title: The relationship of blood lead with immunoglobulin E, eosinophils, and asthma among children: NHANES 2005-2006.
abstract: Early life lead exposure may alter immune function and predispose a child to develop asthma. In an initial exploration of this hypothesis, we examined the association between blood lead, and serum immunoglobulin E (IgE), eosinophils, and asthma prevalence in a cross-sectional study of 1788 children from the National Health and Nutrition Examination Survey 2005-2006. Geometric mean blood lead, serum IgE, and percent eosinophils were 1.13 μg/dL (95% confidence interval (CI): 1.04, 1.22), 46.3 kU/L (95% CI: 40.3, 53.1), and 2.82 percent (95% CI 2.67, 2.98), respectively. Prevalence of asthma, atopic asthma, and atopy were 11.8% (95% CI: 9.5, 14.2), 8.1% (6.2, 9.9), and 44.4% (40.1, 48.7), respectively. Regression models controlled for season, age, sex, race/ethnicity, education, passive smoke exposure, and body mass index. Based on these models, there was an 11.1% (95% CI: 5.6, 16.9) increase in IgE and a 4.9% (95% CI: 2.3, 7.6) increase in eosinophils per 1 μg/dL increase in blood lead. In independent stratified analyses, lead was found to increase IgE and eosinophils among non-Hispanic whites, but not other children; and stronger associations were observed among children who lived with a smoker vs. not. Lead was not associated with asthma, atopic asthma, or general atopy. This study provides additional evidence of a cross-sectional association between lead with IgE and new evidence for eosinophils. This may be a mechanism for development of downstream allergic disease. The mechanisms that determine ultimate development of allergic disease are currently unknown, but are the focus of ongoing studies.
authors.affiliation: Department of Environmental Health Sciences, Case Western Reserve University School of Medicine, Cleveland, OH, USA; Department of Epidemiology and Biostatistics, Case Western Reserve University School of Medicine, Cleveland, OH, USA. Electronic address: ellen.wells@case.edu.
authors.forename: Ellen M
authors.initials: EM
authors.lastname: Wells
authors.affiliation: Department of Pediatrics, Case Western Reserve University School of Medicine, Cleveland, OH, USA.
authors.forename: Tracey L
authors.initials: TL
authors.lastname: Bonfield
authors.affiliation: Department of Environmental Health Sciences, Case Western Reserve University School of Medicine, Cleveland, OH, USA.
authors.forename: Dorr G
authors.initials: DG
authors.lastname: Dearborn
authors.affiliation: Department of Environmental Health Sciences, Case Western Reserve University School of Medicine, Cleveland, OH, USA; Department of Epidemiology and Biostatistics, Case Western Reserve University School of Medicine, Cleveland, OH, USA; Applied Public Health Research and Evaluation, Cleveland, OH, USA.
authors.forename: Leila W
authors.initials: LW
authors.lastname: Jackson
mesh_terms: D001249:Asthma / Q000453:epidemiology / Q000209:etiology; D002648:Child; D002675:Child, Preschool; D003430:Cross-Sectional Studies; D004804:Eosinophils / Q000378:metabolism*; D005006:Ethnicity; D005260:Female; D006801:Humans; D006969:Hypersensitivity, Immediate / Q000453:epidemiology / Q000209:etiology; D007073:Immunoglobulin E / Q000097:blood*; D007854:Lead / Q000097:blood / Q000276:immunology; D008297:Male; D009749:Nutrition Surveys; D015995:Prevalence; D014028:Tobacco Smoke Pollution
chemical_list: D014028:Tobacco Smoke Pollution; D007854:Lead; D007073:Immunoglobulin E
keywords: Asthma; Child; Eosinophils; Immunoglobulin E; Lead; NHANES; National Health and Nutrition Examination Survey