Environmental and dietary exposure of young children to inorganic trace elements.

Children are exposed to toxic metals and metalloids via their diet and environment. Our objective was to assess the aggregate chronic exposure of children aged 3-6years, living in France, to As, Cd, Cr, Cu, Mn, Pb, Sb, Sr, and V present in diet, tap water, air, soil and floor dust in the years 2007-2009. Dietary data came from the French Total Diet Study, while concentrations in residential tap water, soil and indoor floor dust came from the 'Plomb-Habitat' nationwide representative survey on children's lead exposure at home. Indoor air concentrations were assumed to be equal to outdoor air concentrations, which were retrieved from regulatory measurements networks. Human exposure factors were retrieved from literature. Data were combined with Monte Carlo simulations. Median exposures were 1.7, 0.3, 10.2, 34.1, 60.3, 0.7, 0.1, 44.3, 1.5 and 95th percentiles were 4.4, 0.5, 15.8, 61.3, 98.3, 2.5, 0.1, 111.1, 2.9µg/kgbw/d for As, Cd, Cr, Cu, Mn, Pb, Sb, Sr, and V respectively. Dietary exposures dominate aggregate exposures, with the notable exception of Pb - for which soils and indoor floor dust ingestion contribute most at the 95th percentile. The strengths of this study are that it aggregates exposures that are often estimated separately, and uses a large amount of representative data. This assessment is limited to main diet and residential exposure, and does not take into account the relative bioavailability of compounds. These results could be used to help target prevention strategies.

Exposure of children to metals via tap water ingestion at home: Contamination and exposure data from a nationwide survey in France.

29 inorganic compounds (Al, As, B, Ba, Be, Bi, Ca, Cd, Ce, Co, Cr, Cu, Fe, Gd, K, Mg, Mn, Mo, Na, Nd, Ni, Pb, Sb, Se, Sr, Tl, U, V and Zn) were measured in the tap water of 484 representative homes of children aged 6months to 6years in metropolitan France in 2008-2009. Parents were asked whether their children consumed tap water. Sampling design and sampling weights were taken into account to estimate element concentrations in tap water supplied to the 3,581,991 homes of 4,923,058 children aged 6months to 6years. Median and 95th percentiles of concentrations in tap water were in µg/L: Al: <10, 48.3, As: 0.2, 2.1; B: <100, 100; Ba: 30.7, 149.4; Ca: 85,000, 121,700; Cd: <0.5, <0.5; Ce: <0.5, <0.5; Co: <0.5, 0.8; Cr: <5, <5; Cu: 70, 720; K: 2210, 6740; Fe: <20, 46; Mn: <5, <5; Mo: <0.5, 1.5; Na: 14,500, 66,800; Ni: <2, 10.2; Mg: 6500, 21,200; Pb: <1, 5.4; Sb: <0.5, <0.5; Se: <1, 6.7; Sr: 256.9, 1004; Tl: <0.5, <0.5; U: <0.5, 2.4; V: <1, 1; Zn: 53, 208. Of the 2,977,123 young children drinking tap water in France, some were drinking water having concentrations above the 2011 World Health Organization drinking-water quality guidelines: respectively 498 (CI 95%: 0-1484) over 700µg/L of Ba; 121,581 (CI 95%: 7091-236,070) over 50mg/L of Na; 2044 (CI 95%: 0-6132) over 70µg/L of Ni, and 78,466 (17,171-139,761) over 10µg/L of Pb. Since it is representative, this tap water contamination data can be used for integrated exposure assessment, in conjunction with diet and environmental (dust and soil) exposure data.

Environmental determinants of different blood lead levels in children: a quantile analysis from a nationwide survey.

Blood lead levels (BLLs) have substantially decreased in recent decades in children in France. However, further reducing exposure is a public health goal because there is no clear toxicological threshold. The identification of the environmental determinants of BLLs as well as risk factors associated with high BLLs is important to update prevention strategies. We aimed to estimate the contribution of environmental sources of lead to different BLLs in children in France. We enrolled 484 children aged from 6months to 6years, in a nationwide cross-sectional survey in 2008-2009. We measured lead concentrations in blood and environmental samples (water, soils, household settled dusts, paints, cosmetics and traditional cookware). We performed two models: a multivariate generalized additive model on the geometric mean (GM), and a quantile regression model on the 10th, 25th, 50th, 75th and 90th quantile of BLLs. The GM of BLLs was 13.8µg/L (=1.38µg/dL) (95% confidence intervals (CI): 12.7-14.9) and the 90th quantile was 25.7µg/L (CI: 24.2-29.5). Household and common area dust, tap water, interior paint, ceramic cookware, traditional cosmetics, playground soil and dust, and environmental tobacco smoke were associated with the GM of BLLs. Household dust and tap water made the largest contributions to both the GM and the 90th quantile of BLLs. The concentration of lead in dust was positively correlated with all quantiles of BLLs even at low concentrations. Lead concentrations in tap water above 5µg/L were also positively correlated with the GM, 75th and 90th quantiles of BLLs in children drinking tap water. Preventative actions must target household settled dust and tap water to reduce the BLLs of children in France. The use of traditional cosmetics should be avoided whereas ceramic cookware should be limited to decorative purposes.

Source contributions of lead in residential floor dust and within-home variability of dust lead loading.

Evidence of the impact of exposure to low levels of lead on children's health is increasing. Residential floor dust is the assumed origin of lead exposure by young children. In this study, we estimate the contribution of different lead sources to household interior floor dust contamination. We also estimate the within-home variability of interior floor dust lead loadings. A multilevel model was developed based on data collected in a French survey in 2008-2009 (484 housing units, 1834 rooms). Missing data were handled by multiple imputation using chained equations. The intra-home correlation between interior floor Log dust lead loadings was approximately 0.6. Dust lead from the landing of an apartment, mostly originating outside the building, was the major contributor to interior floor dust lead. Secondary contributors included the lead-based paint on exterior railings, track-in of the exterior soil of the children's play area into the dwelling, smoking inside the home, demolition of nearby old buildings and sites of pollution in the vicinity. Interior lead-based paint contaminated interior floor dust only in old and non-renovated dwellings. To reduce interior floor dust lead levels in the general population of dwellings, common areas should be maintained, and track-in from the outside should be limited as much as possible.

Implications of different residential lead standards on children's blood lead levels in France: predictions based on a national cross-sectional survey.

Despite the dramatic reductions in children's blood lead levels (BLLs), there is considerable evidence that low-level lead exposure is associated with intellectual deficits and behavioral problems, without apparent threshold. There are limited data, however, about the contribution of residential sources of lead to contemporary children's blood lead levels. The aim of this study is to calculate the contributions of residential sources of lead to assess the potential impact of setting new standards for lead levels in residential dust, soil and water. We enrolled 484 French children aged from 6 months to 6 years, and collected data on social, housing and individual characteristics. Lead concentrations in blood and environmental samples (water, soils, and dusts) were measured using inductively coupled plasma mass spectrometry. Data were analyzed using a multivariate generalized additive model accounting for the sampling design and the sampling weights. We found that exceedingly low concentrations of lead in dust, soil and water were significant predictors of children's BLLs, after adjustment for potential confounding variables. Lead-contaminated floor dust was the main source of lead in blood. BLLs (GM: 14µg/L) increased by 65%, 13%, 25%, and 5% when lead content in floor dust, loose soil, hard soil and water increased from their 25th percentile to their 95th percentile, respectively. We also observed that the steepest increase in BLLs occurred at the lowest levels of lead-contaminated floor dust, which indicates that lead contamination should be kept as low as possible. Impact of different possible standards on children's BLLs was also tabulated and indicated that unless standards are set low, they will only benefit a small proportion of children who have the highest exposures.

French children's exposure to metals via ingestion of indoor dust, outdoor playground dust and soil: contamination data.

In addition to dietary exposure, children are exposed to metals via ingestion of soils and indoor dust, contaminated by natural or anthropogenic outdoor and indoor sources. The objective of this nationwide study was to assess metal contamination of soils and dust which young French children are exposed to. A sample of 484 children (6 months to 6 years) was constituted in order to obtain representative results for young French children. In each home indoor settled dust was sampled by a wipe in up to five rooms. Outdoor playgrounds were sampled with a soil sample ring (n=315) or with a wipe in case of hard surfaces (n=53). As, Cd, Cr, Cu, Mn, Pb, Sb, Sr, and V were measured because of their potential health concern due to soil and dust ingestion. The samples were digested with hydrochloric acid, and afterwards aqua regia in order to determine both leachable and total metal concentrations and loadings by mass spectrometry with a quadrupole ICP-MS. In indoor settled dust most (total) loadings were below the Limit of Quantification (LOQ), except for Pb and Sr, whose median loadings were respectively 9 and 10 µg/m². The 95th percentile of loadings were 2 µg/m² for As, <0.8 for Cd, 18 for Cr, 49 for Cu, <64 for Mn, 63 for Pb, 2 for Sb, 56 for Sr, and <8 for V. Median/95th percentile of loadings in settled dust on outdoor playgrounds were 2/16, <0.8/1.3, 17/53, 49/330, 99/424, 32/393, 2/13, 86/661 and 10/37 µg/m² for As, Cd, Cr, Cu, Mn, Pb, Sb, Sr, and V respectively. In outdoor playground soil median/95th percentile of concentrations (µg/g) were 8/26, <0.65/1, 25/52, <26/53,391/956, 27/254, 0.7/4, 54/295, 23/57 for As, Cd, Cr, Cu, Mn, Pb, Sb, Sr, and V respectively. These results are comparable with those observed in other countries. Because of their representative nature, we can assess children's exposures to these metals via soil and dust and the associated risks in urban and rural environments. Ratios of leachable/total concentrations and loadings, calculated on >LOQ measurements, differed among metals. To a lesser extent, they were also affected by type of matrix, with (except for Cd) a greater leachability of dust (especially indoor) compared to soils.

Lead contamination in French children's homes and environment.

Lead in homes is a well-known source of childhood lead exposure, which is still of concern due to the health effects of low lead doses. This study aims to describe lead contamination in the homes of children aged 6 months to 6 years in France (without overseas). Between October 2008 and August 2009, 484 housing units were investigated. Lead in tap water and total and leachable lead levels from floor dust, outdoor soils and paint chips were measured. X-ray fluorescence measurements were carried out on non-metallic and metallic substrates. Nationwide results are provided. The indoor floor dust lead (PbD) geometric mean (GM) was 8.8 µg/m² (0.8 µg/ft²) and 6.8 µg/m² (0.6 µg/ft²) for total and leachable lead respectively; 0.21% of homes had an indoor PbD loading above 430.5 µg/m² (40 µg/ft²). The outdoor play area concentration GM was 33.5 mg/kg and 21.7 mg/kg in total and leachable lead respectively; 1.4% of concentrations were higher than or equal to 400 mg/kg. Outdoor floor PbD GM was 44.4 µg/m² (4.1 µg/ft²) that was approximately 3.2 times higher than the GM of indoor PbD. Lead-based paint (LBP) was present in 25% of dwellings, LBP on only non-metallic substrates was present in 19% of homes and on metallic substrates in 10% of dwellings. The GM of lead concentrations in tap water was below 1 µg/L; 58% of concentrations were lower than 1 µg/L and 2.9% were higher than or equal to 10 µg/L. The age cut-off for homes with lead would be 1974 for paint and 1993 for indoor floor dust. This study provides, for the first time, a look at the state of lead contamination to which children are exposed in French housing. Moreover, it provides policy makers an estimate of the number of French dwellings sheltering children where abatement should be conducted.

Identification of sources of lead exposure in French children by lead isotope analysis: a cross-sectional study.

BACKGROUND: The amount of lead in the environment has decreased significantly in recent years, and so did exposure. However, there is no known safe exposure level and, therefore, the exposure of children to lead, although low, remains a major public health issue. With the lower levels of exposure, it is becoming more difficult to identify lead sources and new approaches may be required for preventive action. This study assessed the usefulness of lead isotope ratios for identifying sources of lead using data from a nationwide sample of French children aged from six months to six years with blood lead levels ≥25 µg/L. METHODS: Blood samples were taken from 125 children, representing about 600,000 French children; environmental samples were taken from their homes and personal information was collected. Lead isotope ratios were determined using quadrupole ICP-MS (inductively coupled plasma - mass spectrometry) and the isotopic signatures of potential sources of exposure were matched with those of blood in order to identify the most likely sources. RESULTS: In addition to the interpretation of lead concentrations, lead isotope ratios were potentially of use for 57% of children aged from six months to six years with blood lead level ≥ 25 µg/L (7% of overall children in France, about 332,000 children), with at least one potential source of lead and sufficiently well discriminated lead isotope ratios. Lead isotope ratios revealed a single suspected source of exposure for 32% of the subjects and were able to eliminate at least one unlikely source of exposure for 30% of the children. CONCLUSIONS: In France, lead isotope ratios could provide valuable additional information in about a third of routine environmental investigations.