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Blood lead (Pb) clearance (CbPb) and serum creatinine clearance (CsCr), a metric of glomerular filtration rate (GFR), were estimated in approximately 7,600 subjects from the NHANES (2009-2016). Median CbPb in adults was 0.04 L/day (5th-95th percentile range: 0.01-0.12). Linear regression models explained approximately 68% of variance in CbPb in adults, with >98% of explained variance attributed to CsCr. These results provide an improved quantitative understanding of the possible effects of reverse causality in the interpretation of studies of associations between blood Pb and decrements in GFR.

Lead (Pb) in soil is an important exposure source for children. Thus, determining bioavailability of Pb in soil is critical in evaluating risk and selecting appropriate strategies to minimize exposure. A mouse model was developed to estimate relative bioavailability of Pb in NIST SRM 2710a (Montana 1 Soil). Based on Pb levels in tissues, the mean relative bioavailability of this metal in this soil was 0.5. Estimates of relative bioavailabilities derived from mouse compared favorably with those obtained in juvenile swine. The mouse model is thus an efficient and inexpensive method to obtain estimates of relative bioavailability of soil Pb.

Ingested soil and surface dust may be important contributors to elevated blood lead (Pb) levels in children exposed to Pb contaminated environments. Mitigation strategies have typically focused on excavation and removal of the contaminated soil. However, this is not always feasible for addressing widely disseminated contamination in populated areas often encountered in urban environments. The rationale for amending soils with phosphate is that phosphate will promote formation of highly insoluble Pb species (e.g., pyromorphite minerals) in soil, which will remain insoluble after ingestion and, therefore, inaccessible to absorption mechanisms in the gastrointestinal tract (GIT). Amending soil with phosphate might potentially be used in combination with other methods that reduce contact with or migration of contaminated soils, such as covering the soil with a green cap such as sod, clean soil with mulch, raised garden beds, or gravel. These remediation strategies may be less expensive and far less disruptive than excavation and removal of soil. This review evaluates evidence for efficacy of phosphate amendments for decreasing soil Pb bioavailability. Evidence is reviewed for (1) physical and chemical interactions of Pb and phosphate that would be expected to influence bioavailability, (2) effects of phosphate amendments on soil Pb bioaccessibility (i.e., predicted solubility of Pb in the GIT), and (3) results of bioavailability bioassays of amended soils conducted in humans and animal models. Practical implementation issues, such as criteria and methods for evaluating efficacy, and potential effects of phosphate on mobility and bioavailability of co-contaminants in soil are also discussed.

Typical exposures to lead often involve a mix of long-term exposures to relatively constant exposure levels (e.g., residential yard soil and indoor dust) and highly intermittent exposures at other locations (e.g., seasonal recreational visits to a park). These types of exposures can be expected to result in blood lead concentrations that vary on a temporal scale with the intermittent exposure pattern. Prediction of short-term (or seasonal) blood lead concentrations arising from highly variable intermittent exposures requires a model that can reliably simulate lead exposures and biokinetics on a temporal scale that matches that of the exposure events of interest. If exposure model averaging times (EMATs) of the model exceed the shortest exposure duration that characterizes the intermittent exposure, uncertainties will be introduced into risk estimates because the exposure concentration used as input to the model must be time averaged to account for the intermittent nature of the exposure. We have used simulation as a means of determining the potential magnitude of these uncertainties. Simulations using models having various EMATs have allowed exploration of the strengths and weaknesses of various approaches to time averaging of exposures and impact on risk estimates associated with intermittent exposures to lead in soil. The International Commission of Radiological Protection (ICRP) model of lead pharmacokinetics in humans simulates lead intakes that can vary in intensity over time spans as small as one day, allowing for the simulation of intermittent exposures to lead as a series of discrete daily exposure events. The ICRP model was used to compare the outcomes (blood lead concentration) of various time-averaging adjustments for approximating the time-averaged intake of lead associated with various intermittent exposure patterns. Results of these analyses suggest that standard approaches to time averaging (e.g., U.S. EPA) that estimate the long-term daily exposure concentration can, in some cases, result in substantial underprediction of short-term variations in blood lead concentrations when used in models that operate with EMATs exceeding the shortest exposure duration that characterizes the intermittent exposure. Alternative time-averaging approaches recommended for use in lead risk assessment more reliably predict short-term periodic (e.g., seasonal) elevations in blood lead concentration that might result from intermittent exposures. In general, risk estimates will be improved by simulation on shorter time scales that more closely approximate the actual temporal dynamics of the exposure.

Lead intervention at Superfund sites typically seeks to reduce pediatric blood lead levels by disrupting the surface-to-hand-to-mouth pathway. This article presents the results of a survey of the publicly available literature on the effectiveness of lead intervention on pediatric blood lead levels at hazardous waste sites. The survey includes six hazardous waste sites located in Canada, Australia, and the United States at which intervention activities were conducted and pediatric blood lead levels were sampled both pre- and postintervention. Evaluation of the effectiveness of intervention on pediatric blood lead levels is often complicated due to confounding variables and statistical limitations. Nevertheless, the outcomes of the intervention studies reviewed in this report suggest that various approaches to the intervention of the dust ingestion pathway, alone or in combination, contributed to declines in blood lead levels in children living in areas heavily contaminated with lead.

Superfund sites that are contaminated with lead and undergoing remedial action generate lead-enriched dust that can be released into the air. Activities that can emit lead-enriched dust include demolition of lead smelter buildings, stacks, and baghouses; on-site traffic of heavy construction vehicles; and excavation of soil. Typically, air monitoring stations are placed around the perimeter of a site of an ongoing remediation to monitor air lead concentrations that might result from site emissions. The National Ambient Air Quality (NAAQ) standard, established in 1978 to be a quarterly average of 1.5 microg/m(3), is often used as a trigger level for corrective action to reduce emissions. This study explored modeling approaches for assessing potential risks to children from air lead emissions from the RSR Superfund site in West Dallas, TX, during demolition and removal of a smelter facility. The EPA Integrated Exposure Uptake Biokinetic (IEUBK) model and the International Commission of Radiologic Protection (ICRP) lead model were used to simulate blood lead concentrations in children, based on monitored air lead concentrations. Although air lead concentrations at monitoring stations located in the downwind community intermittently exceeded the NAAQ standard, both models indicated that exposures to children in the community areas did not pose a significant long-term or acute risk. Long-term risk was defined as greater than 5% probability of a child having a long-term blood lead concentration that exceeded 10 microg/dl, which is the CDC and the EPA blood lead concern level. Short-term or acute risk was defined as greater than 5% probability of a child having a blood lead concentration on any given day that exceeded 20 microg/dl, which is the CDC trigger level for medical evaluation (this is not intended to imply that 20 microg/dl is a threshold for health effects in children exposed acutely to airborne lead). The estimated potential long-term and short-term exposures at the downwind West Dallas community did not result in more than 5% of children exceeding the target blood lead levels. The models were also used to estimate air lead levels for short-term and long-term exposures that would not exceed specified levels of risk (risk-based concentrations, RBCs). RBCs were derived for various daily exposure durations (3 or 8 h/day) and frequencies (1-7 days/week). RBCs based on the ICRP model ranged from 0.3 (7 days/week, 8 h/day) to 4.4 microg/m(3) (1 day/week, 3 h/day) for long-term exposures and were lower than those based on the IEUBK model. For short-term exposures, the RBCs ranged from 3.5 to 29.0 microg/m(3). Recontamination of remediated residential yards from deposition of air lead emitted during remedial activities at the RSR Superfund site was also examined. The predicted increase in soil concentration due to lead deposition at the monitoring station, which represented the community at large, was 3.0 mg/kg. This potential increase in soil lead concentration was insignificant, less than 1% increase, when compared to the clean-up level of 500 mg/kg developed for residential yards at the site.

The effect of dietary lead on the intestinal microbiome has not been fully elucidated. To determine if there was an association between microflora modulation, predicted functional genes, and Pb exposure, mice were provided diets amended with increasing concentrations of a single lead compound, lead acetate, or a well characterized complex reference soil containing lead, i.e. 6.25–25 mg/kg Pb acetate (PbOAc) or 7.5–30 mg/kg Pb in reference soil SRM 2710a having 0.552 % Pb among other heavy metals such as Cd. Feces and ceca were collected following 9 days of treatment and the microbiome analyzed by 16 S rRNA gene sequencing. Treatment effects on the microbiome were observed in both feces and ceca of mice. Changes in the cecal microbiomes of mice fed Pb as Pb acetate or as a constituent in SRM 2710a were statistically different except for a few exceptions regardless of dietary source. This was accompanied by increased average abundance of functional genes associated with metal resistance, including those related to siderophore synthesis and arsenic and/or mercury detoxification. Akkermansia , a common gut bacterium, was the highest ranked species in control microbiomes whereas Lactobacillus ranked highest in treated mice. Firmicutes/Bacteroidetes ratios in the ceca of SRM 2710a treated mice increased more than with PbOAc, suggestive of changes in gut microbiome metabolism that promotes obesity. Predicted functional gene average abundance related to carbohydrate, lipid, and/or fatty acid biosynthesis and degradation were greater in the cecal microbiome of SRM 2710a treated mice. Bacilli/Clostridia increased in the ceca of PbOAc treated mice and may be indicative of increased risk of host sepsis. Family Deferribacteraceae also was modulated by PbOAc or SRM 2710a possibly impacting inflammatory response. Understanding the relationship between microbiome composition, predicted functional genes, and Pb concentration, especially in soil, may provide new insights into the utility of various remediation methodologies that minimize dysbiosis and modulate health effects, thus assisting in the selection of an optimal treatment for contaminated sites. • Ingesting lead acetate or mining soil altered murine fecal and cecal microbiome differently. • Differences in cecal microflora were observed at different taxon levels. • Cecal Firmicutes/Bacteroidetes ratio was greater with exposure to soil than lead acetate. • Predicted cecal microbiome metabolism and detoxification genes were elevated. • Microbiome impacts in soil treated mice did not directly correlate with lead acetate. [ABSTRACT FROM AUTHOR]