[Levels of plasmatic lead in children 8-10 years of age and its relation to changes in visual-motor system and balance]. / Niveles de plomo en sangre en niños de 8 a 10 años y su relación con la alteración en el sistema visomotor y del equilibrio.

OBJECTIVE: To assess the association between blood lead concentrations and visual-motor coordination and equilibrium in school age children. MATERIAL AND METHODS: In November-December 1998, a cross-sectional study was conducted among 255 children aged 8-10, who attended public schools in Sector 1 of the Oaxaca State Public Education Institute. Data were collected using the Frostig Evaluation of Visual Perception test and the equilibrium subscale of the Frostig Movement Skills Test Battery. A blood sample was taken to measure lead levels by atomic absorption spectrometry. Socioeconomic data and health histories were collected for use as control variables. Statistical analysis consisted of multiple regression models to test the relationship between blood lead level and the visual-motor and equilibrium tests. We assessed the effect of lead within the model using 1,000 Montecarlo simulations. RESULTS: The geometric mean of blood lead concentrations was 11.5 micrograms/dl (geometric standard deviation +6.3, -5.2). After adjusting for control variables, the visual-motor integration subscale was significantly related to blood lead concentration (p > 0.042). The visual-motor integration value decreased 1.78 (95% CI -3.51, -0.06) points for each 10 micrograms/dl increase in blood lead concentration. Among the four sub-tests comprising the visual-motor integration subscale, only eye-hand coordination (p = 0.045) and spatial relations (p = 0.039) were significantly related to blood lead. The visual-motor integration subscale was also significantly related to family income; greater income was related to greater testing scores. Only 3.1% of the children had clinically abnormal testing scores. No statistically significant association was found between blood lead levels and the Frostig subscale Index of Reduced Motor Response, the General Visual Perception Index, or any other equilibrium tests. CONCLUSIONS: The inverse relationship between blood lead concentration and visual-motor skill is consistent with results from studies in other countries. Blood lead levels common among children of Oaxaca are sufficient to produce subtle visual-motor impairments. These findings point out the need to strengthen the initiative to reduce child exposure to known lead sources, particularly lead-glazed ceramics, and thus lower the blood lead levels of the population.

[Factors related to the blood lead level in children 6 to 30 months old in the Prospective Lead Study in Mexico City]. / Factores relacionados con el nivel de plomo en sangre en niños de 6 a 30 meses de edad en el Estudio Prospectivo de Plomo en la Ciudad de México.

A majority of the sample of children (N = 160-121, ages 6-30 months) from the Mexico City Prospective Lead Study exceeds the lowest limit action level (10 micrograms/dl) of the Centers for Disease Control standards for childhood lead exposure. Over one-third of the sample at 18 months and 24 months exceeds the action level (15 micrograms/dl) for aggressive intervention. Diet plays an important role in regulating early childhood blood lead levels. Fresh milk and breast feeding are associated with lower lead levels, but extended breast feeding is related to elevated lead levels. Low income and poor maternal education are associated with higher lead concentration in children. Child consumption of canned milk and juice, up to this date, is associated with elevated child lead levels. Canned products sealed with lead are disappearing from Mexican markets. Efforts to improve childhood nutrition and poverty may be expected to have the additional benefit of lowering lead levels of Mexican children.

Prenatal and postnatal blood lead level and head circumference in children to three years: preliminary results from the Mexico City Prospective Lead Study.

Multiple regression modeling was used to explore the relationship between prenatal and postnatal blood lead levels and child head circumference in the first three years of life. Maternal blood lead at 36 weeks of pregnancy and cord blood lead were found to be inversely related to 6 month and 18 month head circumference, respectively. Child 12 month blood lead was inversely related to 36 month head circumference. Limitations of the data set and the statistical techniques were discussed, as were the interpretations of the findings.

[Sources of lead in pregnant women in the Valley of Mexico]. / Fuentes de plomo en embarazadas de la Cuenca de México.

Lead levels in samples of the groups at highest risk to the effects of lead exposure, pregnant women and their infants, are higher than levels known to produce developmental retardation in children in a considerable proportion of the sample tested in Mexico City. Modeling of prenatal factors predicting maternal lead during pregnancy shows the strong effect of the use of low-temperature ceramics on lead level. The data also suggests an important contribution from air lead. The downward trend in lead exposure in pregnant women in the Valley of Mexico over the last 10 years, concurrent with downward trends in air lead is encouraging. However, reducing the manufacture and use of leaded pottery could produce a significant further reduction of lead exposure with a modest program of public education, government regulation and subsidization of lead free pottery.

Neurobehavioral deficits after low level lead exposure in neonates: the Mexico City pilot study.

Gestation age and ability of the baby to self-quiet and to be consoled during the first 30 days of life decrease when mother's blood lead levels rise from 36 weeks of pregnancy to birth of child. These effects appear to be independent of the absolute lead levels of mother and child (N = 42). Since pre- and perinatal stress predicts higher maternal birth lead, further work could determine the relative contributions of undetected stress during pregnancy and elevated lead levels upon subsequent development. Several cases, not included in the statistical analyses, showed associations between cord leads greatly elevated over maternal leads and poor outcome.