Human Blood Lead Levels and the First Evidence of Environmental Exposure to Industrial Pollutants in the Amazon

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Abstract

The main routes of lead (Pb) absorption are through the airways and orally, and through consumption of contaminated food and beverage, with Pb mainly being absorbed in the atmospheric particulate form. In 2012, a cross-sectional study was performed to evaluate the Pb environmental exposure in two Amazonian districts, Dom Manuel (DMN) and Laranjal (CLA), located in Barcarena City, northern Brazil. CLA is located outside the industrial area of Barcarena (control population), whereas DMN is an old community located in the vicinity of industrial activities. A significant number of residents in these districts participated in an epidemiological inquiry and blood sampling. Total Pb blood levels were quantified using inductively coupled plasma mass spectrometry (ICP-MS). The mean Pb blood level in people that live in DMN was 281.60 (98.73–570.80) μg·L ⁻¹, approximately nine times higher than the level found in CLA (32.77 μg·L ⁻¹). In these districts, the Pb blood levels showed statistically significant differences ( p < 0.05) based on gender, schooling, residence time, and smoking. This is the first evidence of industrial environmental pollutant exposure in the Amazon.

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Bone lead as a biological marker in epidemiologic studies of chronic toxicity: conceptual paradigms.

H-H Hu, M. Rabinowitz, D D Smith (1998)

The skeleton contains the majority of the body's lead burden in both children and adults. The half-life of lead in bone is in the range of years to decades, depending on bone type, metabolic state, and subject age, among other things. Measurement of skeletal lead has benefited greatly from the recent development of X-ray fluorescence (XRF) instruments that can make rapid, safe, accurate, and relatively precise measurements of lead in bone. Two types of XRF technologies exist, LXRF and KXRF; this paper focuses on KXRF, which has been the most widely validated and used. KXRF is proving to be a powerful analytical methodology for evaluating bone lead levels as a measure of time-integrated (i.e., cumulative) lead dose in epidemiologic studies of the effects of chronic lead exposure. However, insufficient attention has been given to conceptualizing the paradigms by which bone lead levels reflect lead exposure and by which the skeleton serves as an endogenous source of lead. Consideration of these paradigms, which rely on bone lead kinetics, is necessary for the proper development of a priori hypotheses involving bone lead accumulation and release, the selection of bone sites for measurement by KXRF, and the design of epidemiologic studies involving bone lead dynamics. We discuss and present supporting evidence for a conceptual model that distinguishes two major paradigms of skeletal lead, including 1) bone lead as an indicator of cumulative lead exposure (bone lead as repository), and 2) bone lead as a source of body lead burden that is mobilizable into the circulation (bone lead as source). These two roles are not mutually exclusive. Instead, they are components of the processes controlling lead accumulation into and release from bone over time. Developing successful strategies for distinguishing these two processes in epidemiologic studies will require separate measurements of lead in cortical and trabecular bone and additional measurement of specific markers of bone mineral turnover and resorption. It may also involve developing accurate methods for evaluating lead in labile compartments of the circulation, such as plasma, as a potentially useful and responsive measure of bone lead release, of the partitioning of circulatory lead, and of the toxicological significance of lead released from bone to other target organs. Images Figure 1 Figure 2 Figure 3

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Recent Developments in Low-Level Lead Exposure and Intellectual Impairment in Children

Karin Koller, Terry Brown, ANNE SPURGEON … (2004)

In the last decade children’s blood lead levels have fallen significantly in a number of countries, and current mean levels in developed countries are in the region of 3 μg/dL. Despite this reduction, childhood lead poisoning continues to be a major public health problem for certain at-risk groups of children, and concerns remain over the effects of lead on intellectual development in infants and children. The evidence for lowered cognitive ability in children exposed to lead has come largely from prospective epidemiologic studies. The current World Health Organization/Centers for Disease Control and Prevention blood level of concern reflects this and stands at 10 μg/dL. However, a recent study on a cohort of children whose lifetime peak blood levels were consistently < 10 μg/dL has extended the association of blood lead and intellectual impairment to lower levels of lead exposure and suggests there is no safety margin at existing exposures. Because of the importance of this finding, we reviewed this study in detail along with other recent developments in the field of low-level lead exposure and children’s cognitive development. We conclude that these findings are important scientifically, and efforts should continue to reduce childhood exposure. However, from a public health perspective, exposure to lead should be seen within the many other risk factors impacting on normal childhood development, in particular the influence of the learning environment itself. Current lead exposure accounts for a very small amount of variance in cognitive ability (1–4%), whereas social and parenting factors account for 40% or more.

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The lessons of user fee experience in Africa.

L Gilson (1997)

This paper reviews the experience of implementing user fees in Africa. It describes the two main approaches to implementing user fees that have been applied in African countries, the standard and the Bamako Initiative models, and their common objectives. It summarizes the evidence concerning the impact of fees on equity, efficiency and system sustainability (as opposed to financial sustainability), and the key bottlenecks to their effective implementation. On the basis of this evidence it then draws out three main sets of lessons, focusing on: where and when to implement fees; how to enhance the impact of fees on their objectives; and how to strengthen the process of implementation. If introduced by themselves, fees are unlikely to achieve equity, efficiency or sustainability objectives. They should, therefore, be seen as only one element in a broader health care financing package that should include some form of risk-sharing. This financing package is important in limiting the potential equity dangers clearly associated with fees. There is a greater potential role for fees within hospitals rather than primary facilities. Achievement of equity, efficiency and, in particular, sustainability will also require the implementation of complementary interventions to develop the skills, systems and mechanisms of accountability critical to ensure effective implementation. Finally, the process of policy development and implementation is itself an important influence over effective implementation.

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Author and article information

Journal

Journal ID (nlm-ta): Int J Environ Res Public Health

Journal ID (iso-abbrev): Int J Environ Res Public Health

Journal ID (publisher-id): ijerph

Title: International Journal of Environmental Research and Public Health

Publisher: MDPI

ISSN (Print): 1661-7827

ISSN (Electronic): 1660-4601

Publication date (Electronic): 22 August 2019

Publication date (Print): September 2019

Volume: 16

Issue: 17

Electronic Location Identifier: 3047

Affiliations

[1 ]Programa de Pós-Graduação em Epidemiologia e Vigilância em Saúde (PPGEVS), Instituto Evandro Chagas (IEC), Ananindeua 67030-000, Brazil

[2 ]Seção de Meio Ambiente (SAMAM), Instituto Evandro Chagas (IEC), Ananindeua 67030-000, Brazil

[3 ]Programa de Pós-Graduação em Ecologia Aquática e Pesca (PPGEAP), Universidade Federal do Pará (UFPA), Belem 66075-110, Brazil

[4 ]Programa de Pós-Graduação em Saúde Coletiva (PPGSC), Universidade Federal do Rio de Janeiro (UFRJ), Rio de Janeiro 21941-901, Brazil

Author notes

[* ]Correspondence: thaiskarolina@ 123456hotmail.com (T.K.L.d.Q.); marcelolima@ 123456iec.gov.br (M.d.O.L.)

Author information

Thaís Karolina Lisboa de Queiroz https://orcid.org/0000-0002-6792-5986

Volney de Magalhães Câmara https://orcid.org/0000-0002-6596-6653

Article

Publisher ID: ijerph-16-03047

DOI: 10.3390/ijerph16173047

PMC ID: 6747206

PubMed ID: 31443420

SO-VID: 2165f735-4322-4c13-b15c-3b8d42774e3b

License:

Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license ( http://creativecommons.org/licenses/by/4.0/).

Human Blood Lead Levels and the First Evidence of Environmental Exposure to Industrial Pollutants in the Amazon

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Most cited references 26

Bone lead as a biological marker in epidemiologic studies of chronic toxicity: conceptual paradigms.

Recent Developments in Low-Level Lead Exposure and Intellectual Impairment in Children

The lessons of user fee experience in Africa.

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