Brief Report: Lead Levels in Selected Electronic Cigarettes from Canada and the United States

BackgroundAlthough patients with kidney disease may be particularly susceptible to the adverse health effects associated with lead exposure, whether levels of lead found commonly in drinking water are associated with adverse outcomes in patients with ESKD is not known.MethodsTo investigate associations of lead in community water systems with hemoglobin concentrations and erythropoietin stimulating agent (ESA) use among incident patients with ESKD, we merged data from the Environmental Protection Agency (EPA) Safe Drinking Water Information System (documenting average 90th percentile lead concentrations in community water systems during 5 years before dialysis initiation, according to city of residence) with patient-level data from the United States Renal Data System.ResultsAmong 597,968 patients initiating dialysis in the United States in 2005 through 2017, those in cities with detectable lead levels in community water had significantly lower pre-ESKD hemoglobin concentrations and more ESA use per 0.01 mg/L increase in 90th percentile water lead. Findings were similar for the 208,912 patients with data from the first month of ESKD therapy, with lower hemoglobin and higher ESA use per 0.01 mg/L higher lead concentration. These associations were observed at lead levels below the EPA threshold (0.015 mg/L) that mandates regulatory action. We also observed environmental inequities, finding significantly higher water lead levels and slower declines over time among Black versus White patients.ConclusionsThis first nationwide analysis linking EPA water supply records to patient data shows that even low levels of lead that are commonly encountered in community water systems throughout the United States are associated with lower hemoglobin levels and higher ESA use among patients with advanced kidney disease.

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Pediatric Collections: Vaping: Effects and Solutions

10.1542/9781610024693 ◽

2020 ◽

Author(s):

Keyword(s):

Public Health ◽

United States ◽

Health Care ◽

Health Care Providers ◽

Electronic Cigarettes ◽

The United States ◽

Care Providers ◽

Tobacco Products ◽

Pediatric Health ◽

Pediatric Health Care

Electronic cigarettes are the tobacco products most commonly used by youths in the United States. The use of e-cigarettes, also known as vaping or JUULing, is a public health epidemic. This collection offers reviews and research to assist pediatric health care providers in identifying and treating adolescent use and exposure to e-cigarettes. https://shop.aap.org/pediatric-collections-vaping-effects-and-solutions-paperback/

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Cognitive and Behavioral Manifestations of Lead

Cognitive and Behavioral Abnormalities of Pediatric Diseases ◽

10.1093/oso/9780195342680.003.0071 ◽

2010 ◽

Author(s):

Hugh L. Evans

Keyword(s):

United States ◽

Blood Lead ◽

The United States ◽

Conduct Disorders ◽

Lead Content ◽

Blood Lead Levels ◽

Toxic Exposure ◽

Postnatal Exposure ◽

Household Dust ◽

Lead Levels

The link between exposure to lead and children’s cognitive problems was implied in the earliest medical reports of frank lead poisoning of young children in Australia in the 1800s (Lin-Fu 1992). Children with acute severe toxicity of lead (Pb) are now rarely seen in the United States. However, millions of children may have subclinical neurobehavioral disorders associated with chronic low-level exposure to lead, representing a major public health concern (Bellinger 2008a). Lead is a nonessential metal that is recognized as a source of toxic exposure, with the developing nervous system particularly vulnerable. Because of this, U.S. regulations limiting the lead content of gasoline and household paint have led to a gradual reduction of the average blood lead concentration of Americans over the last three decades. Average blood lead levels of children in the United States dropped an estimated 78% from 1976 to 1991 (Brody et al. 1994; Caldwell et al. 2009). Despite these reductions in exposure to lead, new advances in research techniques have documented harmful consequences associated with lower blood lead levels. This raises the possibility that there is no threshold for occurrence of lead-induced toxicity. Bellinger (2008a) refers to “the silent pandemic of neurodevelopmental disorders resulting from children’s continuing exposure to low levels of lead.” The developing brain may be more sensitive to exposure to lead than the adult. Since the pioneering work of Needleman and colleagues (1979), a large scientific literature has documented the deleterious effects of pre- and neonatal exposure to lead. Decrements in IQ scores have proven to be among the most sensitive and consistent consequences of a child’s exposure to lead, but other cognitive and behavioral changes have been described as well, including attention-deficit hyperactivity disorder (ADHD). Among the important current sources of children’s exposure to lead is household dust (Dixon et al. 2009) the lead content in old water pipes, batteries, and from contamination by numerous industrial processes. Pre and postnatal exposure to cigarette smoke is a cofactor with lead exposure in children’s conduct disorders (Braun et al. 2008). Diagnosis of lead-induced disorders involves the determination of exposure to lead and the atomic absorption assay of lead in whole blood.

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Demographic and Socioeconomic Factors Associated with Blood Lead Levels among Mexican-American Children and Adolescents in the United States

Public Health Reports ◽

10.1177/003335490512000412 ◽

2005 ◽

Vol 120 (4) ◽

pp. 448-454 ◽

Cited By ~ 28

Author(s):

Leo S. Morales ◽

Peter Gutierrez ◽

Jose J. Escarce

Keyword(s):

United States ◽

Drinking Water ◽

Mexican American ◽

Family Income ◽

Blood Lead ◽

The United States ◽

Blood Lead Levels ◽

Mexican American Youth ◽

Lead Levels ◽

American Children

Objective. This study was designed to assess demographic and socioeconomic differences in blood lead levels (BLLs) among Mexican-American children and adolescents in the United States. Methods. We analyzed data from the Third National Health and Nutrition Examination Survey, 1988–1994, for 3,325 Mexican-American youth aged 1 to 17 years. The main study outcome measures included a continuous measure (μg/dL) of BLL and two dichotomous measures of BLL (⩾5 μg/dL and ⩾10 μg/dL). Results. The mean BLL among Mexican-American children in the United States was 3.45 μg/dL (95% confidence interval [CI] 3.07, 3.87); 20% had BLL ⩾5 μg/dL (95% CI 15%, 24%); and 4% had BLL ⩾10 μg/dL (95% CI 2%, 6%). In multivariate analyses, gender, age, generational status, home language, family income, education of head of household, age of housing, and source of drinking water were statistically significant independent predictors ( p<0.05) of having higher BLLs and of having BLL ⩾5 μg/dL, whereas age, family income, housing age, and source of drinking water were significant predictors ( p<0.05) of having BLL ⩾10 μg/dL. Conclusions. Significant differences in the risk of having elevated BLLs exist among Mexican-American youth. Those at greatest risk should be prioritized for lead screening and lead exposure abatement interventions.

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The rise of electronic nicotine delivery systems and the emergence of electronic-cigarette-driven disease

AJP Lung Cellular and Molecular Physiology ◽

10.1152/ajplung.00160.2020 ◽

2020 ◽

Vol 319 (4) ◽

pp. L585-L595 ◽

Cited By ~ 2

Author(s):

Kielan Darcy McAlinden ◽

Mathew Suji Eapen ◽

Wenying Lu ◽

Pawan Sharma ◽

Sukhwinder Singh Sohal

Keyword(s):

United States ◽

Cigarette Smoking ◽

Electronic Cigarettes ◽

Scientific Evidence ◽

The United States ◽

Chronic Obstructive ◽

Obstructive Pulmonary Disease ◽

Cellular Processes ◽

Increased Risk

In 2019, the United States experienced the emergence of the vaping-associated lung injury (VALI) epidemic. Vaping is now known to result in the development and progression of severe lung disease in the young and healthy. Lack of regulation on electronic cigarettes in the United States has resulted in over 2,000 patients and 68 deaths. We examine the clinical representation of VALI and the delve into the scientific evidence of how deadly exposure to electronic cigarettes can be. E-cigarette vapor is shown to affect numerous cellular processes, cellular metabolism, and cause DNA damage (which has implications for cancer). E-cigarette use is associated with a higher risk of developing crippling lung conditions such as chronic obstructive pulmonary disease (COPD), which would develop several years from now, increasing the already existent smoking-related burden. The role of vaping and virus susceptibility is yet to be determined; however, vaping can increase the virulence and inflammatory potential of several lung pathogens and is also linked to an increased risk of pneumonia. As it has emerged for cigarette smoking, great caution should also be given to vaping in relation to SARS-CoV-2 infection and the COVID-19 pandemic. Sadly, e-cigarettes are continually promoted and perceived as a safer alternative to cigarette smoking. E-cigarettes and their modifiable nature are harmful, as the lungs are not designed for the chronic inhalation of e-cigarette vapor. It is of interest that e-cigarettes have been shown to be of no help with smoking cessation. A true danger lies in vaping, which, if ignored, will lead to disastrous future costs.

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