title: Blood lead levels in children after phase-out of leaded gasoline in Kinshasa, the capital of Democratic Republic of Congo (DRC).
abstract: BACKGROUND
  The phasing out of lead from gasoline has resulted in a significant decrease in blood lead levels (BLLs) in children during the last two decades. Tetraethyl lead was phased out in DRC in 2009. The objective of this study was to test for reduction in pediatric BLLs in Kinshasa, by comparing BLLs collected in 2011 (2 years after use of leaded gasoline was phased out) to those collected in surveys conducted in 2004 and 2008 by Tuakuila et al. (when leaded gasoline was still used).
  
  
  METHODS
  We analyzed BLLs in a total of 100 children under 6 years of age (Mean ± SD: 2.9 ± 1.6 age, 64% boys) using inductively coupled argon plasma mass spectrometry (ICP - MS).
  
  
  RESULTS
  The prevalence of elevated BLLs (≥ 10 μg/dL) in children tested was 63% in 2004 [n = 100, GM (95% CI) = 12.4 μg/dL (11.4 - 13.3)] and 71% in 2008 [(n = 55, GM (95% CI) = 11.2 μg/dL (10.3 - 14.4)]. In the present study, this prevalence was 41%. The average BLLs for the current study population [GM (95% CI) = 8.7 μg/dL (8.0 - 9.5)] was lower than those found by Tuakuila et al. (F = 10.38, p <0.001) as well as the CDC level of concern (10 μ/dL), with 3% of children diagnosed with BLLs ≥ 20 μg/dL.
  
  
  CONCLUSIONS
  These results demonstrate a significant success of the public health system in Kinshasa, DRC-achieved by the removal of lead from gasoline. However, with increasing evidence that adverse health effects occur at BLLs < 10 μg/dL and no safe BLLs in children has been identified, the BLLs measured in this study continue to constitute a major public health concern for Kinshasa. The emphasis should shift to examine the contributions of non-gasoline sources to children's BLLs: car batteries recycling in certain residences, the traditional use of fired clay for the treatment of gastritis by pregnant women and leaded paint.
authors.affiliation: Environmental Chemistry, Faculty of Sciences, University of Kinshasa, Kinshasa, Democratic Republic of Congo. joeltuakuila@yahoo.fr.
authors.forename: Joel
authors.initials: J
authors.lastname: Tuakuila
authors.forename: Martin
authors.initials: M
authors.lastname: Kabamba
authors.forename: Honoré
authors.initials: H
authors.lastname: Mata
authors.forename: Gerard
authors.initials: G
authors.lastname: Mata
references.citation: Sci Total Environ. 1993 Sep 30;138(1-3):301-8
references.pmid: 7505059
references.citation: N Engl J Med. 2003 Apr 17;348(16):1515-6
references.pmid: 12700370
references.citation: Sci Total Environ. 1997 Oct 20;205(2-3):179-87
references.pmid: 9372629
references.citation: Analyst. 1987 Dec;112(12):1701-4
references.pmid: 3445938
references.citation: Environ Res. 1990 Feb;51(1):25-34
references.pmid: 2298181
references.citation: J Expo Sci Environ Epidemiol. 2013 Jan-Feb;23(1):81-7
references.pmid: 22617721
references.citation: N Engl J Med. 2003 Apr 17;348(16):1517-26
references.pmid: 12700371
references.citation: Pediatrics. 2006 Aug;118(2):e323-30
references.pmid: 16882776
references.citation: Curr Opin Pediatr. 2008 Apr;20(2):172-7
references.pmid: 18332714
references.citation: Environ Health Perspect. 2005 Jul;113(7):894-9
references.pmid: 16002379
references.citation: N Engl J Med. 2003 Jul 31;349(5):500-2; author reply 500-2
references.pmid: 12890850
references.citation: Brain. 2003 Jan;126(Pt 1):5-19
references.pmid: 12477693
references.citation: Environ Health Perspect. 2010 Jun;118(6):884-9
references.pmid: 20194080
references.citation: Environ Health Perspect. 2009 Oct;117(10):1535-40
references.pmid: 20019903
references.citation: Neurotoxicol Teratol. 2004 May-Jun;26(3):359-71
references.pmid: 15113598
references.citation: Pediatrics. 2009 Mar;123(3):e376-85
references.pmid: 19254973
references.citation: Environ Res. 2006 Mar;100(3):371-86
references.pmid: 16169549
references.citation: Environ Res. 2006 Mar;100(3):319-22
references.pmid: 16213479
references.citation: Mutat Res. 2008 Jul-Aug;659(1-2):166-75
references.pmid: 18436472