title: Environmental factors predicting blood lead levels in pregnant women in the UK: the ALSPAC study.
abstract: BACKGROUND
  Lead is a widespread environmental toxin. The behaviour and academic performance of children can be adversely affected even at low blood lead levels (BLL) of 5-10 µg/dl. An important contribution to the infant's lead load is provided by maternal transfer during pregnancy.
  
  
  OBJECTIVE
  Our aim was to determine BLL in a large cohort of pregnant women in the UK and to identify the factors that contribute to BLL in pregnant women.
  
  
  METHODS
  Pregnant women resident in the Avon area of the UK were enrolled in the Avon Longitudinal Study of Parents and Children (ALSPAC) in 1991-1992. Whole blood samples were collected at median gestational age of 11 weeks and analysed by inductively coupled plasma dynamic reaction cell mass spectrometry (n = 4285). Self-completion postal questionnaires were used to collect data during pregnancy on lifestyle, diet and other environmental exposures. Statistical analysis was carried out with SPSS v19.
  
  
  RESULTS
  The mean±SD BLL was 3.67±1.47 (median 3.41, range 0.41-19.14) µg/dl. Higher educational qualification was found to be one of the strongest independent predictor of BLL in an adjusted backwards stepwise logistic regression to predict maternal BLL <5 or ≥5 µg/dl (odds ratio 1.26, 95% confidence interval 1.12-1.42; p<0.001). Other predictive factors included cigarette smoking, alcohol and coffee drinking, and heating the home with a coal fire, with some evidence for iron and calcium intake having protective effects.
  
  
  CONCLUSIONS
  The mean BLL in this group of pregnant women is higher than has been found in similar populations in developed countries. The finding that high education attainment was independently associated with higher BLL was unexpected and currently unexplained. Reduction in maternal lead levels can best be undertaken by reducing intake of the social drugs cigarettes, alcohol and caffeine, although further investigation of the effect of calcium on lead levels is needed.
authors.affiliation: Centre for Child and Adolescent Health, School of Social and Community Medicine, University of Bristol, Bristol, United Kingdom.
authors.forename: Caroline M
authors.initials: CM
authors.lastname: Taylor
authors.forename: Jean
authors.initials: J
authors.lastname: Golding
authors.forename: Joseph
authors.initials: J
authors.lastname: Hibbeln
authors.forename: Alan M
authors.initials: AM
authors.lastname: Emond
mesh_terms: D000328:Adult; D002675:Child, Preschool; D004739:England; D004781:Environmental Exposure; D005260:Female; D006801:Humans; D007854:Lead / Q000097:blood*; D008137:Longitudinal Studies; D011247:Pregnancy / Q000097:blood*; D055815:Young Adult
chemical_list: D007854:Lead
references.citation: Int J Hyg Environ Health. 2007 May;210(3-4):447-54
references.pmid: 17347042
references.citation: Am J Public Health. 1996 Sep;86(9):1247-52
references.pmid: 8806376
references.citation: Environ Health Perspect. 2011 May;119(5):664-9
references.pmid: 21292600
references.citation: Pediatrics. 2004 Apr;113(4 Suppl):1016-22
references.pmid: 15060194
references.citation: Int J Epidemiol. 2013 Feb;42(1):111-27
references.pmid: 22507743
references.citation: Int Arch Occup Environ Health. 1981;48(4):391-7
references.pmid: 7298208
references.citation: Hum Exp Toxicol. 1992 Jan;11(1):3-9
references.pmid: 1354457
references.citation: Food Addit Contam. 1990 Jan-Feb;7(1):93-9
references.pmid: 2307272
references.citation: Sci Total Environ. 2010 Nov 1;408(23):5744-9
references.pmid: 20825977
references.citation: PLoS One. 2012;7(3):e31354
references.pmid: 22427803
references.citation: J Lab Clin Med. 1997 Jul;130(1):51-62
references.pmid: 9242366
references.citation: J Environ Monit. 2009 Jul;11(7):1322-30
references.pmid: 20449220
references.citation: Int J Hyg Environ Health. 2011 Mar;214(2):79-101
references.pmid: 21093366
references.citation: J Environ Monit. 2007 Aug;9(8):884-93
references.pmid: 17671671
references.citation: BMJ. 1996 Oct 19;313(7063):979-81
references.pmid: 8892418
references.citation: Sci Total Environ. 2011 May 1;409(11):2298-305
references.pmid: 21397928
references.citation: Am J Ind Med. 2000 Sep;38(3):300-9
references.pmid: 10940968
references.citation: Am J Epidemiol. 2000 Nov 1;152(9):829-37
references.pmid: 11085394
references.citation: Med J Aust. 1987 Jan 19;146(2):69-73
references.pmid: 3796424
references.citation: J Epidemiol Community Health. 2012 Feb;66(2):106-13
references.pmid: 20974841
references.citation: Environ Health Perspect. 2009 Jan;117(1):26-31
references.pmid: 19165383
references.citation: Basic Clin Pharmacol Toxicol. 2010 Dec;107(6):971-5
references.pmid: 20629654
references.citation: Environ Health Perspect. 2003 Feb;111(2):195-200
references.pmid: 12573905
references.citation: Arch Dis Child. 2009 Nov;94(11):844-8
references.pmid: 19770197
references.citation: Environ Health Perspect. 1994 Oct;102(10):876-80
references.pmid: 9644197
references.citation: Clin Biochem. 2000 Mar;33(2):131-8
references.pmid: 10751591
references.citation: Environ Res. 2006 Mar;100(3):295-318
references.pmid: 16081062
references.citation: Med J Aust. 1985 Nov 25;143(11):499-503
references.pmid: 4069047
references.citation: Food Chem Toxicol. 2002 Sep;40(9):1263-70
references.pmid: 12204390
references.citation: BMC Res Notes. 2009 Mar 24;2:47
references.pmid: 19309527
references.citation: Neurotoxicol Teratol. 2010 Mar-Apr;32(2):256-61
references.pmid: 19744554
references.citation: Environ Health Perspect. 1999 Apr;107(4):257-63
references.pmid: 10090703
references.citation: Occup Environ Med. 2005 Apr;62(4):263-9
references.pmid: 15778260
references.citation: Neurotoxicol Teratol. 1989 Mar-Apr;11(2):85-93
references.pmid: 2733657
references.citation: J Environ Monit. 2011 Aug;13(8):2143-52
references.pmid: 21738945
references.citation: Int J Epidemiol. 2013 Feb;42(1):97-110
references.pmid: 22507742
references.citation: Pediatrics. 2009 Aug;124(2):e195-202
references.pmid: 19620194
references.citation: Sci Total Environ. 2002 May 6;290(1-3):157-64
references.pmid: 12083707
references.citation: Arch Environ Health. 2002 Sep-Oct;57(5):489-95
references.pmid: 12641194
references.citation: Sci Total Environ. 2000 Jan 17;245(1-3):195-202
references.pmid: 10682367
references.citation: Pediatr Res. 1978 Jan;12(1):29-34
references.pmid: 643372
references.citation: IUBMB Life. 2005 Dec;57(12):805-9
references.pmid: 16393783
references.citation: Neurotoxicology. 1987 Fall;8(3):395-401
references.pmid: 2443882
references.citation: Arch Environ Health. 1992 May-Jun;47(3):185-95
references.pmid: 1596101