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The Science of the Total Environment Dec 2020Lead contamination is a widely recognised conservation problem for raptors worldwide. There are a number of studies in individual raptor species but those data have not... (Meta-Analysis)
Meta-Analysis Review
Lead contamination is a widely recognised conservation problem for raptors worldwide. There are a number of studies in individual raptor species but those data have not been systematically evaluated to understand raptor-wide lead exposure and effects at a pan-European scale. To critically assess the extent of this problem, we performed a systematic review compiling all published data on lead in raptors (1983-2019) and, through a meta-analysis, determined if there was evidence for differences in exposure across feeding traits, geographical regions, between hunting and non-hunting periods, and changes over time. We also reviewed the impact of lead on raptors and the likely main source of exposure. We examined 114 studies that were unevenly distributed in terms of time of publication and the countries in which studies were performed. Peer-reviewed articles reported data for 39 raptor species but very few species were widely monitored across Europe. Obligate (vultures) and facultative scavengers (golden eagle, common buzzard and white-tailed sea eagle) accumulated the highest lead concentrations in tissues and generally were the species most at risk of lead poisoning. We found no evidence of a spatial or decadal trend in lead residues, but we demonstrated that high lead blood levels relate to hunting season. Exposure at levels associated with both subclinical and lethal effects is common and lead from rifle bullets and shot is often the likely source of exposure. Overall, our review illustrates the high incidence and ubiquity of lead contamination in raptors in Europe. However, we did not find studies that related exposure to quantitative impacts on European raptor populations nor detailed studies on the impact of mitigation measures. Such information is urgently needed and requires a more harmonised approach to quantifying lead contamination and effects in raptors across Europe.
Topics: Animals; Eagles; Europe; Lead; Lead Poisoning; Raptors
PubMed: 32818895
DOI: 10.1016/j.scitotenv.2020.141437 -
Environmental Science and Pollution... Apr 2023Lead-based ammunition (gunshot and bullets) frequently leaves small lead fragments embedded in the meat of wild-shot game animals. Australia produces several commercial...
Lead-based ammunition (gunshot and bullets) frequently leaves small lead fragments embedded in the meat of wild-shot game animals. Australia produces several commercial game meat products from wild animals harvested with lead-based ammunition and has a growing population of recreational hunters. However, no studies have previously investigated the frequency of lead fragments or lead concentrations in Australian game meat. We examined 133 Australian minced game meat items of four types for evidence of lead contamination. Samples were meat from kangaroos (Macropus and Osphranter spp.; n=36) and Bennett's wallabies (Notamacropus rufogriseus; n=28) sold for human consumption, and deer ('venison'; multiple spp.; n=32) and stubble quail (Coturnix pectoralis; n=37) harvested for private consumption by recreational hunters. All packages were studied by digital radiography to detect the presence of radio-dense fragments, assumed to be lead fragments from ammunition. Visible fragments were absent in commercially available kangaroo products, but were present in 4%, 28% and 35% of wallaby, venison and quail, respectively. Mean meat lead concentrations (mg/kg wet weight) were 0.01 ± 0.01 for kangaroo, 0.02 ± 0.01 for wallaby, 0.12 ± 0.07 for venison, and 1.76 ± 3.76 for quail. The Australian food standards threshold for livestock meat (0.1 mg/kg w.w.) was not exceeded by any kangaroo or wallaby products but was exceeded by 53% and 86% of venison and quail, respectively. Radiography only detected 35% of samples that were above the food safety threshold. While average lead concentrations in commercially available macropod (kangaroo and wallaby) meat were low, those in recreationally harvested game meat may pose health risks for hunters and associated consumers.
Topics: Humans; Animals; Lead; Lead Poisoning; Macropodidae; Coturnix; Food Contamination; Deer; Australia; Meat; Animals, Wild; Quail
PubMed: 36797390
DOI: 10.1007/s11356-023-25949-y -
Basic & Clinical Pharmacology &... Jan 2018Adulteration of drugs with poisonous substances during production or consumption has caused numerous health problems. Among contaminants that have the potential of... (Review)
Review
Adulteration of drugs with poisonous substances during production or consumption has caused numerous health problems. Among contaminants that have the potential of producing poisonous effects are the heavy metals lead, arsenic and thallium that make up an important group of toxic substances. The emergence of these new health problems related to opioid abuse has precipitated this MiniReview on the status of the most hazardous and common opioid adulterants. In fact, adulterated opium is a major public health problem and can threaten the health of users. In this study, we searched for information on opium, opiates, lead poisoning, toxicity, intoxication, Iran and heavy metals in the TUMS Digital Library, PubMed, Scopus, EMBASE and Google Scholar bibliographical databases. This MiniReview primarily included articles on lead poisoning, signs and symptoms, and management in opioid-dependent individuals. Exclusion criteria were articles dealing with animal studies, specific paediatric studies, adulterants other than heavy metals and substances other than opioids. Adulterated opium is one of the new sources of exposure to lead and has precipitated an increase in lead-poisoned cases owing to the widespread use of opium. The toxicology of lead and general guidelines on diagnosis and treatment of lead poisoning is briefly reviewed. The symptoms of lead toxicity mimic several diseases often leading to unnecessary diagnostic methods, misdiagnoses and even surgery. Finally, owing to the fact that lead toxicity shows non-specific signs and symptoms, screening for this disease, by taking blood samples and assessing blood lead levels in high-risk people, should be given an utmost priority. It is recommended that screening tests are adopted and applied for any drug-abusing patient with non-specific subacute signs and symptoms like abdominal pain, constipation and anaemia.
Topics: Antidotes; Drug Contamination; Gastric Lavage; Humans; Iran; Lead; Lead Poisoning; Mass Screening; Opioid-Related Disorders; Opium
PubMed: 28802093
DOI: 10.1111/bcpt.12855 -
Journal of Exposure Science &... Apr 2019Childhood lead exposure has been shown to have a significant effect on neurodevelopment. Many of the biokinetics involved with lead biomarkers in children still remain...
Childhood lead exposure has been shown to have a significant effect on neurodevelopment. Many of the biokinetics involved with lead biomarkers in children still remain unknown. Two hundred fifty (157 in the exposed group and 93 controls) children were enrolled in our study and lead exposed children returned for multiple visits for measurement of blood and bone lead and chelation treatment. We demonstrated that the correlation between blood and bone lead increased with subsequent visits. We calculated the blood lead half-life for 50 patients, and found a significant (p-value < 0.001) positive correlation with age. For ages 1-3 years (N = 17), the blood lead half-life was found to be 6.9 ± 4.0 days and for 3+ years it was found to be (N = 33) 19.3 ± 14.1 days. In conclusion, the turnover of lead in children is faster than in adults. Our results indicate that blood lead is a more acute biomarker of exposure than previously thought, which will impact studies of children's health using blood lead as a biomarker.
Topics: Adult; Biomarkers; Case-Control Studies; Child; Child, Preschool; China; Environmental Exposure; Female; Half-Life; Humans; Infant; Lead; Lead Poisoning; Male; Young Adult
PubMed: 29706621
DOI: 10.1038/s41370-018-0036-y -
International Journal of Environmental... Apr 2021The adult population in lead-related occupations or environmentally exposed to lead may be at risk for renal impairment and lead nephropathy. This meta-analysis aims to... (Meta-Analysis)
Meta-Analysis
The adult population in lead-related occupations or environmentally exposed to lead may be at risk for renal impairment and lead nephropathy. This meta-analysis aims to determine the impact of blood lead level (BLL) on renal function among middle-aged participants. Cross-sectional, longitudinal, or cohort studies that reported BLL and renal function tests among adult participants were retrieved from PubMed, Scopus, and ISI Web of Science. Relevant studies were included and assessed for quality using the Newcastle-Ottawa Scale (NOS). The pooled mean BLL of participants with a high BLL (≥30 µg/dL), moderate BLL (20-30 µg/dL), and low BLL (<20 µg/dL) was estimated using the random effects model. The pooled mean differences in BLL, blood urea nitrogen (BUN), creatinine, uric acid, and creatinine clearance between the exposed and non-exposed participants were estimated using the random effects model. Meta-regression was performed to demonstrate the association between the effect size (ES) of the pooled mean BLL and renal function. Heterogeneity among the included studies was assessed using the Cochrane Q and I statistics. Cochrane Q with a value less than 0.05 and I more than 50% demonstrated substantial heterogeneity among the studies included. Publication bias was assessed using the funnel plot between the effect size and standard error of the effect size. Out of 1657 articles, 43 were included in the meta-analysis. The meta-analysis demonstrated that the pooled mean BLL in the participants with a high BLL, moderate BLL, and low BLL was 42.41 µg/dL (95% confidence interval (CI): 42.14-42.67, I: 99.1%), 22.18 µg/dL (95% CI: 21.68-22.68, I: 60.4%), and 2.9 µg/dL (95% CI: 2.9-2.9, I: 100%), respectively. The mean BLL of the exposed participants was higher than that of the non-exposed participants (weighted mean difference (WMD): 25.5, < 0.0001, 95% CI: 18.59-32.45, I: 99.8%, 17 studies). The mean BUN (WMD: 1.66, < 0.0001, 95% CI: 0.76-2.55, I: 76%, 10 studies) and mean creatinine (WMD: 0.05, = 0.007, 95% CI: 0.01-0.08, I: 76.8%, 15 studies) in the exposed participants were higher than those in the non-exposed participants. The mean creatinine clearance in the exposed participants was lower than that in the non-exposed participants (standard mean difference (SMD): -0.544, = 0.03, 95% CI: -1.035-(-0.054), I: 96.2%). The meta-regression demonstrated a significant positive effect of BLL on BUN ( = 0.022, coefficient: 0.75, constant: -3.7, 10 studies). BLL was observed to be associated with abnormal renal function test parameters, including high BUN, high creatinine, and low creatinine clearance. Moreover, BUN seemed to be the most valuable prognostic marker for lead-induced renal impairment. Therefore, regular checks for renal function among lead-exposed workers should be a priority and publicly promoted.
Topics: Adult; Creatinine; Cross-Sectional Studies; Humans; Kidney Function Tests; Lead; Lead Poisoning; Middle Aged
PubMed: 33920861
DOI: 10.3390/ijerph18084174 -
Environment International Jun 2019The city of Port Pirie in South Australia has been a world leading centre for lead and zinc smelting and processing since 1889 that continues to cause contamination of...
BACKGROUND
The city of Port Pirie in South Australia has been a world leading centre for lead and zinc smelting and processing since 1889 that continues to cause contamination of its environment and resident population. This study quantifies the effect of lead and SO emissions from Nyrstar Port Pirie Pty Ltd's smelter on blood lead and respiratory health outcomes, respectively, and establishes what air quality values are required to better protect human health.
METHOD
Blood lead and emergency department presentation data collected by South Australia Health (SA Health) and lead in air and SO data collected by the South Australian Environment Protection Authority (SAEPA) were obtained and analysed to quantify health outcomes due to smelter emissions in Port Pirie. Regression analysis was used to assess the relationship between the concentration of lead in air and children's blood lead levels between the years of available data: 2003 to 2017. Ambient SO concentrations (SAEPA) measured continuously between 2008 and 2018 were 24-hour averaged and compared to daily local emergency department respiratory presentation rates (available from July 2012 to October 2018). Rates of emergency department respiratory presentations at Port Pirie and regional comparators were calculated as age-standardised rates.
RESULTS
The data show that increases in ambient SO concentrations are associated with increased rates of emergency department respiratory presentations of Port Pirie residents, in which children are over-represented. The 30-day rolling average of respiratory presentations was significantly associated (p < 0.05) with incremental increases in SO. Analysis of the relationship between lead in air and blood lead shows that annual geometric mean air lead concentrations need to be <0.11 μg/m to ensure the geometric mean blood lead of Port Pirie children under 5 years is ≤5 μg/dL. For children aged 24 months, lead in air needs to be no greater than 0.082 μg/m (annual geometric mean) to ensure geometric mean blood lead does not exceed 5 μg/dL.
CONCLUSION
Current smelting emissions continue to pose a clear risk of harm to Port Pirie children. Allowable emissions must be lowered significantly to limit adverse childhood health outcomes including respiratory illness and IQ, academic achievement and socio-behavioural problems that are associated with lead exposure at levels experienced by Port Pirie children. Current SO levels are likely to be responsible for increased rates of emergency department respiratory presentations in Port Pirie compared with other South Australian locations. As a minimum, Australian SO air quality standards need to be enforced in Port Pirie to better protect human health. Lead in air needs to be approximately 80% lower than the current national standard (0.5 μg/m) to ensure that the geometric blood lead of children under 5 years is less than or equal to 5 μg/dL.
Topics: Air Pollutants; Air Pollution; Child; Child, Preschool; Environmental Exposure; Female; Humans; Infant; Lead; Lead Poisoning; Male; Metallurgy; Prevalence; Regression Analysis; Respiration Disorders; Respiratory Tract Diseases; South Australia
PubMed: 30954720
DOI: 10.1016/j.envint.2019.01.062 -
International Journal of Environmental... Aug 2020Older buildings in the United States often contain lead paint, and their demolition poses the risk of community lead exposure. We investigated associations between...
Older buildings in the United States often contain lead paint, and their demolition poses the risk of community lead exposure. We investigated associations between demolitions and elevated blood lead levels (EBLLs) among Detroit children aged <6 years, 2014-2018, and evaluated yearly variation given health and safety controls implemented during this time. Case-control analysis included incident EBLL cases (≥5 µg/dL) and non-EBLL controls from test results reported to the Michigan Department of Health and Human Services. Exposure was defined as the number of demolitions (0, 1, 2+) within 400 feet of the child's residence 45 days before the blood test. We used logistic regression to calculate odds ratios (ORs) and 95% confidence intervals (CIs), and test effect modification by year. Associations between demolition and EBLL differed yearly ( = 0.07): 2+ demolitions were associated with increased odds of EBLLs in 2014 (OR: 1.75; 95% CI: (1.17, 2.55), 2016 (2.36; 1.53, 3.55) and 2017 (2.16; 1.24, 3.60), but not in 2018 (0.94; 0.41, 1.86). This pattern remained consistent in sensitivity analyses. The null association in 2018 may be related to increased health and safety controls. Maintenance of controls and monitoring are essential, along with other interventions to minimize lead exposure, especially for susceptible populations.
Topics: Child; Child, Preschool; Environmental Exposure; Female; Housing; Humans; Infant; Lead; Lead Poisoning; Logistic Models; Male; Michigan; United States
PubMed: 32824913
DOI: 10.3390/ijerph17176018 -
BMC Public Health Oct 2021Lead poisoning prevention efforts include preparing and disseminating informational materials such as brochures and pamphlets to increase awareness of lead poisoning,...
BACKGROUND
Lead poisoning prevention efforts include preparing and disseminating informational materials such as brochures and pamphlets to increase awareness of lead poisoning, lead exposures and lead poisoning prevention. However, studies have demonstrated that patient education materials for diseases and health conditions are prepared at a reading level that is higher than the recommended 7th-8th grade reading level. This study, therefore, aims to assess the reading levels of lead poisoning informational materials.
METHODS
Lead poisoning materials (N = 31) were accessed from three states; Michigan, New York and Pennsylvania. The readability levels of the materials were assessed using the Flesh Kincaid Grade Level readability test. The Kruskal-Wallis test was conducted to determine if the readability levels differed between the materials obtained from the different states. Thematic content analyses were carried out to assess the inclusion of four themes; definition of lead poisoning, risk factors and exposures, testing and referral and prevention covering 12 subtopics. The Wilcoxon rank sum test was used to examine if there was a difference in the number of subtopics by readability level (dichotomized to >8th grade and < 8th grade).
RESULTS
The median readability level of the informational materials was 6.7 (IQR: 5.1-8.1). However, there was variability in the readability levels of the materials (range 3.5 to 10.6); materials obtained from Michigan had the highest median reading level of 8.1 (IQR: 6.9-9.0) followed by Pennsylvania. Heterogeneity was observed in the content of the materials. Most of the materials (80%) from Michigan focused on water as a source of lead poisoning, whereas materials from New York and Pennsylvania focused on lead-based paint and other sources. The materials prepared at >8th grade reading level contained fewer topics than materials prepared at <8th grade reading level.
CONCLUSIONS
We find that the materials were often prepared at reading levels lower than the recommended 8th grade reading level. However, there is variability in the reading levels and in the content of the materials. While the materials met the general readability guidelines, they did not necessarily meet the needs of specific groups, especially groups at risk.
Topics: Comprehension; Educational Status; Health Literacy; Humans; Internet; Lead Poisoning; Michigan; Pamphlets
PubMed: 34657616
DOI: 10.1186/s12889-021-11944-w -
Clinical Pediatrics Jun 2019
Review
Topics: Ambulatory Care; Autism Spectrum Disorder; Child; Combined Modality Therapy; Hospitalization; Humans; Lead Poisoning
PubMed: 30938166
DOI: 10.1177/0009922819839237 -
International Journal of Environmental... Mar 2016In Flint; MI; USA; a public health crisis resulted from the switching of the water supply from Lake Huron to a more corrosive source from the Flint River in April 2014;... (Review)
Review
In Flint; MI; USA; a public health crisis resulted from the switching of the water supply from Lake Huron to a more corrosive source from the Flint River in April 2014; which caused lead to leach from water lines. Between 2010 and 2015; Flint area children's average blood lead patterns display consistent peaks in the third quarter of the year. The third quarter blood lead peaks displayed a declining trend between 2010 and 2013; then rose abruptly between the third quarters of 2013 from 3.6% blood lead levels ≥5 µg/dL to a peak of about 7% in the third quarter of 2014; an increase of approximately 50%. The percentage of blood lead level ≥5 µg/dL in the first quarter of 2015 then dropped to 2.3%; which was the same percentage as the first quarter of 2014 (prior to the Flint River water source change). The Flint quarterly blood lead level peak then rose to about 6% blood lead levels ≥ 5 µg/dL in the third quarter of 2015; and then declined to about 2.5% in the fourth quarter of 2015. Soil lead data collected by Edible Flint food collaborative reveal generally higher soil lead values in the metropolitan center for Flint; with lower values in the outskirts of the city. The questions that are not being asked is why did children's blood lead levels display a seasonal blood lead pattern before the introduction of the new water supply in Flint; and what are the implications of these seasonal blood lead patterns? Based upon previous findings in Detroit and other North American cities we infer that resuspension to the air of lead in the form of dust from lead contaminated soils in Flint appears to be a persistent contribution to lead exposure of Flint children even before the change in the water supply from Lake Huron to the Flint River.
Topics: Child; Cities; Dust; Environmental Exposure; Environmental Pollution; Humans; Lead; Lead Poisoning; Michigan; Public Health; Risk; Seasons; Soil; Soil Pollutants; Water Supply
PubMed: 27023578
DOI: 10.3390/ijerph13040358