Examining the relationship between blood lead level and stunting, wasting and underweight- A cross-sectional study of children under 2 years-of-age in a Bangladeshi slum

Abstract

Elevated blood lead level (BLL) is known to cause cardiac, immune, and cognitive damage but had not been thoroughly studied in relation to stunting among children under two years of age. We primarily aimed to assess the relationship between elevated BLL, the accumulation of concerned amount of the metal lead in blood and stunting and secondarily—wasting and underweight amongst Bangladeshi children less than two years of age. For this cross-sectional study, BLL measurements, anthropometric data, and socioeconomic indicator information were collected and analyzed for 729 children under two years of age upon enrollment in the MAL-ED study conducted in a Bangladeshi slum area. Univariate, bivariate and multivariate analyses were carried out to observe the proportion and mean and contribution of elevated BLL and other relevant variables in explaining the occurrence of stunting. Of the enrolled subjects, 39.0% were stunted [length-for-age z score (LAZ<-2)], 50.3% were male, and 86.6% had an elevated BLL (≥5μg/dL). Mean BLL of stunted children was 8.47 ± 3·37 μg/dL and 8.10 ± 3·80 μg/dL for non-stunted children. Proportion of children with elevated BLL was not significantly different between the stunted and non-stunted groups (p>0.05). When adjusted for other variables, elevated BLL was found to be a significant predictor of stunting and underweight (p<0.05) but not wasting (p>0.05). Elevated BLL (p<0·01), child’s gender and weight (p<0·001), maternal body mass index (BMI) (p<0.05) and severe household food insecurity (p<0·05) were all significantly associated with stunting in the multivariate model. Increased odds of stunting was also observed for increased BLL. The findings suggest that chronic lead poisoning is significantly associated with high level of stunting among child slum dwellers in Bangladesh. These findings strengthen the argument for improved lead reduction efforts in Bangladesh, where lead poisoning and stunting are both highly prevalent.

Environmental exposure to metal mixtures and linear growth in healthy Ugandan children

“…The population in this study had a higher prevalence of stunting, at 52.4%, compared to our urban population in Uganda (22.7%) and a lower median blood lead level at 4.2 μg/dL (IQR: 1.7-7.6) vs 5.8 μg/dL (4.5-7.7) in our Ugandan population. Another Bangladeshi study of 729 children under age 2 years in an urban slum environment, of which 39% were stunted and 86.6% had an elevated blood lead level (�5μg/dL), found no difference in blood lead levels between children who were stunted and those who were not [32]. In addition to childhood concurrent Pb level, prenatal Pb exposures have been associated with decreased https://doi.org/10.1371/journal.pone.0233108.g003…”

Risk factors of stunting during the complementary feeding period 6-23 months in the Philippines

“…The negative impact of household food insecurity on childhood stunting was reported in Bangladesh (Alam et al, 2017;Mistry et al, 2019), where significant negative association between food insecurity and stunting among children under 2 years was documented. Other studies reported, however, that only severe food insecurity was significantly responsible for short stature in children (Choudhury et al, 2017;Raihan et al, 2018). Empirically, higher income enables households to secure adequate, diverse, frequent, and safe foods, and to ensure proper hygiene and sanitation that may result in a more enabling environment that leads to better nutrition among household members, specifically young children under 2 years of age.…”

Determinants of stunting during the first 1,000 days of life in Bangladesh: A review

“…and Mistry et al(2019)documented a significant negative association between food insecurity and stunting among children under 2 years old. However, the other two studies that investigate according to the status of food insecurity, and they reported only severe food insecurity was responsible significantly for being short stature(Choudhury et al, 2017;Raihan et al, 2018) Mistry et al (2019). identified the quality of drinking water is not significantly associated with being short stature among children 0-2 years in Bangladesh.…”