Rozprawy doktorskie na temat „Lead poisoning”

Thesis (M.C.P.)--Massachusetts Institute of Technology, Dept. of Urban Studies and Planning, 1992.
Title as it appears in the June, 1992 MIT Graduate List: The role of equity in environmental policy--low and moderate income homeowner's financing of lead abatement in Massachusetts.
Includes bibliographical references (leaves 92-98).
by Virginia R. Parker.
M.C.P.

Maintaining due diligence on safety practices at the workplace of battery technicians is the most cost-effective intervention against lead-related hazards. The safety practice on lead poisoning in Nigeria is below average, and the compliance level is far from the expected target of 90%. Using Dejoy's workplace self-protective behavior theory, this study investigated multilevel factors that influence safety practices on lead poisoning and compared the rate of utilization of personal protective equipment by battery technicians in the organized and roadside settings. The study was a quantitative, cross-sectional survey design, and a multistage and systematic sampling technique was used to select 293 adult battery technicians aged 18 years and above. Hypotheses were tested with chi-square and multivariate logistic regressions at the significant level of p < 0.05 and 95% confidence interval. The outcome of the safety practice status of battery technicians is 20%, and the rate of utilization of personal protective equipment is 18% in Lagos, Nigeria. Findings revealed that workplace conditions, blood lead levels, knowledge, education, and the rate of utilization of personal protective equipment are predictors of the safety practice status of battery technicians. There was no significant difference between battery technicians in the organized and roadside setting considering the perceived risk of lead poisoning and utilization of personal protective equipment. The positive social change implications of this study include recommendations for battery technicians to use the evolved alternative safety approaches to reduce lead-related hazards. Public health professional and policymakers should invest resources towards reducing the impact of lead poisoning on battery technicians at the workplace.

The effects of lead poisoning have been known for centuries and the deleterious effects of chronic, low to moderate levels of lead exposure on children's cognitive functioning is now well-established (Needleman & Gatsonis, 1990; Schwartz, 1995). Similarly, low and moderate levels of lead exposure early in life have been frequently associated with behavioural disturbances later in life in children and animals. However, few studies have systematically investigated the link between lead-induced deficits in cognitive functioning and lead-induced behavioural disturbances. This project describes a series of studies investigating the effects of lead on auditory processing and attentional behaviour, and their ability to account for the deleterious effects of lead on IQ in children participating in the Port Pirie Cohort study. Capillary blood samples were collected from the children at various ages from birth to 2 years, and annually thereafter until the age of 7. A measure of lifetime PbB was calculated for each child using the geometric mean of all the blood lead samples. This measure of lifetime PbB was used as a continuous explanatory variable in each of the studies described below. A variety of sociodemographic, health, anthropometric, birth and developmental covariates and potential confounders were recorded prospectively and concurrently. Using Needleman et al.'s (1996) analysis protocol, 8 of these covariates were included in all final regression models. Study One: A total of 387 children from Port Pirie, Australia (mean age of 7.7 years) participated in a study of children’s simple auditory processing. Children completed a series of monaural listening tasks across 4 ear/hand conditions. It was hypothesised that auditory reaction time and auditory processing accuracy would be related the lifetime PbB. Analysis revealed no significant associations between lifetime PbB and the reaction time to target words and a small significant association (3.6%) between lifetime PbB and accuracy of target word detection in just one of the four ear/hand conditions. The strongest associations were found between PbB and false responses to distractor words (10.1%, after adjusting for confounders). It was speculated that this pattern of results could be explained via lead effects on other processes such as impairments to impulse control or attentional processes. Study Two: Study Two investigated the effect of lifetime PbB on children’s complex auditory processing. In this study participants completed dichotic listening tasks across 4 different ear/hand conditions. After controlling for potential confounders, lifetime PbB accounted for 6.2% of the variance in the accuracy of target word detection. A weak direct association (3.0% of the adjusted variance) was also found between lifetime PbB and target word reaction time. No significant associations were found between lifetime PbB and the percentage of false responses or the speed of the false responses. Again the pattern of results was suggestive of a deficit in attentional processes such as freedom from distraction and impulse control. Study Three: This study hypothesised that lead-induced impairments to attentional behaviour - similar to those observed in Studies One and Two - would be observed in other contexts. The mothers of 492 cohort children, and teachers of 454 of the children participated in this study. The mean age of children for whom ratings were collected was 7 years and 4 months. Two versions of the Conner’s Behavior Rating Scale were used to rate the children’s behaviour: The Parent Rating Scale and the Teacher Rating Scale. Lifetime PbB accounted for a significant amount of the variance in Conner’s Parent Behavior Rating Scale scores. It accounted for 5.9% and 7.3% of the unadjusted variance in the Immature/Inattentive, and Hyperactive/Impulsive scores respectively. After adjusting for covariates, each of these associations remained significant. The associations between lifetime PbB and girls' behaviour scores were much higher (11.2%) than the PbB associations with boys' behaviour scores (4.6%). The unadjusted associations between lifetime PbB and Teacher Rating Scores, although much lower, were also significant and accounted for between 1.2% and 2.4% of the variance in the behaviour scores. However, after controlling for potential covariates these associations were no longer significant. These results indicated that increases in lifetime PbB were associated with higher Hyperactivity/Impulsivity and Immature/Inattention and scores on the Conner's Parent Rating Scale, but not the Conner's Teachers Rating Scale. Study Four: In this study it was hypothesised that a significant association would exist between children’s auditory processing performance and parent and teacher behavioural ratings of inattention and impulsivity. Correlational analysis was conducted on the data from Studies One, Two, and Three, to ascertain if the behavioural patterns as reported by the children's parents and teachers, were associated with the children's performance on the auditory processing tasks. Correlational analysis revealed highly significant correlation coefficients in the direction predicted between auditory processing scores and the Inattention and Hyperactivity/Impulsive scores of the Conner's Parent and Teacher Rating Scales. Study Five: The purpose of this study was to examine the extent to which auditory processing and attentional behaviour scores could account for the lead-induced deficits in children's global cognitive abilities. Combining IQ data with data from Studies One, Two, and Three, a hierarchical analysis was conducted with lifetime PbB as the continuous explanatory variable. The analysis entered potential covariates at step 1, behaviour ratings at step 2, auditory processing efficiency in step 3, auditory processing speed in step 4, and lifetime PbB at step 5. The results indicated that when parent and teacher ratings of behaviour and auditory processing efficiency were included in the model, lifetime PbB no longer accounted for a significant proportion of Verbal, Performance or Full-Scale IQ scores. On the other hand, further analyses demonstrated that the significant associations between lifetime PbB and parental behaviour ratings could not be accounted for by including IQ scores as mediating variables in the analytical model. Conclusion: The results of this project provide evidence for the deleterious effect of lead exposure on children's auditory processing performance and parent ratings of behaviour. Further, including these variables in an analysis of the effects of lifetime PbB on IQ served to markedly attenuate direct effect of lead on IQ to the level of non-significance. Taken together the data implicates disturbances to attentional processes (such as impulsivity and inattention) as possible mediators of lead-induced deficits in IQ.

The effects of lead poisoning have been known for centuries and the deleterious effects of chronic, low to moderate levels of lead exposure on children's cognitive functioning is now well-established (Needleman & Gatsonis, 1990; Schwartz, 1995). Similarly, low and moderate levels of lead exposure early in life have been frequently associated with behavioural disturbances later in life in children and animals. However, few studies have systematically investigated the link between lead-induced deficits in cognitive functioning and lead-induced behavioural disturbances. This project describes a series of studies investigating the effects of lead on auditory processing and attentional behaviour, and their ability to account for the deleterious effects of lead on IQ in children participating in the Port Pirie Cohort study. Capillary blood samples were collected from the children at various ages from birth to 2 years, and annually thereafter until the age of 7. A measure of lifetime PbB was calculated for each child using the geometric mean of all the blood lead samples. This measure of lifetime PbB was used as a continuous explanatory variable in each of the studies described below. A variety of sociodemographic, health, anthropometric, birth and developmental covariates and potential confounders were recorded prospectively and concurrently. Using Needleman et al.'s (1996) analysis protocol, 8 of these covariates were included in all final regression models. Study One: A total of 387 children from Port Pirie, Australia (mean age of 7.7 years) participated in a study of children’s simple auditory processing. Children completed a series of monaural listening tasks across 4 ear/hand conditions. It was hypothesised that auditory reaction time and auditory processing accuracy would be related the lifetime PbB. Analysis revealed no significant associations between lifetime PbB and the reaction time to target words and a small significant association (3.6%) between lifetime PbB and accuracy of target word detection in just one of the four ear/hand conditions. The strongest associations were found between PbB and false responses to distractor words (10.1%, after adjusting for confounders). It was speculated that this pattern of results could be explained via lead effects on other processes such as impairments to impulse control or attentional processes. Study Two: Study Two investigated the effect of lifetime PbB on children’s complex auditory processing. In this study participants completed dichotic listening tasks across 4 different ear/hand conditions. After controlling for potential confounders, lifetime PbB accounted for 6.2% of the variance in the accuracy of target word detection. A weak direct association (3.0% of the adjusted variance) was also found between lifetime PbB and target word reaction time. No significant associations were found between lifetime PbB and the percentage of false responses or the speed of the false responses. Again the pattern of results was suggestive of a deficit in attentional processes such as freedom from distraction and impulse control. Study Three: This study hypothesised that lead-induced impairments to attentional behaviour - similar to those observed in Studies One and Two - would be observed in other contexts. The mothers of 492 cohort children, and teachers of 454 of the children participated in this study. The mean age of children for whom ratings were collected was 7 years and 4 months. Two versions of the Conner’s Behavior Rating Scale were used to rate the children’s behaviour: The Parent Rating Scale and the Teacher Rating Scale. Lifetime PbB accounted for a significant amount of the variance in Conner’s Parent Behavior Rating Scale scores. It accounted for 5.9% and 7.3% of the unadjusted variance in the Immature/Inattentive, and Hyperactive/Impulsive scores respectively. After adjusting for covariates, each of these associations remained significant. The associations between lifetime PbB and girls' behaviour scores were much higher (11.2%) than the PbB associations with boys' behaviour scores (4.6%). The unadjusted associations between lifetime PbB and Teacher Rating Scores, although much lower, were also significant and accounted for between 1.2% and 2.4% of the variance in the behaviour scores. However, after controlling for potential covariates these associations were no longer significant. These results indicated that increases in lifetime PbB were associated with higher Hyperactivity/Impulsivity and Immature/Inattention and scores on the Conner's Parent Rating Scale, but not the Conner's Teachers Rating Scale. Study Four: In this study it was hypothesised that a significant association would exist between children’s auditory processing performance and parent and teacher behavioural ratings of inattention and impulsivity. Correlational analysis was conducted on the data from Studies One, Two, and Three, to ascertain if the behavioural patterns as reported by the children's parents and teachers, were associated with the children's performance on the auditory processing tasks. Correlational analysis revealed highly significant correlation coefficients in the direction predicted between auditory processing scores and the Inattention and Hyperactivity/Impulsive scores of the Conner's Parent and Teacher Rating Scales. Study Five: The purpose of this study was to examine the extent to which auditory processing and attentional behaviour scores could account for the lead-induced deficits in children's global cognitive abilities. Combining IQ data with data from Studies One, Two, and Three, a hierarchical analysis was conducted with lifetime PbB as the continuous explanatory variable. The analysis entered potential covariates at step 1, behaviour ratings at step 2, auditory processing efficiency in step 3, auditory processing speed in step 4, and lifetime PbB at step 5. The results indicated that when parent and teacher ratings of behaviour and auditory processing efficiency were included in the model, lifetime PbB no longer accounted for a significant proportion of Verbal, Performance or Full-Scale IQ scores. On the other hand, further analyses demonstrated that the significant associations between lifetime PbB and parental behaviour ratings could not be accounted for by including IQ scores as mediating variables in the analytical model. Conclusion:The results of this project provide evidence for the deleterious effect of lead exposure on children's auditory processing performance and parent ratings of behaviour. Further, including these variables in an analysis of the effects of lifetime PbB on IQ served to markedly attenuate direct effect of lead on IQ to the level of non-significance. Taken together the data implicates disturbances to attentional processes (such as impulsivity and inattention) as possible mediators of lead-induced deficits in IQ.
Thesis (PhD Doctorate)
Doctor of Philosophy (PhD)
School of Applied Psychology - Business
Full Text

Thesis (M.S.)--West Virginia University, 2008.
Title from document title page. Document formatted into pages; contains vii, 83 p. : ill. (some col.), col. maps. Includes abstract. Includes bibliographical references.

Lead is a serious developmental neurotoxin with the capacity to interrupt brain development and impair functioning. Since at least 1930 numerous case studies in American, Canadian and Australian literature have identified lead based paint in the home as a source of poisoning for young children; and since at least 1990 evidence has shown that it is the lead dust from deteriorating paint in older homes and renovating activities that is the primary source of chronic exposure for young children today. Not much is known about the extent of childhood lead poisoning in Canada. Gaps in our understanding include a lack of national survey data on childhood blood lead levels and an absence of reliable data to determine the era of housing that poses the greatest risk. This thesis posits that despite this paucity of research knowledge there is evidence to suggest that populations of vulnerable children continue to be harmed by exposure to historic sources of lead, such as lead-based paint found in older housing stock. This thesis examines the evidence to support this contention by critically analyzing the Canadian public health response to the issue of childhood lead poisoning. Specific attention is paid to discourse corresponding to lead-based paint, the putative major pathway of exposure for children ages 1 to 5 years. Using Foucault’s genealogical/archaeological approach, as elaborated upon by Rawlinson (1987) this thesis discusses the socio-political and economical processes that shaped health care knowledge regarding childhood lead poisoning in Canada and influenced the way knowledge was produced and used by health care providers and policy makers. The analysis is assisted via a comparison of Canadian public health discourse with American discourse, with an emphasis on discourse appearing in the post leaded gasoline era (1990-2008). The strength of a Foucauldian archaeological/genealogical analysis for nursing research and particularly for this analysis is in its focus on discourse, surfaces of emergence, transformations, mutations, contingencies, events, recognition of power/knowledge strategies, descriptions of discipline technologies and consequences, and suggested possibilities of resistance. This thesis proposes that surveillance data constituted both a product and acatalyst of the dominant view on childhood lead poisoning occurring from residential sources and posits that a lack of Canadian context specific surveillance data was the major “policing” factor limiting Canadian public health discourse. Further, privileged access to blood lead survey data maintained the view that childhood lead poisoning was a problem of the past or an American problem. Third, tensions among Canada’s two federal agencies which hold primary responsibility for lead, health and housing resulted in a weakened response whereby, to date, no legislation exists to protect vulnerable populations of Canadian children from exposure to historic sources of lead in residential dwellings.

Doñana National Park in south-west Spain is one of the last remaining strongholds of the Spanish Imperial eagle Aquila adalberti, which is one of the world’s rarest birds with only around 150 pairs remaining.  Lead poisoning is known to be a problem that affects other eagle species, and the purpose of this thesis is to determine whether this is a potential problem for the Doñana population of eagles. Bird exposure to lead in this area is estimated to come from two main sources, soil and sediment lead from upriver mining operations including the 1998 Aznalcollar toxic spill, and resident lead shot due to long-term hunting activity.  a soil lead distribution model is constructed for the whole Doñana, using known principles of pollution deposition in combination with satellite imagery analysis and a training dataset of soil samples dating from 1983 to the present.  A lead shot distribution model is also constructed for the whole Doñana, using a simple rule-based approach to estimate the maximum niche of availability for this lead source. A Monte Carlo simulation model is developed to model the processes of transfer of lead to eagles via their prey species Greylag geese Anser anser and Mallard ducks Anas platyrhynchos.  The model predicts potentially high (5.2%) probability of an eagle being lead poisoned.  A GIS-based ecological risk assessment model quantifies the spatial pattern of lead shot ingestion for Greylag geese and Mallard ducks and grades each of Doñana’s eagle territories according to their lead risk value. The sensitivity, uncertainty and error for all of the above models are assessed in detail.  Finally, future research needs are identified, conservation actions prioritised and management decisions recommended.

Melville wrote Bartleby the Scrivener as a literary portrayal of the Humoral theory of disease. Virchow disproved that theory five years after the novella was published, suggesting Melville was humanizing an unknown pathology. A clinical assessment of the text reveals low-grade lead poisoning, which best explains the strange behavior, abnormal appearance, and premature death of the character Bartleby as depicted by the author. In conjunction with the textual substantiation, historical evidence indicates that at the time Melville wrote the work, one in ten people he encountered suffered from the effects of the same disease. Informed with the identity of Melville’s unknown pathology, the work can be critically read in terms of the Kubler-Ross Grief Cycle as an archetypal first-person account of a population whose societal norms are disrupted when confronted with the victims of undiagnosed lead poisoning.

Lead is a central nervous system poison. Healthy People 2010 established a target blood lead level (BLL) for children of 0 μg/dL by 2010, but is silent with regard to any changes in BLLs standards for working age adults. In this paper, the relation of BLL to performance on two neurobehavioral tests was assessed in working age adults (N = 4909; Age 20 to 59 years; 51.4% Female) employing data from the Third National Health and Nutrition Survey (NHANES 111). Multiple linear regression analyses indicated a significant effect of BLL on time taken to complete an attention demanding cognitive task (Symbol Digit Substitution Task, SDST) but not accuracy of performance of the SDST or simple reaction time, after controlling for confounding variables of age, sex, race-ethnicity, and education. Persons with BLL ≥5 μg /dL took longer (multivariate adjusted mean = 23.6 Sec, SE = 0.30) compared to individuals with BLLs <5 μg /dL (mean = 22.5 Sec, SE = 0.14). The results suggest that lead burden in working age persons impairs central nervous processes involving executive mental functions (decision speed and attention). The findings, if confirmed by case control and or cohort studies would indicate a need to reconsider currently accepted lead levels in working age adults.

Lead (Pb) is a known toxicant that affects young children. It is believed that old water reticulation systems are prone to lead leaching from the walls of lead pipes and fixtures where water is conveyed to households. Many households in Christchurch city particularly in the Northwestern and Central parts of the city contain old water reticulation systems thereby, putting children at considerable health risks. The purpose of this dissertation is to identify the hazards of lead exposure that comes from old water reticulation system of Northwest (NW) Christchurch water supply to households, characterize the health risks due to such contamination and, finally, to suggest possible ways to minimize the hazards. This is accomplished by conducting a systematic review of literature on the exposure patterns of lead from reticulation systems and a literature review of the possible dose response patterns of health effects of lead contamination from old water reticulation systems on children. Thus, this dissertation involves a literature based risk assessment of lead contamination of drinking water supply in the Northwest Christchurch Zone and particularly, its effects on young children. The selection process of the research studies is based on whether they offer accurate and suitable information on the risk of adverse mental function in infants and young children due to environmental lead exposure; whether the studies have been peer reviewed by qualified scientists; whether the results are confirmed by other studies; and involves only human subjects. Future research may consider whether lead levels in drinking water are seasonal; whether these values are significant to health or, the possible role of the government in tightening product controls when monitoring the availability and health risk of high lead drinking water supply plumbing products available in the New Zealand market.

Made available in DSpace on 2014-06-11T19:33:25Z (GMT). No. of bitstreams: 0 Previous issue date: 2009-05-25Bitstream added on 2014-06-13T20:24:55Z : No. of bitstreams: 1 gaspar_af_dr_botfm.pdf: 479621 bytes, checksum: c410da6a3836e0f572669f507194c3d0 (MD5)
Coordenação de Aperfeiçoamento de Pessoal de Nível Superior (CAPES)
A exposição ao chumbo (Pb) exerce papel relevante no desenvolvimento da hipertensão arterial. Sabe-se que as vias NO/GMPc e AMPc e a Na+-K+ ATPase participam na modulação do tono e da contratilidade do músculo liso vascular. Investigou-se as alterações de pressão arterial (PA) e de reatividade vascular à acetilcolina, ao nitroprussiato e ao isoproterenol, bem como a atividade funcional da Na+/K+ ATPase vascular de ratos recém-desmamados e adultos expostos ou não ao Pb nos períodos pré-natal e de amamentação, com enfoque sobre a célula endotelial. Para tanto, curvas concentração-efeito à acetilcolina, nitroprussiato, isoproterenol e potássio foram obtidas em anéis de aorta torácica com e sem endotélio de ratos recém-desmamados e adultos expostos ao chumbo durante a prenhez e amamentação. A exposição perinatal ao Pb determinou hipertensão arterial em proles recém-desmamadas [PA (mmHg): controle 107,1 ± 1,8; Pb 117,8* ± 3,9] e proles adultas [PA (mmHg): controle 126,1 ± 1,1; Pb 139,6* ± 1,6], associada a uma diminuição de sensibilidade ao K+ [CE50 (M): controle 1,93 (1,67 – 2,22); Pb 2,58*(2,14 – 3,11)]. *P < 0,05, n= 6-20. Contudo, nenhuma alteração do relaxamento induzido pelos demais agentes vasodilatadores foi observada. Esses dados sugerem que a hipertensão arterial induzida pela exposição perinatal ao Pb acontece independentemente de alterações nas vias de transdução para a vasodilatação NO/GMPc e b-adrenoceptor/AMPc. Ainda, uma diminuição na modulação endotelial...
Exposure to lead (Pb) has a role in the development of hypertension. It is known that the NO/cGMP and cAMP pathways and Na+-K+ ATPase are involved in the modulation of tone and contractility of vascular smooth muscle. It was investigated the changes in blood pressure (BP) and vascular reactivity to acetylcholine, nitroprusside and isoproterenol, as well as the functional activity of vascular Na+/K+ ATPase of weaned and adult rats exposed or not to Pb during pregnancy and lactation, focusing on the endothelial cell. Concentration-effect curves to acetylcholine, nitroprusside, isoproterenol and potassium were obtained in rings of thoracic aorta with and without endothelium of weaned and adult rats exposed to Pb during pregnancy and lactation. The perinatal exposure to Pb determined arterial hypertension in weaned offsprings [BP (mmHg): control 107,1 ± 1,8; Pb 117,8* ± 3,9] and adult rats [BP (mmHg): control 126,1 ± 1,1; Pb 139,6* ± 1,6], associated with a decreased sensitivity to K+ [EC50 (M): control 1,93 (1,67 – 2,22); Pb 2,58*(2,14 – 3,11)]. *P < 0.05, n= 6-20. However, no change in relaxation induced by other vasodilator agents was observed. These data suggest that the hypertension induced by perinatal Pb-exposure occurs independently of changes in the transduction pathways for NO/cGMP and b-adrenoceptor/AMPc vasodilation... (Complete abstract click electronic access below)

Orientador: Tânia Gracy Martins do Valle
Banca: Maria de Lourdes Merighi Tabaquim
Banca: José Gualberto Tuga Martins Angerami
Resumo: A intoxicação por chumbo é prejudicial ao desenvolvimento das crianças, sendo potencializada por outras variáveis ambientais e sociais como: alimentação inadequada, pobreza, baixa renda e qualidade da estimulação e interação fornecidas pelos pais e escola. Isso posto, o presente estudo tem por objetivo geral comparar o desempenho intelectual de crianças com alta e baixa plumbemia com os estilos parentais nas respectivas interações com os filhos. Para isso, foi utilizada a Escala Wechsler de Inteligência - WISC-III; Roteiro de Anammese e o IEP (Inventário de Estilos Parentais). Este estudo foi realizado com 80 participantes - 40 crianças, de ambos os sexos, com idades entre 7 e 13 anos; e 40 pais (pai e mãe), todos moradores da área de risco próximo ao local de contaminação. As crianças foram divididas em dois grupos: G1 - 20 crianças com alta plumbemia (superior a 10μg/dl); e G2 - 20 crianças com baixa plumbemia (inferior a 10μ/dl). Com as informações coletadas, procedeu-se a análise estatística com Teste do Mann Whitney, com 5% de significância. Os resultados foram apresentados de forma a contemplar cinco conjuntos de dados: I) Caracterização das crianças com alta plumbemia; II) Dados anamnésicos; III) WISC-III; IV) IEP - Inventário de Estilos Parentais e V) Comparação entre o WISC-III com o IEP. A análise dos dados apontou redução da plumbemia nas crianças entre os anos de 2002 e 2005. Para as crianças com alta plumbemia os pais relataram maior número de queixa escolar, problemas de saúde, socialização e motor, embora sem significância estatística entre os grupos. Nos itens avaliados pelo WISC-III, o desempenho do Grupo I foi menor que o do Grupo 2. Na Escala de Execução o desempenho dos dois grupos foi menor que para a escala Verbal, com diferença estatística entre os grupos em: QIE (0,001) e QIOP (0,04)... (Resumo completo, clicar acesso eletrônico abaixo)
Abstract: The lead poisoning cause impairment to the children's development, being strenghten by other environmental and social variables, as inadequate feeding, poverty, low income and quality of the stimulation and interaction supplied by the parents and school. The aim of the present study is to evaluate the children's intellectual development with high and low blood lead level with the parenting styles in the respective interactions with these children. In order to accomplish this study were used - WISC-III; Anamnese's Script and IEP (Parenting Styles's Inventory), in which all of the 80 participants - 40 children, of both sexes, with ages among 7 to 13 years old, and 40 parents (father or mother), lived in the risk's area, next to the contamination place. The children were divided into two groups: G1-20 children with blood lead level above 10μg/dl; and G2 - 20 children with blood lead level lower than 10μg/dl. With the collected information, the statistical analysis was preceded with Mann Whitney's test, with 5%. The results were presented in way to contemplate five groups of data: I) the children's Characterization with plumbemia; II) Anamnese's Script Date; III) WISC-III; IV) IEP - Parenting Styles's Inventory I and V) Comparison between WISC-III IEP. The analyzed data's showed a reduction of the bllod lead level in children between 2002 and 2005. For the children blood lead level the parents related a larger number of school complaints, health problems, socialization and less motor development, although without statistical difference between the groups. In the items evaluated by WISC-III, the development of Group 1 was smaller than Group 2. In the Scale of Execution the development for both groups were lower than the Verbal Scale, with statistical difference between the groups in: QIE (0,001) and QIOP (0,04). In the Parenting Styles... (Complete abstract click electronic access below)
Mestre

This study examines the relationship between the federal government, nongovernmental organizations (NGOs), and the effectiveness of this partnership when addressing environmental justice (EJ) issues for vulnerable populations. The principal objectives of the study were: (1) examining the techniques an NGO utilizes to influence public policy from the bottom-up; (2) examining the techniques an NGO utilizes to educate, bring awareness, and increase testing of childhood lead poisoning in Savannah, Georgia, and (3) analyzing the effectiveness of a government and NGO partnership. For many years, people-of-color and low-income populations have shared a lack of trust for the federal government, therefore grassroots organizations have been the voice for these populations. For the first time, the CDC Healthy Homes and Lead Poisoning Prevention Branch partnered with an EJ organization to influence policy, increase lead testing, and education of childhood lead poisoning in Savannah, Georgia. The methodology utilized for this research was a multi-method, descriptive, explanatory, case study. The Citizens for Environmental Justice (CFEJ) conducted a 6 month intervention with 40 head start parents to increase their knowledge of childhood lead poisoning and lead testing. A control group, located in the same demographic area who did not participate in the intervention, was also tested on their knowledge of childhood lead poisoning. The average test score for the experimental group was higher than the control group. The research shows that lead testing rates for the demographic area increased during the study period, and the EJ group organized a political task force comprised of elected officials and community members to influence the Savannah lead law. Eighty-two percent (82%) of the children within the experimental and control groups were tested for the first time, as a result of the CFEJ lead campaign. A limitation of the study includes the administration of the test. The conclusions drawn from the qualitative and quantitative findings suggests the federal government is more effective resolving environmental disparity issues for vulnerable populations, when partnering with EJ organizations that have a relationship with the community. Implications for future research include extrapolating the Whitehead Model to other federal government / NGO partnerships, and policies such as education, housing and transportation that impact the life of underserved populations inequitably. This study contributes to the political science literature by examining the social and economic occurrences that impact low income social groups, while applying public health and environmental justice concepts, to advance policy implementation for impoverished populations.

Orientador: Sandra Cordellini
Banca: Ione P. Lemonica
Banca: Luiz B. B. da Silva
Banca: Carlos A. Lazarini
Banca: Alaor A. Almeida
Resumo: A exposição ao chumbo (Pb) exerce papel relevante no desenvolvimento da hipertensão arterial. Sabe-se que as vias NO/GMPc e AMPc e a Na+-K+ ATPase participam na modulação do tono e da contratilidade do músculo liso vascular. Investigou-se as alterações de pressão arterial (PA) e de reatividade vascular à acetilcolina, ao nitroprussiato e ao isoproterenol, bem como a atividade funcional da Na+/K+ ATPase vascular de ratos recém-desmamados e adultos expostos ou não ao Pb nos períodos pré-natal e de amamentação, com enfoque sobre a célula endotelial. Para tanto, curvas concentração-efeito à acetilcolina, nitroprussiato, isoproterenol e potássio foram obtidas em anéis de aorta torácica com e sem endotélio de ratos recém-desmamados e adultos expostos ao chumbo durante a prenhez e amamentação. A exposição perinatal ao Pb determinou hipertensão arterial em proles recém-desmamadas [PA (mmHg): controle 107,1 ± 1,8; Pb 117,8* ± 3,9] e proles adultas [PA (mmHg): controle 126,1 ± 1,1; Pb 139,6* ± 1,6], associada a uma diminuição de sensibilidade ao K+ [CE50 (M): controle 1,93 (1,67 - 2,22); Pb 2,58*(2,14 - 3,11)]. *P < 0,05, n= 6-20. Contudo, nenhuma alteração do relaxamento induzido pelos demais agentes vasodilatadores foi observada. Esses dados sugerem que a hipertensão arterial induzida pela exposição perinatal ao Pb acontece independentemente de alterações nas vias de transdução para a vasodilatação NO/GMPc e b-adrenoceptor/AMPc. Ainda, uma diminuição na modulação endotelial... (Resumo completo, clicar acesso eletrônico abaixo)
Abstract: Exposure to lead (Pb) has a role in the development of hypertension. It is known that the NO/cGMP and cAMP pathways and Na+-K+ ATPase are involved in the modulation of tone and contractility of vascular smooth muscle. It was investigated the changes in blood pressure (BP) and vascular reactivity to acetylcholine, nitroprusside and isoproterenol, as well as the functional activity of vascular Na+/K+ ATPase of weaned and adult rats exposed or not to Pb during pregnancy and lactation, focusing on the endothelial cell. Concentration-effect curves to acetylcholine, nitroprusside, isoproterenol and potassium were obtained in rings of thoracic aorta with and without endothelium of weaned and adult rats exposed to Pb during pregnancy and lactation. The perinatal exposure to Pb determined arterial hypertension in weaned offsprings [BP (mmHg): control 107,1 ± 1,8; Pb 117,8* ± 3,9] and adult rats [BP (mmHg): control 126,1 ± 1,1; Pb 139,6* ± 1,6], associated with a decreased sensitivity to K+ [EC50 (M): control 1,93 (1,67 - 2,22); Pb 2,58*(2,14 - 3,11)]. *P < 0.05, n= 6-20. However, no change in relaxation induced by other vasodilator agents was observed. These data suggest that the hypertension induced by perinatal Pb-exposure occurs independently of changes in the transduction pathways for NO/cGMP and b-adrenoceptor/AMPc vasodilation... (Complete abstract click electronic access below)
Doutor

The activity of erythrocyte amino levulenic acid dehydratase (ALA-D) and liver and bone lead concentrations were measured in 141 wild rainbow trout from two highway-influenced and two pristine streams. A significant relationship between ALA-D activity and liver lead concentrations among streams (r = 0.157) was observed. However, this relationship was opposite of expected. Trout tissue lead and stream-water lead concentrations were lower than most concentrations observed for control laboratory trout. At these low tissue and water lead concentrations observed in the present study, ALA-D activity cannot be used to document exposure of fish to environmental lead. Other significant correlations with the activity of the enzyme included: trout length (r = -0.411); trout age (r = -0.385); and sediment lead (r = 0.093). Erythrocyte ALA-D activity significantly varied due to sampling period. However, reasons for this deviation cannot be explained from the present study. Multiple regression techniques revealed little concerning trout liver lead concentrations and ALA-D activity relationships. Like ALA-D activity, liver lead concentrations were deemed a poor indicator of organisms' exposure to environmental lead. Bone lead concentrations were the best indicator of environmental contamination. However, the best regression model, which regressed water lead on bone lead, explained only 20.6% of the variation in bone lead burden. In both roadside streams, water lead was positively correlated to turbidity and area precipitation. Water lead concentrations were also positively correlated to discharge in one roadside stream.
M.S.

Les jeunes enfants sont les plus exposés au plomb et les plus sensibles à ses effets sur la santé, notamment sur le développement. Une enquête d’imprégnation sur 3831 enfants vivant en France a permis d’établir la moyenne géométrique des expositions au plomb à 14,9 (+/- 0,5) µg/L de sang avec 76000 enfants au-delà du seuil d’intervention obligatoire de 50µg/L. Les critères actuels de dépistage se sont avérés peu aptes à repérer ces enfants surexposés et de nouveaux critères sont proposés. En complément, une enquête environnementale avec mesures de plomb dans le logement a été réalisée dans 484 logements. Les poussières au sol des habitations et l’eau du robinet sont des facteurs important de surexposition, ainsi que l’utilisation de vaisselle et cosmétiques traditionnels. Les politiques de prévention doivent être poursuivies compte tenu de la persistance de sources d’exposition et de la toxicité même à faible dose
Young children are most exposed to lead and the most susceptible to its health effects, notably on development. A nationwide representative survey on 3831 children in France has established the geometric mean of lead exposures at 14.9 (+/- 0.5) µg/L of blood with 76000 children beyond the mandatory action level of 50μg / L. The current screening criteria have proved insufficient to identify these overexposed children and new ones are proposed. In addition, an environmental investigation with lead measurements in housing was performed in 484 homes. Household floor dust and tap water are major factors of overexposure, and also the use of traditional dishes and cosmetics. Prevention policies must be pursued in light of the continuing sources of exposure and toxicity even at low doses

Made available in DSpace on 2014-06-11T19:28:59Z (GMT). No. of bitstreams: 0 Previous issue date: 2007-09-21Bitstream added on 2014-06-13T18:35:18Z : No. of bitstreams: 1 dascanio_d_me_bauru.pdf: 540186 bytes, checksum: c3dd2c0d9467bd15fa5a8e18bcac9e4c (MD5)
Coordenação de Aperfeiçoamento de Pessoal de Nível Superior (CAPES)
A intoxicação por chumbo é prejudicial ao desenvolvimento das crianças, sendo potencializada por outras variáveis ambientais e sociais como: alimentação inadequada, pobreza, baixa renda e qualidade da estimulação e interação fornecidas pelos pais e escola. Isso posto, o presente estudo tem por objetivo geral comparar o desempenho intelectual de crianças com alta e baixa plumbemia com os estilos parentais nas respectivas interações com os filhos. Para isso, foi utilizada a Escala Wechsler de Inteligência - WISC-III; Roteiro de Anammese e o IEP (Inventário de Estilos Parentais). Este estudo foi realizado com 80 participantes - 40 crianças, de ambos os sexos, com idades entre 7 e 13 anos; e 40 pais (pai e mãe), todos moradores da área de risco próximo ao local de contaminação. As crianças foram divididas em dois grupos: G1 - 20 crianças com alta plumbemia (superior a 10μg/dl); e G2 - 20 crianças com baixa plumbemia (inferior a 10μ/dl). Com as informações coletadas, procedeu-se a análise estatística com Teste do Mann Whitney, com 5% de significância. Os resultados foram apresentados de forma a contemplar cinco conjuntos de dados: I) Caracterização das crianças com alta plumbemia; II) Dados anamnésicos; III) WISC-III; IV) IEP - Inventário de Estilos Parentais e V) Comparação entre o WISC-III com o IEP. A análise dos dados apontou redução da plumbemia nas crianças entre os anos de 2002 e 2005. Para as crianças com alta plumbemia os pais relataram maior número de queixa escolar, problemas de saúde, socialização e motor, embora sem significância estatística entre os grupos. Nos itens avaliados pelo WISC-III, o desempenho do Grupo I foi menor que o do Grupo 2. Na Escala de Execução o desempenho dos dois grupos foi menor que para a escala Verbal, com diferença estatística entre os grupos em: QIE (0,001) e QIOP (0,04)...
The lead poisoning cause impairment to the children's development, being strenghten by other environmental and social variables, as inadequate feeding, poverty, low income and quality of the stimulation and interaction supplied by the parents and school. The aim of the present study is to evaluate the children's intellectual development with high and low blood lead level with the parenting styles in the respective interactions with these children. In order to accomplish this study were used - WISC-III; Anamnese's Script and IEP (Parenting Styles's Inventory), in which all of the 80 participants - 40 children, of both sexes, with ages among 7 to 13 years old, and 40 parents (father or mother), lived in the risk's area, next to the contamination place. The children were divided into two groups: G1-20 children with blood lead level above 10μg/dl; and G2 - 20 children with blood lead level lower than 10μg/dl. With the collected information, the statistical analysis was preceded with Mann Whitney's test, with 5%. The results were presented in way to contemplate five groups of data: I) the children's Characterization with plumbemia; II) Anamnese's Script Date; III) WISC-III; IV) IEP - Parenting Styles's Inventory I and V) Comparison between WISC-III IEP. The analyzed data's showed a reduction of the bllod lead level in children between 2002 and 2005. For the children blood lead level the parents related a larger number of school complaints, health problems, socialization and less motor development, although without statistical difference between the groups. In the items evaluated by WISC-III, the development of Group 1 was smaller than Group 2. In the Scale of Execution the development for both groups were lower than the Verbal Scale, with statistical difference between the groups in: QIE (0,001) and QIOP (0,04). In the Parenting Styles... (Complete abstract click electronic access below)

Varios fatores contribuem para o desenvolvimento da anemia, que constitui um dos mais graves problemas de saude publica. A anemia hipocromica microcitica e a forma mais comum em criancas e adolescentes. Dentre as causas desta anemia estao: a) deficiencia de ferro, que resulta de um longo periodo do balanco negativo do micronutriente e causa retardo no crescimento e comprometimento do desempenho cognitivo de criancas; b) contaminacao por chumbo (plumbismo) que tambem afeta o desenvolvimento das criancas, podendo ser agravada nos portadores de polimorfismo da enzima ALAD; c) hemoglobinopatias (hemoglobinas variantes e talassemias), anemias herdadas que afetam 7% da populacao mundial. Devido a alta prevalencia destas patologias, o presente trabalho teve como objetivo estudar um grupo de criancas de escolas publicas, identificando os fatores que contribuem para o desenvolvimento de anemias hipocromicas microciticas e estabelecer relacoes entre as caracteristicas laboratoriais das doencas. Participaram do estudo 427 criancas, com idade entre 6 a 9 anos, sendo 235 do sexo feminino e 192 do sexo masculino, alunos de Escolas Municipais e Estaduais, da zona norte da cidade de Ribeirao Preto-SP. Foram analisados: a) numero global de eritrocitos e leucocitos, concentracao de hemoglobina, hematocrito, indices hematimetricos e distribuicao da amplitude das celulas vermelhas (contador automatico Micros 45 . Horiba ABXR) e calculo do indice matematico RDWI; b) niveis plasmaticos de chumbo (espectrometro de massa com plasma indutivamente acoplado VG Plasmaquad PQIIR) e estudo das delecoes dos polimorfismos da enzima ALAD, por PCR; c) status ferrico pelos niveis de ferritina serica (imunoquimioluminescencia utilizando kit Ferritin Immulite . DPCR e equipamento Immulite 1 - DPCR), receptor de transferrina soluvel (ensaio imunoenzimatico, utilizando o kit Quantikine soluble transferrin receptor da R&D SystemsR e o leitor de microplacas de ELISA READER 210, modelo Microwell System Organon TeknikaR) e calculo do indice sTfR/log ferritina; d) analise das hemoglobinas por eletroforese em acetato de celulose, pH alcalino, por HPLC (sistema automatizado Variant II Bio-RadR e kit gÀ-talassemia Short Program) e PCR para a principal delecao de ¿- talassemias. Com base no criterio recomendado pela OMS para definir anemia (Hb menor que 11,5 g/dL), verificou-se que 75 (17,6%) criancas eram anemicas, sendo 33 (44%) portadoras de algum tipo de hemoglobinopatia, 29 (38,6%) com anemias de causa desconhecida e 13 (17,4%) com anemia por deficiencia de ferro. Das anemias, apenas 14 eram anemias hipocromicas microciticas, sendo que 10 (71,4%) eram algum tipo de hemoglobinopatia, 2 (14,2%) ADF e 2 (14,2%) de causa desconhecida. Na populacao estudada, a prevalencia de hemoglobinopatias foi de 16,6% , a saber: 11,6% com ¿-talassemia; 4% com aumento de Hb F; 3,5% com Hb AS; 2,8% com À-talassemia; 0,96% com ¿/À-talassemia e 0,24% com Hb AC. Os niveis de chumbo plasmatico, em todos os participantes do estudo, estavam dentro do recomendado pelo Center for Disease Control and Prevention (< 10 Êg/dL), nao havendo interferencia do metal na patogenese das anemias. Nao houve associacao entre os polimorfismos da ALAD-1 (ALAD1-1 e ALAD1-2) e os niveis de chumbo plasmatico. Anemia por deficiencia de ferro foi diagnosticada em 3% das criancas e DF em 6,1%, utilizando um cut off de 30 ng/mL para ferritina serica. Houve concordancia na identificacao de hemoglobinopatias utilizando as metodologias eletroforese de hemoglobina em acetato de celulose e HPLC, sendo que estas metodologias nao sao uteis para diagnosticar ¿-talassemia. Para identificar os portadores da delecao de ¿-talassemia (.¿3,7) e necessaria a utilizacao da análise molecular (PCR). A suspeita de Hb S/-talassemia identificada por HPLC deve ser confirmada por análise dos pais e/ou irmãos. A ferritina foi um bom parâmetro para identificar DF precocemente e útil para diferenciar os portadores de hemoglobinopatias dos portadores de DF e ADF. O índice sTfR/log da ferritina foi mais sensível do que o sTfR, na diferenciação de DF e talassemia. No diagnóstico das anemias hipocrômicas microcíticas é necessário analisar um conjunto de determinações, incluindo exame hematológico, status férrico, perfil eletroforético, em alguns casos incluindo avaliação dos familiares, e análise molecular das hemoglobinopatias.
Several factors contribute to the development of anemia, which constitutes one of the most serious problems in public health. The hypochromic microcytic anemia is the most common type in children and adolescents. Among the causes for this type of anemia are: a) iron deficiency, which results from a long period of negative balance of the micronutrient, causing delay in growth and compromising the cognitive performance of the children; b) contamination by lead (lead poisoning), which also affects the development of children, and may be aggravated in carriers of polymorphism of the enzyme ALAD; c) hemoglobinopathies (variants hemoglobin and thalassemia), inherited anemia that affects 7% of the world population. Due to the high prevalence of these pathologies, the present study aimed at studying a group of children from public schools, identifying the factors that contribute to the development of hypochromic microcytic anemia and establishing relations between the laboratorial characteristics of the diseases. The study had the participation of 427 children, aged between 6 and 9 years old, being 235 female and 192 male students from Municipal and State Schools in the north area of Ribeirao Preto-SP. It analyzed: a) number of erythrocytes and leucocytes, hemoglobin concentration, hematocrit, red cell indices and red cell distribution width (automatic counter Micros 45 . Horiba ABXR) and calculation of the mathematical index RDWI; b) plasma lead levels (inductively coupled plasma mass spectrometer VG PlasmaQuad PQIIR) and study of the deletions of the polymorphisms of the enzyme ALAD, by PCR; c) iron status by serum ferritin levels (immunochemiluminescence using the kit Ferritin Immulite . DPCR and the equipment Immulite 1 - DPCR), soluble transferrin receptor (enzyme immune assay, using the kit Quantikine soluble transferrin receptor of R&D SystemsR and the microplate reader ELISA READER 210, model Microwell System Organon TeknikaR) and calculation of the sTfR/log ferritin index; d) hemoglobin analysis by electrophoresis on cellulose acetate at alkaline pH, HPLC (automated system Variant II Bio-RadR and the kit gÀ-thalassemia Short Program) and PCR for the main deletion of ¿-thalassemias. Based on the WHO criteria by to define anemia (Hb under 11.5 g/dL), it was verified that 75 (17.6%) children were anemic, being 33 (44%) with hemoglobinopathy, 29 (38.6%) with anemia of unknown causes and 13 (17.4%) with iron deficiency anemia. Among the anemias, only 14 were hypochromic microcytic, 10 (71.4%) being some sort of hemoglobinopathy, 2 (14.2%) due to iron deficiency and 2 (14.2%) due to unknown causes. In the studied population, the prevalence of hemoglobinopathies was 16.6%, namely: 11.6% with ¿-thalassemia; 4% with Hb F elevated; 3.5% with Hb AS; 2.8% with À- thalassemia; 0.96% with ¿/À-thalassemia and 0.24% with Hb AC. The plasma lead levels, in all participants of the study, were within the levels recommended by the Center for Disease Control and Prevention (< 10 Êg/dL), without the interference of the metal in the pathogenesis of the anemias. There was no significant association between the polymorphisms of the ALAD-1 (ALAD1-1 and ALAD1-2) and the plasma lead levels. Iron deficiency anemia was diagnosed in 3% of the children and ID in 6.1%, using a cutoff of 30 ng/mL for serum ferritin. There was agreement in the identification of hemoglobinopathies using the methodologies electrophoresis of hemoglobin in cellulose acetate and the HPLC, as these methodologies are not useful to diagnose ¿-thalassemia. In order to identify the carriers of ¿-thalassemia gene deletion (.¿3,7) it is necessary to use the molecular analysis (PCR). The suspicion of Hb S/À-thalassemia identified by HPLC must be confirmed through the analysis iv of the parents and/or siblings. The ferritin was a good parameter to identify ID early and useful to differ the carriers of hemoglobinopathies of the carriers of ID and IDA. The sTfR/log ferritin level was more sensitive than the sTfR, in the differentiation of ID and thalassemia. In the diagnosis of the hypochromic microcytic anemias, it is necessary to analyze a set of determinations, including hematological exam, iron status, electrophoretic profile, in some cases including relatives, and molecular analysis of the hemoglobinopathies.

A exposição ambiental ao chumbo é uma das questões mais sérias de contaminação de populações do ponto de vista de saúde pública. Mesmo em pequenas quantidades, o chumbo causa mudanças bioquímicas e neurológicas, convulsões e hiperatividade. No Brasil, não existe programa nacional para detecção de crianças contaminadas por este metal, as quais são mais sensíveis aos efeitos deletérios resultantes da exposição crônica a baixas concentrações de chumbo. A maioria dos trabalhos que comprovaram a associação entre exposição ambiental a chumbo no passado e problemas no desenvolvimento neurológico utilizou dentina de dentes decíduos como tecido marcador de exposição. Trabalhos do nosso grupo indicam que o esmalte superficial de dentes decíduos seria um bom marcador cumulativo da exposição passada ao chumbo, sendo que esse tecido apresenta consideráveis vantagens do ponto de vista de acesso e desenvolvimento de testes para monitoramento ambiental. Uma questão importante é verificar se as concentrações de chumbo encontradas no esmalte superficial decíduo variam ao longo do tempo em crianças de baixa exposição. Outra questão importante é verificar se há correlações entre as concentrações de chumbo no esmalte superficial e aquelas dos principais fluidos corporais a partir dos quais o chumbo seria acumulado no esmalte, que são sangue total, plasma e saliva. Assim, o objetivo deste trabalho foi verificar in vivo, por meio de testes em esmalte em dentes decíduos, se o chumbo acumulado nos primeiros micrometros do esmalte aumenta ao longo de três anos e se as concentrações de chumbo encontradas no esmalte apresentam correlação com aquelas encontradas no sangue total, plasma e saliva. A amostra inicial foi constituída por 50 crianças com idade de 2 a 3 anos procedentes de Ribeirão Preto que estavam recebendo atendimento odontológico na Clínica Infantil da Faculdade de Odontologia de Ribeirão Preto USP e alunos da Creche Carochinha (USPRibeirão Preto). Obtiveram-se as seguintes amostras: primeira etapa (2009): 01 amostra de sangue total e 01 amostra de esmalte de um incisivo central superior; segunda etapa (2010): 01 amostra de sangue total, 01 amostra de plasma sanguíneo, 01 amostra de saliva e 01 amostra de esmalte do dente contralateral. terceira etapa (2011): 01 amostra de sangue total, 01 amostra de plasma sanguíneo, 01 amostra de saliva e 02 amostras de amostra de esmalte dos incisivos laterais. O fósforo foi determinado colorimetricamente, para calcular a profundidade dos testes de esmalte. As concentrações de chumbo no plasma, saliva e esmalte dental foram determinadas por espectrometria de massas com plasma indutivamente acoplado (ICPMS) e no sangue total, por espectrometria de absorção atômica com forno de grafite. Muitas crianças ou seus responsáveis não permitiram a coleta de sangue em algum dos períodos, e assim ao longo dos 3 anos tivemos participação efetiva de 20 crianças. Em 2009, a concentração de chumbo no sangue total variou de 0,2 μg/dL a 7,48 μg/dL e teve como a mediana 0,26 μg/dL. Apenas uma criança apresentou nível de chumbo no sangue 5 μg/dL. Em 2010, a concentração de chumbo no sangue total variou de 0.2 μg/dL a 3,8 μg/dL e teve como a mediana 0,32 μg/dL. Em 2011, a concentração de chumbo no sangue variou de 1,15 μg/dL a 3,55 μg/dL e teve como mediana 0,95 μg/dL. Os dados de chumbo no sangue não apresentam diferenças estatisticamente significantes entre os grupos ao longo dos anos (p>0.05). Em 2010, valores de chumbo no plasma variaram de 0,29 3,20 μg/L e a mediana foi 0,49. Em 2011, variaram de 0,38 1,60 μg/L com mediana 0,52 μg/L. A concentração de chumbo na saliva em 2010 variou de 0,02 3,00 μg/L, com mediana de 0,34 μg/L. Em 2011, esses valores variaram de 0,02 4,27 μg/L e a mediana foi de 0,19 μg/L. Para as concentrações de chumbo no plasma e na saliva, não houve diferenças estatisticamente significantes entre os grupos (Saliva 2010 x Saliva 2011; Plasma 2010 x Plasma 2011) (teste de Mann Whitney; p>0.05). No caso dos dados obtidos no esmalte dentário, os valores de chumbo foram recalculados para uma mesma profundidade, que foi de 3,4 μm. Nenhum dos grupos (Esmalte 2009, Esmalte 2010 e Esmalte 2011) teve distribuição normal, e não houve diferença entre nas concentrações de chumbo encontradas ao longo dos anos, com medianas de 36, 35 e 38 μg/g em 2009, 2010 e 2011, respectivamente (p=0,71, teste de Kruskal-Wallis). A análise de correlação foi feita após a transformação logarítmica (log10) de todos os valores. Mesmo após esta transformação, dois grupos ainda não apresentaram distribuição normal, o grupo Plasma 2011 e Esmalte 2010. As associações que envolviam estes grupos foram testadas utilizando-se a correlação de Spearman, enquanto todas as demais associações foram testadas utilizando-se o teste de correlação de Pearson. As correlações significativas positivas encontradas foram: entre Sangue Total 2009 e Sangue Total 2010 (rP = 0,64; p = 0,002) ; Sangue Total 2010 e Sangue Total 2011 (rP = 0,66; p = 0,002); Esmalte 2011 e Sangue Total 2009 (rP= 0,44; p=0,05) e entre Esmalte 2009 e Esmalte 2010 (rS = 0,45 e p=0,03). Houve uma associação inversa entre a Saliva 2010 e Esmalte 2011 (rP = - 0,55; p=0,013). Conclusão: Os valores de chumbo obtidos em todas as amostras ao longo de 3 anos caracterizam baixa exposição a chumbo no grupo estudado. As concentrações de chumbo no sangue, saliva, plasma e esmalte não variaram ao longo do tempo. Das 28 associações testadas, foram estatisticamente significantes e positivas aquelas entre o Sangue Total 2009 e o Esmalte 2011 e entre o Esmalte 2009 e Esmalte 2010. A associação entre Saliva 2010 e Esmalte 2011 foi inversa. Os resultados sugerem que o esmalte tenha associação com a exposição de chumbo passada, neste estudo caracterizado pelos valores de chumbo no sangue total. Os resultados sugerem que o esmalte possa ser um biomarcador fidedigno para avaliar o grau de exposição a chumbo em populações com baixa exposição a este metal, uma vez que o esmalte superficial de dentes decíduos não incorporou chumbo em quantidades significativas entre 2 e 5 anos de idade em crianças com baixa exposição e baixa atividade de cárie.
Environmental exposure to lead is one of the most serious contamination problems that affect public health. Even in small amounts, lead can cause neurological and biochemical changes, such as mental problems and hyperactivity. In Brazil, there is no program for the detection of children contaminated by this metal. Children are more sensitive to the deleterious effects of chronic lead exposure. Studies that proved association between environmental exposure to lead and neurological developmental problems used dentine of primary teeth as a marker of lead exposure. Studies by our group suggest that superficial enamel of deciduous teeth would be a good cumulative marker of past exposure to lead, and this tissue has considerable advantages regarding access and the perspective of development of tests for environmental monitoring of children. An important question is whether the concentrations of lead found in deciduous enamel surface vary over time in children with low exposure and if there are correlations between the concentrations of lead in the enamel surface and those of the main body fluids from which the lead was accumulated in the enamel, which are whole blood, plasma and saliva. The aims of this study was to investigate in vivo, by testing lead concentration in deciduous enamel of primary teeth, if the lead accumulated in the first micrometers of enamel increases along three years and if the concentrations of lead found in enamel surface were correlated with those found in whole blood, plasma and saliva. The initial sample consisted of 50 children aged 2 to 3 years from Ribeirão Preto, who were receiving dental care at Children\'s Clinic of the Faculty of Dentistry of Ribeirão Preto - USP and students of Nursery Carochinha (USP-Ribeirão Preto). The following samples were obtained: first stage (2009): 01 sample of whole blood and 01 sample of enamel of a central upper incisor, second stage (2010): 01 sample of whole blood, 01 sample of blood plasma, 01 sample of saliva and 01 sample of enamel from the contralateral tooth; third stage (2011): 01 sample of whole blood, 01 sample of blood plasma, 01 sample of saliva and 02 enamel samples of lateral upper incisors. Phosphorus was determined by a colorimetric method, in order to calculate the depth of enamel tests. Lead concentrations in plasma, saliva and enamel were determined by inductively coupled plasma mass spectrometry (ICPMS) and whole blood by atomic absorption spectrometer with graphite furnace. Many children or their guardians did not allow the collection of blood in any of the periods, and thus, over the three years, we had the enrollment of only 20 children. In 2009, the concentration of lead in whole blood varied from 0.2 μg / dL to 7.48 μg /dL and the median was 0.26 μg/dL. Only one child had a blood lead level 5 μg/ dL. In 2010, the concentration of lead in whole blood ranged from 0.2 μg/dL to 3.8 μg/dL and the median was 0.32 μg/dL. In 2011, the concentration of lead in blood ranged from 1.15 μg/dL to 3.55 μg/dL and the median was 0.95 μg/dL. The blood lead data do not show statistically significant differences over the years (p> 0.05). In 2010, values of lead in plasma ranged from 0.29 to 3.20 μg/L and the median was 0.49 μg/L. In 2011, lead levels in plasma ranged from 0.38 to 1.60 μg/L with median 0.52 μg/L. The lead concentration in Saliva 2010 ranged from 0.02 to 3.00μ g/L, median 0.34 μg/L. In 2011, these values ranged from 0.02 to 4.27 μg/L and the median was 0.19 μg/L. For lead concentrations in plasma and saliva, there were no statistically significant differences between groups (Saliva 2010 x Saliva 2011; Plasma 2010 x Plasma 2011)(Mann-Whitney test, p> 0.05). To analyze enamel samples, the values of lead were recalculated so they would reflect the lead found in one same depth, which was 3.4 micrometers. None of the groups (enamel from 2009, enamel from 2010 and enamel from 2011) presented normal distribution. There was no statistically significant difference between these three groups (p=0.71, Kruskal-Wallis). A correlation analysis was performed after logarithmic transformation (log10) of all values. Even after this transformation, two groups still did not exhibit normal distribution, which were Plasma 2011 & Enamel 2010. The associations that involved these two groups were tested using the Spearman correlation test, while all other associations were tested using the Pearson correlation test. The significant positive correlations found were: Whole Blood 2009 and Whole Blood 2010 (rP = 0,64; p = 0,002) ; Whole Blood 2010 and Whole Blood 2011 (rP = 0,66; p = 0,002); between Enamel 2011 and Whole Blood 2009 (rP= 0.44, p = 0.05) and between Enamel 2009 and Enamel 2010 (rS= 0.45, p= 0.03). There was an inverse association between Saliva 2010 and Enamel 2011 (rP= - 0,55; p = 0,013). Conclusion: The lead values obtained in all samples over three years characterized low exposure to lead by the group studied. Lead concentrations in blood, saliva, plasma and enamel did not vary over time. Of the 28 associations tested, the ones between Whole Blood 2009 and 2011 and between Enamel 2009 and 2010 were positive and significant. The association between Saliva 2010 and Enamel 2011 was negative and significant. The results suggest that the lead found in the enamel is correlated with past exposure to lead characterized in this study by the yearly whole blood lead data. The results further suggest that the dental enamel can be a reliable marker to assess the degree of exposure to lead of populations, since the primary teeth´s enamel surface did not incorporate lead in substantial quantities between 2 and 5 years in children with low exposure to this metal and low caries activity.

Introdução: Intoxicação ambiental por chumbo é uma questão extensamente investigada em diversos países. No Brasil existem poucos estudos sobre o tema, em sua maioria realizada em locais com relato prévio de contaminação do meio ambiente. O objetivo deste estudo é a determinação da prevalência de intoxicação por chumbo em crianças de uma Vila na cidade de Porto Alegre sem relatos prévios de contaminação do meio ambiente por chumbo e com fatores de risco descritos na literatura. Além disso, foram avaliados fatores associados e possíveis fontes de contaminação. Metodologia: Estudo transversal de prevalência com amostra randomizada de crianças de 0 a 5 anos, em que foi medido o nível de chumbo no sangue e aplicado um questionário para avaliação de fatores associados. Posteriormente, foi realizada uma avaliação ambiental preliminar com análise direta do solo e indireta da poluição atmosférica, utilizando bioindicadores, na tentativa de averiguar possíveis fontes de contaminação. Resultados: 97 crianças participaram do estudo (83.6% da amostra selecionada), com prevalência de intoxicação por chumbo encontrada de 16.5% ([Pb] sanguíneo >= 10,0?g/dL). Reciclagem de lixo, nível educacional do pai e idade estiveram relacionados a um aumento na concentração de chumbo no sangue. Foram encontrados níveis elevados de chumbo no solo e pouca indicação de poluição atmosférica por este metal. Discussão: Encontrou-se uma prevalência significativa de intoxicação por chumbo e as possíveis fontes de contaminação nesta comunidade parecem ter relação com atividades de reciclagem de lixo. Outros estudos sobre a questão com a população infantil em geral devem ser conduzidos, bem como avaliações de possíveis fontes locais e gerais, para que se possa dimensionar corretamente essa questão no Brasil.
Introduction: Environmental lead intoxication is an extensively investigated issue in several countries. In Brazil, there are only a few studies on the theme, most of which were carried out in places with previous reports of environmental lead contamination. The objective of this study was to determine the prevalence of lead intoxication in children, from a neighborhood of the city of Porto Alegre without previous descriptions of environmental lead contamination, but with risk factors described in the literature and additionally to evaluate associated factors and possible local sources of contamination. Methodology: Cross-sectional study of prevalence with random sample of children aged 0 to 5, in which the level of lead in the blood was measured and a questionnaire was applied to evaluate associated factors. Afterwards, a preliminary environmental evaluation was carried out with direct analyses of soil and indirect analyses of air pollution, using bioindicators, in an attempt to verify possible local sources of contamination. Results: 97 children participated in the study (83.6% of the selected sample), with 16.5% of the sample showing intoxication (blood [Pb] >= 10.0 ?g/dL). Waste recycling at home, father\'s educational level and age were factors related to an increase in the concentration of lead in the blood. High levels of lead were found in the soil and there was little indication of lead deposition through atmospheric emissions. Discussion: A significant prevalence of lead intoxication was found and the possible sources of contamination in this community seem to be related to activities of waste recycling. Other studies on this matter in children in the general Brazilian population should be carried out, as well as assessments of possible sources and local risk factors.

A falta de consenso na literatura acerca dos efeitos tóxicos do chumbo no sistema auditivo é notória, tanto em estudos clínicos quanto experimentais. Em adição, tem sido relatado que o ferro apresenta um efeito protetor na toxicidade cerebral causada pelo chumbo. Assim, estudos clínicos e bioquímicos têm sido realizados no intuito de compreender a relação entre o chumbo e o sistema auditivo, bem como identificar possíveis substâncias protetoras para a toxicidade deste metal. Neste sentido, no presente estudo verificou-se o processo maturacional do nervo auditivo e tronco encefálico, associado à análise proteômica da porção auditiva do tronco encefálico de ratos expostos a acetato de chumbo e suplementados com sulfato ferroso. O experimento foi realizado por seis semanas com 30 ratos (Rattus norvergicus, variedade Wistar) machos, recém-desmamados, divididos em seis grupos de cinco animais cada, sendo um controle, que recebeu água deionizada; dois grupos experimentais que receberam 100 mg/L de Pb(CH3COO)2 na água de beber, sendo administrado simultaneamente para um deles 20 mg/kg de FeSO4 a cada dois dias; dois grupos que receberam a dose de 400 mg/L de Pb (CH3COO)2 na água de beber, onde para um deles foi administrado simultaneamente 20 mg/kg de FeSO4 a cada dois dias e um grupo experimental que recebeu água deionizada e uma solução de 20 mg/kg de FeSO4 a cada dois dias. O processo maturacional do sistema auditivo foi verificado por meio da análise do Potencial Evocado Auditivo de Tronco Encefálico (PEATE) em dois momentos distintos, antes e depois da exposição ao chumbo. Os animais foram então sacrificados, coletado sangue e removido o tronco encefálico. A concentração de chumbo no sangue e tronco encefálico, apresentou um efeito dose-resposta, confirmado pela alta correlação entre a concentração nos dois compartimentos (r2=0,905, p<0,0001), tendo o sulfato ferroso reduzido a concentração de chumbo no sangue e no tecido, embora a diferença só tenha sido significativa para o sangue grupo que recebeu 100 mg/L de Pb(CH3COO)2). Com relação ao PEATE observou-se diferença estatisticamente significativa para o interpico I-II (p=0,049) nos grupos experimentais 100 mg/L Pb(CH3COO)2 e 400 mg/L Pb(CH3COO)2 e interpico I-IV, quando comparados os grupos 100 mg/L Pb(CH3COO)2 e 100 mg/L Pb(CH3COO)2 + FeSO4 (p=0,033). A análise proteômica apontou uma diminuição considerável no número de spots proteicos detectados em todos os grupos experimentais em relação ao controle, bem como uma redução na expressão do padrão proteico. Assim, o presente estudo reforça a hipótese do papel deletério do chumbo nas dosagens de 100 e 400 mg/L de Pb (CH3COO)2 na maturação do nervo auditivo e região do núcleo coclear, com possível efeito protetor do ferro. A análise proteômica do tronco encefálico de ratos demonstrou que o acetato de chumbo altera a expressão proteica desta estrutura, contudo o efeito protetor do sulfato ferroso não foi confirmado nas proteínas identificadas.
There is a lack of consensus in the literature about the toxic effects of lead in the auditory system, both in clinical and experimental studies. In addition to that, it has been reported that iron has a protective effect on brain toxicity caused by lead. Therefore, clinical and biochemical studies have been carried out to understand the relationship between Pb and the auditory function, as well as if the ferreous sulfate as an otoprotectant. In this study the maturational process of the auditory nerve and brainstem and the proteomic profile of the auditory portion of the brainstem of rats exposed to lead and supplemented with iron were evaluated. The experiment was carried out for six weeks with 30 wealing rats (Rattus norvegicus, Wistar), divided into six groups of five animals each: a control group that received deionized water; two experimental groups receiving 100 mg/L Pb(CH3COO)2 in drinking water, being given 20 mg/kg FeSO4 simultaneously to one of them every two days; two groups received 400 mg/LPb(CH3COO)2 in drinking water, where to one of them was given 20 mg/kg FeSO4 simultaneously every two days; and an experimental group that received deionized water and a solution of 20 mg/kg FeSO4 every two days. The maturational process of the auditory system was verified by analyzing the Brainstem Auditory-Evoked Potential (BAEP) at two different times, before and after lead exposure. The animals were sacrificed, their blood collected and brainstem removed. The concentration of lead in blood and brain stem showed a dose-response, confirmed by correlation between the concentration in the two compartments (rr2 = 0.905, p <0.0001). Ferreous sulfate reduced the levels of lead in blood and tissue, although the difference was only significant for blood (group receiving 100 mg/L Pb(CH3COO)2). Concerning to BEAP we observed a statistically significant difference for the interpeak I-II (p = 0.049) in the experimental groups 100 and 400 mg/L Pb(CH3COO)2 and for the interpeak I-IV, when groups 100 and 100 mg/L Pb(CH3COO)2 + FeSO4 were compared (p = 0.033). The proteomic analysis showed a considerable decrease in the number of protein spots detected in all experimental groups compared to control, as well as a reduction in the expression pattern of the proteins. Thus, the present study reinforces the hypothesis of deleterious role of Pb in dosages of 100 and 400 mg/L Pb(CH3COO)2 in the maturation of the auditory nerve and cochlear nucleus region, with a possible protective effect of ferreous sulfate. The proteomic analysis of the brainstem of rats showed that lead acetate alters protein expression of this structure. However, the protective effect of ferreous sulfate was not confirmed for the identified proteins.

Introdução - A intoxicação por chumbo é um conhecido problema de saúde pública e o envenenamento por este metal pode causar danos a vários órgãos, especialmente ao Sistema Nervoso Central de crianças em desenvolvimento. Objetivo geral- estudar a associação entre exposição a chumbo e comportamento anti-social (CAS) em adolescentes brasileiros. Objetivos específicos: a) analisar a associação entre exposição a chumbo e CAS / cometimento de atos infracionais (CAI); b) estudar potenciais fontes de exposição domiciliar a chumbo que mais estão associadas a altas concentrações de chumbo no esmalte dentário (CCED) e; c) avaliar o impacto de alterações metodológicas na técnica de microbiópsia ácida de esmalte dentário superficial (MAEDS) sobre CCED e profundidade da bíópsia. Métodos- Um estudo transversal foi conduzido com 173 jovens (Bauru, SP). MAEDS foram realizadas nestes jovens por dois diferentes protocolos metodológicos. Além disso, questionários sobre comportamento dos adolescentes e exposição a possíveis fontes de contaminação por chumbo foram aplicados a pais e adolescentes. Análises de regressão logística, testes de Wilcoxon e testes t pareados foram aplicados aos dados. Resultados- Odd ratios ajustados para covariáveis indicaram que alta CCED está associada a risco aumentado de exceder o escore clínico para queixas somáticas, problemas sociais, comportamento de quebrar regras e problemas externalizantes (IC 95%). Alta CCED não foi associado com escores elevados de CAI. Os fatores de risco mais associados com alta CCED foram residir em área contaminada ou até 2 km da área contaminada e trabalhar na fabricação de tintas, pigmentos, cerâmicas ou baterias. A profundidade da biópsia, calculada pela fórmula da altura do cilindro, para um dos protocolos, levou a resultados errôneos de profundidade da biópsia, confirmados por testes de perfilometria. Conclusões- A exposição a altos níveis de chumbo parece disparar o estabelecimento de CAS, o que alerta para a necessidade de desenvolvimento e implantação de políticas públicas de saúde que previnam o envenenamento da população por chumbo. Adolescentes foram expostos ao chumbo por algumas fontes estudadas, no Brasil. O esmalte dentário é um marcador fidedigno e a MAEDS é bastante útil e confiável. No entanto, CCEDs não podem ser comparadas entre resultados de pesquisas diferentes quando houver qualquer variação metodológica entre os estudos, havendo a necessidade da padronização do procedimento.
Introduction - Lead poisoning is a long known public health problem. Thus, lead exposure may cause damage to diverse organs, especially in the Central Nervous System of children in developing process. Objectives- a) to analyze the association between lead exposure and antisocial / delinquent behavior; b) to study the potential sources of lead home exposure more associated to high dental enamel lead levels (DELL) and c) to evaluate two distinct enamel biopsy protocols in relation to biopsy depth and DELL. Methods- A cross-sectional study was conducted with 173 adolescents (Bauru, SP, Brazil). Surface dental enamel (SDE) etch-acid microbiopsies were performed in upper central incisors of these youths by two different methodological protocols. In addition, questionnaires about adolescents behavior and about possible sources of lead contamination were responded by youths and their parents. Logistic regression, Wilcoxon and paired t tests were applied to data. Results- Odd ratios adjusted for familial and social covariates indicated that high DELL is associated with increased risk of exceeding the clinical score for somatic complaints, social problems, rulebreaking behavior (T70) and externalizing problems (T63) (CI 95%). High DELL was not found to be associated with elevated SRD scores. The risk factors associated to high DELL were residing in contaminated area or close proximity and working in paints, pigments, ceramic or batteries manufacturing. The biopsy depth, calculated by the cylinder formula, for Protocol II induced misleading results, as confirmed by profilometry tests. Conclusions- It seems that exposure to high lead levels can indeed trigger antisocial behavior, which claims for public policies to prevent lead poisoning. Adolescents were exposed to lead, by some studied sources, in Brazil. SDE, measured by etch-acid microbiopsy, is a reliable biomarker, but DELL could not be compared when there is some methodological variation among the studies. A standardization of the procedure is necessary.

ABSTRACT The porphyrias are a diverse group of metabolic disorders arising from diminished activity of enzymes in the heme biosynthetic pathway. They can present with acute neurovisceral symptoms, cutaneous symptoms, or both. The complexity of these disorders is demonstrated by the fact that some acute porphyria patients with the underlying genetic defect(s) are latent and asymptomatic while others present with severe symptoms. This indicates that there is at least one other risk factor required in addition to the genetic defect for symptom manifestation. A systematic review of the heme biosynthetic pathway highlighted the involvement of a number of micronutrient cofactors. An exhaustive review of the medical literature uncovered numerous reports of micronutrient deficiencies in the porphyrias as well as successful case reports of treatments with micronutrients. Many micronutrient deficiencies present with symptoms similar to those in porphyria, in particular vitamin B6. It is hypothesized that a vitamin B6 deficiency and related micronutrient deficiencies may play a major role in the pathogenesis of the acute porphyrias. In order to further investigate the porphyrias, a computational model of the heme biosynthetic pathway was developed based on kinetic parameters derived from a careful analysis of the literature. This model demonstrated aspects of normal heme biosynthesis and illustrated some of the disordered biochemistry of acute intermittent porphyria (AIP). The testing of this model highlighted the modifications necessary to develop a more comprehensive model with the potential to investigated hypotheses of the disordered biochemistry of the porphyrias as well as the discovery of new methods of treatment and symptom control. It is concluded that vitamin B6 deficiency might be the risk factor necessary in conjunction with the genetic defect to trigger porphyria symptoms.

A research report submitted to the Faculty of Health Sciences, University of Witwatersrand, South Africa in partial fulfilment of the requirements for the Master of Medicine in the branch of Community Health Johannesburg, 2014
BACKGROUND: Lead is one of the most widely used and studied heavy metals. Lead has a number of serious detrimental effects including those related to the nervous system (seizures, ataxia) heamotological system (anaemia) and renal system. The severity and prognosis of diseases related to lead exposure is more pronounced in children, even with very low blood levels. Anecdotal reports of lead melting to make fishing sinkers in South African subsistence fishing communities prompted the conduct of an epidemiological study in four South African fishing villages to investigate the extent of lead melting and the associated risks in children. METHODS: A cross sectional analytical study was conducted. The study was conducted in two schools located along the western (Atlantic Ocean) coast of South Africa (HP Williams Primere in Stompneusbaai and NGK Primary School in Elands Bay) and in two schools located along the southern (Indian Ocean) coast of South Africa Bertie Barnard School in Stilbaai, Struisbaai Primere School in Struisbaai. Blood samples were collected for lead content analysis, and anthropometric measurements were taken. Questionnaires were administered to obtain information about socio-economic status and risk factors for lead exposure. A total of 196 children from grade 0, 1 and 2 were included in the study. RESULTS: Blood lead levels in the sample ranged from 1.9 to 22.4 μg/dl. Central tendency of the blood lead level demonstrated an arithmetic mean of 6.87 μg/dl (95% CI: 6.36 to 7.37 μg/dl) and a median of 6.1 μg/dl. More than half of the children in the study had blood lead levels between 5.0 - 9.9 μg/dl, whilst 13% that had levels higher than 10 μg/dl. Age, sex and ethnicity was not significantly associated with high blood lead levels whilst, lead melting practices and interaction of children with pets were strongly associated with high blood lead levels in children. Multivariate analysis showed that the presence of a fisherman in the household and children watching smelting were significantly associated with higher blood lead levels. Village remained a confounding variable in the model. CONCLUSIONS: This study is the first report on blood lead levels in fishing villages on the African continent and provides evidence that lead is still used widely as the primary substance used to make fishing sinkers. The prevalence of plumbism was high at 75%. Policy and awareness is needed to address this neglected public health concern.

Lead poisoning of young children has been deemed the number one environmental threat to America's young children. It is estimated that 890,000 children have levels high enough to effect their ability to learn$\sp{62}.$ While levels have decreased dramatically over the past 15 years, African-American children living in poverty in inner cities continue to be at particular risk for lead poisoning This study was undertaken to determine the prevalence of lead poisoning in high risk children residing in the City of New Orleans from 1993-1995 and to examine the relationship between elevated blood lead levels and sociodemographic and environmental characteristics. A model, at the census tract level, identifying the demographic and environmental factors associated with elevated blood lead levels was developed and used to evaluate whether the variables recommended for use by CDC effectively predict elevated blood lead levels The study confirmed that lead toxicity of poor, minority children in New Orleans is a severe problem. Overall, 38% of children had elevated levels ($\ge$10 $\mu$g/dL), 20% had levels $\ge$15 $\mu$g/dL. Eleven percent had levels $\ge$20 $\mu$g/dL, twice what is considered safe by the CDC. Furthermore, the study showed that not all poor, minority children are affected equally. Analysis by geographical unit, both clinic and census tract, show areas of greatest risk; in some parts of the city more than half of the children screened had elevated levels The geometric mean blood lead level was 7.85 $\mu$g/dL and levels remained constant over the three year study period. This is substantially higher than levels reported from the National Health and Nutritional Examination Survey, a cross-sectional survey of the U.S. population Distinct patterns by age were noted. Children three to five years had significantly (p $\le$.01) higher geometric mean blood lead levels than their younger counterparts and levels continued to stay elevated with increasing age. Surprisingly, children five to six years had the highest geometric mean levels Percent of houses vacant, median soil lead level and median income were consistent predictors of elevated lead levels. Percent of houses built prior to 1950 was not a significant predictor is any of the models run. This has important policy implications. CDC guidelines place heavy emphasis on the use of this variable to estimate lead-exposure risk in a geographic area$\sp{62}.$ However, in cities like New Orleans with a large stock of old houses and a cross-section of people living in them, age of housing alone is not a good surrogate for condition of housing. The variable percent of houses vacant may more accurately reflect the condition of the housing thereby being better able to estimate lead-exposure risk The results of this study may be helpful to other communities responding to CDC recommendations to tailor screening guidelines to local concerns
acase@tulane.edu

碩士
中國醫藥大學
職業安全與衛生學系碩士在職專班
106
Lead poisoning is a serious condition that effects multiple organs systems in humans. Identifying source of exposure is essential to both preventing and controlling intoxication. We presented a family who performed Chinese exorcism at home, was tested with high blood lead level and classical symptoms of lead poisoning. Analysis of dust samples in the patient’s house found abnormally high concentration of lead. The results indicated that incense fume is the well-founded culprit of occupational and domestic lead poisoning. We suggested enhancing ventilation as a mean to reduce lead exposure associated with incense burning.