Determinants of Elevated Blood Lead during Pregnancy in a Population Surrounding a Lead Smelter in Kosovo, Yugoslavia

Abstract

We are prospectively examining the relation between environmental lead exposure and pregnancy outcome in cohorts of women exposed to a wide range of air lead concentrations. Titova Mitrovica, Yugoslavia, is the site of a large lead smelter, refinery, and battery factory. At midpregnancy, 602 women in T. Mitrovica and 900 women in Pristina, a non-lead-exposed control town, were interviewed. Blood was obtained for blood lead (PbB), hemoglobin, erythrocyte protoporphyrin, and serum ferritin measurements. Women were seen again at delivery, at which time maternal and umbilical cord blood samples were obtained. While many demographic and social characteristics were similar across the two towns, women in Pristina were more likely to report employment outside the home, cigarette smoking, and alcohol use during pregnancy. As expected, PbB levels were substantially higher in the smelter town. At midpregnancy, PbB geometric means were 17.1 ,g/dL in T. Mitrovica and 5.1 Ag/dL in Pristina; 86% of the pregnant women in T. Mitrovica, compared to 3.4% of those in Pristina, had PbB levels > 10 ytg/dL. Within T. Mitrovica, distance between the home and the smelter was the most important predictor of PbB at mid-pregnancy and delivery. Husband's employment in the lead industry was associated with a significant increase in maternal PbB levels independent of place of residence. Higher maternal serum ferritin concentrations were associated with lower PbB levels, suggesting that dietary iron inhibits lead absorption. Overall, the placenta was a poor barrier to lead; the relationship between maternal PbB and umbilical cord PbB was linear across a wide range of PbB levels.

Association between hemochromatosis genotype and lead exposure among elderly men: the normative aging study.

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Lead Exposure in Children: Prevention, Detection, and Management

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Follow-up screening of lead-poisoned children near an auto battery recycling plant, Haina, Dominican Republic.

“…Based on the mean BPb levels of severely lead-poisoned Haina children and those of pregnant women from earlier and present groups, recent newborns in the community are expected to have high BPb levels and should be further investigated. Studies from similar situations have shown persistent high BPb levels in both mothers and newborns (35). This issue should be of equal or perhaps greater concern to the local public health authorities because the detrimental effect of lead causes far more severe damage in fetuses and newborns than in children or adults.…”