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Lead exposure is toxic even at low levels, resulting in impairments that can affect a child's lifelong success. In North Carolina, testing for lead is encouraged for all children at ages 1 and 2 years and required for children covered by Medicaid; investigations are performed to identify potential exposure sources for children with blood lead levels (BLLs) ≥5 μg/dL. During June--August 2023, routine lead testing identified four asymptomatic North Carolina children with BLLs ≥5 μg/dL. Home investigations identified only WanaBana brand apple cinnamon fruit puree pouches as a potential exposure source; product samples contained 1.9--3.0 ppm of lead. An expanded nationwide investigation led to identification of approximately 500 cases of childhood lead exposure believed to be linked to consumption of apple cinnamon purees, including 22 cases in North Carolina. Fewer than one half (45%) of the 22 North Carolina cases were among children covered by Medicaid. A coordinated multiagency communication strategy was implemented in North Carolina to notify consumers of the hazard and provide recommendations for preventing further exposure. The Food and Drug Administration issued a nationwide public health advisory on October 28, 2023; 2 days later, the manufacturer issued a voluntary recall. Routine testing of young children for lead exposure, combined with thorough environmental investigations, can identify emerging sources of lead exposure and limit further harm. [ABSTRACT FROM AUTHOR]

Developmental science has increasingly scrutinized how environmental hazards influence child outcomes, but few studies examine how contaminants affect disparities in early skill formation. Linking research on environmental inequality and early childhood development, this study assessed whether differences in exposure to neurotoxic lead explain sociodemographic gaps in school readiness. Using panel data tracking a representative sample of 1266 Chicago children (50% female, 16% White, 30% Black, 49% Hispanic, μage = 5.2 months at baseline, collected 1994–2002), analyses quantified the contribution of lead contamination to class and racial disparities in vocabulary skills and attention problems at ages 4 and 5. Results suggested that lead contamination explains 15%–25% and 33%–66% of the disparities in each outcome, respectively, although imprecise estimates preclude drawing firm inferences about attention problems. [ABSTRACT FROM AUTHOR]

Opportunities for lead exposure are common in the United States. The American Academy of Pediatrics, in collaboration with the Centers for Disease Control and Prevention, launched the Increasing Capacity for Blood Lead Testing Extension for Community Healthcare Outcomes (ECHO) project to educate pediatricians on the importance of testing children for lead exposure and to assess practice behavior change. We found that two weeks to one month after receiving training, more than 80% of participants reported increased lead testing and practice changes. Our results support use of the ECHO model as a mechanism for practice change. (Am J Public Health. 2022;112(S7):S647–S650. https://doi.org/10.2105/AJPH.2022.307084) [ABSTRACT FROM AUTHOR]

Polymorphisms in the Aminolevulinic Acid Dehydratase (ALAD) gene responsible for the ALAD1 and ALAD2 alleles have been implicated in susceptibility to lead toxicity. This study aimed to determine the allelic frequency of ALAD2 among children living in Bogor District, Indonesia, and its association with blood lead levels (BLLs) and lead toxicity. A cross-sectional study involving 128 children was conducted during September-October 2019 in the former ULAB area in Cinangka Village. The ALAD polymorphism, BLLs, and hematological parameters were evaluated. Blood samples were taken for dried blood spotting on filter paper, blood film, and BLL measurement. The PCR amplification and sequencing of the genomic DNA revealed the presence of two forms of the ALAD2 allele: 177C and 177T with a frequency of 0.05. Analysis of the correlation between the ALAD2 allele, BLLs, and basophilic stippling revealed that ALAD2 carriers had a five times higher risk of high BLLs, (OR = 5.359, p-value = 0.155) and had a slightly higher risk of exhibiting basophilic stippling (OR = 1.09, p-value = 1.000). Although not statistically significant, these findings suggested that the ALAD genotype may modify BLLs and lead to toxicity. The ALAD2 allele (177T) is firstly reported in any population in the world. [ABSTRACT FROM AUTHOR]

Background: Ingestion and inhalation are common routes of exposure for lead in humans. Developing countries still have unacceptably high rates of lead toxicity, especially in children. Studies on probable risk factors of lead poisoning in Iranian children are insufficient. In this study, we aimed to evaluate possible environmental factors in children with high blood lead concentrations living in Tehran and neighboring cities.Methods: In a prospective cross-sectional study between March 2018 and March 2019 we followed all children referred from two pediatric gastrointestinal clinics with blood lead level (BLL) > 5 μg/dL in metropolitan Tehran to investigate possible environmental risk factors in their home. Household specimens including scratched wall paint, house floor dust, windowsill dust, tap water, and consumed spice were evaluated using atomic absorption method to detect lead concentrations. Epidemiological and environmental data collected through in-depth interviews with parents/guardians. Industrial areas were defined based on municipality maps on industrial places.Results: Thirty of 56 parents/guardians with BLL > 5 μg/dL agreed to be followed through environmental investigation. The only categorical statistically significant risk factor was a history of lead poisoning in the family and living in an industrial zone. There was a positive correlation between BLL and interior windowsills dust lead level, r = 0.46, p = 0.01. Scratched paint lead level and BLL showed a significant positive correlation, r = 0.50, p = 0.005. House floor dust lead level (median = 77.4, p < 0.001) and interior windowsill dust lead level (median = 291, p = 0.011) were both significantly higher than the environmental protection agency (EPA) standards of 40 μg/ft2, 250 μg/ft2. Interior windowsill dust lead concentrations were significantly higher in industrial areas (p = 0.026).Conclusion: Children's playing environment should be cleaned more often to reduce dust. Moreover, specific rules may need to be implemented for paint lead concentrations and air pollution, especially in industrial areas. [ABSTRACT FROM AUTHOR]

Background: Lead poisoning is very much common in India and has significant negative impact on general health of children. Lead inhibits necessary enzymes required for heme synthesis, this results in increased levels of delta aminolevulinic acid excretion through urine. Objective: To find out the prevalence of lead poisoning among the age group 1 to 5 years, in a suburban Mumbai, Maharashtra, India. Methods: This is cross-sectional pilot study in Mumbai suburban localities. The study was done on 60 randomly chosen children of age group 1 to 5 years with their brief history related with lead exposure. Their urine samples were analyzed for δ ALA by Ehrlich method. Results: According to our observation it was found that out of 60 urine samples 20 samples have urinary δ-ALA levels below 0.2 mg/dl, while 40 samples showed increased urinary δ-ALA levels. Prevalence of lead exposure among our study population is 66.66% hence lead exposure is a serious public health issue. Conclusion: we conclude that there is high prevalence of lead exposure in Mumbai and necessary precautions to be taken to avoid it.

Background: Pediatric lead exposure in the United States (U.S.) remains a preventable public health crisis. Shareable electronic clinical decision support (CDS) could improve lead screening and management. However, discrepancies between federal, state and local recommendations could present significant challenges for implementation.Methods: We identified publically available guidance on lead screening and management. We extracted definitions for elevated lead and recommendations for screening, follow-up, reporting, and management. We compared thresholds and level of obligation for management actions. Finally, we assessed the feasibility of development of shareable CDS.Results: We identified 54 guidance sources. States offered different definitions of elevated lead, and recommendations for screening, reporting, follow-up and management. Only 37 of 48 states providing guidance used the Center for Disease Control (CDC) definition for elevated lead. There were 17 distinct management actions. Guidance sources indicated an average of 5.5 management actions, but offered different criteria and levels of obligation for these actions. Despite differences, the recommendations were well-structured, actionable, and encodable, indicating shareable CDS is feasible.Conclusion: Current variability across guidance poses challenges for clinicians. Developing shareable CDS is feasible and could improve pediatric lead screening and management. Shareable CDS would need to account for local variability in guidance. [ABSTRACT FROM AUTHOR]

Over forty years ago, the United States federal government banned the use of lead-based paint in residences. Yet, tens of millions of American homes still contain lead paint today--exposing huge numbers of children to a grave risk of irreversible brain damage. While most Americans are familiar with the devastating 2014 crisis caused by lead-contaminated water in Flint, Michigan, few realize that Flint is only a small piece of a much larger lead poisoning problem. In thousands of towns across the United States today, children suffer elevated blood lead levels at even greater rates than those observed in Flint. In many cases, the cause of lead exposure for these children is not water, but paint. A child living in a home with deteriorating lead paint can easily suffer life-long harm--just by breathing in invisible lead dust or touching lead-contaminated surfaces and later putting their hands in their mouth. Despite clear evidence of the serious consequences of lead since the early 1900s, however, the lead paint problem has festered in America's shadows for over a century. Most recently, in the decades since the residential ban, landlords and sellers have refused to adequately test for and remove lead paint from their properties--and governments and regulatory agencies have failed to enact effective laws and enforce regulations. Why has this crisis been allowed to continue for so long? History, empirical data, and anecdotal evidence all strongly suggest that America has ignored the issue largely because lead poisoning mainly affects low-income communities and people of color. This Note argues that the current legal remedies used to address the lead paint epidemic are inadequate and have failed to fix a completely preventable public health crisis. In addition, it demonstrates that all of the existing approaches to lead poisoning--legislative reform, regulatory action, lawsuits sounding in common law negligence, and the use of market share liability and public nuisance doctrine--do not address the underlying issues of racial and economic discrimination that have perpetuated this problem for decades. In order to ensure enforcement of federal and state laws, to legitimize the experiences of children who have suffered at the hands of discriminatory policies, and to garner national attention to the issue, this Note argues that advocates should expand their response to lead paint by pursuing claims under constitutional and civil rights theories. In particular, this Note analyzes how litigators can bring successful lead poisoning claims under the Fourteenth Amendment to the U.S. Constitution, the Fair Housing Act, and Title VI of the Civil Rights Act of 1964. [ABSTRACT FROM AUTHOR]

Objective: This study aimed to report three representative childhood lead poisoning cases in China from domestic products exposure and to highlight their critical implications for practice, education, and policy in prevention and treatment of childhood lead poisoning by health care providers, especially public health nurses. Design and Sample: Three representative childhood lead poisoning cases occurring in 2017 were collected and analyzed. Results: The lead exposure sources of three cases were evaluated by experts in the field and determined to be tin pots, home factories for tinfoil, and contamination of folk medicine, respectively. These cases demonstrated that the lack of lead exposure risk assessment, insufficient knowledge of potential lead exposure sources, underdeveloped policy, and regulations were areas for improvement. Conclusions: The best strategies for preventing lead poisoning include an appropriate risk assessment of lead exposure, implementation of comprehensive parental health education, conduction of further research by public health providers, and the application of policy strategies by the government. It was determined that public health nurses are at the frontline of prevention of lead poisoning in children. [ABSTRACT FROM AUTHOR]

The Flint water crisis demonstrates the importance of adequate legal preparedness in dealing with complicated legal arrangements and multiple statutory responsibilities. It also demonstrates the need for alternative accountability measures when public officials fail to protect the public's health and explores mechanisms for restoring community trust in governmental public health. [ABSTRACT FROM AUTHOR]

The article discusses the lead hazard control programs at the U.S. Department of Housing and Urban Development (HUD) aimed at making homes safer for children and families to live in. Topics covered include lead exposure of children through lead-based paint in the home, cost benefits of removing lead paint hazards in older homes of children from low-income families, and role of the Residential Lead-Based Paint Hazard Reduction Act of 1992 in addressing the lead-based paint problem.

Though the adverse consequences of lead exposure in children have been well known for over a century, the recent Flint water crisis has drawn renewed attention to the impacts of lead exposure on human health and development. This study considers connections to educational outcomes, asking whether population-level lead exposure in early childhood influences later academic achievement and racial achievement gaps. It assesses the effectiveness of recent local- and state-level lead hazard control programs in mitigating exposure and uses this source of exogenous variation in early childhood exposure across birth cohorts to draw inferences about the long-term effects of lead on mean student test scores. Our findings indicate that lead hazard control grants reduced lead poisoning incidents by over 70% of the baseline prevalence. And each one percentage point reduction in lead poisoning in early childhood translated to a growth of 0.04 standard deviations in student math test scores and 0.08 standard deviations in student reading scores. This same reduction in lead poisoning narrowed both the white-Hispanic math achievement gap and white-Hispanic reading achievement gap by 0.06 standard deviations, implying important downstream consequences for economic inequality. [ABSTRACT FROM AUTHOR]

The article reviews key issues that affected the lives of indigenous peoples in French Guiana in 2018. Topics discussed include the resistance to the Montagne d'Or mining project, the election of the Grand Customary Council's officers, the petition to teach maternal languages at schools, and the prevalence of lead poisoning in children.

Lead is a toxic heavy metal that is associated with lowered intelligence quotient scores, behavioural problems, and physical health impairments in children. Current consensus is that there is no safe level of child lead exposure and that even low doses of lead can have negative effects. Several reviews conducted in South Africa have revealed the sources and potential risk factors associated with child lead poisoning. However, no South African reviews have focused on the quality of studies focusing on child lead poisoning and psychological outcomes (intelligence, cognitive, and behavioural outcomes). This study reviews epidemiological studies of child lead poisoning with a particular focus on the association between child lead poisoning and psychological outcomes in South Africa over a 30-year time span (1986–2016). The review pays particular attention to study design, measurement, sampling, and confounding variables. Nine studies that measured child lead poisoning were included in the review. Just two of the nine studies (one cross-sectional and one follow-up) measured psychological outcomes and neither study adequately adjusted for confounding. In all studies, sampling was purposive and lead exposure indicators were suited to short-term acute exposure. There is, therefore, insufficient evidence to determine the magnitude of the association between child lead poisoning and psychological outcomes in South Africa. More rigorous epidemiological studies are needed to strengthen the evidence base. The article also highlights opportunities for psychological research in intervention studies and studies that are framed by an environmental justice agenda. [ABSTRACT FROM AUTHOR]

The United States and the World Health Organization have worked to decrease lead exposure in children, but despite these efforts lead poisoning continues to exist in industrialized and developing countries. Prevention is the only way to preclude the health, academic and behavioral problems that occur due to the effects of lead. Public awareness remains a critical factor in prevention as the problem has not gone away, yet research on the effects of lead poisoning on school aged children is largely absent in educational journals. The effect of lead poisoning on health, academics, and behavior is reviewed.

We assessed whether a home fire safety intervention targeting families with newborn children in Jefferson County, Kentucky, reached those at severe risk using a cartographic model. Demographic and economic factors of 61 families were compared by census tract. Using geographic information systems (GIS), families were assigned a risk level (low, medium, high, or severe) based on the risk model. Families who participated differed from census tracts in that of being minority race (p=0.01). The median risk category of the families was medium risk. Sixty-five tracts were identified as high or severe risk and in need of future intervention. The model yielded a way to prioritize at-risk families. GIS is a useful tool for examining whether prevention interventions reached those in the severe risk category. [ABSTRACT FROM AUTHOR]

The water crisis in Flint, Michigan, where residents discovered dangerous levels of lead in their water supply in 2015, has continued to unfold over the past three years and has brought the damaging effects of lead exposure to national attention. When developing children are exposed to even low levels of lead, they are at risk of developing cognitive impairments—disorders that cause aggressive behavior and diminished intellectual functioning. This Comment seeks to bring criminal law into the conversation about lead exposure and its damaging effects. Researchers have found that children exposed to lead have a higher risk of engaging in criminal behavior. But the neurological impact of lead exposure in children suggests these children may not possess the culpability that traditionally justifies criminal punishment. This Comment proposes that, in accordance with the utilitarian and retributive goals of criminal law, evidence of lead exposure and resulting brain damage be considered mitigating factors in sentencing. [ABSTRACT FROM AUTHOR]

Objectives: This study explored the sources of lead exposure, identified patients’ geographic distribution and evaluated the symptoms of children with elevated blood lead levels (BLLs) referred to a pediatric lead specialty clinic in China. Material and methods: Data were collected from 515 consecutive outpatients attending the Pediatric Lead Poisoning Clinic in Xinhua Hospital, Shanghai, China, between 2011 and 2016, referred for BLLs ≥5 μg/dL. Atomic absorption spectrometry was used to measure venous BLLs. Results: The mean ± standard deviation age of the patients was 4.1 ± 3.2 years. Their BLLs ranged from 5 to 126 μg/dL. The geometric mean and median BLLs were 24 and 26 μg/dL, respectively. Two hundred and twenty-two children (43.1%) were exposed to industrial lead pollution—mainly from Zhejiang, Jiangsu, Hunan, Henan and Anhui provinces; whereas, 41.4% (213 cases) were induced by folk medicines used widely throughout China. Other nonindustrial sources of lead exposure included lead-containing tinfoil and tin pots. Household lead paint was a rare source. Most patients exhibited nonspecific symptoms, such as hyperactivity, attention difficulty, aggressiveness, constipation and anorexia. Conclusions: Industrial pollution and folk medicines are important sources of lead exposure in China. Childhood lead poisoning may be difficult to diagnose clinically as symptoms are nonspecific. Thus, blood lead screening may be necessary to identify children at high risk of exposure. Education to raise the awareness of potential sources of exposure resulting in their elimination would be expected to decrease the incidence of children with elevated BLLs. [ABSTRACT FROM AUTHOR]

In the present study, a simple ultrasonically dispersed modified liquid-phase microextraction method was developed for the extraction of lead (Pb) from blood and scalp hair samples of malnourished children (MNC). The complexation of Pb was executed by means of the complexing agent, ammonium pyrrolidinedithiocarbamate (APDC), whereas extraction was carried out through the ionic liquid (IL), 1-butyl-3- methylimidazolium hexafluorophosphate. Ultrasound energy was used for the dispersion and extraction of the metal complex into an IL because it enhances the extraction of the metal complex into infinite IL drops at a temperature range of 40-80°C for 1-5 min. After sonication, the enriched analyte phase was separated by centrifugation. Nitric acid (HNO3; 0.5-2 mol/L) was added to the IL-enriched phase to back-extract the analyte into the acidic aqueous phase and analyzed by flame atomic absorption spectrometry. Various experimental parameters that affect the efficiency of the proposed method, such as volume of IL, concentration of the complexing agent, pH, ultrasonication time and temperature, and concentration of HNO3, were optimized. The enhancement factor was calculated as 70. The LOD for Pb ions was found to be 0.19 µg/L, with an RSD of <5%. Accuracy was ensured by applying the procedure to a certified reference material for whole blood and scalp hair. The developed procedure was successfully applied for the analysis of the concentration of Pb ion in wholeblood and scalp hair samples of MNC from different areas of Sindh, Pakistan. The concentration of Pb among MNC was 2-fold higher than the referent. [ABSTRACT FROM AUTHOR]

Background: A girl with blood lead level [BLL] of 166 mcg/dL was admitted in hospital due to status epilepticus. A high level of lead dust and contamination in environment was detected in her living area. All the children in a school that was located around 100 meters from the recycling factory were examined. Among these group of children, the prevalence of high BLL (10 mcg/dL or more) was 44.2% (75 from 165 children). Objective: To find the associations of demographic, risk behaviors, and external or internal environmental factors in children with high BLL (10 mcg/dL or more) who lives in area of industrial community. A second objective is to study the effects of high BLL (15 mcg/dL or more) on IQ level and learning disability [LD] among these children. Materials and Methods: A case control study was conducted with 43 cases of school children (BLL of 10 mcg/dL or more), and 43 children as a control group in same school by matching of classroom and gender with 1:1 matched ratio. The baseline characteristics, behavioral, and environmental risk factors (internal and external), and collected samplings of the household environment were sent to standard laboratory to identify lead contamination and the association among the environmental risk factors with high BLL (10 mcg/dL or more) by multiple logistic regression analysis, and looking for the prevalence of low IQ and LD among children who were detected BLL of 15 mcg/dL or more. Results: The study found statistically significant association between high level of BLL and school duration (more than four academic years) (odds ratio 4.86, 95% CI 1.81 to 13.04, p-value 0.002), the distance between home and the factory (less than 500 meters) (odds ratio 2.98, 95% CI 1.12 to 7.94, p-value 0.029), and father's occupation (odds ratio 2.75, 95% CI 1.03 to 7.37, p-value 0.044). In the group of children who high BLL (15 mcg/dL or more), the studied found the prevalence of 25% in low IQ, 5% of mental retardation, and 66.7% of LD were detected. Conclusion: This study found positive association of high BLL among children living around the industrial community. The most important factors were related with the duration of living in the place related with lead contamination, father's occupation, and the distance between the housing and the factory. The prevalence of low IQ and LD among children with BLL of 15 mcg/dL or more was higher than average of Thai children. There is a need for blood lead screening for these children and prompt care and prevention if high blood levels of lead is detected. [ABSTRACT FROM AUTHOR]

Introduction: Elevated blood lead levels (BLL) cause poor neurocognitive outcomes in children. In Connecticut, universal testing is mandated twice between 9 and 35 months of age. Our office serves an urban center and conducts universal BLL testing yearly from 12 to 36 months. We sought to determine the current state of lead poisoning in our clinic. Results: 1900 patients were identified in the 2009 - 2013 birth cohort. Prevalence and incidence rates were similar to state rates. Prevalence peaked at 24 months (4.2%). At 36 months, 14 new cases of elevated BLL were identified. Conclusions: Prevalence and incidence rates in our population were similar to state averages despite increased risk factors. Newly diagnosed cases of elevated BLL at 36 months were rare. Our screening rates were significantly higher than state averages. [ABSTRACT FROM AUTHOR]

Objectives. To examine elevated blood lead levels (EBLLs) in refugee children by postrelocation duration with control for several covariates. Methods. We assessed EBLLs (‡ 5μg/dL) between 2012 and 2016 of children younger than 15 years (n = 1950) by the duration of resettlement to health screening by using logistic regression, with control for potential confounders (gender, region of birth, age of housing, and intestinal infestation) in a cross-sectional study. Results. Prevalence of EBLLs was 11.2%. Length of time from resettlement to health screening was inversely associated with EBLLs (tertile 2 unadjusted odds ratio [OR] = 0.79; 95% confidence interval [CI] = 0.56, 1.12; tertile 3 OR= 0.62; 95% CI = 0.42, 0.90; tertile 2 adjusted odds ratio [AOR] = 0.62; 95% CI = 0.39, 0.97; tertile 3 AOR = 0.57; 95% CI = 0.34, 0.93).Therewas a significant interaction between intestinal infestation and age of housing (P < .003), indicating significant risk in the joint exposure of intestinal infestation (a pica proxy) and age of house. Conclusions. Elevated blood lead levels were reduced with increasing length of time of resettlement in unadjusted and adjusted models. Improved housing, early education, and effective safe-house inspections may be necessary to address EBLLs in refugees. [ABSTRACT FROM AUTHOR]

This Article asserts that the Massachusetts Lead Poisoning Prevention and Control Act violates the federal Fair Housing Act (FHA) by discriminating against families with children under age six. The Massachusetts Lead Law was hailed as a ground-breaking effort to prevent childhood lead poisoning when it was enacted in 1971. However, because it requires landlords to incur the costs of lead abatement only when a child under age six resides in a dwelling, it has created a profoundly discriminatory rental housing market for these families. Part I of this Article discusses the scope of the problem for families with children under age six and provides an overview of the Massachusetts Lead Law. Part II advances the argument that the Massachusetts Lead Law violates the FHA. Part III explores the problems of housing instability and homelessness caused by housing discrimination against families with young children. The Conclusion recommends that the legislature amend the Massachusetts Lead Law to avoid discriminating against families with children under age six for three reasons: (1) to eliminate the harm of systemic discrimination; (2) to fully comply with the FHA; and (3) to achieve the original goal of the statute--to end childhood lead poisoning through a housing approach that requires property owners to abate lead hazards. [ABSTRACT FROM AUTHOR]

Background: Prenatal exposure to lead (Pb) has been shown to have negative and irreversible health impacts on foetal and early childhood development, affecting morbidity and mortality in adulthood. This study aimed to assess in utero Pb exposure, examine birth outcomes, and identify confounding factors in the large cohort of South African population, following the legislated removal of Pb from petrol. Methods: Lead was measured in the maternal blood, urine and cord blood using Inductive Coupled Plasma Mass spectrometry (ICP-MS). The statistical analyses included Spearman’s correlation, Wilcoxon rank sum (Mann Whitney), Kruskal-Wallis rank tests and multivariate linear regression. Results: Overall, the geometric mean (GM) of Pb in maternal blood (PbB) was 1.32 μg/dL (n = 640; 95% CI, 1.24–1.40). In the subset cohort, the GM of paired maternal PbB and cord blood (PbC) was 1.73 μg/dL (n = 350; 95% CI, 1.60–1.86) and 1.26 μg/dL (n = 317; 95% CI, 1.18–1.35), respectively with a positive correlation between the log PbB and the log PbC (rho = 0.65, p = <0.001). Birth outcomes showed geographical differences in the gestational age (p<0.001), birth length (p = 0.028) and head circumference (p<0.001), Apgar score at 5 min (p<0.001) and parity (p<0.002). In female neonates, a positive association was found between PbC and head circumference (rho = 0.243; p<0.016). The maternal PbB levels were positively correlated with race, educational status, water sources, cooking fuels and use of pesticides at home. Conclusions: This study has demonstrated not only the positive impact that the introduction of unleaded petrol and lead-free paint has had on in utero exposure to Pb in South Africa, but has also contributed new data on the topic, in a region where such data and scientific investigations in this field are lacking. Future research should evaluate if similar effects can be detected in young children and the adult population. [ABSTRACT FROM AUTHOR]

BACKGROUND: Drinking water and other sources for lead are the subject of public health concerns around the Flint, Michigan, drinking water and East Chicago, Indiana, lead in soil crises. In 2015, the U.S. Environmental Protection Agency (EPA)'s National Drinking Water Advisory Council (NDWAC) recommended establishment of a "health-based, household action level" for lead in drinking water based on children's exposure. OBJECTIVES: The primary objective was to develop a coupled exposure-dose modeling approach that can be used to determine what drinking water lead concentrations keep children's blood lead levels (BLLs) below specified values, considering exposures from water, soil, dust, food, and air. Related objectives were to evaluate the coupled model estimates using real-world blood lead data, to quantify relative contributions by the various media, and to identify key model inputs. METHODS: A modeling approach using the EPA's Stochastic Human Exposure and Dose Simulation (SHEDS)-Multimedia and Integrated Exposure Uptake and Biokinetic (IEUBK) models was developed using available data. This analysis for the U.S. population of young children probabilistically simulated multimedia exposures and estimated relative contributions of media to BLLs across all population percentiles for several age groups. RESULTS: Modeled BLLs compared well with nationally representative BLLs (0-23% relative error). Analyses revealed relative importance of soil and dust ingestion exposure pathways and associated Pb intake rates; water ingestion was also a main pathway, especially for infants. CONCLUSIONS: This methodology advances scientific understanding of the relationship between lead concentrations in drinking water and BLLs in children. It can guide national health-based benchmarks for lead and related community public health decisions. [ABSTRACT FROM AUTHOR]

Objectives. To assess the relationships between childhood lead exposure and 3 domains of later adolescent health: mental, physical, and behavioral. Methods. We followed a random sample of birth cohort members from the Project on Human Development in Chicago Neighborhoods, recruited in 1995 to 1997, to age 17 years and matched to childhood blood test results from the Department of Public Health. We used ordinary least squares regression, coarsened exact matching, and instrumental variables to assess the relationship between average blood lead levels in childhood and impulsivity, anxiety or depression, and body mass index in adolescence. All models adjusted for relevant individual, household, and neighborhood characteristics. Results. After adjustment, a 1 microgram per deciliter increase in average childhood blood lead level significantly predicts 0.06 (95% confidence interval [CI] = 0.01, 0.12) and 0.09 (95% CI = 0.03, 0.16) SD increases and a 0.37 (95% CI = 0.11, 0.64) point increase in adolescent impulsivity, anxiety or depression, and body mass index, respectively, following ordinary least squares regression. Results following matching and instrumental variable strategies are very similar. Conclusions. Childhood lead exposure undermines adolescent well-being, with implications for the persistence of racial and class inequalities, considering structural patterns of initial exposure. [ABSTRACT FROM AUTHOR]

It was just over forty years ago, shortly before the Safe Drinking Water Act was passed, that a group of mothers in the small, sleepy town of Woburn, Massachusetts realized there just may have been a connection between their children's leukemia and the town's water supply. They withstood the terrible smell and masked the water's rancid flavor with orange juice. For months they inquired, complained, and assembled in hopes that someone in a position of authority would notice what was so obvious to them. And for months they were dismissed and even ridiculed. Turns out they were right. It took a lawsuit and years of work by the Environmental Protection Agency, epidemiologists, and lawyers to shine a light on the seriousness of the contamination, the consequences, and the need for regulatory oversight. Fast forward to 2014: a group of concerned mothers begin complaining about the taste and smell of the water in Flint, Michigan. Bringing bottles of brown water with them to assemblies in front of the town hall did little to prompt city and state officials to do anything. It took a caring pediatrician and a brave professor to wrangle city, state, and even federal officials into acknowledging the highly toxic levels of lead in the water supply. But this time, more than forty years later, it should have been different. With decades of perspective and what some say are "overreaching" regulations in place, the environmental disaster in Flint should not have happened. This Article explores how and why the crisis occurred, despite the safeguards created by the Safe Drinking Water Act and the Lead and Copper Rule of 1991, which were meant to prevent this kind of disaster. This Article will then argue why the current "action level" for lead concentrations in tap water, which requires public water systems to act to protect the public, is unsafe according to current toxicological and epidemiological data. Finally, it will discuss how the current climate of "state exceptionalism"and lack of federal oversight contributed to the crisis, and suggest regulatory changes to provide a much needed public safety net. [ABSTRACT FROM AUTHOR]

Objectives. To highlight contextual factors tied to increased blood lead level (BLL) risk following the lead-in-water contamination in Flint, Michigan. Methods. Using geocoded BLL data collected in 2013 and 2015 and areal interpolation, we predicted BLLs at every residential parcel in the city. We then spatially joined social and built environmental variables to link the parcels with neighborhood-level factors that may influence BLLs. Results. When we compared levels before and during the water crisis, we saw the highest estimates of predicted BLLs during the water crisis and the greatest changes in BLLs in neighborhoods with the longest water residence time in pipes (μ = 2.30 μg/dL; Δ = 0.45 μg/dL), oldest house age (μ = 2.22 μg/dL; Δ = 0.37 μg/dL), and poorest average neighborhood housing condition (μ = 2.18 μg/dL; Δ = 0.44 μg/dL). Conclusions. Key social and built environmental variables correlate with BLL; such information can continue to guide response by prioritizing older, deteriorating neighborhoods with the longest water residence time in pipes. [ABSTRACT FROM AUTHOR]

Introduction Information on the prevalence of lead exposure is essential to formulate efficient public health policies. Developed countries have implemented successful public policies for the prevention and control of lead poisoning. In the United States, Canada, Japan and the European Union, for instance, periodically repeated prevalence studies show that blood lead levels (BLLs) in children have decreased overall. Although BLL of Latino children in the U.S. have also dropped in recent years, the geometric mean remains higher than that of white children. Little is known about lead exposure in children in Latin America and the Caribbean (LAC). In this review, we responded to two questions: What is currently known about lead sources and levels in children in LAC? Are there public policies to prevent children's exposure to lead in LAC? Method We conducted a literature review covering the period from January 2000 to March 2014 in the PubMed and Lilacs databases to obtain English, Portuguese and Spanish language studies reporting the prevalence of BLLs in children aged 0–18 years living in LAC countries. No specific analytical method was selected, and given the scarcity of data, the study was highly inclusive. Results Fifty-six papers were selected from 16 different LAC countries. The children's BLLs found in this review are high (≥ 10 μg/dL) compared to BLLs for the same age group in the U. S. However, most studies reported an association with some type of “lead hot spot”, in which children can be exposed to lead levels similar to those of occupational settings. Only Peru and Mexico reported BLLs in children from population-based studies. Conclusions Most BLLs prevalence studies carried out in LAC were in areas with known emission sources. The percentage of children at risk of lead poisoning in LAC is unknown, and probably underestimated. Thus, there is an urgent need to establish public health policies to quantify and prevent lead poisoning, specifically by prioritizing the identification and control of “hot spots”. [ABSTRACT FROM AUTHOR]

Importance: Many children in the United States and around the world are exposed to lead, a developmental neurotoxin. The long-term cognitive and socioeconomic consequences of lead exposure are uncertain.Objective: To test the hypothesis that childhood lead exposure is associated with cognitive function and socioeconomic status in adulthood and with changes in IQ and socioeconomic mobility between childhood and midlife.Design, Setting, and Participants: A prospective cohort study based on a population-representative 1972-1973 birth cohort from New Zealand; the Dunedin Multidisciplinary Health and Development Study observed participants to age 38 years (until December 2012).Exposures: Childhood lead exposure ascertained as blood lead levels measured at age 11 years. High blood lead levels were observed among children from all socioeconomic status levels in this cohort.Main Outcomes and Measures: The IQ (primary outcome) and indexes of Verbal Comprehension, Perceptual Reasoning, Working Memory, and Processing Speed (secondary outcomes) were assessed at age 38 years using the Wechsler Adult Intelligence Scale-IV (WAIS-IV; IQ range, 40-160). Socioeconomic status (primary outcome) was assessed at age 38 years using the New Zealand Socioeconomic Index-2006 (NZSEI-06; range, 10 [lowest]-90 [highest]).Results: Of 1037 original participants, 1007 were alive at age 38 years, of whom 565 (56%) had been lead tested at age 11 years (54% male; 93% white). Mean (SD) blood lead level at age 11 years was 10.99 (4.63) µg/dL. Among blood-tested participants included at age 38 years, mean WAIS-IV score was 101.16 (14.82) and mean NZSEI-06 score was 49.75 (17.12). After adjusting for maternal IQ, childhood IQ, and childhood socioeconomic status, each 5-µg/dL higher level of blood lead in childhood was associated with a 1.61-point lower score (95% CI, -2.48 to -0.74) in adult IQ, a 2.07-point lower score (95% CI, -3.14 to -1.01) in perceptual reasoning, and a 1.26-point lower score (95% CI, -2.38 to -0.14) in working memory. Associations of childhood blood lead level with deficits in verbal comprehension and processing speed were not statistically significant. After adjusting for confounders, each 5-µg/dL higher level of blood lead in childhood was associated with a 1.79-unit lower score (95% CI, -3.17 to -0.40) in socioeconomic status. An association between greater blood lead levels and a decline in IQ and socioeconomic status from childhood to adulthood was observed with 40% of the association with downward mobility mediated by cognitive decline from childhood.Conclusions and Relevance: In this cohort born in New Zealand in 1972-1973, childhood lead exposure was associated with lower cognitive function and socioeconomic status at age 38 years and with declines in IQ and with downward social mobility. Childhood lead exposure may have long-term ramifications. [ABSTRACT FROM AUTHOR]

Objective. To determine the blood lead levels and identify related risk factors among preschool children in a lead polluted area (Taizhou, China) and provide theoretical support for prevention of lead pollution. Methods. A stratified-clustered-random sampling method was used to determine the survey sample. Blood lead levels were determined by the tungsten atomizer absorption spectrophotometer. Results. A total of 2,018 subjects (average age of 59 months; 1,087 boys and 931 girls) were included. The arithmetic mean, geometric mean, and median blood lead levels of the preschool children were 56.4 μg/L, 48.9 μg/L, and 46 μg/L. A total of 8.8% children had blood lead levels >100 μg/L and 43.9% had blood lead levels >50 μg/L. Mother’s education level, father’s occupation, decorative tableware, exposure to makeup, and the residential floor were all risk factors for elevated blood lead levels (odds ratios of 1.42, 1.21, 1.11, 1.19, and 1.27, resp.), while hand washing before eating food was a protective factor (odds ratio of 0.88). Conclusions. The blood lead levels of preschool children in Taizhou were higher than in other areas in China and in developed countries. Therefore, policies ensuring lead-based industries are not placed in close proximity to residential areas are required. [ABSTRACT FROM AUTHOR]

The adverse effects of lead on human especially childhood have been well established. Largely due to the phase out of lead in gasoline, blood lead levels (BLLs) had declined substantially all over the world including China. In 2004, 2007, 2010, and 2013, we conducted a continuous project including 47,346 children aged 0-6 years old from 11 cities all over China to show how the decline happened and to explore what to do next to improve the BLLs of children of China. Our data shown the BLLs of Chinese children decreased from 46.38, 43.58, 38.95 to 37.17 μg/L, but the decline was not enough. These decline was mainly because of the number decrease of children with high BLLs. Integrated strategy should be used to promote the BLLs of Chinese children, like striving to improve the environment, setting new cutoff for high BLLs, and establishing routine blood lead screening. [ABSTRACT FROM AUTHOR]

Objective: Landfills are high‐risk areas for environmental lead exposure for children living in poverty stricken areas in many countries. This review examines landfills and lead toxicity in children. The review discusses the effects of lead toxicity, provides evidenced based recommendations to reduce lead exposure, and identify gaps in the evidence. Design and Sample: A database search was conducted of articles in English from 1985 to 2014. Ten articles met the inclusion criteria. The Whittemore and Knafl framework and the John Hopkins Research Evidence Appraisal Tool© were used for reviewing the data. Results: Elevated blood lead levels (BLLs) of children living near landfills were related to increased soil lead levels. Toxic effects of lead included adverse outcomes such as encephalopathy or death for children. Different approaches to decrease lead level include environmental surveillance, BLL screening, and soil abatement which are costly. Conclusion: Increased BLL through environmental exposure is connected with poor health outcomes and death among children. Evidence‐based prevention included monitoring and screening and costly soil abatement. It is recommended that future studies focus on community education for exposure avoidance for children living near landfill areas. [ABSTRACT FROM AUTHOR]

Lead paint in old houses is the leading cause of lead poisoning in children under 6 today. To combat this problem, several states have passed lead abatement laws, forcing landlords to remove lead in the homes they rent if tenants have children under the age of 6. However, these laws have unintended consequences, causing landlords to evict tenants rather than abate lead. I use a difference-in-differences approach while employing various model specifications with various fixed effects and sets of controls to examine the impact of Ohio's 2003 lead abatement law on eviction rates. Using newly collected data from the Eviction Lab at Princeton University, I find that the passage of Ohio's lead abatement law sharply increased targeted evictions. Due to the law's passage, the average census district in Ohio faced an increased eviction rate of roughly 0.457 points, corresponding to an additional 13.93 evictions a year. These impacts are highly statistically significant, sizeable, and economically meaningful, indicating that policy makers should incorporate distributional consequences when designing future lead abatement laws in order to avoid unintended consequences and ensure equitable outcomes. [ABSTRACT FROM AUTHOR]

The present study concentrated on a cross-sectional analysis of recent exposure to lead (Pb) and the socioeconomic factors behind increased Pb exposure in Polish children. Lead is one of the most widespread toxic heavy metals in the industrial region of Upper Silesia (Poland). Elevated blood Pb levels in children continue to be a matter of serious concern. The present study involved 4882 children from the Upper Silesia region, aged from 3 yr to 18 yr, over the calendar years 1999 to 2013. The concentration of Pb in blood was determined in each child. The children's parents were asked to answer survey questions about the child's environmental exposure to Pb as well as the socioeconomic condition of the family. Factors that correspond with increased exposure to Pb included: lower level of education of parents, unemployment, parents' occupational Pb exposure, poor socioeconomic status of the family, smoking at home, living on the ground floor of buildings, consumption of locally grown vegetables and fruits, longer outdoor playing periods in a polluted environment, and male gender. Environmental exposure to Pb is the most important factor behind chronic poisoning of children in Upper Silesia. The most important socioeconomic factor associated with concentrations of Pb in children's blood is a lower level of education of a child's mother and father. Environ Toxicol Chem 2016;35:2597-2603. © 2016 SETAC [ABSTRACT FROM AUTHOR]

The article discusses efforts to prevent lead poisoning in both private and public housing. Topics include public perceptions that lead poisoning has been resolved and does not exist in most areas despite scientific evidence proving that lead poisoning is a widespread problem as of 2019, the efficacy of concerted public actions against lead poisoning when implemented and enforced, and the high risk of lead exposure for refugee children both from their native lands and low-income U.S. housing.

The biological or physical outcomes related to living in poverty are predominantly observed in early childhood development, including low birth weight (Bradley et al., 1994; US Department of Health & Human Services, 2000) and lead poisoning (Cecil et al., 2008; Needleman et al., 1990) which precipitate issues with brain development and overall healthy functioning. The present paper explores findings on psychological and sociological impact of poverty and various coping strategies for poverty. [ABSTRACT FROM AUTHOR]