Are Blood Lead Levels in the United States Still Declining? The US National Health Nutrition and Examination Survey (NHANES) 1999-2016

2020 ◽  
Author(s):  
Kelvin KW Lui ◽  
Man-Fung Tsoi ◽  
Tommy Tsang Cheung ◽  
Ching-Lung Cheung ◽  
Bernard MY Cheung
Keyword(s):  
Low Income ◽  
Lead Level ◽  
Blood Lead ◽  
The United States ◽  
Reference Level ◽  
The Us ◽  
Low Income Groups ◽  
Lead Levels ◽  
Safe Limit ◽  
The Mean

Abstract Background: Lead is toxic without a safe limit. The current upper reference blood lead level (BLL), 5 μg/dL, came from the 97.5th percentile in children aged 1-5 years in NHANES 2007-2010.Objectives: We studied the latest trend in BLL in US NHANES and estimated the proportion of children with BLL ≥5 μg/dL, which would inform the setting of an upper reference level.Methods: We analyzed 68877 participants (aged 1 to 85 years) with BLL measurements in NHANES 1999-2016 using SPSS complex sample module v25.0.Results: In NHANES 2011-2012, 2013-2014, and 2015-2016, the mean and 95% confidence intervals (CIs) of BLLs (μg/dL) were 0.97 (0.96, 0.99), 0.86 (0.85, 0.87), and 0.82 (0.81, 0.83), respectively (P <0.0001). The estimated proportion (95% CI) of children aged 1-5 years with elevated BLL (EBLL) in 2011-2012, 2013-2014, and 2015-2016 were 2.0% (1.3, 3.0), 0.5% (0.4, 0.7), and 1.3% (0.8, 2.3), respectively (P=0.267). In 2015-2016, the proportion of children with EBLL was similar in high- and low-income groups (P = 0.9979). The estimated 97.5th percentile of BLL in children was 3.71 μg/dL in NHANES 2015-2016.Conclusions: BLL continued to decline in the overall US population. The disparity in BLL in children from higher and lower income families has decreased. Our findings support a reduction in the reference BLL, continual monitoring of population BLL and continual efforts to reduce environmental exposure to lead.

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.

scholarly journals Association Between Blood Lead Level and Uncontrolled Hypertension in the US Population (NHANES 1999–2016)

2020 ◽  
Vol 9 (13) ◽  
Author(s):  
Hui Miao ◽  
Yan Liu ◽  
Thomas C. Tsai ◽  
Joel Schwartz ◽  
John S. Ji
Keyword(s):  
Blood Pressure ◽  
Smoking Status ◽  
Lead Level ◽  
Blood Lead ◽  
Uncontrolled Hypertension ◽  
Serum Cotinine ◽  
Cross Sectional ◽  
Health And Nutrition ◽  
The Us ◽  
Lead Levels

Background This study aims to explore whether higher blood lead levels ( BLL ) may be associated with failure to control blood pressure and subsequent uncontrolled hypertension. Methods and Results We used serial cross‐sectional waves of the US National Health and Nutrition Examination Survey (NHANES) from 1999 to 2016. 30 762 subjects aged 20 years and above were included. Uncontrolled hypertension was defined as systolic blood pressure ≥130 mm Hg or diastolic blood pressure ≥80 mm Hg. We estimated odds ratios ( OR s) of quartiles of BLL for any hypertension and uncontrolled hypertension by sex using logistic regression, adjusted for demographics, smoking status, serum cotinine, alcohol intake, body mass index, and menopause status in women. The weighted prevalence of hypertension was 46.7%, of which 80.1% were uncontrolled. Men, younger ages, ethnic minorities, people with lower income, never and current smokers, and people with higher BLL were less likely to have their hypertension controlled. In men, compared with the lowest quartile of BLL (<0.94 μg/dL), the highest 2 quartiles (0.94–1.50 μg/dL, 1.50–2.30 μg/dL) were associated with hypertension (Q2: OR , 1.12; 95% CI , 0.96–1.30; Q3: OR , 1.16; 95% CI , 1.01–1.34; Q4: OR , 1.25; 95% CI , 1.08–1.45), but not in women. In hypertensive men, higher BLL was related to uncontrolled hypertension compared with the lowest quartile (Q2: OR , 1.34; 95% CI , 0.98–1.85; Q3: OR , 1.70; 95% CI , 1.26–2.30; Q4: OR , 1.96; 95% CI , 1.45–2.65). In women, the relationship was similar (Q2: OR , 1.26; 95% CI , 0.95–1.67; Q3: OR , 1.48; 95% CI , 1.10–2.00; Q4: 1.70; 95% CI , 1.26–2.30). Conclusions BLL is associated with higher prevalence of hypertension and uncontrolled hypertension, with more pronounced association in men.

scholarly journals Saliva as a matrix for biomonitoring of occupational and environmental exposure to lead

Biomonitoring ◽  
2014 ◽  
Vol 1 (1) ◽  
Author(s):  
Jackie Morton ◽  
Elizabeth Leese ◽  
Anne-Helen Harding ◽  
Kate Jones ◽  
Ovnair Sepai
Keyword(s):  
Blood Lead Level ◽  
Lead Level ◽  
Blood Lead ◽  
Blood Samples ◽  
Icp Ms ◽  
Occupational And Environmental Exposure ◽  
Lead Levels ◽  
Exposure Levels ◽  
Lead Workers ◽  
The Mean

AbstractBackground: To evaluate whether salivary lead can be used as a surrogate for blood lead, and if so, over what concentration range.Methodology: Three saliva devices were evaluated and one chosen to undertake this project. Paired saliva and blood samples were collected from 89 UK lead workers. Lead concentrations were determined using ICP-MS. In addition, haemoglobin and ZPP levels were determined in the blood samples and albumin was determined in the saliva samples to investigate standardisation using protein adjustments.Results: The chosen saliva device gave low but consistent recoveries for lead in saliva and the blank levels were low. The mean +/- SD blood lead level was 19.9 +/- 14 μg/dl; the mean +/- SD saliva lead level was 19.1 +/- 32.5 μg/l for 89 workers. Log10-transformed data showed correlation of r=0.69. The protein adjustments did not improve the blood-saliva correlation.Conclusions: This study has demonstrated that salivary lead measurement is feasible and correlated with blood lead levels, at least at occupational exposure levels, and may have value as a screening technique. Correlation may improve at environmental levels where exposures are generally more consistent and chronic, although this needs to be demonstrated in a genuine environmental population.

Comparison of serum and urine lead levels in opium addicts with healthy control group

2016 ◽  
Vol 35 (8) ◽  
pp. 861-865 ◽  
Author(s):  
H Khatibi-Moghadam ◽  
M Khadem-Rezaiyan ◽  
R Afshari
Keyword(s):  
Patient Group ◽  
Lead Level ◽  
Blood Lead ◽  
Atomic Absorption Spectrophotometry ◽  
Mean Value ◽  
Healthy Control Group ◽  
Control Group ◽  
Healthy Control ◽  
Lead Levels ◽  
The Mean

Context: Lead-contaminated opium is one of the new sources of lead exposure in our region. As far as the literature review is concerned, there are limited comparative studies about comparison of blood lead level (BLL) in addict patients with healthy controls. Objective: We aimed to compare BLL and urine lead level (ULL) between opium addicts with the healthy control group. Materials and Methods: Forty opium addict subjects (mean age: 43 ± 10 years) as the patient group and 40 healthy subjects (mean age: 41 ± 9 years) as the control group participated. Three milliliter of whole blood and urine was obtained from both groups and lead level was assessed using atomic absorption spectrophotometry. Results: The mean value of BLL in patient group was 7.14 ± 1.41 mcg/dL and that in the healthy control group was 5.42 ± 1.46 mcg/dL. The mean value of ULL was 2.62 ± 0.83 mcg/dL in the patient group and 2.50 ± 0.76 mcg/dL in the healthy control group. BLL was different in the two groups ( p < 0.001), but ULL was not ( p = 0.5). There was a significant correlation between BLL with duration of opium addiction in the patient group ( r = −0.403, p = 0.01). BLL and ULL were significantly correlated in controls ( r = 0.436, p = 0.005) and not in patients. Discussion and conclusion: It was observed that the BLL in opium addicts was significantly higher than that in the healthy control group. This can be due to use of adulterated opium with lead. Therefore, screening of blood lead concentration is helpful for opium-addict patients especially with nonspecific symptoms.

scholarly journals Lead in Air in Bangladesh: Exposure in a Rural Community with Elevated Blood Lead Concentrations among Young Children

2018 ◽  
Vol 15 (9) ◽  
pp. 1947 ◽  
Author(s):  
May Woo ◽  
Elisabeth Young ◽  
Md Mostofa ◽  
Sakila Afroz ◽  
Md Sharif Ibne Hasan ◽  
...  
Keyword(s):  
Rural Community ◽  
Rural Areas ◽  
Urban Areas ◽  
Blood Lead ◽  
The United States ◽  
Reference Level ◽  
Industrial Sites ◽  
Lead Levels ◽  
Lead In Air ◽  
Shed Light

Previous evaluations of a birth cohort in the Munshiganj District of Bangladesh had found that over 85% of 397 children aged 2–3 years had blood lead concentrations above the United States Centers for Disease Control and Prevention’s reference level of 5 μg/dL. Studies in urban areas of Bangladesh have found elevated levels of lead in the air due to industries and remaining contamination from the historic use of leaded gasoline. Sources of lead in rural areas of Bangladesh remain unknown. We conducted air sampling in both residential and industrial sites in Munshiganj to determine whether children are exposed to elevated lead concentrations in the air and study the association between the children’s blood lead levels and sampled air lead concentrations. Residential and industrial air samples in Munshiganj were found to have elevated lead concentrations (mean 1.22 μg/m3) but were not found to be associated with the observed blood lead concentrations. Lead in air is an important environmental health exposure risk to the for children in Munshiganj, and further research may shed light on specific sources to inform exposure prevention and mitigation programs.

Relation of Statistically Significant, Abnormal, and Typical WAIS-R VIQ-PIQ Discrepancies to Full Scale IQs

2000 ◽  
Vol 16 (2) ◽  
pp. 107-114 ◽  
Author(s):  
Louis M. Hsu ◽  
Judy Hayman ◽  
Judith Koch ◽  
Debbie Mandell
Keyword(s):  
Graphical Method ◽  
The United States ◽  
Full Scale ◽  
True Score ◽  
Absolute Value ◽  
Normative Population ◽  
The Us ◽  
The Mean ◽  
And Performance ◽  
Quadratic Models

Summary: In the United States' normative population for the WAIS-R, differences (Ds) between persons' verbal and performance IQs (VIQs and PIQs) tend to increase with an increase in full scale IQs (FSIQs). This suggests that norm-referenced interpretations of Ds should take FSIQs into account. Two new graphs are presented to facilitate this type of interpretation. One of these graphs estimates the mean of absolute values of D (called typical D) at each FSIQ level of the US normative population. The other graph estimates the absolute value of D that is exceeded only 5% of the time (called abnormal D) at each FSIQ level of this population. A graph for the identification of conventional “statistically significant Ds” (also called “reliable Ds”) is also presented. A reliable D is defined in the context of classical true score theory as an absolute D that is unlikely (p < .05) to be exceeded by a person whose true VIQ and PIQ are equal. As conventionally defined reliable Ds do not depend on the FSIQ. The graphs of typical and abnormal Ds are based on quadratic models of the relation of sizes of Ds to FSIQs. These models are generalizations of models described in Hsu (1996) . The new graphical method of identifying Abnormal Ds is compared to the conventional Payne-Jones method of identifying these Ds. Implications of the three juxtaposed graphs for the interpretation of VIQ-PIQ differences are discussed.

scholarly journals Under-Sink Activated Carbon Water Filters Effectively Remove Lead from Private Well Water for over Six Months

Water ◽  
2020 ◽  
Vol 12 (12) ◽  
pp. 3584
Author(s):  
Riley Mulhern ◽  
Jacqueline MacDonald Gibson
Keyword(s):  
Activated Carbon ◽  
Blood Lead ◽  
The United States ◽  
Well Water ◽  
Point Of Use ◽  
Metals Removal ◽  
Lead Levels ◽  
Minimal Data ◽  
Water Filters ◽  
Private Wells

Children who rely on private well water in the United States have been shown to be at greater risk of having elevated blood lead levels. Evidence-based solutions are needed to prevent drinking water lead exposure among private well users, but minimal data are available regarding the real-world effectiveness of available interventions like point-of-use water treatment for well water. In this study, under-sink activated carbon block water filters were tested for lead and other heavy metals removal in an eight-month longitudinal study in 17 homes relying on private wells. The device removed 98% of all influent lead for the entirety of the study, with all effluent lead levels less than 1 µg/L. Profile sampling in a subset of homes showed that the faucet fixture is a significant source of lead leaching where well water is corrosive. Flushing alone was not capable of reducing first-draw lead to levels below 1 µg/L, but the under-sink filter was found to increase the safety and effectiveness of faucet flushing. The results of this study can be used by individual well users and policymakers alike to improve decision-making around the use of under-sink point-of-use devices to prevent disproportionate lead exposures among private well users.

scholarly journals The convergence of racial and income disparities in health insurance coverage in the United States

2021 ◽  
Vol 20 (1) ◽  
Author(s):  
De-Chih Lee ◽  
Hailun Liang ◽  
Leiyu Shi
Keyword(s):  
Health Insurance ◽  
Low Income ◽  
Insurance Coverage ◽  
Health Insurance Coverage ◽  
The United States ◽  
Combined Effect ◽  
Medical Expenditure ◽  
The Us ◽  
Race Ethnicity ◽  
Vulnerability Measure

Abstract Objective This study applied the vulnerability framework and examined the combined effect of race and income on health insurance coverage in the US. Data source The household component of the US Medical Expenditure Panel Survey (MEPS-HC) of 2017 was used for the study. Study design Logistic regression models were used to estimate the associations between insurance coverage status and vulnerability measure, comparing insured with uninsured or insured for part of the year, insured for part of the year only, and uninsured only, respectively. Data collection/extraction methods We constructed a vulnerability measure that reflects the convergence of predisposing (race/ethnicity), enabling (income), and need (self-perceived health status) attributes of risk. Principal findings While income was a significant predictor of health insurance coverage (a difference of 6.1–7.2% between high- and low-income Americans), race/ethnicity was independently associated with lack of insurance. The combined effect of income and race on insurance coverage was devastating as low-income minorities with bad health had 68% less odds of being insured than high-income Whites with good health. Conclusion Results of the study could assist policymakers in targeting limited resources on subpopulations likely most in need of assistance for insurance coverage. Policymakers should target insurance coverage for the most vulnerable subpopulation, i.e., those who have low income and poor health as well as are racial/ethnic minorities.

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.

Sign in / Sign up

Export Citation Format

Share Document