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.

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 Breast milk to blood lead ratios among women from the West Bank of Palestine: a cross-sectional study of associated factors

2021 ◽  
Vol 16 (1) ◽  
Author(s):  
Ramzi Shawahna
Keyword(s):  
Breast Milk ◽  
Rural Areas ◽  
Maternity Care ◽  
Urban Areas ◽  
Blood Lead ◽  
The West ◽  
Hair Dye ◽  
Cross Sectional ◽  
Milk Samples ◽  
Lead Levels

Abstract Background Infants fed contaminated breast milk are at an increased risk of exposure to lead. Breast milk to blood (M/B) ratios have not been investigated among women in Palestine. The aim of this study was to assess blood, breast milk, and M/B lead ratios in samples collected from Palestinian breastfeeding women. Associations between sociodemographic characteristics with breast milk lead levels and M/B lead ratios were also investigated. Methods This study was conducted in a cross-sectional design in the period between October 2017 and April 2018. Breastfeeding women visiting maternity care centers in different regions of the West Bank of Palestine were recruited to the study by the nurses in the maternity care centers. Sociodemographic characteristics, venous blood, and breast milk samples were collected from each participant. Lead concentrations were analyzed using a validated inductively coupled plasma-mass spectrometric method. Mann–Whitney U test, Pearson’s Chi-square, Fisher’s exact, and Spearman’s correlations were used to analyze the data. Odds ratios (OR) were computed using a multivariate logistic regression model. Results Matching blood and milk samples were collected from 80 women. Lead concentrations in 11 (13.8%) of the breast milk samples were above the World Health Organization’s recommended levels. Breast milk lead levels were more likely to be ≥5 μg/L in breastfeeding women who lived in urban areas (aOR 4.96; 95% CI 1.10, 22.38) compared to those who lived in rural areas. Breast milk to blood lead ratios were more likely to be ≥25% in breastfeeding women who lived in urban areas (aOR 7.06; 95% CI 1.68, 29.77), used eye kohl (aOR 14.29; 95% CI 1.32, 155.06), and used hair dye (aOR 5.33; 95% CI 1.58, 18.00) compared to those who lived in rural areas, did not use eye kohl, and did not use hair dye, respectively. Conclusions Higher M/B lead ratios were predicted by living in urban areas, using eye kohl, and using hair dye. Decision makers in health authorities should address sources of exposure to lead in urban areas. Cosmetics containing lead should be assessed and regulated for lead content.

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 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.

The Rural-Urban Continuum of Polarization: Understanding the Geography of the 2018 Midterms

The Forum ◽  
2021 ◽  
Vol 0 (0) ◽  
Author(s):  
Kenneth M. Johnson ◽  
Dante J. Scala
Keyword(s):  
Rural Areas ◽  
Urban Areas ◽  
Metropolitan Areas ◽  
Political Attitudes ◽  
The United States ◽  
Rural America ◽  
Rural Regions ◽  
Urban America ◽  
Urban And Rural Areas ◽  
The Continuum

Abstract This study of the 2018 congressional midterms demonstrates how voting patterns and political attitudes vary across a spectrum of urban and rural areas in the United States. Rural America is no more a monolith than is urban America. The rural-urban gradient is better represented by a continuum than a dichotomy. This is evident in the voting results in 2018, just as it was in 2016. We found that the political tipping point lies beyond major metropolitan areas, in the suburban counties of smaller metropolitan areas. Democrats enjoyed even greater success in densely populated urban areas in 2018 than in 2016. Residents of these urban areas display distinctive and consistent social and political attitudes across a range of scales. At the other end of the continuum in remote rural areas, Republican candidates continued to command voter support despite the challenging national political environment. Voters in these rural regions expressed social and political attitudes diametrically opposed to their counterparts in large urban cores.

Housing Finance Reform: Should There Be a Government Guarantee?

2011 ◽  
Vol 01 (04) ◽  
pp. 811-822 ◽  
Author(s):  
Richard K. Green
Keyword(s):  
Rural Areas ◽  
Urban Areas ◽  
The United States ◽  
Economic Stress ◽  
Mortgage Market ◽  
Best Interest ◽  
Finance Reform ◽  
Fixed Rate ◽  
The Great Depression ◽  
The Republic

In 2007 and 2008, the mortgage market failed. It failed in a number of dimensions: Default rates rose to their highest levels since the great depression, and mortgage liquidity ground to a halt. This failure has produced recriminations: Blame has been laid at the feet of borrowers, brokers, lenders, investment banks, investors and government and quasi-government entities that guaranteed mortgages. These recent events have produced an important debate: Whether the U.S. mortgage market requires a federal guarantee in order to best serve consumers, investors and markets. My view is that such a guarantee is necessary. I will divide my argument into four areas: (1) I will argue that the United States has had a history of providing guarantees, either implicit or explicit, regardless of its professed position on the matter. This phenomenon goes back to the origins of the republic. It is in the best interest of the country to acknowledge the existence of such guarantees, and to price them appropriately before, rather than after, they become necessary. (2) I will argue that in times of economic stress, such as now, the absence of government guarantees would lead to an absence of mortgages. (3) I will argue that a purely "private" market would likely not provide a 30 year fixed rate pre-payable mortgage. I think that this is no longer a particularly controversial statement; what is more controversial is whether such a mortgage is necessary — I will argue that it is. (4) I will argue that in the absence of a federal guarantee, the price and quantity of mortgages will vary across geography. In particular, rural areas will have less access to mortgage credit that urban areas, central cities will have less access than suburbs. Condominiums already are treated less favorably than detached houses, and this difference is likely to get larger in the absence of a guarantee.

An Academic-Community Collaboration to Deliver Medication Therapy Management (MTM) Services to Patients Living in Rural Counties of a Southwestern State in the United States

2021 ◽  
pp. 089719002110002
Author(s):  
David Rhys Axon ◽  
Melissa Johnson ◽  
Brittany Abeln ◽  
Stephanie Forbes ◽  
Elizabeth J. Anderson ◽  
...  
Keyword(s):  
Rural Areas ◽  
Urban Areas ◽  
Program Effectiveness ◽  
Small Town ◽  
The United States ◽  
Small Towns ◽  
Academic Community ◽  
Service Needs ◽  
Medication Therapy

Background: Patients living in rural communities often experience pronounced health disparities, have a higher prevalence of diabetes and hypertension, and poorer access to care compared to urban areas. To address these unmet healthcare service needs, an established, academic-based MTM provider created a novel, collaborative program to provide comprehensive, telephonic services to patients living in rural Arizona counties. Objective: This study assessed the program effectiveness and described differences in health process and outcome measures (e.g., clinical outcomes, gaps in care for prescribed medications, medication-related problems) between individuals residing in different rural-urban commuting area (RUCA) groups (urban, micropolitan, and small town) in rural Arizona counties. Methods: Subjects eligible for inclusion were 18 years or older with diabetes and/or hypertension, living in rural Arizona counties. Data were collected on: demographic characteristics, medical conditions, clinical values, gaps in care, medication-related problems (MRPs), and health promotion guidance. Subjects were analyzed using 3 intra-county RUCA levels (i.e., urban, micropolitan, and small town). Results: A total of 384 patients were included from: urban (36.7%), micropolitan (19.3%) and small town (44.0%) areas. Positive trends were observed for clinical values, gaps in care, and MRPs between initial and follow-up consultations. Urban dwellers had significantly lower average SBP values at follow-up than those from small towns (p < 0.05). A total of 192 MRPs were identified; 75.0% were resolved immediately or referred to providers and 16.7% were accepted by prescribers. Conclusion: This academic-community partnership highlights the benefits of innovative collaborative programs, such as this, for individuals living in underserved, rural areas.

Lead Levels, Home Dust, and Proximity to Lead Smelters

PEDIATRICS ◽  
1996 ◽  
Vol 97 (4) ◽  
pp. 603-603
Author(s):  
Philip J. Landrigan
Keyword(s):  
Blood Lead ◽  
The United States ◽  
Outdoor Play ◽  
Blood Lead Levels ◽  
Elevated Blood ◽  
Lead Smelter ◽  
Soil Lead ◽  
Control And Prevention ◽  
Lead Levels ◽  
Elevated Blood Lead Levels

The article by Kimbrough et al (Pediatrics. 1995;95:550-554) concerning a survey of blood lead levels among children residing near a closed, heavily contaminated lead smelter found that 78 of 490 preschoolers (16%) had blood lead levels at or above the Centers for Disease Control and Prevention action level of 10 µg/dL. By contrast, the prevalence of elevated blood lead levels among all preschool children in the United States is 8.9%.1 Kimbrough et al found that blood lead levels were positively correlated with home dust lead levels, soil lead levels, hours of outdoor play, and levels of lead in indoor paint.

Cognitive and Behavioral Manifestations of Lead

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.

scholarly journals Stroke Incidence and Case Fatality According to Rural or Urban Residence

Stroke ◽  
2019 ◽  
Vol 50 (10) ◽  
pp. 2661-2667 ◽  
Author(s):  
Olivier Grimaud ◽  
Yacine Lachkhem ◽  
Fei Gao ◽  
Cindy Padilla ◽  
Mélanie Bertin ◽  
...  
Keyword(s):  
Rural Areas ◽  
Urban Areas ◽  
Healthcare Access ◽  
Case Fatality ◽  
The United States ◽  
Stroke Severity ◽  
Day Case ◽  
Stroke Incidence ◽  
Stroke Registry ◽  
Stroke Type

Background and Purpose— Recent findings suggest that in the United States, stroke incidence is higher in rural than in urban areas. Similar analyses in other high-income countries are scarce with conflicting results. In 2008, the Brest Stroke Registry was started in western France, an area that includes about 366 000 individuals living in various urban and rural settings. Methods— All new patients with stroke included in the Brest Stroke Registry from 2008 to 2013 were classified as residing in town centers, suburbs, isolated towns, or rural areas. Poisson regression was used to analyze stroke incidence and 30-day case fatality variations in the 4 different residence categories. Models with case fatality as outcome were adjusted for age, stroke type, and stroke severity. Results— In total, 3854 incident stroke cases (n=2039 women, 53%) were identified during the study period. Demographic and socio-economic characteristics and primary healthcare access indicators were significantly different among the 4 residence categories. Patterns of risk factors, stroke type, and severity were comparable among residence categories in both sexes. Age-standardized stroke rates varied from 2.90 per thousand (95% CI, 2.59–3.21) in suburbs to 3.35 (95% CI, 2.98–3.73) in rural areas for men, and from 2.14 (95% CI, 2.00–2.28) in town centers to 2.34 (95% CI, 2.12–2.57) in suburbs for women. Regression models suggested that among men, stroke incidence was significantly lower in suburbs than in town centers (incidence rate ratio =0.87; 95% CI, 0.77–0.99). Case fatality risk was comparable across urban categories but lower in rural patients (relative risk versus town centers: 0.76; 95% CI, 0.60–0.96). Conclusions— Stroke incidence was comparable, and the 30-day case fatality only slightly varied in the 4 residence categories despite widely different socio-demographic features covered by the Brest Stroke Registry.

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