title: Implications of different residential lead standards on children's blood lead levels in France: predictions based on a national cross-sectional survey.
abstract: Despite the dramatic reductions in children's blood lead levels (BLLs), there is considerable evidence that low-level lead exposure is associated with intellectual deficits and behavioral problems, without apparent threshold. There are limited data, however, about the contribution of residential sources of lead to contemporary children's blood lead levels. The aim of this study is to calculate the contributions of residential sources of lead to assess the potential impact of setting new standards for lead levels in residential dust, soil and water. We enrolled 484 French children aged from 6 months to 6 years, and collected data on social, housing and individual characteristics. Lead concentrations in blood and environmental samples (water, soils, and dusts) were measured using inductively coupled plasma mass spectrometry. Data were analyzed using a multivariate generalized additive model accounting for the sampling design and the sampling weights. We found that exceedingly low concentrations of lead in dust, soil and water were significant predictors of children's BLLs, after adjustment for potential confounding variables. Lead-contaminated floor dust was the main source of lead in blood. BLLs (GM: 14μg/L) increased by 65%, 13%, 25%, and 5% when lead content in floor dust, loose soil, hard soil and water increased from their 25th percentile to their 95th percentile, respectively. We also observed that the steepest increase in BLLs occurred at the lowest levels of lead-contaminated floor dust, which indicates that lead contamination should be kept as low as possible. Impact of different possible standards on children's BLLs was also tabulated and indicated that unless standards are set low, they will only benefit a small proportion of children who have the highest exposures.
authors.affiliation: EHESP, Rennes, Sorbonne Paris Cité, France; INSERM UMR1085 IRSET - Institut de Recherches sur la santé l'environnement et le travail, Rennes, France; INSERM U954, Nancy University Medical School, Vandoeuvre Les Nancy, France.
authors.forename: Youssef
authors.initials: Y
authors.lastname: Oulhote
authors.forename: Alain
authors.initials: A
authors.lastname: LeTertre
authors.forename: Anne
authors.initials: A
authors.lastname: Etchevers
authors.forename: Barbara
authors.initials: B
authors.lastname: Le Bot
authors.forename: Jean-Paul
authors.initials: JP
authors.lastname: Lucas
authors.forename: Corinne
authors.initials: C
authors.lastname: Mandin
authors.forename: Yann
authors.initials: Y
authors.lastname: Le Strat
authors.forename: Bruce
authors.initials: B
authors.lastname: Lanphear
authors.forename: Philippe
authors.initials: P
authors.lastname: Glorennec
mesh_terms: D002648:Child; D002675:Child, Preschool; D003430:Cross-Sectional Studies; D004391:Dust / Q000032:analysis; D004781:Environmental Exposure / Q000032:analysis* / Q000592:standards; D004785:Environmental Pollutants / Q000032:analysis / Q000097:blood*; D005260:Female; D005602:France; D006798:Housing; D006801:Humans; D007223:Infant; D007854:Lead / Q000032:analysis / Q000097:blood*; D008297:Male; D012987:Soil / Q000737:chemistry*; D014867:Water / Q000737:chemistry*; D014874:Water Pollutants, Chemical
chemical_list: D004391:Dust; D004785:Environmental Pollutants; D012987:Soil; D014874:Water Pollutants, Chemical; D014867:Water; D007854:Lead
keywords: Bll; CI; CMUc; Dust; Environmental exposure; GM; LOD; LOQ; Lead; Lead poisoning; Soil; Water; blood lead level; complementary free health insurance; confidence interval; geometric mean; limit of detection; limit of quantification; mg/kg; micrograms per liter; micrograms per square meter; miligrams per kilogram; μg/L; μg/m(2)