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


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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    • "We acknowledge that the concentration of Pb in blood is a better biomarker than the concentration of Pb in urine to assess the body burden of Pb (Lauwerys and Hoet, 1993), but the elevated values of urinary Pb found here testify to a high (ongoing) exposure in these children. These findings are compatible with other studies: Pb has been reported to be ≥10 g/dL in blood in children of various South Asian countries, including Pakistan (90%) (Rahman et al., 2002), India (51%) (Falk, 2003), and Indonesia (35%) (Albalak et al., 2003). An environmental study conducted in Lahore in 2007 showed high levels of environmental Pb in air compared to WHO guidelines (4.4 g/m 3 vs 0.5 g/m 3 ) (von Schneidemesser et al., 2010). "
    [Show abstract] [Hide abstract] ABSTRACT: In order to document the exposure to trace metals among urban schoolchildren and rural working children, we measured the urinary concentrations of metals in schoolchildren from two areas of differing traffic intensity in Lahore, and in children working in carpet weaving or the brick industry outside Lahore. In a cross-sectional design, we recruited a convenience sample of 339 children aged 8-12 years (mean age 9.9 y, SD 1.4; 47% girls) from two elementary schools in Lahore–one situated in a high air pollution area (n = 100) and one situated in an area with lower air pollution (n = 79)–and from the carpet weaving industry (n = 80) and brick industry (n = 80). A spot urine sample was collected and concentrations of 20 metals and metalloids were measured by inductively coupled plasma-mass spectrometry (ICP-MS). Samples of drinking water were similarly analyzed. In general, the urinary concentrations of several toxic metals (including Cr, Mn, As, Mo, Cd, Pb, U) were higher than international reference values. Concentrations of As were especially elevated in children working in the brick making industry [geometric mean (GM) 118 μg/L], but they were also high among urban schoolchildren (GM 68 μg/L and 56 μg/L). Lead (Pb) was higher in urine from schoolchildren in the high air pollution area (GM 11 μg/L) than in those from the lower pollution area (GM 5.3 μg/L). Uranium (U) was high in both carpet weavers (GM 0.28 μg/L) and brick kiln workers (GM 0.45 μg/L). Concentrations of As, Pb, and U in drinking water corresponded well with urinary concentrations of metals. This descriptive study provides evidence for a high exposure to several toxic metals in this area of Pakistan. The concentrations of urinary As are in the order of those found in other regions of the world with high environmental exposure to As. The sources and pathways of exposure and the health significance of these findings need to be further investigated.
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    • "Chronic lead intoxication may affect children because they have more hand-to-mouth activities and they absorb lead in small intestine more efficiently than adults.101922 All children evaluated in this study had lead intoxication. "
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