Behavioral and Environmental Explanations of Elevated Blood Lead Levels in Immigrant Children and Children of Immigrants

Background: This study aims to assess lead exposure and associated risk factors among newly arrived migrant (M) (immigrant and refugees) children in Greece and a matched control of native (N) children. Methods: A prospective, cross-sectional study was performed in an outpatient clinic of a tertiary children’s hospital. Results: From 2010 to 2014, 598 children (M/N: 349/249) with a mean age of 6.96 years old (range 1–14, SD 3.76) were enrolled. Blood lead levels (BLLs) ranged from 0.7 to 21 μg/dL in migrant and from 0.4 to 10 μg/dL in native Greek children. Elevated BLLs ≥ 5 μg/dL were detected in 27.7% of migrants and 1.2% of natives (p < 0.001). A significant association was found between EBLLs and childrens’ age (≤5 years) (OR: 1.8, p-value 0.02) and EBLLs with Asian origin (OR: 3.63, p-value 0.023). Conclusion: New migrant children presented with increased BLLs when compared to their age- and sex-matched controls. Younger age and Asian origin were significant risk factors associated with elevated BLLs among children. Early screening, secondary prevention, and regular follow-up could prove useful in this vulnerable population.

Section: Discussionsupporting

confidence: 92%

Lead Exposure and Associated Risk Factors among New Migrant Children Arriving in Greece

Tanaka

Petsios

Dikalioti

et al. 2018

“…To improve the sensitivity of this criterion (30% risk of having BLLs higher than 44 µg/L), we recommend asking the child’s parents whether they use ceramics, cosmetics or remedies containing lead, as in the US lead risk questionnaires [ 43 ]. Immigrant children were also more at risk of having BLLs exceeding 44 µg/L, possibly explained by an environmental lead exposure in their country of origin, as shown by Kaplowitz and coll [ 44 ].…”

Section: Discussionmentioning

confidence: 99%

Screening for Elevated Blood Lead Levels in Children: Assessment of Criteria and a Proposal for New Ones in France

Etchevers

Glorennec

Strat

et al. 2015

The decline in children’s Blood Lead Levels (BLL) raises questions about the ability of current lead poisoning screening criteria to identify those children most exposed. The objectives of the study were to evaluate the performance of current screening criteria in identifying children with blood lead levels higher than 50 µg/L in France, and to propose new criteria. Data from a national French survey, conducted among 3831 children aged 6 months to 6 years in 2008–2009 were used. The sensitivity and specificity of the current criteria in predicting blood lead levels higher than or equal to 50 µg/L were evaluated. Two predictive models of BLL above 44 µg/L (for lack of sufficient sample size at 50 µg/L) were built: the first using current criteria, and the second using newly identified risk factors. For each model, performance was studied by calculating the area under the ROC (Receiver Operating Characteristic) curve. The sensitivity of current criteria for detecting BLL higher than or equal to 50 µg/L was 0.51 (0.26; 0.75) and specificity was 0.66 (0.62; 0.70). The new model included the following criteria: foreign child newly arrived in France, mother born abroad, consumption of tap water in the presence of lead pipes, pre-1949 housing, period of construction of housing unknown, presence of peeling paint, parental smoking at home, occupancy rates for housing and child’s address in a cadastral municipality or census block comprising more than 6% of housing that is potentially unfit and built pre-1949. The area under the ROC curve was 0.86 for the new model, versus 0.76 for the current one. The lead poisoning screening criteria should be updated. The risk of industrial, occupational and hobby-related exposure could not be assessed in this study, but should be kept as screening criteria.

“…Also, because of decreasing ubiquitous exposure to ambient air lead [25], the impact of lifestyle-related factors, including individual dietary habits, on erythrocyte lead levels, may be stronger today than in the past. There is evidence that early exposure to lead (e.g., those amenable to a lower socio-economic status of parents, including living in poorly maintained houses, and passive exposure to parental smoking) substantially affects blood lead levels in children [45,46,47]. As lead accumulates in the body, our lack of information on possible sources of exposure to lead in childhood may be seen as a limitation, although possibly not a major one considering that erythrocyte lead is thought to mainly reflect recent exposures [48].…”

Section: Discussionmentioning

confidence: 99%

Determinants of Erythrocyte Lead Levels in 454 Adults in Florence, Italy

Caini¹,

Bendinelli²,

Masala³

et al. 2019

Background: Lead exposure, even at low levels, is associated with adverse health effects in humans. We investigated the determinants of individual lead levels in a general population-based sample of adults from Florence, Italy. Methods: Erythrocyte lead levels were measured (using inductively coupled plasma-mass spectrometry) in 454 subjects enrolled in the Florence cohort of the European Prospective Investigation into Cancer and Nutrition (EPIC) study in 1992–1998. Multiple linear regression models were used to study the association between demographics, education and working history, lifestyle, dietary habits, anthropometry, residential history, and (among women) menstrual and reproductive history and use of exogenous sex hormones, and erythrocyte lead levels. Results: Median lead levels were 86.1 μg/L (inter-quartile range 65.5–111.9 μg/L). Male gender, older age, cigarette smoking and number of pack-years, alcohol intake, and residing in urban areas were positively associated with higher erythrocyte lead levels, while performing professional/managerial or administrative work or being retired was inversely associated with lead levels. Among women, lead levels were higher for those already in menopause, and lower among those who ever used hormone replacement therapy. Conclusions: Avoidable risk factors contribute to the lead body burden among adults, which could therefore be lowered through targeted public health measures.