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Special Issue "Preventing Lead Exposure and Its Consequences in Vulnerable Populations: The Unfinished Agenda"

A special issue of International Journal of Environmental Research and Public Health (ISSN 1660-4601). This special issue belongs to the section "Environmental Health".

Deadline for manuscript submissions: closed (31 August 2018)

Special Issue Editors

Guest Editor
Prof. Katarzyna Kordas

Department of Epidemiology and Environmental Health, School of Public Health and Health Professions, University at Buffalo, Buffalo, NY 14214, USA
Website | E-Mail
Interests: metal exposures; metal-nutrient interactions; child cognition and behavior; family relationships
Guest Editor
Dr. Julia Ravenscroft

Department of Epidemiology and Environmental Health, School of Public Health and Health Professions, University at Buffalo, Buffalo, NY 14214, USA
E-Mail
Interests: lead exposure; child growth and development; endocrine disruption

Special Issue Information

Dear Colleagues,

Lead exposure among vulnerable population groups, including women of reproductive age and young children, is an important public health problem globally. In the U.S., this problem has been well described, but has gained renewed notoriety in recent years. In other parts of the world, particularly Low and Middle-Income Countries (LMIC), the extent of lead exposure is only now gaining recognition and is of emerging concern. This is because exposure often coincides with other conditions harmful to human health, growth, and development, such as micronutrient deficiencies or lack of access to quality health care. Although significant progress has been made in the reduction of blood lead levels in some nations through the removal of lead from gasoline and paint, unfortunately, the lead ‘problem’ has not been solved. In fact, lead exemplifies the disparities in environmental exposures that occur along socioeconomic or racial/ethnic lines. The consequences of early life lead exposure (starting in utero, through the school years) are wide-ranging and long-term, with no lower boundaries for the occurrence of harm. Despite many decades of research into the predictors and health impacts of lead exposure, this problem remains unresolved, with many communities just beginning to recognize its harmful effects while others struggle to design efficient and effective prevention efforts. In that sense, lead is a legacy public health issue, and the work of mitigating lead exposure and its effects, an unfinished global public health agenda.

The goal of this Special Issue is to create a forum to highlight research-to-policy linkages and provide an opportunity for the research and public health program communities to come together to consider why lead remains an unfinished public health agenda, what outstanding issues should receive attention from these communities, and how to best address and scale up prevention and mitigation efforts for the benefit of vulnerable individuals and groups. These broad issues can be explored with publications of original research findings, reviews or commentaries across several key themes:

Lead as a legacy vs. emerging public health issue:

  1. Characterizing the extent of lead exposure as either a legacy or an emerging concern, particularly in LMICs.
  2. Understanding lead-related disparities in exposure and health globally, with a particular focus on LMICs.
  3. Exploration of newer, emerging health outcomes related to lead exposure.
  4. Understanding of the evolving role of lead in drinking water as an exposure source in light of progress made globally in removing lead from paint and gasoline.
  5. Understanding the interplay of migration and urbanization phenomena and processes as contributor to lead exposure among urban populations.

Solutions, needs, and lessons learned:

In addition, contributors are invited to address the above issues with exemplars of successful approaches and/or lessons learned that inform public health prevention or policy efforts. We welcome commentary from intergovernmental bodies and agencies regarding what position lead exposure prevention efforts occupy within their larger agenda, what is needed from the research community to facilitate their policy work, and what type of guidance and support governments and governmental agencies need to further local prevention efforts.

Prof. Katarzyna Kordas
Dr. Julia Ravenscroft
Guest Editors

Manuscript Submission Information

Manuscripts should be submitted online at www.mdpi.com by registering and logging in to this website. Once you are registered, click here to go to the submission form. Manuscripts can be submitted until the deadline. All papers will be peer-reviewed. Accepted papers will be published continuously in the journal (as soon as accepted) and will be listed together on the special issue website. Research articles, review articles as well as short communications are invited. For planned papers, a title and short abstract (about 100 words) can be sent to the Editorial Office for announcement on this website.

Submitted manuscripts should not have been published previously, nor be under consideration for publication elsewhere (except conference proceedings papers). All manuscripts are thoroughly refereed through a single-blind peer-review process. A guide for authors and other relevant information for submission of manuscripts is available on the Instructions for Authors page. International Journal of Environmental Research and Public Health is an international peer-reviewed open access semimonthly journal published by MDPI.

Please visit the Instructions for Authors page before submitting a manuscript. The Article Processing Charge (APC) for publication in this open access journal is 1800 CHF (Swiss Francs). Submitted papers should be well formatted and use good English. Authors may use MDPI's English editing service prior to publication or during author revisions.

Keywords

  • Lead exposure
  • Global health
  • Urban development and lead
  • Disparities in exposure
  • Environmental justice
  • Policy and prevention

Published Papers (16 papers)

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Open AccessArticle Chronic Environmental and Occupational Lead Exposure and Kidney Function among African Americans: Dallas Lead Project II
Int. J. Environ. Res. Public Health 2018, 15(12), 2875; https://doi.org/10.3390/ijerph15122875
Received: 17 October 2018 / Revised: 28 November 2018 / Accepted: 4 December 2018 / Published: 14 December 2018
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Abstract
Background: We examined the effects of lead on kidney function in occupationally and environmentally exposed adults from a Dallas lead smelter community that was the site of an Environmental Protection Agency (EPA) Superfund clean-up. All subjects were African Americans—a racial group that bears [...] Read more.
Background: We examined the effects of lead on kidney function in occupationally and environmentally exposed adults from a Dallas lead smelter community that was the site of an Environmental Protection Agency (EPA) Superfund clean-up. All subjects were African Americans—a racial group that bears a disproportionate burden of kidney disease. Methods: A two-phase health screening was conducted. Phase II included a physical examination and laboratory tests. Study subjects were African Americans residents, aged ≥19 years to ≤89 years. Of 778 subjects, 726 were environmentally exposed and 52 were both occupationally and environmentally exposed. The effects of lead exposure on estimated glomerular filtration rate (eGFR) were examined in three groups: male and female smelter-community residents, as well as males with both occupational and environmental exposure. Multiple linear regression was used to analyze the dependence of eGFR on log (blood lead level), duration of residence in the community, type 2 diabetes, and hypertension. Results: There was a statistically significant negative effect on kidney function for all three groups. Comparison of female and male residents showed a slightly larger negative effect of blood lead level on eGFR in females versus males, with the largest effect seen in male smelter-working residents. For each unit increase (log10 10 µg/dL = 1) in blood lead level, age-adjusted eGFR was reduced 21.2 mL/min/1.73 m2 in male residents, 25.3 mL/min/1.73 m2 in female residents and 59.2 mL/min/1.73 m2 in male smelter-working residents. Conclusions: Chronic lead exposure is associated with worsening kidney function in both African American male and female residents, as well as male workers in Dallas smelter communities. This effect is slightly, but not statistically significantly, worse in female residents than male residents, and significantly worse in males that both worked and resided in the smelter community. Full article
Open AccessArticle Association of Low Lead Levels with Behavioral Problems and Executive Function Deficits in Schoolers from Montevideo, Uruguay
Int. J. Environ. Res. Public Health 2018, 15(12), 2735; https://doi.org/10.3390/ijerph15122735
Received: 29 October 2018 / Revised: 27 November 2018 / Accepted: 29 November 2018 / Published: 4 December 2018
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Abstract
The negative effect of lead exposure on children’s intelligence is well-documented. Less is known about the impact of lead on the use of executive functions to self-regulate behavior. We measured blood lead level (BLL) in a sample of first grade children from Montevideo, [...] Read more.
The negative effect of lead exposure on children’s intelligence is well-documented. Less is known about the impact of lead on the use of executive functions to self-regulate behavior. We measured blood lead level (BLL) in a sample of first grade children from Montevideo, Uruguay (n = 206, age 6.7 ± 0.5 years, 59.7% boys). Behavior was assessed with teacher versions of the Conners Rating Scale (CRS) and the Behavior Rating Inventory of Executive Functions (BRIEF). Mean BLL was 4.2 ± 2.1 μg/dL; 10% had mild-to-severe ratings of Attentional Deficit with Hyperactivity Disorder (ADHD) (T score > 65). In negative binomial regression, BLL was not associated with CRS sub-scales, but was associated with a poorer ability to inhibit inappropriate behaviors, prevalence ratio (PR) [95% CI]: 1.01 [1.00, 1.03] as measured by the BRIEF. In covariate-adjusted models, the association with BLL was attenuated. When stratified by sex, the covariate-adjusted association between BLL, hyperactivity, poorer inhitibion, emotional control, and behavioral regulation was marginally significant for girls but not boys. In summary, among children with low lead-exposure, we found some, but nonetheless modest, evidence of a relationship between higher BLL and child behavior. If confirmed by larger studies and other objective measures of behavior, such links could have implications for learning and social interaction, particularly among girls. Full article
Open AccessFeature PaperArticle Environmental Co-Exposure to Lead and Manganese and Intellectual Deficit in School-Aged Children
Int. J. Environ. Res. Public Health 2018, 15(11), 2418; https://doi.org/10.3390/ijerph15112418
Received: 30 September 2018 / Revised: 21 October 2018 / Accepted: 27 October 2018 / Published: 31 October 2018
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Abstract
Studies have demonstrated that, for urban children, dust represents the main exposure to sources of metals like lead (Pb) and manganese (Mn). We aimed to investigate the exposure to these metals and their association with intellectual deficit in children living in an industrial [...] Read more.
Studies have demonstrated that, for urban children, dust represents the main exposure to sources of metals like lead (Pb) and manganese (Mn). We aimed to investigate the exposure to these metals and their association with intellectual deficit in children living in an industrial region. This cross-sectional study recruited volunteers from four elementary schools in the town of Simões Filho, Brazil. We evaluated 225 school-aged children (7–12 years) for blood lead (PbB) and manganese hair (MnH) and toenails (MnTn) by graphite furnace atomic absorption spectrometry. Child and maternal IQs were estimated using the Wechsler Abbreviated Scale for Intelligence (WASI). Median and range PbB were 1.2 (0.3–15.6) μg/dL. MnH and MnTn medians (ranges) were 0.74 (0.16–8.79) μg/g and 0.85 (0.15–13.30) μg/g, respectively. After adjusting for maternal IQ, age and Mn exposure, child IQ drops by 8.6 points for a 10-fold increase in PbB levels. Moreover, an effect modification of Mn co-exposure was observed. In children with low MnTn, association between Pb and child IQ was not significant (β = −6.780, p = 0.172). However, in those with high MnTn, the association was increased by 27.9% (β = −8.70, p = 0.036). Low Pb exposure is associated with intellectual deficit in children, especially in those with high MnTn. Full article
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Open AccessFeature PaperArticle Sex-Dependent Impact of Low-Level Lead Exposure during Prenatal Period on Child Psychomotor Functions
Int. J. Environ. Res. Public Health 2018, 15(10), 2263; https://doi.org/10.3390/ijerph15102263
Received: 17 September 2018 / Revised: 9 October 2018 / Accepted: 12 October 2018 / Published: 16 October 2018
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Abstract
The impact of exposure to lead on child neurodevelopment has been well established. However, sex differences in vulnerability are still not fully explained. We aimed at evaluating the effect of a low-level lead exposure, as measured between 20 to 24 weeks of pregnancy [...] Read more.
The impact of exposure to lead on child neurodevelopment has been well established. However, sex differences in vulnerability are still not fully explained. We aimed at evaluating the effect of a low-level lead exposure, as measured between 20 to 24 weeks of pregnancy and in cord blood, on developmental scores up to 24 months of age in 402 children from the Polish Mother and Child Cohort (REPRO_PL). Additionally, sex-dependent susceptibility to lead at this very early stage of psychomotor development was assessed. The blood lead levels were analyzed using inductively coupled plasma mass spectrometry (ICP-MS). In order to estimate the children’s neurodevelopment, the Bayley Scales of Infant and Toddler Development was applied. The geometric mean (GM) for blood lead level during 20–24 weeks of pregnancy was 0.99 ± 0.15 µg/dL and, in the cord blood, it was 0.96 ± 0.16 µg/dL. There was no statistically significant impact of lead exposure during prenatal period on the girls’ psychomotor abilities. Among the boys, we observed lower scores for cognitive functions, along with increasing cord blood lead levels (β = −2.07; p = 0.04), whereas the results for the language and motor abilities were not statistically significant (p > 0.05). Our findings show that fetal exposure to very low lead levels might affect early cognitive domain, with boys being more susceptible than girls. Education on health, higher public awareness, as well as intervention programs, along with relevant regulations, are still needed to reduce risks for the vulnerable population subgroups. Full article
Open AccessArticle Soil Contamination by a Lead Smelter in Brazil in the View of the Local Residents
Int. J. Environ. Res. Public Health 2018, 15(10), 2166; https://doi.org/10.3390/ijerph15102166
Received: 31 August 2018 / Revised: 24 September 2018 / Accepted: 27 September 2018 / Published: 2 October 2018
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Abstract
A primary lead smelter operated in Santo Amaro City in Brazil from 1960 to 1993, leaving approximately 500,000 tons of industrial dross containing 2–3% of lead and other toxic elements that contaminated the industry grounds and the urban environment. This study aimed to [...] Read more.
A primary lead smelter operated in Santo Amaro City in Brazil from 1960 to 1993, leaving approximately 500,000 tons of industrial dross containing 2–3% of lead and other toxic elements that contaminated the industry grounds and the urban environment. This study aimed to present the local residents’ perception towards soil contamination by the smelter. In a cross-sectional study, 208 residents from randomly selected households were interviewed about dross hazards and proposals for its management. A city map depicts the distribution and concentration of lead, cadmium, arsenic, zinc, nickel, and antimony, measured in the soil of the 39 households with visible smelter dross. Only one site complies with the soil quality reference values; 27 (69.2%) call for preventive measures, and 11 (28.2%) require intervention. The smelter dross continues widely spread over the city. Thirty (76.9%) out of the 39 residents were able to recognize the smelter dross on household surroundings. However, this ability was not associated with the concentrations of toxic elements in the soil of their residences and surroundings. The smelter and the local Prefecture were most frequently held liable for taking soil cleanup actions. The most frequently (38.0%) cited solution for managing the dross found in the households was “to provide the residents with information about health risks related to the dross”. Full article
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Open AccessArticle Children’s Blood Lead Concentrations from 1988 to 2015 in Mexico City: The Contribution of Lead in Air and Traditional Lead-Glazed Ceramics
Int. J. Environ. Res. Public Health 2018, 15(10), 2153; https://doi.org/10.3390/ijerph15102153
Received: 31 August 2018 / Revised: 22 September 2018 / Accepted: 25 September 2018 / Published: 30 September 2018
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Abstract
Despite the removal of lead from gasoline in 1997, elevated blood lead levels (BLLs) > 5 µg/dL are still detectable in children living in Mexico City. The use of lead-glazed ceramics may explain these persistent exposure levels. Mexico lacks a national surveillance program [...] Read more.
Despite the removal of lead from gasoline in 1997, elevated blood lead levels (BLLs) > 5 µg/dL are still detectable in children living in Mexico City. The use of lead-glazed ceramics may explain these persistent exposure levels. Mexico lacks a national surveillance program for BLL, but temporal trends can be derived from epidemiological studies. With this approach, we leveraged a series of birth cohorts to report BLL trends from 1987 to 2002 and expanded our analysis to 2015. Data were from 1–5-year-old children from five Mexico City cohorts followed between 1988 and 2015. BLLs are reported on 1963 children, who contributed 4975 BLLs. We estimated the trend of mean BLL, which decreased from 15.7 µg/dL in 1988, to 7.8 µg/dL in 1998 (a year after the total ban of lead in gasoline), to 1.96 µg/dL in 2015. The proportion of BLL ≥ 5 µg/dL decreased from 92% (1988–1998) to 8% (2008–2015). The use of lead-glazed ceramics was associated with an 11% increase in BLLs throughout the study period. Replacing lead-based glazes in traditional ceramics may be the key to further reducing exposure, but this presents challenges, as it involves a cultural tradition deeply rooted in Mexico. In addition, the creation of a rigorous, standardized, and on-going surveillance program of BLL is necessary for identifying vulnerable populations. Full article
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Open AccessArticle Lead in Air in Bangladesh: Exposure in a Rural Community with Elevated Blood Lead Concentrations among Young Children
Int. J. Environ. Res. Public Health 2018, 15(9), 1947; https://doi.org/10.3390/ijerph15091947
Received: 13 August 2018 / Revised: 28 August 2018 / Accepted: 30 August 2018 / Published: 6 September 2018
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Abstract
Previous evaluations of a birth cohort in the Munshiganj District of Bangladesh had found that over 85% of 397 children aged 2–3 years had blood lead concentrations above the United States Centers for Disease Control and Prevention’s reference level of 5 μg/dL. Studies [...] Read more.
Previous evaluations of a birth cohort in the Munshiganj District of Bangladesh had found that over 85% of 397 children aged 2–3 years had blood lead concentrations above the United States Centers for Disease Control and Prevention’s reference level of 5 μg/dL. Studies in urban areas of Bangladesh have found elevated levels of lead in the air due to industries and remaining contamination from the historic use of leaded gasoline. Sources of lead in rural areas of Bangladesh remain unknown. We conducted air sampling in both residential and industrial sites in Munshiganj to determine whether children are exposed to elevated lead concentrations in the air and study the association between the children’s blood lead levels and sampled air lead concentrations. Residential and industrial air samples in Munshiganj were found to have elevated lead concentrations (mean 1.22 μg/m3) but were not found to be associated with the observed blood lead concentrations. Lead in air is an important environmental health exposure risk to the for children in Munshiganj, and further research may shed light on specific sources to inform exposure prevention and mitigation programs. Full article
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Open AccessArticle Spatial Hurdle Models for Predicting the Number of Children with Lead Poisoning
Int. J. Environ. Res. Public Health 2018, 15(9), 1792; https://doi.org/10.3390/ijerph15091792
Received: 19 July 2018 / Revised: 11 August 2018 / Accepted: 18 August 2018 / Published: 21 August 2018
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Abstract
Objective The purpose of this study is to identify the high-risk areas of children’s lead poisoning in Syracuse, NY, USA, using spatial modeling techniques. The relationships between the number of children’s lead poisoning cases and three socio-economic and environmental factors (i.e., building year [...] Read more.
Objective The purpose of this study is to identify the high-risk areas of children’s lead poisoning in Syracuse, NY, USA, using spatial modeling techniques. The relationships between the number of children’s lead poisoning cases and three socio-economic and environmental factors (i.e., building year and town taxable value of houses, and soil lead concentration) were investigated. Methods Spatial generalized linear models (including Poisson, negative binomial, Poisson Hurdle, and negative binomial Hurdle models) were used to model the number of children’s lead poisoning cases using the three predictor variables at the census block level in the inner city of Syracuse. Results The building year and town taxable value were strongly and positively associated with the elevated risk for lead poisoning, while soil lead concentration showed a weak relationship with lead poisoning. The negative binomial Hurdle model with spatial random effects was the appropriate model for the disease count data across the city neighborhood. Conclusions The spatial negative binomial Hurdle model best fitted the number of children with lead poisoning and provided better predictions over other models. It could be used to deal with complex spatial data of children with lead poisoning, and may be generalized to other cities. Full article
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Open AccessFeature PaperArticle Effectiveness of Prevailing Flush Guidelines to Prevent Exposure to Lead in Tap Water
Int. J. Environ. Res. Public Health 2018, 15(7), 1537; https://doi.org/10.3390/ijerph15071537
Received: 31 May 2018 / Revised: 28 June 2018 / Accepted: 17 July 2018 / Published: 20 July 2018
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Abstract
Flushing tap water is promoted as a low cost approach to reducing water lead exposures. This study evaluated lead reduction when prevailing flush guidelines (30 s–2 min) are implemented in a city compliant with lead-associated water regulations (New Orleans, LA, USA). Water samples [...] Read more.
Flushing tap water is promoted as a low cost approach to reducing water lead exposures. This study evaluated lead reduction when prevailing flush guidelines (30 s–2 min) are implemented in a city compliant with lead-associated water regulations (New Orleans, LA, USA). Water samples (n = 1497) collected from a convenience sample of 376 residential sites (2015–2017) were analyzed for lead. Samples were collected at (1) first draw (n = 375) and after incremental flushes of (2) 30–45 s (n = 375); (3) 2.5–3 min (n = 373), and (4) 5.5–6 min (n = 218). There was a small but significant increase in water lead after the 30 s flush (vs. first draw lead). There was no significant lead reduction until the 6 min flush (p < 0.05); but of these samples, 52% still had detectable lead (≥1 ppb). Older homes (pre-1950) and low occupancy sites had significantly higher water lead (p < 0.05). Each sample type had health-based standard exceedances in over 50% of sites sampled (max: 58 ppb). While flushing may be an effective short-term approach to remediate high lead, prevailing flush recommendations are an inconsistently effective exposure prevention measure that may inadvertently increase exposures. Public health messages should be modified to ensure appropriate application of flushing, while acknowledging its short-comings and practical limitations. Full article
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Open AccessArticle How Does Low Socioeconomic Status Increase Blood Lead Levels in Korean Children?
Int. J. Environ. Res. Public Health 2018, 15(7), 1488; https://doi.org/10.3390/ijerph15071488
Received: 25 May 2018 / Revised: 6 July 2018 / Accepted: 10 July 2018 / Published: 13 July 2018
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Abstract
Although studies have shown that a low socioeconomic status (SES) is associated with high blood lead levels (BLLs) in children, the mechanism underlying this observation is not well known. To determine how SES influences BLLs via environmental factors in Korean children, we conducted [...] Read more.
Although studies have shown that a low socioeconomic status (SES) is associated with high blood lead levels (BLLs) in children, the mechanism underlying this observation is not well known. To determine how SES influences BLLs via environmental factors in Korean children, we conducted a population-based cross-sectional study of 4744 children aged 5–13 years. Questionnaires on sociodemographic information, environmental factors, and food consumption were administered to the children’s parents. BLLs in the study subjects were measured.The complete set of hypothesized associations was assessed using regression analysis and structural equation modeling. SES was associated with high BLLs. The total effects of nutritional factors, lead in the air and total length of nearby roads, and agriculture on BLLs were −0.062 (p < 0.001), 0.068 (p = 0.005), and 0.038 (p = 0.035), respectively. The direct effects of playing outdoors and SES on BLLs were 0.113 (p < 0.001) and −0.111 (p < 0.001), respectively. Although playing outdoors had a greater direct effect on BLLs than did SES, the total effect of SES (standardized β = −0.132, p < 0.001) was greater than that of other sources owing to indirect effects (β = −0.020, p = 0.004). A low SES was a major risk factor for elevated BLLs via environmental factors. Full article
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Open AccessFeature PaperArticle Hunting, Sale, and Consumption of Bushmeat Killed by Lead-Based Ammunition in Benin
Int. J. Environ. Res. Public Health 2018, 15(6), 1140; https://doi.org/10.3390/ijerph15061140
Received: 3 May 2018 / Revised: 22 May 2018 / Accepted: 25 May 2018 / Published: 1 June 2018
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Abstract
Human consumption of animal meat killed by lead ammunition has been reported as a risk factor for elevated blood lead levels. However, little is known about how meat killed by lead ammunition is hunted, prepared, sold, and consumed. We explored the process from [...] Read more.
Human consumption of animal meat killed by lead ammunition has been reported as a risk factor for elevated blood lead levels. However, little is known about how meat killed by lead ammunition is hunted, prepared, sold, and consumed. We explored the process from hunting to consumption within communities in Benin from the perspective of preventive measures. We conducted 38 semi-structured interviews with hunters (n = 9) and sellers (n = 8) of bushmeat and families (n = 21) as consumers of bushmeat killed by lead ammunition. Data were transcribed, translated, and coded for analysis. We conducted content analysis to identify and describe key themes and processes from hunting to consumption. Many hunters (n = 7/9) used lead-based ammunition. After the meat is hunted, market sellers often buy it directly from the hunters. Amongst the hunters and sellers, few (n = 4/17) acknowledged removing the meat impacted by lead shot prior to sale. Many families (n = 15/21) mentioned consumption of the hunted bushmeat. The meat is cooked before sharing with children. Many families (n = 19/21) mentioned they look for the remains of the lead shot or remove the meat impacted by the shot. The finding suggests that hunting, sale, and consumption of bushmeat killed by lead ammunition are well-known practices in Allada, Benin. The bushmeat often hunted illegally with lead shot is sold in the markets and eventually consumed by families who attempt to clean the meat impacted by the lead shot before cooking it. Full article
Open AccessArticle Environmental Lead Exposure and Adult Literacy in Myanmar: An Exploratory Study of Potential Associations at the Township Level
Int. J. Environ. Res. Public Health 2018, 15(6), 1086; https://doi.org/10.3390/ijerph15061086
Received: 9 April 2018 / Revised: 19 May 2018 / Accepted: 25 May 2018 / Published: 28 May 2018
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Abstract
Environmental lead exposure is a population health concern in many low- and middle-income countries. Lead is found throughout Myanmar and prior to the 1940s the country was the largest producer of lead worldwide. The aim of this study was to examine any potential [...] Read more.
Environmental lead exposure is a population health concern in many low- and middle-income countries. Lead is found throughout Myanmar and prior to the 1940s the country was the largest producer of lead worldwide. The aim of this study was to examine any potential association between lead mining and adult literacy rates at the level of 330 townships in Myanmar. Townships were identified as lead or non-lead mining areas and 2015 census data were examined with association being identified using descriptive, analytical and spatial statistical methods. Overall, there does appear to be a significant relationship between lead mining activity and adult literacy levels among townships with both low access (p = 0.05; OR = 2.701 (1.136–6.421)) as well with high access to safe sanitation (p = 0.01; OR = 18.40 (1.794–188.745)). Local Indicators of Spatial Association (LISA) cluster maps confirm these findings. This exploratory analysis is a first step in the examination of potential environmental lead exposure and its implications in Myanmar. Full article
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Open AccessArticle Lead Emissions and Population Vulnerability in the Detroit (Michigan, USA) Metropolitan Area, 2006–2013: A Spatial and Temporal Analysis
Int. J. Environ. Res. Public Health 2017, 14(12), 1445; https://doi.org/10.3390/ijerph14121445
Received: 23 September 2017 / Revised: 16 November 2017 / Accepted: 20 November 2017 / Published: 23 November 2017
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Abstract
Objective: The purpose of this research is to geographically model airborne lead emission concentrations and total lead deposition in the Detroit Metropolitan Area (DMA) from 2006 to 2013. Further, this study characterizes the racial and socioeconomic composition of recipient neighborhoods and estimates [...] Read more.
Objective: The purpose of this research is to geographically model airborne lead emission concentrations and total lead deposition in the Detroit Metropolitan Area (DMA) from 2006 to 2013. Further, this study characterizes the racial and socioeconomic composition of recipient neighborhoods and estimates the potential for IQ (Intelligence Quotient) loss of children residing there. Methods: Lead emissions were modeled from emitting facilities in the DMA using AERMOD (American Meteorological Society/Environmental Protection Agency Regulatory Model). Multilevel modeling was used to estimate local racial residential segregation, controlling for poverty. Global Moran’s I bivariate spatial autocorrelation statistics were used to assess modeled emissions with increasing segregation. Results: Lead emitting facilities were primarily located in, and moving to, highly black segregated neighborhoods regardless of poverty levels—a phenomenon known as environmental injustice. The findings from this research showed three years of elevated airborne emission concentrations in these neighborhoods to equate to a predicted 1.0 to 3.0 reduction in IQ points for children living there. Across the DMA there are many areas where annual lead deposition was substantially higher than recommended for aquatic (rivers, lakes, etc.) and terrestrial (forests, dunes, etc.) ecosystems. These lead levels result in decreased reproductive and growth rates in plants and animals, and neurological deficits in vertebrates. Conclusions: This lead-hazard and neighborhood context assessment will inform future childhood lead exposure studies and potential health consequences in the DMA. Full article
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Open AccessCommentary Lead Exposure in Low and Middle-Income Countries: Perspectives and Lessons on Patterns, Injustices, Economics, and Politics
Int. J. Environ. Res. Public Health 2018, 15(11), 2351; https://doi.org/10.3390/ijerph15112351
Received: 27 September 2018 / Revised: 19 October 2018 / Accepted: 21 October 2018 / Published: 24 October 2018
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Abstract
Lead exposure is a legacy issue that continues to affect vulnerable population groups globally, but particularly in low and middle-income countries (LMICS). We take a multi-disciplinary approach to examine the patterns of lead exposure in these countries, discuss the underlying injustices and socio-political [...] Read more.
Lead exposure is a legacy issue that continues to affect vulnerable population groups globally, but particularly in low and middle-income countries (LMICS). We take a multi-disciplinary approach to examine the patterns of lead exposure in these countries, discuss the underlying injustices and socio-political causes, and the economic costs that are associated with exposure. We conclude with some lessons we drew from our discussion of lead across the disciplines and advocate for a number of approaches to solving this ongoing issue. These include (i) biomonitoring that could be integrated into existing health surveys or public health programs targeting young children; (ii) greater civic engagement to push for solutions; and, (iii) environmental control policies that represent a continuum of local, context-specific to broad, national-level, and even global approaches. Full article
Open AccessCommentary Policies to Reduce Lead Exposure: Lessons from Buffalo and Rochester
Int. J. Environ. Res. Public Health 2018, 15(10), 2197; https://doi.org/10.3390/ijerph15102197
Received: 29 August 2018 / Revised: 27 September 2018 / Accepted: 27 September 2018 / Published: 9 October 2018
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Abstract
Lead exposure remains a major issue in cities, such as Buffalo and Rochester, with concentrated, segregated poverty and old, deteriorated housing stock. Exploring and comparing local policies and programs in these two cities, the author suggests that increasing the number of proactive housing [...] Read more.
Lead exposure remains a major issue in cities, such as Buffalo and Rochester, with concentrated, segregated poverty and old, deteriorated housing stock. Exploring and comparing local policies and programs in these two cities, the author suggests that increasing the number of proactive housing inspections in high-risk areas and forming a single-purpose non-profit group dedicated to lead education and advocacy are two valuable interventions. He recommends additional policy steps, such as more stringent inspection standards; state adoption of the Environmental Protection Agency’s Renovation and Repair Program; the lowering of state elevated blood level thresholds; a focus on in-person, interactive education by community health workers; and more vigorous enforcement of testing requirements among physicians. Full article
Open AccessCommentary Lead Poisoning and the Dangers of Pragmatism
Int. J. Environ. Res. Public Health 2018, 15(9), 1997; https://doi.org/10.3390/ijerph15091997
Received: 1 September 2018 / Revised: 12 September 2018 / Accepted: 12 September 2018 / Published: 13 September 2018
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Abstract
Drawing from ethnographic research on lead poisoning in Uruguay and secondary literature from lead poisoning cases around the world, the commentary argues that public health policy guided by pragmatism presents multiple dangers to effective health intervention. Full article
Int. J. Environ. Res. Public Health EISSN 1660-4601 Published by MDPI AG, Basel, Switzerland RSS E-Mail Table of Contents Alert
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