criteria which differs clinic from control groups when higher than 16% - appearedin 18% of the contaminated children group, suggesting conflict signs herein. Cross-sectional research using HFDT, other instruments, a greater control on other variables – in addition to longitudinal research with lead-contaminated children and the utilization of complementary diagnostic instruments – are all further indicated practices.

Exposición crónica a plomo ambiental en lactantes chilenos II: efectos en el desarrollo psicomotor / Effects of chronic lead exposure on neurobehavioral development of Chilean lactating children

Background: Lactating children are specially susceptible to lead toxicity due to their underdeveloped nervous system, lower body mass, higher intestinal absorption and lower elimination rates. Aim: To determine the effects of lead exposure, comparing Chilean lactating children residing in rural areas with low lead exposure, and in urban areas with high lead exposure. Material and methods: Newborns from public maternity hospitals of the rural locality of San Felipe and from Metropolitan Santiago, were recruited for the study. On admission to the study, umbilical cord and maternal blood samples were obtained and an inquiry about perinatal, sociohereditary and lead exposure history was done. Children were followed every 6 months until 24 months of age, measuring blood parameters and neurobehavioral development using Bayley scales. Results: Three hundred twelve children from Santiago and 113 from San Felipe were studied. Maternal and children blood lead levels were higher in Santiago, but lower than those reported in other international studies. At 24 months of age, 4.5 percent of children from Santiago and 0.7 percent of children from San Felipe had levels over 10 µg/dl. No differences in neurobehavioral development were observed between children of both cities. At 24 months, scores of MDI scales were 91 in Santiago and 97 in San Felipe. The figures for PDI scale were 93 in Santiago and 93 in San Felipe. Main risk factors for a retarded neurobehavioral development were socioeconomic level with a mean Odds ratio of 3.5 (0.99-12.4), male sex with an Odds ratio of 2.3 (1.09-5.07) and stimulation at home with an Odds ratio of 0.7 (0.53-0.82. Conclusions: In this cohort of children, no effect of lead levels on neurobehavioral development was found