Modeling elevated blood lead level risk across the United States

AbstractLead is a heavy metal without a biological role. High level of lead exposure is known to be associated with hypertension, but the risk at low levels of exposure is uncertain. In this study, data from US NHANES 1999–2016 were analyzed. Adults with blood lead and blood pressure measurements, or self-reported hypertension diagnosis, were included. If not already diagnosed, hypertension was defined according to the AHA/ACC 2017 hypertension guideline. Results were analyzed using R statistics version 3.5.1 with sample weight adjustment. Logistic regression was used to study the association between blood lead level and hypertension. Odds ratio (OR) and 95% confidence interval (95% CI) were estimated. Altogether, 39,477 participants were included. Every doubling in blood lead level was associated with hypertension (OR [95%CI] 1.45 [1.40–1.50]), which remained significant after adjusting for demographics. Using quartile 1 as reference, higher blood lead levels were associated with increased adjusted odds of hypertension (Quartile 4 vs. Quartile 1: 1.22 [1.09–1.36]; Quartile 3 vs. Quartile 1: 1.15 [1.04–1.28]; Quartile 2 vs. Quartile 1: 1.14 [1.05–1.25]). In conclusion, blood lead level is associated with hypertension in the general population with blood lead levels below 5 µg/dL. Our findings suggest that reducing present levels of environmental lead exposure may bring cardiovascular benefits by reducing blood pressure.

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Blood Lead Screening Practices Among US Pediatricians

PEDIATRICS ◽

10.1542/peds.98.3.372 ◽

1996 ◽

Vol 98 (3) ◽

pp. 372-377

Author(s):

James R. Campbell ◽

Stanley J. Schaffer ◽

Peter G. Szilagyi ◽

Karen G. O'Connor ◽

Peter Briss ◽

...

Keyword(s):

Primary Care ◽

Blood Lead Level ◽

Lead Level ◽

Blood Lead ◽

Blood Lead Levels ◽

Elevated Blood ◽

Control And Prevention ◽

Lead Levels ◽

Primary Care Pediatricians ◽

Elevated Blood Lead Levels

Objectives. In 1991, the Centers for Disease Control and Prevention (CDC) decreased the blood lead level of concern to 10 µg/dL (0.48 µmol/L) and recommended universal screening. Because these guidelines continue to provoke controversy, we conducted a study to:1) estimate the proportion of pediatricians who are members of the American Academy of Pediatrics (AAP) who report screening for elevated blood lead levels; 2) describe their clinical practices regarding screening for elevated blood lead levels; 3) compare attitudes of universal screeners, selective screeners, and nonscreeners; and 4) identify characteristics of pediatricians who universally screen. Design. Confidential, cross-sectional survey of a nationally representative random sample of 1610 pediatricians conducted through the AAP Periodic Survey. Subjects. The study included 1035 responders (64% response rate). Analysis was limited to the 734 pediatricians who provide well-child care (ie, primary-care pediatricians). Results. Fifty-three percent of pediatricians reported screening all their patients aged 9 to 36 months, 39% reported screening some, and 8% reported screening none. Among those who screen, 96% use a blood lead assay. The primary risk factors for which selective screeners screen are: history of pica (94%); living in an older home with recent renovations (92%); living in an older home with peeling paint (93%); and having a sibling who had an elevated blood lead level (88%). Among primary-care pediatricians, 73% agree that blood lead levels ≥10 µg/dL should be considered elevated, and 16% disagree. However, 89% of primary-care pediatricians believe that epidemiologic studies should be performed to determine which communities have high proportions of children with elevated blood lead levels, and 34% of primary-care pediatricians believe that the costs of screening exceed the benefits. Conclusions. Three years after the Centers for Disease Control and Prevention issued new guidelines for the management of elevated blood lead levels, a slight majority of primary-care pediatricians in the United States who are members of the AAP report that they universally screen their appropriately aged patients, while most of the remaining pediatricians report screening high-risk patients. Many pediatricians may want additional guidance about circumstances under which selective screening should be considered.

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Should Children With Constipation Undergo Blood Lead Level Screening?

Clinical Pediatrics ◽

10.1177/0009922819832029 ◽

2019 ◽

Vol 58 (6) ◽

pp. 627-632

Author(s):

Vikram Kalathur Raghu ◽

Andrew J. Nowalk ◽

Arvind I. Srinath

Keyword(s):

Confidence Interval ◽

Disease Control ◽

Odds Ratio ◽

Blood Lead Level ◽

Lead Level ◽

Blood Lead ◽

Routine Screening ◽

Elevated Blood ◽

Population Prevalence ◽

Control And Prevention

This study aimed to compare the prevalence of elevated blood lead level in children with constipation to the population prevalence. We reviewed the charts of 441 children who were screened with a blood lead level on presenting to the gastroenterology clinic at UPMC Children’s Hospital of Pittsburgh for evaluation of constipation. The prevalence of blood lead level greater than 5 µg/dL was 1.36% (6/441; 95% confidence interval = 1.23% to 1.49%), which is significantly lower than the 4.01% prevalence in the population reported by the Center for Disease Control and Prevention. No patients had a blood lead level greater than 10 µg/dL. Age under 5 years old showed an increased odds of lead level greater than 5 µg/dL (odds ratio = 7.5; 95% confidence interval = 1.2 to 47.3, P < .05). We concluded that children seen in the gastroenterology clinic for constipation are unlikely to have an elevated blood lead level on routine screening.

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Increased blood lead level induces oxidative stress and alters the antioxidant status of spray painters

Journal of Basic and Clinical Physiology and Pharmacology ◽

10.1515/jbcpp-2018-0229 ◽

2020 ◽

Vol 31 (2) ◽

Author(s):

Mandakini S. Kshirsagar ◽

Jyotsna A. Patil ◽

Arun Patil

Keyword(s):

Nitric Oxide ◽

Uric Acid ◽

Serum Lipid ◽

Blood Lead Level ◽

Lead Level ◽

Lipid Peroxide ◽

Blood Lead ◽

Elevated Blood ◽

Serum Lipid Peroxide ◽

Antioxidant Parameters

AbstractBackgroundThe aim of this study was to know the present scenario of blood lead level and its effect on serum lipid peroxide and antioxidant parameters of spray painters.MethodsWe included 42 male spray painters and 50 control subjects with an age range of 20–45 years. Blood lead level, serum lipid peroxide and antioxidant parameters, i.e. erythrocyte catalase, superoxide dismutase (SOD), plasma ceruloplasmin, nitric oxide, uric acid and bilirubin, were quantified by standard methods.ResultsWe observed the significant elevated blood lead (p < 0.001, 458%), lipid peroxide (p < 0.001, 170%), uric acid (p < 0.001, 25.6%) and bilirubin (p < 0.01, 24.5%) and the significant decrease in antioxidant enzymes like SOD (p < 0.001, −50.4%), catalase (p < 0.001, −34.33%), ceruloplasmin (p < 0.001, −32.7%) and nitric oxide (p < 0.001, −39.58%) in the study group as compared to control. A significant positive correlation coefficient (r) of blood lead level with lipid peroxide (r = 0.44, p < 0.001), uric acid (r = 0.33 p < 0.05) and bilirubin (r = 0.35, p < 0.05) and a negative correlation with SOD (r = −0.32, p < 0.05), catalase (r = −0.33, p < 0.05), ceruloplasmin (r = −0.27, p < 0.05) and nitric oxide (r = 0.30, p < 0.05) were observed.ConclusionsElevated blood lead level induces serum lipid peroxide and alters the antioxidant enzymes of spray painters. Therefore, it is necessary to reduce the blood lead level by taking proper precautions while spraying the paints, and additional antioxidant supplementation like vitamin C, multivitamin and multiminerals will be useful in reducing oxidative stress.

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