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Blood lead levels and risk factors for lead poisoning among children in Jakarta, Indonesia

Division of Environmental Hazards and Health Effects, National Center for Environmental Health, Centers for Disease Control and Prevention, 1600 Clifton Rd Mailstop E-19, Atlanta, GA 30333, USA.
Science of The Total Environment (Impact Factor: 4.1). 02/2003; 301(1-3):75-85. DOI: 10.1016/S0048-9697(02)00297-8
Source: PubMed

ABSTRACT The phase-out of leaded gasoline began in Jakarta, Indonesia on July 1, 2001. We evaluated mean blood lead levels (BLLs) and the prevalence of elevated BLLs of Jakarta school children and assessed risk factors for lead exposure in these children before the beginning of the phase-out activities. The study involved a population-based, cross-sectional blood lead survey that included capillary blood lead sampling and a brief questionnaire on risk factors for lead poisoning. A cluster survey design was used. Forty clusters, defined as primary schools in Jakarta, and 15 2nd- and 3rd-grade children in each cluster were randomly selected for participation in the study. The average age of children in this study was 8.6 years (range 6-12) and the geometric mean BLL of the children was 8.6 microg/dl (median: 8.6 microg/dl; range: 2.6-24.1 microg/dl) (n=397). Thirty-five percent of children had BLLs > or =10 microg/dl and 2.4% had BLLs > or =20 microg/dl. Approximately one-fourth of children had BLLs 10-14.9 microg/dl. In multivariate models, level of education of the child's primary caregiver, water collection method, home varnishing and occupational recycling of metals, other than lead, by a family member were predictors of log BLLs after adjustment for age and sex. BLLs of children who lived near a highway or major intersection were significantly higher than those of children who lived near a street with little or no traffic when level of education was not included in the model. Water collection method was a significant predictor of BLLs > or =10 microg/dl after adjustment for age and sex. BLLs in children in this study were moderately high and consistent with BLLs of children in other countries where leaded gasoline is used. With the phase-out of leaded gasoline, BLLs of children in Jakarta are expected to rapidly decline as they have in other countries that have phased lead out of gasoline.

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    • "In 1998, it was estimated that about 74% of people tested living in heavy transportation areas in Jakarta had BLLs more than 30 μg/dl (Tugaswati, 1998). In 2001, a study among elementary school children in Jakarta indicated that 35% had BLLs more than 10 μg/dl (Albalak et al., 2003). Four years after Jakarta was supposed to be free from the use of leaded gasoline, 1.3% of elementary school children still indicated BLLs more than 10 μg/dl (Haryanto, 2005). "
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    ABSTRACT: Population exposures to lead are mainly related to: vehicle exhaust, in areas where leaded-gasoline is still being used; paint and lead solder in canned food; drinking water pipes; and from certain culturally-based exposures, such as use of lead-glazed ceramics or traditional medication. It is well documented that excess exposure to lead causes health problems in children including neurobehavioral deficits. The objective of this study was to examine the effect of daily calcium supplementation for a three months period on reducing blood lead levels (BLLs) among elementary school children aged 9 to 11 years old in Bandung, Indonesia. Forty elementary schools were randomly selected, 400 children enrolled, and a total of 298 children completed follow-up of 3 months periode. Schools were divided randomly into two groups of calcium-supplement intervention groups (250 mg and 500 mg) and one control group with no intervention. Capillary blood samples were analyzed for lead levels before and after three months of calcium supplementation. Paired-t test, ANOVA, and multivariate risk factors models using Generalized Estimating Equations (GEE) were performed. The percent reduction in BLLs for each group was: 15.1% (no calcium) from the baseline of 13.7 g/dL; 49.8% (250 mg Ca) from the baseline of 14.8 g/dL; and 74.5% (500 mg Ca) from the baseline of 14.1 g/dL. This study found statistically significant inverse associations with dietary Ca supplementation and BLLs in young children. These findings suggest that calcium supplementation effectively lowers BLLs in school children.
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    • "Frequent floor sweeping with a bloom serves to aerosolize the fine-grained floor dust in the indoor air which probably mitigates any beneficial effect of the less regular scrubbing of the floor. As reported in other parts of the world (Albalaka et al., 2003; Olivero-Verbel et al., 2007; Roïlin et al., 2007), SES is found to be an important predictor of BLL in Nigerian children. We found that children of caregivers who have higher levels of education generally attend school and hence tend to play less often outside which may exercise a moderating (protective) influence on BLL. "
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    ABSTRACT: The principal objectives of this study are to (a) investigate the prevalence of elevated blood lead levels (EBLLs) in children of three major cities of Nigeria with different levels of industrial pollution; (b) identify the environmental, social and behavioral risk factors for the EBLLs in the children; and (c) explore the association between malaria (endemic in the study areas) and EBLLs in the pediatric population. The study involved 653 children aged 2-9 years (average, 3.7 years). The mean blood lead level (BLL) for the children was 8.9+/-4.8microg/dL, the median value was 7.8microg/dL, and the range was 1-52microg/dL. About 25% of the children had BLL greater than 10microg/dL. There were important differences in BLLs across the three cities, with the average value in Ibadan (9.9+/-5.2microg/dL) and Nnewi (8.3+/-3.5microg/dL) being higher than that in Port Harcourt (4.7+/-2.2micro/dL). Significant positive associations were found between BLL and a child's town of residence (p<0.001), age of the child (p=0.004), length of time the child played outside (p<0.001), presence of pets in a child's home (p=0.023), but negatively with educational level of caregiver (p<0.001). This study is one of the first to find a significant negative association between BLL and malaria in a pediatric population, and this association remained significant after controlling for confounding diseases and symptoms. The shared environmental and socio-demographic risks factors for lead exposure and Plasmodium (most common malaria parasites) infection in urban areas of Nigeria are discussed along with possible ways that lead exposure may influence the host response to infection with malarial parasites.
    International Journal of Hygiene and Environmental Health 07/2008; 211(5-6):591-605. DOI:10.1016/j.ijheh.2008.05.001 · 3.28 Impact Factor
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    ABSTRACT: Iron deficiency anemia is the most common nutritional anemia in developed and developing countries. In addition, lead intoxication especially in developing countries is an increasing risk for health, because of rapid urbanization and consumption of leaded fuels. Many studies particularly in children have showed a correlation between iron deficiency and high blood lead concentration. In this study, we have evaluated this association in workers of a car battery manufacturer. This research was performed on workers who exposed to lead in a factory of car battery of Mashhad, Iran in 2006. Hematological tests including complete blood counts (CBC) and serum ferritin concentration (radioimmunoassay method) were measured. Blood lead concentration (BLC) was estimated by heated graphite atomization technique of an atomic absorption spectrophotometer (Perkin Elemer, Model 3030). Results analyzed by the statistical package for social sciences (SPSS, version 11.5), using statistical tests including independent samples t-test, Mann- Whitney U test, Fisher's exact test and Pearson's correlation coefficient. P value < 0.05 was considered as a significant level. Based on clinical (lead line) and laboratory observation, all workers had lead intoxication with mean BLC of 32.2 +/- 13.7 mu g/dl. There were no statistical significant difference on mean BLC in iron deficient (n = 11) and non iron deficient workers (n = 78). There were also no significant correlation between BLC and either serum ferritin or blood hemoglobin (r = 0.18, p value = 0.091 and r = 0.051, p value = 0.682, respectively). In this study, we did not observe any correlation between BLC with either serum ferritin or hemoglobin or the other blood parameters. However, similar research in a larger population is required to make a general conclusion.
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