Journal articles: 'Lead Exposure Associated'

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Mason, Lisa H., Jordan P. Harp, and Dong Y. Han. "Pb Neurotoxicity: Neuropsychological Effects of Lead Toxicity." BioMed Research International 2014 (2014): 1–8. http://dx.doi.org/10.1155/2014/840547.

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Neurotoxicity is a term used to describe neurophysiological changes caused by exposure to toxic agents. Such exposure can result in neurocognitive symptoms and/or psychiatric disturbances. Common toxic agents include heavy metals, drugs, organophosphates, bacterial, and animal neurotoxins. Among heavy metal exposures, lead exposure is one of the most common exposures that can lead to significant neuropsychological and functional decline in humans. In this review, neurotoxic lead exposure's pathophysiology, etiology, and epidemiology are explored. In addition, commonly associated neuropsychological difficulties in intelligence, memory, executive functioning, attention, processing speed, language, visuospatial skills, motor skills, and affect/mood are explored.

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Pacheco-Tovar, Deyanira, María-Guadalupe Pacheco-Tovar, Esperanza Avalos-Díaz, Juan-José Bollain-y-Goytia, María-Elena Pérez-Pérez, Roxana Ramírez-Sandoval, Argelia López-Luna, and Rafael Herrera-Esparza. "Associated Autoimmunity and Lead Exposure in Childhood." International Journal of Immunology 9, no. 1 (2021): 16. http://dx.doi.org/10.11648/j.iji.20210901.14.

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Hipkins, Karen L., Barbara L. Materna, Susan F. Payne, and Luz C. Kirsch. "Family Lead Poisoning Associated with Occupational Exposure." Clinical Pediatrics 43, no. 9 (November 2004): 845–49. http://dx.doi.org/10.1177/000992280404300909.

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Thomson, Ruth M., and Gareth J. Parry. "Neuropathies associated with excessive exposure to lead." Muscle & Nerve 33, no. 6 (2006): 732–41. http://dx.doi.org/10.1002/mus.20510.

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Isidra, Hernández-Serrato Ma, Mendoza-Alvarado Laura R, Rojas-Martínez Rosalba, González-Garza Carlos, Jennifer Meghan Hulme, and Olaiz-Fernández Gustavo. "Factors associated with lead exposure in Oaxaca, Mexico." Journal of Exposure Science & Environmental Epidemiology 13, no. 5 (September 2003): 341–47. http://dx.doi.org/10.1038/sj.jea.7500282.

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Agier, Lydiane, Xavier Basagaña, Carles Hernandez-Ferrer, Léa Maitre, Ibon Tamayo Uria, Jose Urquiza, Sandra Andrusaityte, et al. "Association between the pregnancy exposome and fetal growth." International Journal of Epidemiology 49, no. 2 (March 13, 2020): 572–86. http://dx.doi.org/10.1093/ije/dyaa017.

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Abstract Background Several environmental contaminants were shown to possibly influence fetal growth, generally from single exposure family studies, which are prone to publication bias and confounding by co-exposures. The exposome paradigm offers perspectives to avoid selective reporting of findings and to control for confounding by co-exposures. We aimed to characterize associations of fetal growth with the pregnancy chemical and external exposomes. Methods Within the Human Early-Life Exposome project, 131 prenatal exposures were assessed using biomarkers and environmental models in 1287 mother–child pairs from six European cohorts. We investigated their associations with fetal growth using a deletion-substitution-addition (DSA) algorithm considering all exposures simultaneously, and an exposome-wide association study (ExWAS) considering each exposure independently. We corrected for exposure measurement error and tested for exposure–exposure and sex–exposure interactions. Results The DSA model identified lead blood level, which was associated with a 97 g birth weight decrease for each doubling in lead concentration. No exposure passed the multiple testing-corrected significance threshold of ExWAS; without multiple testing correction, this model was in favour of negative associations of lead, fine particulate matter concentration and absorbance with birth weight, and of a positive sex-specific association of parabens with birth weight in boys. No two-way interaction between exposure variables was identified. Conclusions This first large-scale exposome study of fetal growth simultaneously considered >100 environmental exposures. Compared with single exposure studies, our approach allowed making all tests (usually reported in successive publications) explicit. Lead exposure is still a health concern in Europe and parabens health effects warrant further investigation.

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Kanwal, Sandeep Kumar, and Virendra Kumar. "High Prenatal and Postnatal Lead Exposure Associated Lead Encephalopathy in an Infant." Indian Journal of Pediatrics 78, no. 11 (June 10, 2011): 1420–23. http://dx.doi.org/10.1007/s12098-011-0445-6.

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Patočka, Jiří. "Organic Lead Toxicology." Acta Medica (Hradec Kralove, Czech Republic) 51, no. 4 (2008): 209–13. http://dx.doi.org/10.14712/18059694.2017.26.

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Lead is one of the oldest known and most widely studied occupational and environmental poison. Despite intensive study, there is still debate about the toxic effects of lead, both from low-level exposure in the general population owing to environmental pollution and historic use of lead in paint and plumbing and from exposure in the occupational setting. Significant position have organic lead compounds used more than 60 years as antiknock additives in gasoline. Chemical and toxicological characteristics of main tetraalkyl leads used as gasoline additives are discussed in this article. The majority of industries historically associated with high lead exposure have made dramatic advances in their control of occupational exposure. However, cases of unacceptably high exposure and even of frank lead poisoning are still seen, predominantly in the demolition and tank cleaning industries. Nevertheless, in most industries blood lead levels have declined below levels at which signs or symptoms are seen and the current focus of attention is on the subclinical effects of exposure. The significance of some of these effects for the overt health of the workers is often the subject of debate. Inevitably there is pressure to reduce lead exposure in the general population and in working environments, because current studies show that no level of lead exposure appears to be a ‘safe’ and even the current ‘low’ levels of exposure, especially in children, are associated with neurodevelopmental deficits.

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Khalid, Madiha, and Mohammad Abdollahi. "Epigenetic modifications associated with pathophysiological effects of lead exposure." Journal of Environmental Science and Health, Part C 37, no. 4 (August 12, 2019): 235–87. http://dx.doi.org/10.1080/10590501.2019.1640581.

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Anis, Tarek H., Ahmed ElKaraksy, Taymour Mostafa, Amr Gadalla, Hager Imam, Lamya Hamdy, and Omayma Abu el-Alla. "Chronic Lead Exposure may be Associated with Erectile Dysfunction." Journal of Sexual Medicine 4, no. 5 (September 2007): 1428–36. http://dx.doi.org/10.1111/j.1743-6109.2007.00587.x.

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Mansouri, Mohammad Taghi, Isabel Muñoz-Fambuena, and Omar Cauli. "Cognitive impairment associated with chronic lead exposure in adults." Neurology, Psychiatry and Brain Research 30 (December 2018): 5–8. http://dx.doi.org/10.1016/j.npbr.2018.04.001.

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Taylor, Mark Patrick, Danielle Camenzuli, Louise Jane Kristensen, Miriam Forbes, and Sammy Zahran. "Environmental lead exposure risks associated with children's outdoor playgrounds." Environmental Pollution 178 (July 2013): 447–54. http://dx.doi.org/10.1016/j.envpol.2013.03.054.

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Wang, Man, Boheng Liang, Weiwei Zhang, Kuncai Chen, Yuhua Zhang, Hongwei Zhou, Yanfang Cheng, et al. "Dietary Lead Exposure and Associated Health Risks in Guangzhou, China." International Journal of Environmental Research and Public Health 16, no. 8 (April 19, 2019): 1417. http://dx.doi.org/10.3390/ijerph16081417.

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Lead exposure is associated with a wide range of adverse effects on human health. The principal exposure route in the general population is through the diet. In this study, we estimate the dietary lead intake and associated health risks among the residents of Guangzhou, China. Data on lead concentrations were derived from the food safety risk monitoring system, which included 6339 samples from 27 food categories collected in 2014–2017. Food consumption data were taken from a 2011 dietary survey of 2960 Guangzhou residents from 998 households. Dietary lead intake was estimated by age group (3–6, 7–17, 18–59, and ≥60 years), and relevant health risks were assessed using the margin of exposure (MOE) method. The mean and 95th percentiles (P95) of dietary lead intake were respectively 0.7466 and 2.4525 μg/kg body weight per day for preschool children aged 3–6 years; 0.4739 and 1.5522 μg/kg bw/day for school children aged 7–17 years; 0.3759 and 1.1832 μg/kg bw/day for adults aged 18–59 years; and 0.4031 and 1.3589 μg/kg bw/day for adults aged ≥60 years. The MOE value was less than 1 for preschool children at the mean exposure level and for all age groups at the P95 exposure level. Rice and its products, leafy vegetables, and wheat flour and its products were found to be the primary food sources of lead exposure. Our findings suggest that the health risk from dietary lead exposure is low for Guangzhou residents overall, but that young children and consumers of certain foods may be at increased risk. Continued efforts are needed to reduce the dietary lead exposure in Guangzhou.

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Ramírez Ortega, Daniela, Dinora F. González Esquivel, Tonali Blanco Ayala, Benjamín Pineda, Saul Gómez Manzo, Jaime Marcial Quino, Paul Carrillo Mora, and Verónica Pérez de la Cruz. "Cognitive Impairment Induced by Lead Exposure during Lifespan: Mechanisms of Lead Neurotoxicity." Toxics 9, no. 2 (January 28, 2021): 23. http://dx.doi.org/10.3390/toxics9020023.

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Lead (Pb) is considered a strong environmental toxin with human health repercussions. Due to its widespread use and the number of people potentially exposed to different sources of this heavy metal, Pb intoxication is recognized as a public health problem in many countries. Exposure to Pb can occur through ingestion, inhalation, dermal, and transplacental routes. The magnitude of its effects depends on several toxicity conditions: lead speciation, doses, time, and age of exposure, among others. It has been demonstrated that Pb exposure induces stronger effects during early life. The central nervous system is especially vulnerable to Pb toxicity; Pb exposure is linked to cognitive impairment, executive function alterations, abnormal social behavior, and fine motor control perturbations. This review aims to provide a general view of the cognitive consequences associated with Pb exposure during early life as well as during adulthood. Additionally, it describes the neurotoxic mechanisms associated with cognitive impairment induced by Pb, which include neurochemical, molecular, and morphological changes that jointly could have a synergic effect on the cognitive performance.

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Rinsky, Jessica L., Sheila Higgins, Kim Angelon-Gaetz, Doris Hogan, Pierre Lauffer, Megan Davies, Aaron Fleischauer, et al. "Occupational and Take-home Lead Exposure Among Lead Oxide Manufacturing Employees, North Carolina, 2016." Public Health Reports 133, no. 6 (September 19, 2018): 700–706. http://dx.doi.org/10.1177/0033354918795442.

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Objective: In 2016, North Carolina blood lead level (BLL) surveillance activities identified elevated BLLs among 3 children exposed to take-home lead by household members employed at a lead oxide manufacturing facility. We characterized BLLs among employees and associated children and identified risk factors for occupational and take-home lead exposure. Methods: We reviewed BLL surveillance data for 2012-2016 to identify facility employees and associated children. We considered a BLL ≥5 μg/dL elevated for adults and children and compared adult BLLs with regulatory limits and recommended health-based thresholds. We also conducted an environmental investigation and interviewed current employees about exposure controls and cleanup procedures. Results: During 2012-2016, 5 children associated with facility employees had a confirmed BLL ≥5 μg/dL. Among 77 people employed during 2012-2016, median BLLs increased from 22 μg/dL (range, 4-45 μg/dL) in 2012 to 37 μg/dL (range, 16-54 μg/dL) in 2016. All employee BLLs were <60 μg/dL, the national regulatory threshold for immediate medical removal from lead exposure; however, 55 (71%) had a BLL ≥20 μg/dL, a recommended health-based threshold for removal from lead exposure. Because of inadequate controls in the facility, areas considered clean were visibly contaminated with lead dust. Employees reported bringing personal items to work and then into their cars and homes, resulting in take-home lead exposure. Conclusions: Integration of child and adult BLL surveillance activities identified an occupational source of lead exposure among workers and associated children. Our findings support recent recommendations that implementation of updated lead standards will support better control of lead in the workplace and prevent lead from being carried home.

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Metryka, Emilia, Karina Chibowska, Izabela Gutowska, Anna Falkowska, Patrycja Kupnicka, Katarzyna Barczak, Dariusz Chlubek, and Irena Baranowska-Bosiacka. "Lead (Pb) Exposure Enhances Expression of Factors Associated with Inflammation." International Journal of Molecular Sciences 19, no. 6 (June 20, 2018): 1813. http://dx.doi.org/10.3390/ijms19061813.

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Viskum, Sven, Lene Rabjerg, Poul J. J�rgensen, and Philippe Grandjean. "Improvement in semen quality associated with decreasing occupational lead exposure." American Journal of Industrial Medicine 35, no. 3 (March 1999): 257–63. http://dx.doi.org/10.1002/(sici)1097-0274(199903)35:3<257::aid-ajim5>3.0.co;2-#.

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Cassleman, Kristi L., Kevin A. Dorrance, and Andrew C. Todd. "Neuropsychiatric Implications of Chronic Lead Exposure." Military Medicine 185, no. 5-6 (October 31, 2019): e914-e918. http://dx.doi.org/10.1093/milmed/usz362.

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Abstract There is growing awareness of chronic exposures to lead, with recent evidence indicating that there is an increased risk of a range of health effects that include cardiovascular, kidney, cognitive, and premature mortality, at blood levels lower than what was previously considered elevated. This report describes the case of a 42-year-old active duty officer with a history of anxiety, cognitive impairment, and paroxysmal hypertensive episodes associated with elevated body burdens of lead as measured in bone, while having low or unremarkable blood level measurements. Challenges related to work-up, treatments, and outcomes are discussed. An elevated body burden of lead may contribute to increased irritability, fatigue, and anxiety, mimicking posttraumatic stress disorder and other primary psychiatric conditions. This presentation highlights the need for an increased index of suspicion of lead poisoning in both medical and psychiatric care, particularly in military populations.

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Lange, John H. "Airborne exposure and soil levels associated with lead abatement of a steel tank." Toxicology and Industrial Health 18, no. 1 (February 2002): 28–38. http://dx.doi.org/10.1191/0748233702th127oa.

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This study reports on airborne exposure levels and soil concentrations of lead in regard to abatement of a steel structure (water tank). The tank was de-leaded by abrasive sand blasting. The ball of the tank had a lead surface level that exceeded the Environmental Protection Agency (EPA) definition of lead-based paint (LBP) (0.5% lead), but paint on stem and base was below this criterion. Personal and area airborne samples were collected during different activities of lead abatement of the tank. Summary results suggest during abrasive blasting of ball and stem/base personal exposure levels, as reported with arithmetic and geometric means, exceed the Occupational Safety and Health Administration (OSHA) permissible exposure limit (50 g/m3). Highest personal exposure (occupational exposure) was associated with blasting of ball. Distribution of airborne and soil samples suggest non-normality and is best represented by a logarithmic form. Geometric standard deviations for air and soil lead support a non-normal distribution. Outlying values were found for personal and area air samples. Exposure levels associated with blasting stem/base section of tank support OSHA’s policy requiring air monitoring of work at levels below the criterion established by EPA in identifying LBP. Area samples were statistically lower than personal samples associated with blasting ball and stem/base of tank. Exposure data suggest that workers performing abatement on steel structures have elevated lead exposure from surface lead. Respirator protection requirements are discussed. Soil lead concentration was suggested to decrease as distance increased from tank. Soil lead is suggested to be a result of deposition from LBP on tank surface. Minimal efforts were required to reduce average lead soil levels below EPA’s upper acceptable criterion (1200 ppm Pb).

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Goel, Aanya, and Michael Aschner. "The Effect of Lead Exposure on Autism Development." International Journal of Molecular Sciences 22, no. 4 (February 6, 2021): 1637. http://dx.doi.org/10.3390/ijms22041637.

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Autism Spectrum Disorder (ASD) remains one of the most detrimental neurodevelopmental conditions in society today. Common symptoms include diminished social and communication ability. Investigations on autism etiology remain largely ambiguous. Previous studies have highlighted exposure to lead (Pb) may play a role in ASD. In addition, lead has been shown to be one of the most prevalent metal exposures associated with neurological deficits. A semi-systematic review was conducted using public databases in order to evaluate the extent of lead’s role in the etiology of autism. This review examines the relationship between autistic comorbid symptoms—such as deterioration in intelligence scores, memory, language ability, and social interaction—and lead exposure. Specifically, the mechanisms of action of lead exposure, including changes within the cholinergic, dopaminergic, glutamatergic, gamma aminobutyric acid (GABA)ergic systems, are discussed. The goal of this review is to help illustrate the connections between lead’s mechanistic interference and the possible furthering of the comorbidities of ASD. Considerations of the current data and trends suggest a potential strong role for lead in ASD.

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Satarug, Soisungwan, Glenda C. Gobe, David A. Vesey, and Kenneth R. Phelps. "Cadmium and Lead Exposure, Nephrotoxicity, and Mortality." Toxics 8, no. 4 (October 13, 2020): 86. http://dx.doi.org/10.3390/toxics8040086.

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The present review aims to provide an update on health risks associated with the low-to-moderate levels of environmental cadmium (Cd) and lead (Pb) to which most populations are exposed. Epidemiological studies examining the adverse effects of coexposure to Cd and Pb have shown that Pb may enhance the nephrotoxicity of Cd and vice versa. Herein, the existing tolerable intake levels of Cd and Pb are discussed together with the conventional urinary Cd threshold limit of 5.24 μg/g creatinine. Dietary sources of Cd and Pb and the intake levels reported for average consumers in the U.S., Spain, Korea, Germany and China are summarized. The utility of urine, whole blood, plasma/serum, and erythrocytes to quantify exposure levels of Cd and Pb are discussed. Epidemiological studies that linked one of these measurements to risks of chronic kidney disease (CKD) and mortality from common ailments are reviewed. A Cd intake level of 23.2 μg/day, which is less than half the safe intake stated by the guidelines, may increase the risk of CKD by 73%, and urinary Cd levels one-tenth of the threshold limit, defined by excessive ß2-microglobulin excretion, were associated with increased risk of CKD, mortality from heart disease, cancer of any site and Alzheimer’s disease. These findings indicate that the current tolerable intake of Cd and the conventional urinary Cd threshold limit do not provide adequate health protection. Any excessive Cd excretion is probably indicative of tubular injury. In light of the evolving realization of the interaction between Cd and Pb, actions to minimize environmental exposure to these toxic metals are imperative.

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Shaik, AP, and K. Jamil. "A study on the ALAD gene polymorphisms associated with lead exposure." Toxicology and Industrial Health 24, no. 7 (August 2008): 501–6. http://dx.doi.org/10.1177/0748233708095770.

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δ-aminolevulinic acid dehydratase (ALAD) plays an important role in lead poisoning, and polymorphisms in this gene may affect the response of individuals to lead toxicity symptoms. This study was carried out to examine the effects of ALAD gene polymorphism (G177C) on blood lead levels (BLL) and hematological parameters. In all, 113 battery manufacturing unit workers and 102 occupationally unexposed controls from Hyderabad, A.P, India formed the study group. Genotypes for the ALAD G177C polymorphism were determined by Polymerase chain reaction and restriction fragment length digestion. BLL were determined by anode stripping voltammetry using ESA Model 3010B Lead analyzer. Complete blood picture was analyzed using ADVIA cell counter for each sample. The frequencies for ALAD1 and ALAD2 alleles were 0.98 and 0.01, respectively. ALAD 1-2 and ALAD 2-2 genotypes together were considered as a single group and compared with the ALAD 1-1 genotype group. BLL did not differ significantly among ALAD1-1, 1-2, and 2-2 genotypes; however, subjects from the ALAD 1-2/2-2 genotype group showed higher BLL concentrations of 80.51 μg/dL when compared with subjects from the ALAD 1-1 genotype group (50.4 μg/dL). Approximately 29.2% volunteers ( n = 33) from the occupationally exposed group had hemoglobin levels below 10.0 g/dL. There was no significant difference in total white cell count and platelet count between occupational and non-exposed lead-exposed groups. BLL of occupationally exposed individuals were significantly high compared with the unexposed group. ALAD G177C polymorphism along with BLL and assessment of hematological parameters may play an important role in evaluation and better understanding of the consequences of lead exposure.

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Froom, Paul, Estella Kristal-Boneh, Jochanan Benbassat, Ruth Ashkanazi, and Joseph Ribak. "Lead Exposure in Battery-Factory Workers Is Not Associated With Anemia." Journal of Occupational & Environmental Medicine 41, no. 2 (February 1999): 120–23. http://dx.doi.org/10.1097/00043764-199902000-00007.

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Obeng-Gyasi, Emmanuel. "Cumulative Effects of Low-Level Lead Exposure and Chronic Physiological Stress on Hepatic Dysfunction—A Preliminary Study." Medical Sciences 8, no. 3 (August 5, 2020): 30. http://dx.doi.org/10.3390/medsci8030030.

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Chronic physiological stress and hepatic injury were explored in this cross-sectional study using data from the National Health and Nutrition Examination Survey (NHANES) 2007–2010. Lead exposure was measured using Blood Lead Levels (BLL), which were divided into quartiles of exposure based on the distribution within the database. Allostatic load (AL), a variable representing chronic physiological stress, was operationalized using ten clinical markers. The geometric mean values for markers of liver injury of interest (a) Aspartate Aminotransferase (AST), (b) Alanine Aminotransferase (ALT), (c) Alkaline Phosphatase (ALP), and (d) Gamma glutamyl-transferase (GGT) were explored in quartiles of lead exposure. Associations between AL and AST, ALT, ALP, and GGT among those exposed to lead were analyzed using linear regression models. In examining lead exposure in increasing quartiles, the geometric mean of the liver injury markers showed significant elevations as lead exposure levels increased. Simple linear regression revealed AL was positively associated with several markers of hepatic injury in all degrees of lead exposure. This study demonstrates the potential dangers of social and environmental exposures to liver health.

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Daniell, William E., Lo Van Tung, Ryan M. Wallace, Deborah J. Havens, Catherine J. Karr, Nguyen Bich Diep, Gerry A. Croteau, Nancy J. Beaudet, and Nguyen Duy Bao. "Childhood Lead Exposure from Battery Recycling in Vietnam." BioMed Research International 2015 (2015): 1–10. http://dx.doi.org/10.1155/2015/193715.

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Background. Battery recycling facilities in developing countries can cause community lead exposure.Objective. To evaluate child lead exposure in a Vietnam battery recycling craft village after efforts to shift home-based recycling outside the village.Methods. This cross-sectional study evaluated 109 children in Dong Mai village, using blood lead level (BLL) measurement, parent interview, and household observation. Blood samples were analyzed with a LeadCare II field instrument; highest BLLs (≥45 μg/dL) were retested by laboratory analysis. Surface and soil lead were measured at 11 households and a school with X-ray fluorescence analyzer.Results. All children had high BLLs; 28% had BLL ≥45 μg/dL. Younger age, family recycling, and outside brick surfaces were associated with higher BLL. Surface and soil lead levels were high at all tested homes, even with no recycling history. Laboratory BLLs were lower than LeadCare BLLs, in 24 retested children.Discussion. In spite of improvements, lead exposure was still substantial and probably associated with continued home-based recycling, legacy contamination, and workplace take-home exposure pathways. There is a need for effective strategies to manage lead exposure from battery recycling in craft villages. These reported BLL values should be interpreted cautiously, although the observed field-laboratory discordance may reflect bias in laboratory results.

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Shaheen, Nusrat, Mukhtiar Hassan, Qaisar Mahmood, and Yousaf Hayat. "Maternal and fetal blood lead concentrations under non-occupational lead exposure and associated factors in Pakistan." Toxicological & Environmental Chemistry 97, no. 6 (July 3, 2015): 828–37. http://dx.doi.org/10.1080/02772248.2015.1060726.

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Lorenzana, Roseanne M., Richard Troast, Julie M. Klotzbach, Mark H. Follansbee, and Gary L. Diamond. "Issues Related to Time Averaging of Exposure in Modeling Risks Associated with Intermittent Exposures to Lead." Risk Analysis 25, no. 1 (February 2005): 169–78. http://dx.doi.org/10.1111/j.0272-4332.2005.00576.x.

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Callahan, Catherine L., Melissa C. Friesen, Sarah J. Locke, Pamela J. Dopart, Patricia A. Stewart, Kendra Schwartz, Julie J. Ruterbusch, et al. "Case-control investigation of occupational lead exposure and kidney cancer." Occupational and Environmental Medicine 76, no. 7 (February 13, 2019): 433–40. http://dx.doi.org/10.1136/oemed-2018-105327.

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ObjectivesLead is a suspected carcinogen that has been inconsistently associated with kidney cancer. To clarify this relationship, we conducted an analysis of occupational lead exposure within a population-based study of kidney cancer using detailed exposure assessment methods.MethodsStudy participants (1217 cases and 1235 controls), enrolled between 2002 and 2007, provided information on their occupational histories and, for selected lead-related occupations, answered questions regarding workplace tasks, and use of protective equipment. Industrial hygienists used this information to develop several estimates of occupational lead exposure, including probability, duration and cumulative exposure. Unconditional logistic regression was used to compute ORs and 95% CIs for different exposure metrics, with unexposed subjects serving as the reference group. Analyses were also conducted stratifying on several factors, including for subjects of European ancestry only, single nucleotide polymorphisms in ALAD (rs1805313, rs1800435, rs8177796, rs2761016), a gene involved in lead toxicokinetics.ResultsIn our study, cumulative occupational lead exposure was not associated with kidney cancer (OR 0.9, 95% CI 0.7 to 1.3 for highest quartile vs unexposed; ptrend=0.80). Other lead exposure metrics were similarly null. We observed no evidence of effect modification for the evaluated ALAD variants (subjects of European ancestry only, 662 cases and 561 controls) and most stratifying factors, although lead exposure was associated with increased risk among never smokers.ConclusionsThe findings of this study do not offer clear support for an association between occupational lead exposure and kidney cancer.

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Derosa, C. T., H. Choudhury, and W. B. Peirano. "An Integrated Exposure/ Pharmacokinetic Based Approach to the Assessment of Complex Exposures." Toxicology and Industrial Health 7, no. 4 (July 1991): 231–48. http://dx.doi.org/10.1177/074823379100700401.

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A problem in evaluating the hazard represented by an environ mental toxicant is that exposures can occur via multiple media such as water, land, and air. Lead is one of the toxicants of con cern that has been associated with adverse effects on heme me tabolism, serum vitamin D levels, and the mental and physical development of infants and children exposed at very low envi ronmental levels. Effects of lead on development are particularly disturbing in that the consequences of early delays or deficits in physical or mental development may have long-term conse quences over the lifetime of affected individuals. Experimental and epidemiologic studies have indicated that blood lead levels in the range of 10-15 μ g/ dl , or possibly lower, are likely to produce subclinical toxicity. Since a discernible threshold has not been demonstrated, it is prudent to preclude development of a Reference Dose (RfD) for lead. As an alter nate, the U. S. Environmental Protection Agency (U. S. EPA) has developed the uptake/biokinetic lead model that provides a means for evaluating the relative contribution of various media to establishing blood lead levels in children. This approach will allow for the identification of site- and situation-specific abate ment strategies based on projected blood lead levels in vulnera ble human populations exposed to lead in air, diet, water, soil/ dust, and paint; thus making it possible to evaluate regulatory decisions concerning each medium on blood levels and potential health effects.

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Peters, Junenette L., Melissa J. Perry, Eileen McNeely, Robert O. Wright, Wendy Heiger-Bernays, and Jennifer Weuve. "The association of cadmium and lead exposures with red cell distribution width." PLOS ONE 16, no. 1 (January 11, 2021): e0245173. http://dx.doi.org/10.1371/journal.pone.0245173.

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Elevated red blood cell distribution width (RDW), traditionally an indicator of anemia, has now been recognized as a risk marker for cardiovascular disease incidence and mortality. Experimental and acute exposure studies suggest that cadmium and lead individually affect red blood cell production; however, associations between environmental exposures and RDW have not been explored. We evaluated relationships of environmental cadmium and lead exposures to RDW. We used data from 24,607 participants aged ≥20 years in the National Health and Nutrition Examination Survey (2003–2016) with information on blood concentrations of cadmium and lead, RDW and socio-demographic factors. In models adjusted for age, sex, race/ethnicity, education, poverty income ratio, BMI, alcohol consumption, smoking status and serum cotinine, RDW was increasingly elevated across progressively higher quartiles of blood cadmium concentration. A doubling of cadmium concentration was associated with 0.16 higher RDW (95% CI: 0.14, 0.18) and a doubling of lead concentration with 0.04 higher RDW (95% CI: 0.01, 0.06). Also, higher cadmium and lead concentrations were associated with increased odds of high RDW (RDW>14.8%). The associations were more pronounced in women and those with low-to-normal mean corpuscular volume (MCV) and held even after controlling for iron, folate or vitamin B12 deficiencies. In analysis including both metals, cadmium remained associated with RDW, whereas the corresponding association for lead was substantially attenuated. In this general population sample, blood cadmium and lead exposures were positively associated with RDW. The associations may indicate hemolytic or erythropoietic mechanisms by which exposure increases mortality risk.

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Hassan, MS, MKK Patwary, MM Rahman, SF Sonia, M. Kabiruzzaman, MA Alim, AJM Salahuddin, et al. "Neurological Effect of Lead Exposure in Children." Medicine Today 25, no. 1 (July 28, 2013): 1–5. http://dx.doi.org/10.3329/medtoday.v25i1.15899.

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Lead poisoning is one of the burning issues in Bangladesh. This study assessed the relation of blood lead level with IQ and peripheral nerve function in environmental lead exposed primary school children in Dhaka.Blood lead level (BLL) was measured in 84 primary school children in an urban industrial area of Dhaka. IQ was measured with Wechsler Intelligence Scales- Revised for children. Electrophysiological evaluation was done in 31 children.Verbal, Performance and Full scale IQ had a negative correlation with blood lead level (p<0.001). Decrement in Verbal, Performance and Full scale IQ associated with 1 microgram per deciliter increase in blood lead level were 0.99, 0.86 and 0.95 respectively (p<0.001). None had clinical features of neuropathy. Statistical analysis also did not show any significant difference in NCS between children with normal and elevated BLL (p value >0.05).It was found that IQ of children decreased in a linear trend with increasing blood lead level. This study did not find any clinical or electrophysiological evidence of peripheral nerve dysfunction in the environmental lead exposed children. DOI: http://dx.doi.org/10.3329/medtoday.v25i1.15899 Medicine Today 2013 Vol.25(1): 1-5

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Hagedoorn, Ilse J. M., Christina M. Gant, Sanne v. Huizen, Ronald G. H. J. Maatman, Gerjan Navis, Stephan J. L. Bakker, and Gozewijn D. Laverman. "Lifestyle-Related Exposure to Cadmium and Lead is Associated with Diabetic Kidney Disease." Journal of Clinical Medicine 9, no. 8 (July 30, 2020): 2432. http://dx.doi.org/10.3390/jcm9082432.

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Background: Environmental factors contributing to diabetic kidney disease are incompletely understood. We investigated whether blood cadmium and lead concentrations were associated with the prevalence of diabetic kidney disease, and to what extent lifestyle-related exposures (diet and smoking) contribute to blood cadmium and lead concentrations. Material and methods: In a cross-sectional analysis in 231 patients with type 2 diabetes included in the DIAbetes and LifEstyle Cohort Twente (DIALECT-1), blood cadmium and lead concentrations were determined using inductively coupled plasma mass spectrometry. The associations between diet (derived from food frequency questionnaire), smoking and cadmium and lead were determined using multivariate linear regression. The associations between cadmium and lead and diabetic kidney disease (albumin excretion >30 mg/24 h and/or creatinine clearance <60 mL/min/1.73 m2) were determined using multivariate logistic regression. Results: Median blood concentrations were 2.94 nmol/L (interquartile range (IQR): 1.78–4.98 nmol/L) for cadmium and 0.07 µmol/L (IQR: 0.04–0.09 µmol/L) for lead, i.e., below acute toxicity values. Every doubling of lead concentration was associated with a 1.75 (95% confidence interval (CI): 1.11–2.74) times higher risk for albuminuria. In addition, both cadmium (odds ratio (OR) 1.50 95% CI: 1.02–2.21) and lead (OR 1.83 95% CI: 1.07–3.15) were associated with an increased risk for reduced creatinine clearance. Both passive smoking and active smoking were positively associated with cadmium concentration. Alcohol intake was positively associated with lead concentration. No positive associations were found between dietary intake and cadmium or lead. Conclusions: The association between cadmium and lead and the prevalence of diabetic kidney disease suggests cadmium and lead might contribute to the development of diabetic kidney disease. Exposure to cadmium and lead could be a so far underappreciated nephrotoxic mechanism of smoking and alcohol consumption.

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Earl, Rachel, Nicholas Burns, Ted Nettelbeck, and Peter Baghurst. "Low-level environmental lead exposure still negatively associated with children's cognitive abilities." Australian Journal of Psychology 68, no. 2 (June 2, 2015): 98–106. http://dx.doi.org/10.1111/ajpy.12096.

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Li, Wan-Fen, Mei-Hung Pan, Meng-Chu Chung, Chi-Kung Ho, and Hung-Yi Chuang. "Lead Exposure Is Associated with Decreased Serum Paraoxonase 1 (PON1) Activityand Genotypes." Environmental Health Perspectives 114, no. 8 (August 2006): 1233–36. http://dx.doi.org/10.1289/ehp.9163.

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Nunes, Jack, Marion Ehrich, and John Robertson. "Toxicosis Associated with Dual Oral Exposure of Rats to Lead and Trichloroethylene." Toxicologic Pathology 29, no. 4 (June 2001): 451–57. http://dx.doi.org/10.1080/01926230152499809.

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Schwartz, B. S., W. F. Stewart, K. I. Bolla, D. Simon, K. Bandeen-Roche, B. Gordon, J. M. Links, and A. C. Todd. "Past adult lead exposure is associated with longitudinal decline in cognitive function." Neurology 55, no. 8 (October 24, 2000): 1144–50. http://dx.doi.org/10.1212/wnl.55.8.1144.

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Llop, Sabrina, Xabier Aguinagalde, Jesus Vioque, Jesús Ibarluzea, Mònica Guxens, Maribel Casas, Mario Murcia, et al. "Prenatal exposure to lead in Spain: Cord blood levels and associated factors." Science of The Total Environment 409, no. 11 (May 2011): 2298–305. http://dx.doi.org/10.1016/j.scitotenv.2011.02.004.

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Barry, Vaughn, Andrew Todd, and Kyle Steenland. "O4D.3 Bone lead associations with blood lead, kidney function, and blood pressure among U.S., lead-exposed workers in a surveillance program." Occupational and Environmental Medicine 76, Suppl 1 (April 2019): A38.1—A38. http://dx.doi.org/10.1136/oem-2019-epi.103.

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ObjectivesBone lead and past blood lead (BL) levels may be more strongly associated with current health effects than current BL, representing recent exposure. We examined whether current bone lead is correlated with maximum past BL, and compared three measures of lead as predictors for current blood pressure (BP) and kidney function among workers with past occupational exposure to lead.MethodsAdult men in a lead surveillance program living within 200 miles of New York City were enrolled in this observational study during 2016–2017. We gathered data on current bone and BL, BP, and estimated glomerular filtration rate (eGFR). Maximum past BL was obtained from prior surveillance program data. Regression models were used to determine associations of health endpoints with different measures of lead.ResultsAmong 211 participants, median (interquartile range) bone lead, maximum past BL, and current BL were 13.8 (9.4–19.5) µg of lead per gram of bone mineral, 29.0 (14.0–38.0) µg/dl, and 2.5 (1.5–4.4) µg/dl, respectively. Both maximum past and current BL were significantly associated with current bone lead in adjusted analyses (p<0.0001 for both), with associations driven by those with the highest BL levels. Bone lead was associated with increased systolic BP (p=0.02, model R-square=0.16), but quartile analyses were not monotonic. Bone lead was also non-significantly associated with decreased (worse) eGFR (regression coefficient=−0.15, p=0.18, model R-square=0.28).ConclusionsBone lead was significantly associated with past maximum and current BL. Bone lead, but not past maximum or current BL, was associated with elevated systolic BP.

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Mielke, Howard W., Christopher R. Gonzales, Eric T. Powell, and Sara Perl Egendorf. "Lead in Air, Soil, and Blood: Pb Poisoning in a Changing World." International Journal of Environmental Research and Public Health 19, no. 15 (August 2, 2022): 9500. http://dx.doi.org/10.3390/ijerph19159500.

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(1) Background: Leaded petrol became a worldwide vehicle fuel during the 20th century. While leaded petrol was totally banned on 30 August 2021, its lead (Pb) dust legacy remains in the environment as soil Pb. The health impacts of Pb are well known and risks occur when exposures are above zero. The inextricable links between air Pb, soil Pb, and blood Pb are not widely A. Exposure risks continue even after banning leaded petrol and must be explored. (2) Methods: This article evaluates selected examples of temporal measurements of atmospheric Pb and human Pb exposure and the effect of soil Pb on blood Pb. Several search engines were used to find articles on temporal changes in air Pb and human Pb exposures. New Orleans studies provided empirical data on the association between soil Pb and blood Pb. (3) Results: Vehicle Pb emission trends are closely associated with air Pb and blood Pb. Air Pb deposited in soil becomes a reservoir of Pb dust that is known to be remobilized into the atmosphere. (4) Conclusions: The dust from leaded petrol continues to pose major exposure risks to humans. Exogenous sources of Pb in soil and its remobilization into air along with endogenous bone Pb establish the baseline exposure of children and adults. Reducing human exposure to Pb requires novel policies to decrease exogenous contact from the reservoir of Pb in soil and curtailing remobilization of soil Pb into the atmosphere. Mitigating exposure to soil Pb must therefore play a central role in advancing primary prevention.

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Kim, Kyeong-Ran, Sang-Won Lee, Nam Won Paik, and Kyungho Choi. "Low-Level Lead Exposure Among South Korean Lead Workers, and Estimates of Associated Risk of Cardiovascular Diseases." Journal of Occupational and Environmental Hygiene 5, no. 6 (May 2008): 399–416. http://dx.doi.org/10.1080/15459620802081587.

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Jang, Won-Hee, Kyung-Min Lim, Keunyoung Kim, Ji-Yoon Noh, Seojin Kang, Youn-Kyeong Chang, and Jin-Ho Chung. "Low Level of Lead Can Induce Phosphatidylserine Exposure and Erythrophagocytosis: A New Mechanism Underlying Lead-Associated Anemia." Toxicological Sciences 122, no. 1 (April 11, 2011): 177–84. http://dx.doi.org/10.1093/toxsci/kfr079.

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Namrotee, Zakiyeh, Zsuzsanna Bufa-Dőrr, Viktória Finta, Bálint Izsák, Ágnes Sebestyén, Károly Törő, and Márta Vargha. "Analysis and assessment of human lead exposure from drinking water and the influencing factors associated with lead." DESALINATION AND WATER TREATMENT 275 (2022): 306–12. http://dx.doi.org/10.5004/dwt.2022.28804.

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Kim, Min-Gi, Young-Sun Min, and Yeon-Soon Ahn. "Does Exposure of Lead and Cadmium Affect the Endometriosis?" International Journal of Environmental Research and Public Health 18, no. 17 (August 28, 2021): 9077. http://dx.doi.org/10.3390/ijerph18179077.

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This study aimed to investigate the effects of blood lead levels (BLLs) and lead and cadmium exposure on endometriosis (EM). The study cohort consisted of female workers who underwent a lead-associated special medical examination between 1 January 2000 and 31 December 2004 (n = 26,542). The standard admission rate (SAR) and admission odds ratio (OR) for EM were calculated using the general population and noise-exposed groups, respectively, for the same period as the reference standards. The SAR for EM was 1.24 (95% confidence interval (CI): 1.03–1.48) in lead-exposed workers and 1.44 (95% CI: 1.11–1.85) in workers with BLLs < 5 μg/dL when compared with that of the general population. Admission ORs of EM in lead-exposed workers and those with BLLs < 5 μg/dL were statistically higher than those of noise-exposed workers (OR, 1.40; 95% CI, 1.15–1.70 and OR, 1.48; 95% CI, 1.11–1.98, respectively). The relative excess risk due to interaction of lead and cadmium was 0.33. Lead exposure was associated with EM admission. EM admission in lead-exposed workers with BLLs < 5 μg/dL was statistically higher than that of the general population and noise-exposed workers. Co-exposure to lead and cadmium has a synergistic effect with EM.

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Bellinger, David C. "Lead." Pediatrics 113, Supplement_3 (April 1, 2004): 1016–22. http://dx.doi.org/10.1542/peds.113.s3.1016.

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Children differ from adults in the relative importance of lead sources and pathways, lead metabolism, and the toxicities expressed. The central nervous system effects of lead on children seem not to be reversible. Periods of enhanced vulnerability within childhood have not consistently been identified. The period of greatest vulnerability might be endpoint specific, perhaps accounting for the failure to identify a coherent “behavioral signature” for lead toxicity. The bases for the substantial individual variability in vulnerability to lead are uncertain, although they might include genetic polymorphisms and contextual factors. The current Centers for Disease Control and Prevention screening guideline of 10 μg/dL is a risk management tool and should not be interpreted as a threshold for toxicity. No threshold has been identified, and some data are consistent with effects well below 10. Historically, most studies have concentrated on neurocognitive effects of lead, but higher exposures have recently been associated with morbidities such as antisocial behavior and delinquency. Studies of lead toxicity in experimental animal models are critical to the interpretation of nonexperimental human studies, particularly in addressing the likelihood that associations observed in the latter studies can be attributed to residual confounding. Animal models are also helpful in investigating the behavioral and neurobiological mechanisms of the functional deficits observed in lead-exposed humans. Studies of adults who have been exposed to lead are of limited use in understanding childhood lead toxicity because developmental and acquired lead exposure differ in terms of the maturity of the organs affected, the presumed mechanisms of toxicity, and the forms in which toxicities are expressed.

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Bellinger, David, Alan Leviton, Jone Sloman, Michael Rabinowitz, Herbert L. Needleman, and Christine Waternaux. "Low-Level Lead Exposure and Children's Cognitive Function in the Preschool Years." Pediatrics 87, no. 2 (February 1, 1991): 219–27. http://dx.doi.org/10.1542/peds.87.2.219.

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In a cohort of 170 middle and upper-middle class children participating in a prospective study of child development and low-level lead exposure, higher blood lead levels at age 24 months were associated with lower scores at age 57 months on the McCarthy Scales of Children's Abilities. The mean blood lead level at age 24 months was 6.8 µg/dL (SD = 6.3; 75th, 90th, and 99th percentiles: 8.8, 13.7, 23.6, respectively) and for all but 1 child was less than 25 µg/dL, the current definition of an "elevated" level. After adjustment for confounding, scores on the General Cognitive Index decreased approximately 3 points (SE = 1.4) for each natural log unit increase in 24-month blood lead level. The inverse association between lead level and performance was especially prominent for visual-spatial and visual-motor integration skills. Higher prenatal exposures were not associated with lower scores at 57 months except in the subgroup of children with "high" concurrent blood lead levels (ie, ≥10 µg/dL). The concentration of lead in the dentine of shed deciduous teeth was not significantly associated with children's performance after adjustment for confounding.

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Mason, H. J., L. J. Somervaille, A. L. Wright, D. R. Chettle, and M. C. Scott. "Effect of Occupational Lead Exposure on Serum 1,25-dihydroxyvitamin D Levels." Human & Experimental Toxicology 9, no. 1 (January 1990): 29–34. http://dx.doi.org/10.1177/096032719000900107.

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The effects of lead exposure on serum 1,25-dihydroxyvitamin D levels and calcium homeostasis have been studied in 63 males occupationally exposed to the metal in the UK. The exposure indices used were blood lead, reflecting short-term exposure, and an in vivo X-ray fluorescence measurement of tibia lead which reflects cumulative lead exposure. Serum 1,25-dihydroxyvitamin D levels were higher than those in a referent population, who were non-occupationally exposed to lead, and were correlated with both blood lead and tibia lead. Multiple regression analysis suggested that blood lead was the variable responsible for the increase in serum 1,25-dihydroxyvitamin D. There were no other abnormalities in calcium metabolism associated with the degree of lead exposure.

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Perng, Wei, Marcela Tamayo-Ortiz, Lu Tang, Brisa N. Sánchez, Alejandra Cantoral, John D. Meeker, Dana C. Dolinoy, et al. "Early Life Exposure in Mexico to ENvironmental Toxicants (ELEMENT) Project." BMJ Open 9, no. 8 (August 2019): e030427. http://dx.doi.org/10.1136/bmjopen-2019-030427.

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PurposeThe Early Life Exposure in Mexico to ENvironmental Toxicants (ELEMENT) Project is a mother–child pregnancy and birth cohort originally initiated in the mid-1990s to explore: (1) whether enhanced mobilisation of lead from maternal bone stores during pregnancy poses a risk to fetal and subsequent offspring neurodevelopment; and (2) whether maternal calcium supplementation during pregnancy and lactation can suppress bone lead mobilisation and mitigate the adverse effects of lead exposure on offspring health and development. Through utilisation of carefully archived biospecimens to measure other prenatal exposures, banking of DNA and rigorous measurement of a diverse array of outcomes, ELEMENT has since evolved into a major resource for research on early life exposures and developmental outcomes.Participantsn=1643 mother–child pairs sequentially recruited (between 1994 and 2003) during pregnancy or at delivery from maternity hospitals in Mexico City, Mexico.Findings to dateMaternal bone (eg, patella, tibia) is an endogenous source for fetal lead exposure due to mobilisation of stored lead into circulation during pregnancy and lactation, leading to increased risk of miscarriage, low birth weight and smaller head circumference, and transfer of lead into breastmilk. Daily supplementation with 1200 mg of elemental calcium during pregnancy and lactation reduces lead resorption from maternal bone and thereby, levels of circulating lead. Beyond perinatal outcomes, early life exposure to lead is associated with neurocognitive deficits, behavioural disorders, higher blood pressure and lower weight in offspring during childhood. Some of these relationships were modified by dietary factors; genetic polymorphisms specific for iron, folate and lipid metabolism; and timing of exposure. Research has also expanded to include findings published on other toxicants such as those associated with personal care products and plastics (eg, phthalates, bisphenol A), other metals (eg, mercury, manganese, cadmium), pesticides (organophosphates) and fluoride; other biomarkers (eg, toxicant levels in plasma, hair and teeth); other outcomes (eg, sexual maturation, metabolic syndrome, dental caries); and identification of novel mechanisms via epigenetic and metabolomics profiling.Future plansAs the ELEMENT mothers and children age, we plan to (1) continue studying the long-term consequences of toxicant exposure during the perinatal period on adolescent and young adult outcomes as well as outcomes related to the original ELEMENT mothers, such as their metabolic and bone health during perimenopause; and (2) follow the third generation of participants (children of the children) to study intergenerational effects of in utero exposures.Trial registration numberNCT00558623.

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Svoboda, Laurie K., Kai Wang, Tamara R. Jones, Justin A. Colacino, Maureen A. Sartor, and Dana C. Dolinoy. "Sex-Specific Alterations in Cardiac DNA Methylation in Adult Mice by Perinatal Lead Exposure." International Journal of Environmental Research and Public Health 18, no. 2 (January 12, 2021): 577. http://dx.doi.org/10.3390/ijerph18020577.

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Environmental factors play an important role in the etiology of cardiovascular diseases. Cardiovascular diseases exhibit marked sexual dimorphism; however, the sex-specific effects of environmental exposures on cardiac health are incompletely understood. Perinatal and adult exposures to the metal lead (Pb) are linked to several adverse cardiovascular outcomes, but the sex-specific effects of this toxicant on the heart have received little attention. Perinatal environmental exposures can lead to disease through disruption of the normal epigenetic programming that occurs during early development. Using a mouse model of human-relevant perinatal environmental exposure, we investigated the effects of exposure to Pb during gestation and lactation on DNA methylation in the hearts of adult offspring mice (n = 6 per sex). Two weeks prior to mating, dams were assigned to control or Pb acetate (32 ppm) water, and exposure continued until offspring were weaned at three weeks of age. Enhanced reduced-representation bisulfite sequencing was used to measure DNA methylation in the hearts of offspring at five months of age. Although Pb exposure stopped at three weeks of age, we discovered hundreds of differentially methylated cytosines (DMCs) and regions (DMRs) in males and females at five months of age. DMCs/DMRs and their associated genes were sex-specific, with a small, but statistically significant subset overlapping between sexes. Pathway analysis revealed altered methylation of genes important for cardiac and other tissue development in males, and histone demethylation in females. Together, these data demonstrate that perinatal exposure to Pb induces sex-specific changes in cardiac DNA methylation that are present long after cessation of exposure, and highlight the importance of considering sex in environmental epigenetics and mechanistic toxicology studies.

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LEVINE, FRED, and MAXIMILIAN MUENKE. "VACTERL Association With High Prenatal Lead Exposure: Similarities to Animal Models of Lead Teratogenicity." Pediatrics 87, no. 3 (March 1, 1991): 390–92. http://dx.doi.org/10.1542/peds.87.3.390.

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The VACTERL association is one of the more common patterns of multiple malformations in children, with an incidence of approximately 1.6 cases per 10 000 live births.1 The pattern of defects consists of vertebral anomalies (found in 70% of patients), anal atresia with or without fistula (80%), cardiac defect (50%) with ventricular septal defect being most common, tracheoesophageal fistula (70%), renal anomalies (53%), and limb anomalies (65% with radial anomalies and 23% with lower extremity defects).2 The definition of the VACTERL association as a distinct entity is based on the finding that its constituent anomalies are associated in a nonrandom manner.1,3,4

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Mathec, Angela, Yasmin von Schirnding, Mary Montgomery, and Halina Röllin. "Lead Poisoning in South African Children: The Hazard is at Horne." Reviews on Environmental Health 19, no. 3-4 (July 1, 2004): 347–62. http://dx.doi.org/10.1515/reveh-2004-19-3-411.

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Abstract Lead is a toxic heavy metal that has been used extensively in modern society, causing widespread environmental contamination even in isolated parts of the world. Irrefutable evidence associates lead at different exposure levels with a wide spectrum of health and social effects, including mild intellectual impairment, hyperactivity, shortened concentration span, poor school performance, violent/aggressive behavior, and hearing loss. Lead has an impact on virtually all organ systems, including the heart, brain, liver, kidneys, and circulatory system, resulting in coma and death in severe cases. In recent years, a consensus was reached regarding the absence of a threshold for the key health effects associated with lead exposure and the permanent and irreversible nature of many health and social consequences of lead exposure. The public health problem of environmental lead exposure has been widely investigated in developed countries like the United States of America, where actions taken have led to significant reductions in children's blood lead concentrations. In contrast, there is a relative dearth of information and action regarding lead poisoning in developing countries, particularly in African countries, despite evidence of widespread and excessive childhood lead exposure. In this paper, we will review the information from available published papers, the 'grey Literature', and unpublished reports to give an overview of lead exposure in South African children over the past two decades, with particular emphasis on sources of exposure in the home environment.

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Journal articles on the topic 'Lead Exposure Associated'

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