Elevated Blood Lead Levels in Infants and Mothers in Benin and Potential Sources of Exposure

Florence Bodeau-Livinec, Philippe Glorennec, Michel Cot, Pierre Dumas, Séverine Durand, Achille Massougbodji, Pierre Ayotte, Barbara Le Bot, Florence Bodeau-Livinec, Philippe Glorennec, Michel Cot, Pierre Dumas, Séverine Durand, Achille Massougbodji, Pierre Ayotte, Barbara Le Bot

Abstract

Lead in childhood is well known to be associated with poor neurodevelopment. As part of a study on maternal anemia and offspring neurodevelopment, we analyzed blood lead level (BLL) with no prior knowledge of lead exposure in 225 mothers and 685 offspring 1 to 2 years old from Allada, a semi-rural area in Benin, sub-Saharan Africa, between May 2011 and May 2013. Blood samples were analyzed by inductively coupled plasma mass spectrometry. Environmental assessments in households and isotopic ratio measurements were performed for eight children with BLL > 100 µg/L. High lead levels (BLL > 50 µg/L) were found in 44% of mothers and 58% of children. The median BLL was 55.1 (interquartile range 39.2-85.0) and 46.6 (36.5-60.1) µg/L, respectively. Maternal BLL was associated with offspring's consumption of piped water and animals killed by ammunition. Children's BLL was associated with presence of paint chips in the house and consumption of animals killed by ammunition. In this population, with 98% of children still breastfed, children's BLL was highly associated with maternal BLL on multivariate analyses. Environmental measures and isotopic ratios supported these findings. Offspring may be highly exposed to lead in utero and probably via breastfeeding in addition to lead paint exposure.

Trial registration: ClinicalTrials.gov NCT00811421.

Keywords: Lead Isotopic Ratios; child; lead exposure; sources; sub-Saharan Africa.

Figures

Figure 1
Figure 1
Example 1 of lead isotope ratios (LIRs). The plotted blood LIRs with their confidence intervals (±2 SD) intercept those of paint, soil and bullets.
Figure 2
Figure 2
Example 2 of LIRs. The plotted blood LIRs with their confidence intervals (± 2 SD) intercept those of food and bullets but not soil.

References

    1. Lanphear B.P., Hornung R., Khoury J., Yolton K., Baghurstl P., Bellinger D.C., Canfield R.L., Dietrich K.N., Bornschein R., Greene T., et al. (2005) Low-level environmental lead exposure and children’s intellectual function: An international pooled analysis. Environ. Health Perspect. 2005;113:894–899. doi: 10.1289/ehp.7688.
    1. Chiodo L.M., Jacobson S.W., Jacobson J.L. Neurodevelopmental effects of postnatal lead exposure at very low levels. Neurotoxicol. Teratol. 2004;26:359–371. doi: 10.1016/j.ntt.2004.01.010.
    1. Plusquellec P., Muckle G., Dewailly E., Ayotte P., Begin G., Desrosiers C., Despres C., Saint-Amour D., Poitras K. The relation of environmental contaminants exposure to behavioral indicators in Inuit preschoolers in Arctic Quebec. Neurotoxicology. 2010;31:17–25. doi: 10.1016/j.neuro.2009.10.008.
    1. Grandjean P., Landrigan P.J. Neurobehavioural effects of developmental toxicity. Lancet Neurol. 2014;13:330–338. doi: 10.1016/S1474-4422(13)70278-3.
    1. Centers for Disease Control and Prevention Update on Blood Lead Levels in Children. [(accessed on 3 March 2016)]; Available online: .
    1. Ngueta G., Ndjaboue R. Blood lead concentrations in sub-Saharan African children below 6 years: Systematic review. Trop Med. Int. Health. 2013;18:1283–1291. doi: 10.1111/tmi.12179.
    1. Nriagu J.O., Blankson M.L., Ocran K. Childhood lead poisoning in Africa: A growing public health problem. Sci. Total Environ. 1996;181:93–100. doi: 10.1016/0048-9697(95)04954-1.
    1. Mathee A. Towards the prevention of lead exposure in South Africa: Contemporary and emerging challenges. Neurotoxicology. 2014;45:220–223. doi: 10.1016/j.neuro.2014.07.007.
    1. Kordas K. Iron, Lead, and Children’s Behavior and Cognition. In Annual Review of Nutrition Cousins. Annu. Rev. Nutr. 2010;30:123–148. doi: 10.1146/annurev.nutr.012809.104758.
    1. Bodeau-Livinec F., Briand V., Berger J., Xiong X., Massougbodji A., Day K.P., Cot M. Maternal anemia in Benin: Prevalence, risk factors, and association with low birth weight. Am. J. Trop Med. Hyg. 2011;85:414–420. doi: 10.4269/ajtmh.2011.10-0599.
    1. Gonzalez R., Mombo-Ngoma G., Ouedraogo S., Kakolwa M.A., Abdulla S., Accrombessi M., Aponte J.J., Akerey-Diop D., Basra A., Briand V., et al. Intermittent preventive treatment of malaria in pregnancy with mefloquine in HIV-negative women: A multicenter randomized controlled trial. PLOS Med. 2014;11:316. doi: 10.1371/journal.pmed.1001733.
    1. Koura K.G., Boivin M.J., Davidson L.L., Ouedraogo S., Zoumenou R., Alao M.J., Garcia A., Massougbodji A., Cot M., Bodeau-Livinec F. Usefulness of child development assessments for low-resource settings in francophone Africa. J. Develop Behav. Pediat. 2013;34:486–493. doi: 10.1097/DBP.0b013e31829d211c.
    1. Etchevers A., Bretin P., Lecoffre C., Bidondo M.-L., Le Strat Y., Glorennec P., Le Tertre A. Blood lead levels and risk factors in young children in France, 2008–2009. Int. J. Hyg. Environ. Health. 2014;217:528–537. doi: 10.1016/j.ijheh.2013.10.002.
    1. Etchevers A., le Tertre A., Lucas J.-P., Bretin P., Oulhote Y., Le Bot B., Glorennec P. Environmental determinants of different blood lead levels in children: A quantile analysis from a nationwide survey. Environ. Int. 2015;74:152–159. doi: 10.1016/j.envint.2014.10.007.
    1. Elburg M., Vroon P., van der Wagt B., Tchalikian A. Sr and Pb isotopic composition of five USGS glasses (BHVO-2G, BIR-1G, BCR-2G, TB-1G, NKT-1G) Chem. Geol. 2005;223:196–207. doi: 10.1016/j.chemgeo.2005.07.001.
    1. Glorennec P., Peyr C., Poupon J., Oulhote Y., le Bot B. Identifying sources of lead exposure for children, with lead concentrations and isotope ratios. J. Occup. Environ. Hyg. 2010;7:253–260. doi: 10.1080/15459621003648281.
    1. CDC Recommendations to prevent and control iron deficiency in the United States. MMWR. 1998;47:1–29.
    1. Mathee A., Rollin H., von Schirnding Y., Levin J., Naik I. Reductions in blood lead levels among school children following the introduction of unleaded petrol in South Africa. Environ. Res. 2006;100:319–322. doi: 10.1016/j.envres.2005.08.001.
    1. Montgomery M., Mathee A. A preliminary study of residential paint lead concentrations in Johannesburg. Environ. Res. 2005;98:279–283. doi: 10.1016/j.envres.2004.10.006.
    1. Graber L.K., Asher D., Anandaraja N., Bopp R.F., Merrill K., Cullen M.R., Luboga S., Trasande L. Childhood lead exposure after the phaseout of leaded gasoline: An ecological study of school-age children in Kampala, Uganda. Environ. Health Perspect. 2010;118:884–889. doi: 10.1289/ehp.0901768.
    1. Leggett R.W. An age-specific kinetic-model of lead metabolism in humans. Environ. Health Perspect. 1993;101:598–616. doi: 10.1289/ehp.93101598.
    1. Ettinger A.S., Roy A., Amarasiriwardena C.J., Smith D., Lupoli N., Mercado-Garcia A., Lamadrid-Figueroa H., Tellez-Rojo M.M., Hu H., Hernandez-Avila M. Maternal blood, plasma, and breast milk lead: Lactational transfer and contribution to infant exposure. Environ. Health Perspect. 2014;122:87–92. doi: 10.1289/ehp.1307187.
    1. Ziegler E.E., Edwards B.B., Jensen R.L., Mahaffey K.R., Fomon S.J. Absorption and retention of lead by infants. Pediat. Res. 1978;12:29–34. doi: 10.1203/00006450-197801000-00008.
    1. Levesque B., Duchesne J.F., Gariepy C., Rhainds M., Dumas P., Scheuhammer A.M., Proulx J.F., Dery S., Muckle G., Dallaire F. Monitoring of umbilical cord blood lead levels and sources assessment among the Inuit. Occup. Environ. Med. 2003;60:693–695. doi: 10.1136/oem.60.9.693.
    1. Bressler J.P., Olivi L., Cheong J.H., Kim Y., Bannon D. Divalent metal transporter 1 in lead and cadmium transport. Ann. N Y Acad. Sci. 2004;1012:142–152. doi: 10.1196/annals.1306.011.
    1. Worldwide Prevalence of Anaemia 1993–2005. [(accessed on 24 March 2014)]. Available online:
    1. Nriagu J., Afeiche M., Linder A., Arowolo T., Ana G., Sridhar M.K.C., Oloruntoba E.O., Obi E., Ebenebe J.C., Orisakwe O.E., et al. Lead poisoning associated with malaria in children of urban areas of Nigeria. Int. J. Hyg. Environ. Health. 2008;211:591–605. doi: 10.1016/j.ijheh.2008.05.001.
    1. Kennedy B.S., Doniger A.S., Painting S., Houston L., Slaunwhite M., Mirabella F., Felsen J., Hunt P., Hyde D., Stich E. Declines in elevated blood lead levels among children, 1997–2011. Am. J. Prev. Med. 2014;46:259–264. doi: 10.1016/j.amepre.2013.11.007.

Source: PubMed

3
Subscribe