Blood Lead

A cross-sectional study was conducted to identify the relationship between blood lead concentration and nutritional status among primary school children in Kuala Lumpur. A total of 225 Malay students, 113 male and 112 female, aged 6.3 to 9.8 were selected through a stratified random sampling method. The random blood samples were collected and blood lead concentration was measured by a Graphite Furnace Atomic Absorption Spectrophotometer. The nutrient intake was determined by the 24-hour Dietary Recall method and Food Frequency Questionnaire. An anthropometric assessment was reported according to growth indices (z-scores of weight-for-age, height-for-age, and weight-for-height). The mean blood lead concentration was low (3.4 ± 1.91 ug/dL) and was significantly different between gender. Only 14.7% of the respondents fulfilled the daily energy requirement. The protein and iron intakes were adequate for a majority of the children. However, 34.7% of the total children showed inadequate i...

Around the world, women are subject to an earlier incidence of cataracts, have a higher risk for cataracts, and also have a higher risk for other vision-related problems than men. Previous research has indicated an association between endogenous lead stored in long bones and cataracts in men over 60 years of age; however, a similar study in women did not reveal an association. This case control study was conducted to investigate whether perimenopausal mobilization of endogenous lead serves as a possible causative factor for women's generalized vision issues and cataract incidence in particular. Secondary data were gathered from 1,416 women aged 40 to 55 years of age from the 2005-2006 and 2007-2008 National Health and Nutrition Examination Surveys. Variables of interest included vision-related issues, cataract surgeries, bone density data, blood lead levels, and markers of lead mobilization. The results of the logistic regression analysis in the absence of confounders (OR = 1.50, 95% CI [1.08, 2.09]) indicated that endogenous lead is a possible causative factor for the low-level vision problems women experience during their perimenopausal years. Chi-square analysis of mobilized lead was also associated with cataract surgeries, p < .05. This appears to be the first report of a possible association between lead and cataracts in women and highlights the need for women to be studied in the context of their biology when their clinical results differ from those of men. These results should engender positive social change initiatives to minimize women's perimenopausal exposure to endogenous lead. Recommendations for further research include a case control study, which includes plasma lead levels, and a longitudinal study.

A cross-sectional study was conducted to identify the relationship between blood lead concentration and nutritional status among primary school children in Kuala Lumpur. A total of 225 Malay students, 113 male and 112 female, aged 6.3 to 9.8 were selected through a stratified random sampling method. The random blood samples were collected and blood lead concentration was measured by a Graphite Furnace Atomic Absorption Spectrophotometer. The nutrient intake was determined by the 24-hour Dietary Recall method and Food Frequency Questionnaire. An anthropometric assessment was reported according to growth indices (z-scores of weight-for-age, height-for-age, and weight-for-height). The mean blood lead concentration was low (3.4 ± 1.91 ug/dL) and was significantly different between gender. Only 14.7% of the respondents fulfilled the daily energy requirement. The protein and iron intakes were adequate for a majority of the children. However, 34.7% of the total children showed inadequate i...

Objectives.To assess the prevalence of elevated blood lead levels (EBLLs) among children before and after foster care placement, and to compare the prevalence of EBLLs among children in foster care with that of their siblings and the general population.Methods.We conducted a retrospective cohort study using administrative databases from the Philadelphia Department of Human Services and the Birth Certificate Registry and the Childhood Lead Poisoning Prevention Program at the Philadelphia Department of Public Health. Logistic regression analyses were performed to control for confounding variables, including age, race, gender, and the year, seasonal timing, and source (capillary vs venous) of test.Results.From June 1992 to May 1997, there were 1824 children in foster care with available blood lead results in the Childhood Lead Poisoning Prevention Program database. Of these, 519 (28%) had initial lead screening before foster care placement and 654 (36%) after placement. There were 821 ...

En el presente estudio se ha evaluado la concentracion de plomo en la sangre del cordon umbilical de 64 neonatos nacidos de mujeres gestantes que viven en las ciudades de Huancayo (zona urbana-comercial) y La Oroya (zona metalurgica del Centro del Peru) y su impacto sobre el nivel de hemoglobina, longitud, peso y APGAR al nacimiento. El estudio transversal se realizo en los Hospitales II de EsSalud de La Oroya y Hospital Regional de Huancayo entre noviembre del 2003 a abril del 2004, cuando la fundicion de la Oroya estaba en normal funcionamiento. La cuantificacion del plomo se realizo por espectrometria de absorcion atomica con horno de grafito en el Instituto Peruano de Energia Nuclear. El muestreo biologico respondio a los protocolos de Iyengar y Rapp. Los neonatos de Huancayo y la Oroya tuvieron concentraciones promedio de plomo de 18,03 µg/dL y 22,96 µg/dL (p=0,016), siendo estos valores 1,8 y 2,3 veces mas altos que el nivel critico sugerido por la CDC y la WHO (10 µg/dL). Los...

Lead was administered to three groups of 4 weeks-old female rats at the dose of 1 ppm in drinking water The first group received lead continuously for 150 days before mating (with non-lead-treated male rats), during pregnancy and during 3 weeks after delivery In the second group lead was also administered for 150 days before mating but was withdrawn during pregnancy and during the post natal period In the third group lead was administered for 150 days; the animals were then kept without lead exposure during the 50 days before making them pregnant, during pregnancy and during the post natal period A control group received only demineralized water. On day 21 after delivery the mothers and their newborns were sacrificed and various parameters of blood-lead concentration (Pb-B), hematocrit (Htc), hemoglobin (Hb), free erythrocyte porphyrins concentration (FEP), 6-aminolevulinate dehydratase activity (ALAD) and tissues ALAD, free tissue porphyrins (FTP), lead concentration (Pb-T) were determined. In mothers and in newborns lead concentration in blood and in soft tissues were increased over control values only in the group in which lead had been stopped for 50 days before pregnancy This lead accumulation in soft tissues was associated with an increased FTP in liver, heart and brain of the mothers and in liver of the newborns This observation suggests that lead stored in the organism can be mobilized during pregnancy.

White storks (Ciconia ciconia) fed in contaminated waters resulting from the Aznacollar acid mining-sludge spillage into the R. Guadiamar, which feeds the eastern flank of the Guadalquivir marshes (Donana), S.W. Spain. The sludge was rich in a range of toxic elements, and in organic pollutants such as the aromatic amines. Storks did not exhibit elevated metals in their blood immediately following the accident, but chick blood collected the year following the accident showed genotoxic damage compared to the controls. In this study lead isotope analysis was used to assess if the storks had ingested sludge-derived contaminants. The sludge lead isotope ratio was distinct from that of the Donana sediments. The stork blood lead isotope ratios exactly matched that of the sludge. It was concluded that the storks had ingested sludge-derived contaminants. A detailed study of the lead contamination along the R. Guadiamar and the R. Guadalquivir (of which the Guadiamar is a tributary) was also conducted to place the white stork colony lead exposure in the context of the spatial contamination of the storks' habitat.

The eye is a very important and crucial organ of the human body. It is often said to be the reflection of the human soul and heart. Our eyes serve as a medium of communication, allowing one to read a person's mind through their gaze. Since the advent of civilization, personal grooming has been an integral part of human life, with particular emphasis placed on facial grooming. Among these, the grooming of eyes has always held primary importance, alongside hairstyling. Today, various eye products, such as mascara, eyeliner, and eyeshadow, are available in the market for enhancing the beauty of the eyes. In this research paper, we will focus on the history and evolution of eye makeup, its tools, its significance, and its continuity over time. With this context, the article aims to highlight various aspects of eye makeup from the past, particularly the use of Kajalshalaka or kohl (kajal), and its enduring presence as a means of enhancing the beauty of the eyes.

The purpose of this study was to investigate the neurological integrity and physiological status of the auditory brainstem tracts and nuclei in children with chronic lead (Pb) exposure using noninvasive acoustic stapedius reflex (ASR) measurements of afferent and efferent-neuromuscular auditory function. Following audiological examinations, uncrossed (ipsilateral) and crossed (contralateral) brainstem ASR responses were evoked by pure tone (500, 1000, and 2000 Hz), and broadband noise (bandwidth: 125-4000 Hz) stimulus activators. The ASR threshold (ASRT), amplitude growth, and decay/fatigue were measured by conventional clinical middle ear immittance methods in a group of Andean children (age range: 2-18 years) with a history of chronic environmental Pb exposure from occupational Pb glazing. Blood lead (PbB) levels of the study group (n = 117) ranged from 4.0 to 83.7 μg/dL with a mean PbB level of 33.5 μg/dL (SD: 23.6; median: 33.0: CDC III Classification). The PbB distribution data indicated that 77.8% (n = 91) of the children had PbB levels greater than the CDC action line of 10 μg/dL. Repeatable, normal ASRTs were elicited for ipsilateral (mean: < 90 dB HL) and contralateral (mean: < 97 dB HL) stimulation for each acoustic activator. Spearman Rho correlation analysis indicated no significant association between PbB level and ipsilateral or contralateral ASRT for any of the stimulus activators. The ASR amplitude growth results showed typical growth functions with no Pb-associated aberrations. No statistical association was found between ASR decay/adaptation (ASRD) and PbB level for any of the stimulus activators. The results of stapedius muscle reflex testing using several stimulus activators showed no significant relationship between PbB level and

The authors studied 367 women who were breastfeeding their infants in Mexico City, Mexico, between 1994 and evaluate the effect of cumulative lead exposure, breastfeeding practices, and calcium intake on breast milk lead levels over the course of lactation. Maternal blood and breast milk lead levels were measured at 1, 4, and 7 months postpartum. Bone lead measurements were obtained at 1 month postpartum. At 1, 4, and 7 months postpartum, respectively, the mean breast milk lead levels were 1.4 (standard deviation (SD), 1.1), 1.2 (SD, 1.0), and 0.9 (SD, 0.8) lg/liter and showed a significant decreasing trend over the course of lactation (p < 0.00001). The relations of bone lead and blood lead to breast milk lead were modified by breastfeeding practice, with the highest breast milk lead levels among women with a high level of patella lead who were exclusively breastfeeding. Dietary calcium supplementation increased the rate of decline in breast milk lead by 5-10%, in comparison with a placebo, over the course of lactation, suggesting that calcium supplementation may constitute an important intervention strategy, albeit with a modest effect, for reducing lead in breast milk and thus the potential for exposure by infants.

Research conducted in recent years has increased public health concern about the toxicity of lead at low dose and has supported a reappraisal of the levels of lead exposure that may be safely tolerated in the workplace. In this article, which appears as part of a mini-monograph on adult lead exposure, we summarize a body of published literature that establishes the potential for hypertension, effects on renal function, cognitive dysfunction, and adverse female reproductive outcome in adults with whole-blood lead concentrations < 40 µg/dL. Based on this literature, and our collective experience in evaluating lead-exposed adults, we recommend that individuals be removed from occupational lead exposure if a single blood lead concentration exceeds 30 µg/dL or if two successive blood lead concentrations measured over a 4-week interval are ≥ 20 µg/dL. Removal of individuals from lead exposure should be considered to avoid long-term risk to health if exposure control measures over an extended period do not decrease blood lead concentrations to < 10 µg/dL or if selected medical conditions exist that would increase the risk of continued exposure. Recommended medical surveillance for all lead-exposed workers should include quarterly blood lead measurements for individuals with blood lead concentrations between 10 and 19 µg/dL, and semiannual blood lead measurements when sustained blood lead concentrations are < 10 µg/dL. It is advisable for pregnant women to avoid occupational or avocational lead exposure that would result in blood lead concentrations > 5 µg/dL. Chelation may have an adjunctive role in the medical management of highly exposed adults with symptomatic lead intoxication but is not recommended for asymptomatic individuals with low blood lead concentrations.

Research conducted in recent years has increased public health concern about the toxicity of lead at low dose and has supported a reappraisal of the levels of lead exposure that may be safely tolerated in the workplace. In this article, which appears as part of a mini-monograph on adult lead exposure, we summarize a body of published literature that establishes the potential for hypertension, effects on renal function, cognitive dysfunction, and adverse female reproductive outcome in adults with whole-blood lead concentrations < 40 µg/dL. Based on this literature, and our collective experience in evaluating lead-exposed adults, we recommend that individuals be removed from occupational lead exposure if a single blood lead concentration exceeds 30 µg/dL or if two successive blood lead concentrations measured over a 4-week interval are ≥ 20 µg/dL. Removal of individuals from lead exposure should be considered to avoid long-term risk to health if exposure control measures over an extended period do not decrease blood lead concentrations to < 10 µg/dL or if selected medical conditions exist that would increase the risk of continued exposure. Recommended medical surveillance for all lead-exposed workers should include quarterly blood lead measurements for individuals with blood lead concentrations between 10 and 19 µg/dL, and semiannual blood lead measurements when sustained blood lead concentrations are < 10 µg/dL. It is advisable for pregnant women to avoid occupational or avocational lead exposure that would result in blood lead concentrations > 5 µg/dL. Chelation may have an adjunctive role in the medical management of highly exposed adults with symptomatic lead intoxication but is not recommended for asymptomatic individuals with low blood lead concentrations.

Background Lead stabilizers (e.g., lead sulfate, lead stearate) are common additives in plastics used in electrical devices. In 1997, three plastics compounders at one California company were severely lead-poisoned. Methods The poisonings were investigated by interviewing the workers, employer, and treating physician and reviewing medical records and environmental monitoring results. In addition to measuring blood lead levels (BLLs), noninvasive K X-ray fluorescence was used to measure bone lead concentration of the index case. Results Blood lead concentrations of the three workers at time of diagnosis were 159, 114, and 108 mg/dl. The worker with highest exposure presented with clinical findings of crampy abdominal pain, constipation, normocytic anemia, fatigue, and reversible azotemia. Bone lead concentration in his tibia, calcaneous, and patella were 102, 219, and 182 ppm, respectively. The poisonings resulted from uncontrolled use of powdered lead sulfate stabilizer. Clinicians should be aware of potential serious overexposure to lead in compounding of plastics.

The authors recently reported that blood lead (Pb) was a significant mediator for the positive association between socioeconomic status (SES) and peripheral vascular responses to acute stress in children (B. B. Gump et al., 2007). The present study considers the possibility that Pb may also mediate an association between SES and cortisol responses to acute stress. Design: Early childhood Pb exposure was tested as a mediator for cross-sectional associations between SES and cortisol responses. The primary outcome was cortisol responses to acute stress in 9.5year-old children (N = 108). Results: Lower family income was associated with significantly greater cortisol levels following an acute stress task. A mediational analysis confirmed that Pb was a significant mediator for this association. These results reaffirm the importance of considering the chemical environment as well as social and psychological environment when evaluating psychophysiological effects of low SES.

BACKGROUND-Recent studies have suggested that child ADHD and its symptom domains are related to blood lead level, even at background exposure levels typical in western countries. However, recent studies disagreed as to whether lead was related to inattention or hyperactivityimpulsivity within the ADHD domain. More definitive evaluation of these questions was sought. METHODS-236 children aged 6-17 years participated (61 ADHD-Combined type, 47 ADHD Predominantly Inattentive type, 99 non-ADHD control, 29 unclassified borderline, situational, or NOS cases). Formal diagnosis was reliably established by a best estimate procedure based on a semi-structured clinical interview and parent and teacher ratings. Lead was assayed from whole blood using inductively coupled plasma mass spectrometry with a method detection limit of 0.3 μg/dL. RESULTS-Blood lead levels were slightly below United States and Western Europe population exposure averages, with a mean of 0.73 and a maximum of 2.2 μg/dL. This is the lowest level of blood lead ever studied in relation to ADHD. After statistical control for covariates including IQ and prenatal smoking exposure, blood lead was associated with ADHD-combined type but not inattentive type. Parent and teacher report indicated association of blood lead with Conners cognitive problems, but only teacher report showed effects on DSM-IV inattention symptoms. Blood lead was associated with hyperactivity-impulsivity in parent report regardless of measurement method, whereas teacher report effects depended on child treatment history. CONCLUSIONS-These findings confirm that in children with typical U.S. population lead exposure, careful identification of children with ADHD also identifies children with slightly elevated blood lead.

Background:  Recent studies have suggested that child attention‐deficit/hyperactivity disorder (ADHD) and its symptom domains are related to blood lead level, even at background exposure levels typical in western countries. However, recent studies disagreed as to whether lead was related to inattention or hyperactivity‐impulsivity within the ADHD domain. More definitive evaluation of these questions was sought.Methods:  Two hundred and thirty‐six (236) children aged 6–17 years participated (61 ADHD‐Combined type, 47 ADHD Predominantly Inattentive type, 99 non‐ADHD control, 29 unclassified borderline, situational, or not otherwise specified (NOS) cases). Formal diagnosis was reliably established by a best estimate procedure based on a semi‐structured clinical interview and parent and teacher ratings. Lead was assayed from whole blood using inductively coupled plasma mass spectrometry with a method detection limit of .3 μg/dL.Results:  Blood lead levels were slightly below United Stat...

Background-Attention-deficit/hyperactivity disorder (ADHD) and low-level lead exposure are high-prevalence conditions among children, and studies of large populations have suggested that these conditions are related. We examine this relationship in children from a community sample exposed to average background levels of lead who have a diagnosis of ADHD that is established by clinical criteria. Methods-One hundred fifty children ages 8-17 years participated (mean age = 14 years; 53 control subjects, 47 ADHD Predominantly Inattentive type, 50 ADHD-Combined type). Diagnosis was formally established with a semi-structured clinical interview and parent and teacher ratings. Children completed intelligence quotient (IQ) measures and the stop task (a neuropsychological measure). Lead was assayed from whole blood with inductively coupled plasma mass spectrometry. Results-Blood lead levels in this sample closely matched US population exposure averages, with a maximum level of 3.4 μg/dL. Blood lead levels were statistically significantly higher in ADHDcombined type than in non-ADHD control (p < .05) children. Blood lead was associated with symptoms of hyperactivity-impulsivity but not inattention-disorganization, after control of covariates. Blood lead levels were linked with a lower IQ (p < .05), but IQ did not account for effects on hyperactivity. Instead, hyperactivity mediated effects of lead on IQ. Effects of blood lead on hyperactivity-impulsivity were mediated by poor performance on the stop task. This mediation effect was independent of effects of lead on IQ. Conclusions-Low-level lead exposure might be an important contributor to ADHD. Its effects seem to be mediated by less effective cognitive control, consistent with a route of influence via striatal-frontal neural circuits.

Lead is a neurotoxicant that accumulates in bone with a half life of 25-30 years. To evaluate the association of lead biomarkers and cognitive function, a cohort of exposed and nonexposed workers who had been previously assessed in 1982 was retested approximately 22 years later. For the current assessment, both blood lead and tibia bone lead levels were determined. In addition, cognitive function was tested with the Pittsburgh Occupational Exposures Test battery, which had previously been administered in 1982. In exposed workers, bone lead level predicted lower current cognitive performance and cognitive decline over 22 years. In those lead-exposed workers older than age 55, higher levels of bone lead predicted poorer cognitive scores, suggesting vulnerability for older workers with higher past lead exposure. Finally, there was no association with bone lead level and recency of exposure, suggesting that cumulative body burden is most likely responsible for the progressive cognitive decrement evidenced with vulnerability because of aging.

Objetivo: Determinar la asociación entre intoxicación plúmbica crónica y alteraciones del crecimiento y desarrollo cognitivo-emocional en niños del colegio “María Reiche”- Callao. Diseño: Estudio observacional de corte transversal. Material y métodos: A 70 niños de 8 a 12 años de edad del C.E. Nº 5045 “María Reiche” del A.A.H.H. “Puerto Nuevo”- Callao, que participaron en el estudio de dosaje de plomo en sangre hecho por la Dirección General de Salud Ambiental en 1999, se les aplicó pruebas de seguimiento de instrucciones, habilidades motoras, comunicativas, manipulativas, académicas y la lista de chequeo de ansiedad. Se midió el coeficiente intelectual e índice de masa corporal. Para el procesamiento de los datos se empleó las pruebas chi-cuadrado, t de Student, correlación y regresión lineal simple, usando el paquete estadístico SPSS versión 11.0, con un nivel de confianza de 95%. Resultados: Los niveles de plomo en sangre y los grados de ansiedad se relacionaron significativament...

Tactile defensiveness in children is associated with difficult social relations, emotional dysregulation, and inattention. However, there are no studies of lead exposure and tactile defensiveness in children or animals in spite of the fact that lead exposure is also associated with inattention and emotional dysregulation. OBJECTIVES: In this study we tested whether lead exposure induces tactile defensiveness in rhesus monkeys. METHODS: We tested 61 monkeys from a 3 (no lead, 1-year lead, 2-year lead) × 2 (succimer chelation or not) factorial experiment for tactile defensiveness at 4 years of age. Lead-treated monkeys had been orally administered lead in a daily milk solution from 8 days of life to either 1 or 2 years of age to produce blood lead levels of 35-40 mg/dL. Succimer chelation therapy or placebo was administered at 1 year of age. We measured tactile defensiveness using six repeated trials of each of three textures as a swipe to the cheek and neck. RESULTS: Lead-exposed monkeys showed higher negative responses to repeated tactile stimulation compared with controls. Blood lead during the first 3 months of life was positively correlated with the negative response on the tactile defensiveness test. There was an interaction of lead exposure × succimer chelation × trials, but it is not clear that succimer chelation was beneficial with respect to tactile defensiveness. CONCLUSIONS: This is the first report to implicate lead as a potential cause of tactile defensiveness. Research should examine whether lead exposure is associated with tactile defensiveness in children.

Tactile defensiveness in children is associated with difficult social relations, emotional dysregulation, and inattention. However, there are no studies of lead exposure and tactile defensiveness in children or animals in spite of the fact that lead exposure is also associated with inattention and emotional dysregulation. OBJECTIVES: In this study we tested whether lead exposure induces tactile defensiveness in rhesus monkeys. METHODS: We tested 61 monkeys from a 3 (no lead, 1-year lead, 2-year lead) × 2 (succimer chelation or not) factorial experiment for tactile defensiveness at 4 years of age. Lead-treated monkeys had been orally administered lead in a daily milk solution from 8 days of life to either 1 or 2 years of age to produce blood lead levels of 35-40 mg/dL. Succimer chelation therapy or placebo was administered at 1 year of age. We measured tactile defensiveness using six repeated trials of each of three textures as a swipe to the cheek and neck. RESULTS: Lead-exposed monkeys showed higher negative responses to repeated tactile stimulation compared with controls. Blood lead during the first 3 months of life was positively correlated with the negative response on the tactile defensiveness test. There was an interaction of lead exposure × succimer chelation × trials, but it is not clear that succimer chelation was beneficial with respect to tactile defensiveness. CONCLUSIONS: This is the first report to implicate lead as a potential cause of tactile defensiveness. Research should examine whether lead exposure is associated with tactile defensiveness in children.

Flanders is densely populated with much industry and intensive farming. Body size of 14-to 15-year old adolescents and of adults aged 50-65 was studied in relation to internal exposure to pollutants. 1679 adolescents (887 boys and 792 girls), 775 men and 808 women were selected as a random sample of the population. Concentrations of pollutants in blood or urine were measured in accordance with quality control/quality assurance procedures. Selfassessment questionnaires provided information on personal and life-style factors. Height and weight of subjects were measured. Confounding factors and significant covariates were taken into account. For boys and girls, height and body mass index (BMI) showed a negative association with urinary concentration of cadmium and BMI also with serum concentration of hexachlorobenzene (HCB) and with the sum of serum concentrations of polychlorinated biphenyls (PCBs) 138, 153, and 180 (marker PCBs), whereas BMI showed a positive association with serum concentration of PCB118. For boys, height showed a negative association with urinary concentration of 1-hydroxypyrene (1-OHP) and positive associations with serum concentrations of HCB and PCB118. For adults no significant associations between internal exposure and height were observed. For men, BMI showed negative associations with urinary cadmium concentration and with serum levels of marker PCBs and positive associations with serum levels of HCB, p,p'dichlorodiphenyldichloroethylene (p,p'-DDE), PCB118 and the dioxin fraction of dioxinlike activity. For women, BMI showed a negative association with urinary cadmium concentration, with blood lead concentration and with the concentration of marker PCBs in serum, and a positive association with serum concentrations of HCB, p,p'-DDE and PCB118. Associations between biological effects and internal exposures were, in terms of the regression coefficient, often stronger at exposures below the median. Environmental

By computerized static posturography with sway frequency analysis, subclinical effects of lead on postural balance was examined in 29 female workers (lead workers) employed at a glass factory for 3-17 (mean 7.9) years in Beijing, China, in relation to brainstem function assessed by brainstem auditory evoked potential (BAEP). Their blood lead concentrations ranged from 26 to 79 (mean 55.7) µg/dl; ages were 21-30 (mean 28) years. Control subjects, aged 22-29 (mean 27.0) years, were 14 healthy female workers at a textile factory located in the same district. With eyes closed, power of the sway of high (2-4 Hz) and low (1 Hz or less) frequencies in lead workers was significantly larger than that in controls; with eyes open, their power of the sway of low frequency was significantly larger (p<0.05). The multiple regression analysis showed that the power of high frequency sway with eyes closed and of low and high frequencies with eyes open were significantly related to blood lead concentrations in lead workers (p<0.05). On the other hand, no significant differences in BAEP latencies between lead workers and controls were observed. The low frequency sway with eyes open was significantly correlated with the high frequency sway with eyes closed in the lead workers. The pattern of changes in postural balance suggested that the anterior cerebellar lobe, vestibulo-cerebellar and spinocerebellar afferent systems were affected asymptomatically in female lead workers; the sway of vestibulo-cerebellar and anterior cerebellar lobe types were simultaneously affected by lead. It appears that a computerized static posturography with sway frequency analysis is useful technique for assessment of subclinical lead neurotoxicity.

Lead pollution is a substantial problem in developing countries such as India. The US Centers for Disease Control and Prevention has defined an elevated blood lead level in children as 10 lg/dl, on the basis of neurologic toxicity. The US Environmental Protection Agency suggests a threshold lead level of 20-40 lg/dl for risk of childhood anemia, but there is little information relating lead levels <40 lg/dl to anemia. Therefore, the authors examined the association between lead levels as low as 10 lg/dl and anemia in Indian children under 3 years of age. Anemia was divided into categories of mild (hemoglobin level 10-10.9 g/dl), moderate (hemoglobin level 8-9.9 g/dl), and severe (hemoglobin level <8 g/dl). Lead levels <10 lg/dl were detected in 568 children (53%), whereas 413 (38%) had lead levels 10-19.9 lg/dl and 97 (9%) had levels 20 lg/dl. After adjustment for child's age, duration of breastfeeding, standard of living, parent's education, father's occupation, maternal anemia, and number of children in the immediate family, children with lead levels 10 lg/dl were 1.3 (95% confidence interval: 1.0, 1.7) times as likely to have moderate anemia as children with lead levels <10 lg/dl. Similarly, the odds ratio for severe anemia was 1.7 (95% confidence interval: 1.1, 2.6). Health agencies in India should note the association of elevated blood lead levels with anemia and make further efforts to curb lead pollution and childhood anemia.

Changes in manganese and lead in the environment and young Changes in manganese and lead in the environment and young children associated with the introduction of children associated with the introduction of methylcyclopentadienyl manganese tricarbonyl in methylcyclopentadienyl manganese tricarbonyl in gasoline-preliminary results gasoline-preliminary results

We have measured the concentration and isotopic composition of lead in blood over a 15-month period for a subject who undertook recreational shooting in outdoor and indoor firing ranges on an irregular basis. We have also measured the isotopic composition in cast lead, Cu-jacketed and Teflon-coated bullets, propellant and primer from which he assembled the cartridges. Blood lead concentration increased from 3.2 to 6.7 mgydl with use of dominantly cast lead bullets in the outdoor range. In two intervals when no firing was undertaken for 3-4 months, the blood lead concentrations either decreased towards a baseline value in the case where only Cu-jacketed bullets were fired or remained elevated when dominantly cast lead bullets were fired. The propellants contained -2 ppm Pb and contribute negligibly to blood lead. The isotopic composition of the primer used for all bullets was consistent with a source from the US. The bullets were of different materials and made in Australia and the US, with lead from sources of different geological age and hence different isotopic signatures. Variations in blood lead concentration and isotopic composition appear most strongly influenced by the bullets. Although more expensive, the use of Cu-jacketed bullets, non-lead primers and well-ventilated indoor firing ranges would lessen the health impacts of recreational shooting.

We thank the participants in this study, G. Jacobs for logistical assistance enabling B.G. to visit Esperance and address the community, M. Crisp of the local community group for untiring assistance to B.G. and the community, and R. Field for the particle size measurements and X-ray diffraction analyses. The authors declare they have no competing financial interests.