Blood lead levels in a group of children: the potential risk factors and health problems☆

AbuShady, Mones M.; Fathy, Hanan A.; Fathy, Gihan A.; Fatah, Samer abd el; Ali, Alaa; Abbas, Mohamed A.

doi:10.1016/j.jped.2016.12.006

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Original articles • J. Pediatr. (Rio J.) 93 (6) • Nov-Dec 2017 • https://doi.org/10.1016/j.jped.2016.12.006 copy

Blood lead levels in a group of children: the potential risk factors and health problems^☆ ☆ Please cite this article as: AbuShady MM, Fathy HA, Fathy GA, Fatah Sa, Ali A, Abbas MA. Blood lead levels in a group of children: the potential risk factors and health problems. J Pediatr (Rio J). 2017;93:619-24.

Authorship SCIMAGO INSTITUTIONS RANKINGS

Abstract

Objective:

To investigate blood lead levels in schoolchildren in two areas of Egypt to understand the current lead pollution exposure and its risk factors, aiming to improve prevention politicies.

Subjects and method:

This was a cross-sectional study in children (n = 400) aged 6-12 years recruited from two areas in Egypt (industrial and urban). Blood lead levels were measured using an atomic absorption method. Detailed questionnaires on sources of lead exposure and history of school performance and any behavioral changes were obtained.

Results:

The mean blood lead level in the urban area of Egypt (Dokki) was 5.45 ± 3.90 µg/dL, while that in the industrial area (Helwan) was 10.37 ± 7.94 µg/dL, with a statistically significant difference between both areas (p < 0.05). In Dokki, 20% of the studied group had blood lead levels ≥ 10 µg/dL, versus 42% of those in Helwan. A significant association was found between children with abnormal behavior and those with pallor with blood lead level ≥ 10 µg/dL, when compared with those with blood lead level < 10 µg/dL (p < 0.05). Those living in Helwan area, those with bad health habits, and those living in housing with increased exposure were at a statistically significantly higher risk of having blood lead level ≥ 10 µg/dL.

Conclusion:

Lead remains a public health problem in Egypt. High blood lead levels were significantly associated with bad health habits and housing with increased exposure, as well as abnormal behavior and pallor.

KEYWORDS
Blood lead levels; Children; Lead exposure; Abnormal behavior; Short stature; Egypt

Character	Helwan area n = 200 (Number - %)	Dokki area n = 200 (Number - %)	p
Bad health habits increasing exposure	122 (61%)	64 (32%)	0.000^a a p-Values < 0.05 were considered as significant.
Housing with increased exposure	119 (59.5%)	69 (34.5%)	0.000^a a p-Values < 0.05 were considered as significant.
School achievement <60%	20 (10%)	5 (2.5%)	0.004^a a p-Values < 0.05 were considered as significant.
Abnormal behavior	15 (7.5%)	3 (1.5%)	0.008^a a p-Values < 0.05 were considered as significant.
Short stature	4 (2%)	2 (1%)	0.681
Pallor (Hb < 10 gm%)	79 (39.5%)	44 (22%)	0.005^a a p-Values < 0.05 were considered as significant.
BLL ≥ 10 µg/dL	84 (42%)	40 (20%)	0.000^a a p-Values < 0.05 were considered as significant.

Character	High BLL ≥ 10 µg/dL n = 124 (Number - %)	BLL < 10 µg/dL n = 276 (Number - %)	p
School achievement <60%	18 (14.5%)	7 (2.5%)	<0.000^a a p-Values < 0.05 were considered as significant.
Abnormal behavior	10 (8%)	8 (2.9%)	0.041^a a p-Values < 0.05 were considered as significant.
Short stature	5 (4%)	1 (0.4%)	0.019^a a p-Values < 0.05 were considered as significant.
Pallor (Hb < 10 gm%)	67 (54%)	57 (20.7%)	0.000^a a p-Values < 0.05 were considered as significant.

	B	p	OR	95% CI for OR
				Lower	Upper
Residence (Dokki versus Helwan)	0.763	0.002^a a p-Values < 0.05 were considered as significant.	2.145	1.335	3.447
Health habits (Good health habits versus bad health habits)	0.664	0.005^a a p-Values < 0.05 were considered as significant.	1.943	1.220	3.095
Housing exposure (Housing with no exposure versus housing with increased exposure)	0.565	0.017^a a p-Values < 0.05 were considered as significant.	1.760	1.108	2.796
Age	-0.077	0.243	0.926	0.815	1.053
Sex	0.200	0.392	1.222	0.772	1.932
Constant	-3.410	0.000	0.033

	B	p	OR	95% CI for OR
				Lower	Upper
Covariates
Intercept	-0.07291	0.952
Residence (Dokki versus Helwan)	-0.525	0.049^a a p-Values < 0.05 were considered as significant.	0.591	0.350	1.001
Health habits (Good health habits versus bad health habits)	-0.307	0.252	0.736	0.435	1.243
Housing exposure (Housing with no exposure versus housing with increased exposure)	-0.542	0.039^a a p-Values < 0.05 were considered as significant.	0.581	0.347	0.973
Age	0.100	0.188	1.105	0.952	1.284
Sex	-0.226	0.383	0.798	0.480	1.326

Clinical data
School achievement < 60%	0.302	0.318	1.352	0.748	2.445
School achievement < 60%	0
Abnormal behavior	1.794	0.000^a a p-Values < 0.05 were considered as significant.	6.013	3.159	11.446
Abnormal behavior	0
Short stature	-0.05999	0.924	0.942	0.274	3.234
Short stature	0
Pallor (Hb < 10 gm%)	1.198	0.000^a a p-Values < 0.05 were considered as significant.	3.313	1.845	5.948
Pallor (Hb < 10 gm%)	0

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[1] * Corresponding author. E-mail:monesshady@ymail.com (M.M. AbuShady).