Childhood lead exposure after the phaseout of leaded gasoline: an ecological study of school-age children in Kampala, Uganda.
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.
Graber
Lauren K
LK
Yale University School of Medicine, New Haven, Connecticut, USA.
Asher
Daniel
D
Anandaraja
Natasha
N
Bopp
Richard F
RF
Merrill
Karen
K
Cullen
Mark R
MR
Luboga
Samuel
S
Trasande
Leonardo
L
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
D004391:Dust; D004785:Environmental Pollutants; D005742:Gasoline; D007854:Lead