High blood lead levels are associated with lead concentrations in households and day care centers attended by Brazilian preschool children.

BACKGROUND: A previous study observed high blood lead levels (BLL) in preschool children attending 50 day care centers (DCC) in São Paulo, Brazil. OBJECTIVE: To identify whether lead levels found in both homes and DCC environments are associated with high blood lead levels. METHODS: Children attending 4 DCCs, quoted here as NR, VA, PS and PF, were divided into two groups according to BLL: high exposure (HE: ≥13.9 µg/dL; 97.5 percentile of the 2013 year sample) and low exposure (LE: <5 µg/dL). For in situ lead measurements (lead paint mode: mg/cm2 and ROHS mode: µg/g) in the children's households and in the DCC environments, a field portable X-ray-fluorescence analyzer was used. Multiple logistic regressions were performed to control for confounding factors. Odds ratios were adjusted for age, sex, day care center's measured lead, and tobacco. RESULTS: In an NR DCC building, 33.8% of the measurements had lead levels >600 µg/g, whereas such levels were observed in 77.1% of NR playground measurements. In VA DCC, 22% and 23% of the measurements in the building and in the playgrounds had levels higher than 600 µg/g, respectively. The percentage of high lead levels in the children's houses of the LE group was 5.9% (95% CI: 4.3-7.6%) and 13.2 (95% CI: 8.3-18.0%) in the HE group. Moreover, a significant association was found between high BLLs and lead levels found both in households and DCCs (p < 0.001). Most of the high lead measurements were found in tiles and playground equipment. CONCLUSIONS: Lead exposure estimated from the DCCs, where children spend about 10 h/day, can be as relevant as their household exposure. Therefore, public authorities should render efforts to provide a rigorous surveillance for lead-free painting supplies and for all objects offered to children.

Correlates of influenza vaccine uptake among community-dwelling older adults in Brazil.

This study aimed at assessing the factors associated with vaccine uptake in a representative sample of community-dwelling Brazilian older adults, specifically focusing on differences in socioeconomic factors among the country regions. We conducted a cross-sectional, population-based study, using a probabilistic household sample in 2013. Individuals aged 60 years or more answered a structured questionnaire informing on vaccination status and sociodemographic and behavioral covariates. Associations between variables were evaluated using prevalence ratios estimated by Poisson regression models. The overall vaccination coverage (72.6%) in older adults ranked lower than the goal of 80% stipulated by the Brazilian health authority; vaccine uptake differed significantly among the country regions. The prevalence of vaccination was lower in black individuals in Brazil than that in their white counterparts. The prevalence of vaccine uptake was significantly associated with covariates on current life style, use of health care, and socioeconomic determinants. Compared with individuals with 0-3 years of education, more schooled individuals had higher prevalence of vaccine uptake in the North, Northeast, and South regions of the country. This study showed that there is room for increasing vaccination coverage among the elderly in Brazil. The knowledge previously obtained on factors significantly associated with vaccine uptake has not prevented them to continue influencing this outcome. The socioeconomic inequality in vaccination in some Brazilian regions reinforces the need of targeting the intervention toward the most vulnerable groups.