title: Childhood lead exposure after the phaseout of leaded gasoline: an ecological study of school-age children in Kampala, Uganda.
abstract: BACKGROUND
  Tetraethyl lead was phased out of gasoline in Uganda in 2005. Recent mitigation of an important source of lead exposure suggests examination and re-evaluation of the prevalence of childhood lead poisoning in this country. Ongoing concerns persist about exposure from the Kiteezi landfill in Kampala, the country's capital.
  
  
  OBJECTIVE
  We determined blood lead distributions among Kampala schoolchildren and identified risk factors for elevated blood lead levels (EBLLs; >or= 10 microg/dL). Analytical approach: Using a stratified, cross-sectional design, we obtained blood samples, questionnaire data, and soil and dust samples from the homes and schools of 163 4- to 8-year-old children representing communities with different risks of exposure.
  
  
  RESULTS
  The mean blood lead level (BLL) was 7.15 microg/dL; 20.5% of the children were found to have EBLL. Multivariable analysis found participants whose families owned fewer household items, ate canned food, or used the community water supply as their primary water source to have higher BLLs and likelihood of EBLLs. Distance < 0.5 mi from the landfill was the factor most strongly associated with increments in BLL (5.51 microg/dL, p < 0.0001) and likelihood of EBLL (OR = 4.71, p = 0.0093). Dust/soil lead was not significantly predictive of BLL/EBLL.
  
  
  CONCLUSIONS
  Lead poisoning remains highly prevalent among school-age children in Kampala. Confirmatory studies are needed, but further efforts are indicated to limit lead exposure from the landfill, whether through water contamination or through another mechanism. Although African nations are to be lauded for the removal of lead from gasoline, this study serves as a reminder that other sources of exposure to this potent neurotoxicant merit ongoing attention.
authors.affiliation: Yale University School of Medicine, New Haven, Connecticut, USA.
authors.forename: Lauren K
authors.initials: LK
authors.lastname: Graber
authors.forename: Daniel
authors.initials: D
authors.lastname: Asher
authors.forename: Natasha
authors.initials: N
authors.lastname: Anandaraja
authors.forename: Richard F
authors.initials: RF
authors.lastname: Bopp
authors.forename: Karen
authors.initials: K
authors.lastname: Merrill
authors.forename: Mark R
authors.initials: MR
authors.lastname: Cullen
authors.forename: Samuel
authors.initials: S
authors.lastname: Luboga
authors.forename: Leonardo
authors.initials: L
authors.lastname: Trasande
mesh_terms: D002648:Child; D002947:Cities; D003430:Cross-Sectional Studies; D004391:Dust / Q000032:analysis*; D004781:Environmental Exposure / Q000032:analysis*; D004784:Environmental Monitoring / Q000706:statistics & numerical data*; D004785:Environmental Pollutants / Q000097:blood*; D005260:Female; D005742:Gasoline / Q000032:analysis; D040362:Geographic Information Systems; D006801:Humans; D007854:Lead / Q000097:blood*; D008297:Male; D012037:Refuse Disposal / Q000706:statistics & numerical data; D012044:Regression Analysis; D011795:Surveys and Questionnaires; D014454:Uganda
chemical_list: D004391:Dust; D004785:Environmental Pollutants; D005742:Gasoline; D007854:Lead