Predictors of elevated blood lead levels among 3-year-old Ukrainian children: a nested case-control study.

OBJECTIVES: Lead is common in the general population. However, data are lacking for the Ukraine and many other countries from the former Soviet Union (FSU). In this study we evaluate the level of blood lead among 212 Ukrainian children and determine predictors of elevated lead levels. We also describe the health effects associated with elevated blood lead. METHODS: A nested case-control study from a prospective cohort of Ukrainian 3-year-old children was conducted in March 1998. Blood assays were analyzed for lead by labs at the Centers for Disease Control and using portable examination kits. We evaluated predictors of elevated blood lead (blood levels in the upper quartile >4.65 microg/dL) using a multivariable logistic regression model. The model included socioeconomic status, parent occupation, environmental tobacco smoke, hygiene, diet, and health status. RESULTS: The geometric mean lead level was 3.15 microg/dL (range, 0.7--22.7). In our adjusted model, we observed a strong association between lead levels in the upper quartile and children whose fathers worked manual labor jobs in industries associated with lead exposures [adjusted odds ratio (OR)=2.25; P=0.025] and mothers who smoke indoors (adjusted OR=2.87; P=0.047). Daily hygiene and dietary habits were not associated with elevated lead levels. No increased risks of overall morbidity or lead-associated illness were observed (anemia, dental caries, renal disease, cardiovascular diseases, and musculoskeletal complaints). CONCLUSION: This is the first study to describe lead levels and associated variables among Ukrainian children in the peer-reviewed literature. Elevated lead levels in these children were associated with paternal occupation and mothers smoking indoors. At age 3 no adverse health effects were observed. More data are needed to determine the level of heavy metal contamination in children from the Ukraine and many other former Soviet nation-states.

Collaborative research and research training through the "Family and Children of Ukraine" research program.

Family and Children of Ukraine, the Ukrainian component of the European Longitudinal Study of Pregnancy and Childhood, is a prospective, geographically-based study to evaluate pregnancy outcomes in 8,000 women in five cities in Ukraine and follow the cohort of births through 7 years of age. Family and Children in Ukraine has been the major collaborative research project for the University of Illinois' Fogarty-funded program, International Training and Research in Environmental and Occupational Health. This Fogarty program includes graduate training, U.S.-based training of visiting scientists, in-country training, and collaborative in-country research. Factors that have contributed to the success of the collaboration include: 1) its focus on the environmental health of mothers and children, which is a priority goal for both countries; 2) the adoption of an internationally-endorsed research protocol with strict quality-control criteria, specifically designed for international collaboration; 3) the establishment of an in-country data management center; and 4) the investment in a long-term research program rather than a short-term study. The major obstacles have been the difficult economic situation in Ukraine, which limits in-country research investment, and the difficulty in obtaining U.S. funding for an international research program.