A Randomized Trial of the Effect of Dust Control on Children's Blood Lead Levels

PEDIATRICS ◽  
1996 ◽  
Vol 98 (1) ◽  
pp. 35-40 ◽  
Author(s):  
Bruce P. Lanphear ◽  
Nancy L. Winter ◽  
Leslie Apetz ◽  
Shirley Eberly ◽  
Michael Weitzman
Keyword(s):  
Treatment Group ◽  
Outcome Measures ◽  
Lead Level ◽  
Intervention Group ◽  
Blood Lead ◽  
Dust Control ◽  
Blood Lead Levels ◽  
Control Group ◽  
Significant Difference ◽  
Lead Levels

Objective. Dust control is recommended as one of the cornerstones of controlling childhood lead exposure; however, the effectiveness of dust control has not been demonstrated for children who have low to mild elevations in blood lead (ie, less than 25 µg/dL). The objective of this study was to determine whether dust control, as performed by families, had an effect on children's blood lead levels and dust lead levels in children's homes. Design. Randomized, controlled trial. Setting. Community-based trial in Rochester, NY. Participants. One hundred four children, 12 to 31 months of age at baseline. Intervention. Families and children were randomized to one of two groups. Families of children in the intervention group received cleaning supplies, information about cleaning areas that are often contaminated with lead, and a cleaning demonstration. Families in the control group received only a brochure about lead poisoning prevention. Outcome Measures. Baseline measurements of lead in blood, house dust, soil, water, and paint were taken from both groups. Seven months after enrollment, a second blood lead assay was obtained, and lead levels in household dust were measured. The main outcome measures were change in blood lead levels and dust lead levels by treatment group. Results. The median blood lead level of children enrolled in the study was 6.7 µg/dL (range, 1.7 to 30.6 µg/dL). There was no significant difference in the change of children's blood lead levels or dust lead levels by treatment group. The median change in blood lead levels among children in the intervention group was -0.05 µg/dL compared with -0.60 µg/dL among those in the control group. There also was no significant difference in the change of dust lead by group assignment, although there was a trend toward a significant difference in the percentage of change in dust lead levels on noncarpeted floors, which was greater among houses in the intervention group. Conclusions. These data suggest that an intervention that consists only of providing cleaning supplies and a brief description of dust control is not effective at reducing blood lead levels among urban children with low to mild elevations in blood lead levels at a 7-month followup.

scholarly journals Oxidative Stress in Painters Exposed to Low Lead Levels

2008 ◽  
Vol 59 (3) ◽  
pp. 161-169 ◽  
Author(s):  
Imran Mohammad ◽  
Abbas Mahdi ◽  
Aryapu Raviraja ◽  
Islam Najmul ◽  
Ahmad Iqbal ◽  
...  
Keyword(s):  
Oxidative Stress ◽  
Antioxidant Status ◽  
Aminolevulinic Acid ◽  
Lead Level ◽  
Lead Toxicity ◽  
Blood Lead ◽  
Blood Lead Levels ◽  
Control Group ◽  
Zinc Protoporphyrin ◽  
Lead Levels

Oxidative Stress in Painters Exposed to Low Lead LevelsLead toxicity is a public health problem particularly to the children and to occupationally exposed adults. Evidence is mounting successively regarding the adverse health effects of lead at low levels. This study was undertaken to assess the antioxidant status of lead-exposed residential and commercial painters of Lucknow city in Uttar Pradesh, India.Thirty-five painters aged 20 to 50 years who had blood lead levels ≤400 μg L-1were selected for the study from a population of 56 male painters initially screened for blood lead. The control group included an equal number of subjects of the same age group without any occupational exposure to lead.We studied the association between low lead level exposure and antioxidant status and found that blood lead levels in painters were approximately seven times as high as in controls [(219.2 ± 61.9) μg L-1vs. (30.6±10.1) μg L-1, respectively]. Among the biomarkers of lead toxicity a significant decrease in the level of delta-aminolevulinic acid dehydratase [(9.13±4.62) UL-1vs. (39.38±5.05) UL-1] and an increase in the level of zinc protoporphyrin [(187.9±49.8) μg L-1vs. (26.4±5.5) μg L-1] were observed in painters compared to controls. Among antioxidant enzymes, painters showed a significant decrease in catalase [(56.77±11.11) UL-1vs. (230.30±42.55) UL-1] and superoxide dismutase [(0.64±0.19) UL-1 vs. (2.68±0.62) UL-1] compared to controls. Lipid peroxidation was monitored by measuring thiobarbituric acid reactive substances (TBARS) that were expressed in terms of malondialdehyde (MDA) equivalents. Concentration of MDA in plasma was higher in painters than in controls [(7.48±1.31) nmol mL-1vs. (3.08±0.56) nmol mL-1]. Significant changes were also observed in reduced and oxidised glutathione levels. The strong association between blood lead levels and oxidative stress markers in this population suggests that oxidative stress should be considered in the pathogenesis of lead-related diseases among people with low level environmental exposure to lead.

Relationship of Diet to Lead Poisoning in Children

PEDIATRICS ◽  
1975 ◽  
Vol 55 (5) ◽  
pp. 636-639
Author(s):  
Joyce Mooty ◽  
Charles F. Ferrand ◽  
Paul Harris
Keyword(s):  
Dietary Intake ◽  
Lead Poisoning ◽  
Low Income ◽  
Demographic Data ◽  
Daily Intake ◽  
Blood Lead ◽  
Blood Lead Levels ◽  
Control Group ◽  
Significant Difference ◽  
Lead Levels

Forty-six children, aged 24 to 47 months (25 controls and 21 subjects) chosen according to low and high blood lead levels respectively, were studied to ascertain the presence or absence of a relationship between dietary intake and the occurrence of plumbism (in children of low-income families). Through single-blind interviews by a nutritionist, dietary intakes were gathered, and the average daily intake of calories, protein, and iron was calculated. Hemoglobins, hematocrits, heights, weights, blood lead levels, and social and demographic data had been gathered during the routine check for lead poisoning and at registration at the clinic. The mean caloric and protein intake as percent of recommended dietary allowances were equal and adequate for both controls and subjects. There was no statistically significant difference between the controls and subjects with respect to iron intake which was low in both groups. Mean hemoglobin and hematocrit levels were in the anemic range for both groups. The subjects were shorter and weighed less than the control group. Pica was more prevalent among children with plumbism. The findings of this study suggest that some factors other than dietary intake must account for the occurrence of lead poisoning in the subjects and that Blacks have a higher prevalence of plumbism in our area.

Clinical manifestations of lead workers of Mangalore, India

2006 ◽  
Vol 22 (9) ◽  
pp. 405-413 ◽  
Author(s):  
Ajee Kuruvilla ◽  
V.V. Pillay ◽  
Prabha Adhikari ◽  
T. Venkatesh ◽  
M. Chakrapani ◽  
...  
Keyword(s):  
Blood Lead Level ◽  
Lead Level ◽  
Clinical Manifestations ◽  
Blood Lead ◽  
Exposed Group ◽  
Blood Lead Levels ◽  
Abdominal Colic ◽  
Significant Difference ◽  
Lead Levels ◽  
Battery Workers

Objective: To correlate blood lead levels and clinical manifestations. Participants: Battery workers and painters (occupationally exposed to lead in and around Mangalore, India) and occupationally unexposed controls. Main outcome measures: We measured the blood lead levels by anodic stripping voltammetry, and a clinical examination was carried out on all participants. Results: There was a statistically significant difference between the lead-exposed group and controls with respect to clinical manifestations. The prominent findings among the lead-exposed group were fatigue, abdominal colic, abdominal discomfort, backache, muscular exhaustability, myalgia and paresthesia, at a blood lead level ranging from 0.4 to 116.6 μg/dL. Conclusions: Such a study on battery workers and painters has not been reported in India. Several attempts have been made over the years to relate blood lead levels to adverse health effects. It was not possible to determine a precise blood lead level below which symptoms never occur or a blood lead level at which symptoms are always reported. Toxicology and Industrial Health 2006; 22: 405-413.

scholarly journals Donepezil for mild cognitive impairment in Parkinson’s disease

2021 ◽  
Vol 11 (1) ◽  
Author(s):  
Kyoungwon Baik ◽  
Seon Myeong Kim ◽  
Jin Ho Jung ◽  
Yang Hyun Lee ◽  
Seok Jong Chung ◽  
...  
Keyword(s):  
Parkinson’S Disease ◽  
Parkinson's Disease ◽  
Cognitive Impairment ◽  
Mild Cognitive Impairment ◽  
Treatment Group ◽  
Outcome Measures ◽  
Rating Scale ◽  
Secondary Outcome ◽  
Control Group ◽  
Significant Difference

AbstractWe investigated the efficacy of donepezil for mild cognitive impairment in Parkinson’s disease (PD-MCI). This was a prospective, non-randomized, open-label, two-arm study. Eighty PD-MCI patients were assigned to either a treatment or control group. The treatment group received donepezil for 48 weeks. The primary outcome measures were the Korean version of Mini-Mental State Exam and Montreal Cognitive Assessment scores. Secondary outcome measures were the Clinical Dementia Rating, Unified Parkinson’s Disease Rating Scale part III, Clinical Global Impression scores. Progression of dementia was assessed at 48-week. Comprehensive neuropsychological tests and electroencephalography (EEG) were performed at baseline and after 48 weeks. The spectral power ratio of the theta to beta2 band (TB2R) in the electroencephalogram was analyzed. There was no significant difference in the primary and secondary outcome measures between the two groups. However, the treatment group showed a significant decrease in TB2R at bilateral frontotemporoparietal channels compared to the control group. Although we could not demonstrate improvements in the cognitive functions, donepezil treatment had a modulatory effect on the EEG in PD-MCI patients. EEG might be a sensitive biomarker for detecting changes in PD-MCI after donepezil treatment.

scholarly journals The correlation between uremic pruritus and blood lead levels in prevalent hemodialysis patients and its relation to the severity of pruritus using visual analog score

2021 ◽  
Vol 33 (1) ◽  
Author(s):  
Sahar Mahmoud Shawky ◽  
Reeham Abdel Aziz Abdel Hamid ◽  
Lina Essam Khedr
Keyword(s):  
Blood Lead ◽  
Cross Sectional Study ◽  
Hemodialysis Patients ◽  
Visual Analog Score ◽  
Blood Lead Levels ◽  
Cross Sectional ◽  
Uremic Pruritus ◽  
Significant Difference ◽  
Lead Levels ◽  
Group 2

Abstract Background Pruritus is a common and often distressing symptom in patients with chronic kidney disease. Though the pathogenesis of uremic pruritus remains poorly understood, systemic inflammation has presented itself as one of the possible explanations. High blood lead levels (BLLs) have been noted to be associated with inflammation and poor nutritional status in hemodialysis patients. Our aim is to study the relation between blood lead levels and uremic pruritus. This is a cross-sectional study that enrolled 50 patients; all were on regular hemodialysis 3 times per week for at least 6 months. Patients were divided into 2 groups, group 1 (n =10) with no pruritus and group 2 (n=40) with varying degrees of pruritus. Group 2 was further divided according to intensity of pruritus by visual analog score (VAS) into mild (n=10), moderate (n=20), and severe pruritus (n=10). Results There was a significant difference in serum lead levels and ferritin levels between groups 1 and 2 (p value < 0.01 and < 0.05, respectively). There was a statistically significant difference in serum lead levels in the groups with varying intensity of pruritus, having higher serum lead levels in patients who exhibited severe pruritus (p value < 0.005) Moreover, a statistically significant relation between elevated blood lead levels and the duration of dialysis was observed in this study. Conclusion Uremic pruritus is a multi-factorial phenomenon, and our study showed that blood lead levels in hemodialysis patients might be associated with increased intensity of pruritus.

scholarly journals Blood lead level and risk of hypertension in the United States National Health and Nutrition Examination Survey 1999–2016

2021 ◽  
Vol 11 (1) ◽  
Author(s):  
Man Fung Tsoi ◽  
Chris Wai Hang Lo ◽  
Tommy Tsang Cheung ◽  
Bernard Man Yung Cheung
Keyword(s):  
Blood Pressure ◽  
Lead Exposure ◽  
Blood Lead Level ◽  
Lead Level ◽  
Blood Lead ◽  
The United States ◽  
Study Data ◽  
Blood Lead Levels ◽  
Environmental Lead ◽  
Lead Levels

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.

Hardness of Domestic Water and Blood Lead Levels

1983 ◽  
Vol 2 (4) ◽  
pp. 645-648 ◽  
Author(s):  
P.C. Elwood ◽  
K.M. Phillips ◽  
N. Lowe ◽  
J.K. Phillips ◽  
C. Toothill
Keyword(s):  
Blood Lead Level ◽  
Lead Level ◽  
Blood Lead ◽  
Hard Water ◽  
Control Area ◽  
Blood Lead Levels ◽  
Domestic Water ◽  
Solvent Water ◽  
Small Rise ◽  
Lead Levels

1 The effect on the blood lead levels of residents in an area in which a soft plumbo-solvent water was hardened is examined. 2 Water lead levels fell after hardening was introduced whereas there was a small rise in water lead levels in a control area monitored over the same time. 3 The blood lead levels of residents fell after hardening and the fall was slightly greater than would have been predicted on the basis of the change in water lead levels. This suggests that lead is less well absorbed from hard water than from soft water. 4 Following hardening there was a significant fall in mean blood lead level of subjects living in houses which had initially had negligible amounts of lead in the water. This suggests that hard water may interfere with the absorption of lead from sources other than water.

Blood Lead Screening Practices Among US Pediatricians

PEDIATRICS ◽  
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.

Effect of Pressure Injury Prevention Guides Used In a Pediatric Intensive Care

2019 ◽  
Vol 29 (4) ◽  
pp. 249-255
Author(s):  
Gülzade Uysal ◽  
Duygu Sönmez Düzkaya ◽  
Tülay Yakut ◽  
Gülçin Bozkurt
Keyword(s):  
Intensive Care ◽  
Treatment Group ◽  
Injury Prevention ◽  
Intervention Group ◽  
Pediatric Intensive Care ◽  
Control Group ◽  
Post Intervention ◽  
Significant Difference ◽  
Pressure Injury ◽  
Pressure Injury Prevention

The aim of this study was to determine the effectiveness of a pressure injury prevention guide used in a pediatric intensive care unit (PICU) on the occurrence of pressure injuries. The design is a pre-post intervention with a control group and a prospective intervention group. Pressure injuries occurred on 9.4% of children in the nontreatment group, and in 3.6% of children in the treatment group. There was a statistically significant difference in the occurrence of pressure injuries between the nontreatment group and the treatment group ( p = .033). The average Braden Q pressure injury score was 12.20 ± 2.280 at the beginning of the intensive care hospitalization, and 13.73 ± 3.312 at discharge in the treatment group ( p < .001). The results show that the risk of pressure injuries was reduced and pressure injuries occurred later when an evidence-based pressure injury prevention guide was used.

scholarly journals Against lead poisoning: effectiveness of housing first and counselling in the home

2019 ◽  
Vol 29 (Supplement_4) ◽  
Author(s):  
R Laporte ◽  
H Barberin de Barberini ◽  
E Jouve ◽  
K Hadji ◽  
S Gentile
Keyword(s):  
Lead Poisoning ◽  
Lead Exposure ◽  
Blood Lead Level ◽  
Lead Level ◽  
Blood Lead ◽  
Housing First ◽  
Blood Lead Levels ◽  
Stable Housing ◽  
Lead Levels

Abstract Background Removing lead sources is the main measure against child lead poisoning. Medical treatment is ineffective for most mild cases and particularly against long-term complications in neurological development. However, the effectiveness of interventions to eliminate sources of lead exposure has not been fully established, mainly because of the diversity of situations. The objective of this study was to determine the influence of several interventions (housing counselling, rehabilitation and relocation) on blood lead levels in two situations (stable unhealthy housing with old flaked lead paints, slums with family recycling practices by incineration). Methodology A historical cohort of lead poisoning in children has been established in Marseille, France. Medical follow-up followed national guidelines. Environmental interventions followed legal procedures, where available. In slums, counselling was adapted to the exposure. A generalized mixed model was developed to study the kinetics of blood lead levels after the interventions. Results 151 children were included; age = 5.4 (SD = 7.8) years; 85 (56%) lived in stable unhealthy housing, others lived in slums. Medical follow-up included 492 blood lead levels. For children living in stable unhealthy housing, blood lead level decrease was significantly associated with every intervention: housing counselling, rehabilitation and relocation (respectively p &lt; 0.005; p &lt; 0.05 and p &lt; 0.005). For children living in slums, blood lead level decrease was only associated with relocation in a stable housing (p &lt; 0.005). Conclusions Several interventions are effective to decrease blood lead levels in unhealthy housing. In slums, access to a stable housing first is a prerequisite for any intervention against child lead poisoning, even when related to family practices. Key messages In stable unhealthy housing, several interventions against lead exposure can be effective to raise a strategy. But, environmental health and access to housing first needs to be addressed for their implementation.

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