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      Blood lead levels in the Kinshasa population: a pilot study

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          Abstract

          Objective

          Leaded gasoline and lead paints are still in use in the Democratic Republic of Congo but data on blood lead levels in the general population are not available. We evaluated the Pb impregnation in children and adults (0 - 70 years old) in Kinshasa.

          Methods

          Blood lead was measured by atomic absorption in a sample of 485 healthy people (268 men and 217 women) living in Kinshasa between May 2003 and June 2004.

          Results

          Geometric mean blood lead was 120 µg/L (95% CI: 115-125), with a higher concentration in men than in women (127 vs 114 µg/L, p = 0.01). Sixty-three percent of children aged less than 6 years old presented blood lead levels above the 100 µg threshold. In the adult population, occupations with a potential risk of exposure to gasoline (car mechanics or garage owners, taxi drivers, conveyors and gas pump attendants) were associated with an extra blood lead of about 65µg/L.

          Conclusion

          This study indicates a relatively important Pb impregnation of the Kinshasa population. It demonstrates the existence of a major public health issue requiring corrective actions and the implementation of an appropriate regulation.

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          Most cited references15

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          Intellectual impairment in children with blood lead concentrations below 10 microg per deciliter.

          Richard Canfield, Charles R. Henderson, Deborah A. Cory-Slechta … (2003)
          Despite dramatic declines in children's blood lead concentrations and a lowering of the Centers for Disease Control and Prevention's level of concern to 10 microg per deciliter (0.483 micromol per liter), little is known about children's neurobehavioral functioning at lead concentrations below this level. We measured blood lead concentrations in 172 children at 6, 12, 18, 24, 36, 48, and 60 months of age and administered the Stanford-Binet Intelligence Scale at the ages of 3 and 5 years. The relation between IQ and blood lead concentration was estimated with the use of linear and nonlinear mixed models, with adjustment for maternal IQ, quality of the home environment, and other potential confounders. The blood lead concentration was inversely and significantly associated with IQ. In the linear model, each increase of 10 microg per deciliter in the lifetime average blood lead concentration was associated with a 4.6-point decrease in IQ (P=0.004), whereas for the subsample of 101 children whose maximal lead concentrations remained below 10 microg per deciliter, the change in IQ associated with a given change in lead concentration was greater. When estimated in a nonlinear model with the full sample, IQ declined by 7.4 points as lifetime average blood lead concentrations increased from 1 to 10 microg per deciliter. Blood lead concentrations, even those below 10 microg per deciliter, are inversely associated with children's IQ scores at three and five years of age, and associated declines in IQ are greater at these concentrations than at higher concentrations. These findings suggest that more U.S. children may be adversely affected by environmental lead than previously estimated. Copyright 2003 Massachusetts Medical Society
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            Low-level lead exposure, intelligence and academic achievement: a long-term follow-up study.

            J. K. Stiles, H Needleman, Jessica Bellinger (1992)
            The implications of low-level lead exposure for children's intellectual and academic performance at school age are uncertain. This issue was investigated in a prospective study of middle-class and upper-middle-class children with low lifetime exposures to lead. A battery of neuropsychological tests was administered at age 10 years to 148 children whose lead exposure and cognitive function had been previously assessed at ages 6, 12, 18, 24, and 57 months. Primary endpoints were Wechsler Intelligence Scale for Children-Revised (WISC-R) and the Kaufman Test of Educational Achievement (K-TEA). Higher levels of blood lead at age 24 months, but not at other ages, were significantly associated with lower global scores on both the WISC-R and the K-TEA after adjustment for potential confounders. Over the range of approximately 0 to 25 micrograms/dL, a 0.48-mumol/L (10 micrograms/dL) increase in blood lead at 24 months was associated with a 5.8-point decline in WISC-R Full-Scale IQ (95% confidence interval: 1.7 to 9.9, P = .007) and an 8.9-point decline in K-TEA Battery Composite score (95% confidence interval: 4.2 to 13.6, P = .0003). Mean blood lead level at age 24 months was 0.31 mumol/L (6.5 micrograms/dL; SD: 4.9, 90% percentile: 12.5). Slightly elevated blood lead levels around the age of 24 months are associated with intellectual and academic performance deficits at age 10 years.
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              Environmental exposure to lead and children's intelligence at the age of seven years. The Port Pirie Cohort Study.

              Lynne Roberts, N R Wigg, P A Baghurst … (1992)
              Exposure to lead in early childhood is thought to result in delayed neuropsychological development. As yet there is little longitudinal evidence to establish whether these effects persist into later childhood. We measured IQ scores in 494 seven-year-old children from the lead-smelting community of Port Pirie, Australia, in whom developmental deficits associated with elevated blood lead concentrations had already been reported at the ages of two and four years. Exposure to lead was estimated from the lead concentrations in maternal blood samples drawn antenatally and at delivery and from blood samples drawn from the children at birth (umbilical-cord blood), at the ages of 6 and 15 months and 2 years, and annually thereafter. Data relating to known covariates of child development were collected systematically for each child throughout the first seven years of life. We found inverse relations between IQ at the age of seven years and both antenatal and postnatal blood lead concentrations. After adjustment by multiple regression for sex, parents' level of education, maternal age at delivery, parents' smoking status, socioeconomic status, quality of the home environment, maternal IQ, birth weight, birth order, feeding method (breast, bottle, or both), duration of breast-feeding, and whether the child's natural parents were living together, the relation with lead exposure was still evident for postnatal blood samples, particularly within the age range of 15 months to 4 years. For an increase in blood lead concentration from 10 micrograms per deciliter (0.48 mumol per liter) to 30 micrograms per deciliter (1.45 mumol per liter), expressed as the average of the concentrations at 15 months and 2, 3, and 4 years, the estimated reduction in the IQ of the children was in the range of 4.4 points (95 percent confidence interval, 2.2 to 6.6) to 5.3 points (95 percent confidence interval, 2.8 to 7.8). This reduction represents an approximate deficit in IQ of 4 to 5 percent. Low-level exposure to lead during early childhood is inversely associated with neuropsychological development through the first seven years of life.
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                Author and article information

                Journal
                Journal ID (nlm-ta): Arch Public Health
                Journal ID (iso-abbrev): Arch Public Health
                Title: Archives of Public Health
                Publisher: BioMed Central
                ISSN (Print): 0778-7367
                ISSN (Electronic): 2049-3258
                Publication date Collection: 2010
                Publication date (Electronic): 21 April 2010
                Volume: 68
                Issue: 1
                Pages: 30-41
                Affiliations
                [1 ]Environmental chemistry, Faculty of Sciences, Université de Kinshasa., DR Congo
                [2 ]Louvain center for Toxicology and Applied Pharmacology (LTAP), Université Catholique de Louvain, Brussels, Belgium
                Article
                Publisher ID: 0778-7367-68-1-30
                DOI: 10.1186/0778-7367-68-1-30
                PMC ID: 3436702
                SO-VID: 90617551-d50d-42a6-ae66-816341e41d42
                Copyright © Copyright ©2010 Tuakuila et al.
                History
                Categories
                Subject: Research

                ScienceOpen disciplines: Public health
                Keywords: saturnism,human exposure,leaded gasoline,kinshasa,blood lead
                Data availability:
                ScienceOpen disciplines: Public health
                Keywords: saturnism, human exposure, leaded gasoline, kinshasa, blood lead

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