title: Blood lead levels and risk factors in young children in France, 2008-2009.
abstract: BACKGROUND
  The exposure of children to lead has decreased in recent years, thanks notably to the banning of leaded gasoline. However, lead exposure remains a matter of public health concern, because no toxicity threshold has been observed, cognitive effects having been demonstrated even at low levels. It is therefore important to update exposure assessments. A national study was conducted, in 2008-2009, to determine the blood lead level (BLL) distribution in children between the ages of six months and six years in France. We also assessed the contribution of environmental factors.
  
  
  METHODS
  This cross-sectional survey included 3831 children recruited at hospitals. Two-stage probability sampling was carried out, with stratification by hospital and French region. Sociodemographic characteristics were recorded, and blood samples and environmental data were collected by questionnaire. Generalized linear model and quantile regression were used to quantify the association between BLL and environmental risk factors.
  
  
  RESULTS
  The geometric mean BLL was 14.9μg/l (95% confidence interval (CI)=[14.5-15.4]) and 0.09% of the children (95% CI=[0.03-0.15]) had BLLs exceeding 100μg/l, 1.5% (95% CI=[0.9-2.1] exceeding 50μg/l. Only slight differences were observed between French regions. Environmental factors significantly associated with BLL were the consumption of tap water in homes with lead service connections, peeling paint or recent renovations in old housing, hand-mouth behavior, passive smoking and having a mother born in a country where lead is often used.
  
  
  CONCLUSIONS
  In children between the ages of one and six years in France, lead exposure has decreased over the last 15 years as in the US and other European countries. Nevertheless still 76,000 children have BLL over 50μg/l and prevention policies must be pursued, especially keeping in mind there is no known toxicity threshold.
authors.affiliation: InVS - French Institute for Public Health Surveillance, Saint Maurice, France; INSERM U1085, IRSET-Environmental and Occupational Health Research Institute, Rennes, France. Electronic address: anne.etchevers@inserm.fr.
authors.forename: Anne
authors.initials: A
authors.lastname: Etchevers
authors.affiliation: InVS - French Institute for Public Health Surveillance, Saint Maurice, France.
authors.forename: Philippe
authors.initials: P
authors.lastname: Bretin
authors.affiliation: InVS - French Institute for Public Health Surveillance, Saint Maurice, France.
authors.forename: Camille
authors.initials: C
authors.lastname: Lecoffre
authors.affiliation: InVS - French Institute for Public Health Surveillance, Saint Maurice, France.
authors.forename: Marie-Laure
authors.initials: ML
authors.lastname: Bidondo
authors.affiliation: InVS - French Institute for Public Health Surveillance, Saint Maurice, France.
authors.forename: Yann
authors.initials: Y
authors.lastname: Le Strat
authors.affiliation: EHESP, Rennes, Sorbonne Paris Cité, France; INSERM U1085, IRSET-Environmental and Occupational Health Research Institute, Rennes, France.
authors.forename: Philippe
authors.initials: P
authors.lastname: Glorennec
authors.affiliation: InVS - French Institute for Public Health Surveillance, Saint Maurice, France.
authors.forename: Alain
authors.initials: A
authors.lastname: Le Tertre
mesh_terms: D002648:Child; D002675:Child, Preschool; D003430:Cross-Sectional Studies; D004784:Environmental Monitoring; D005260:Female; D005843:Geography; D006801:Humans; D007223:Infant; D007854:Lead / Q000097:blood*; D008297:Male; D012307:Risk Factors
chemical_list: D007854:Lead
keywords: Biomonitoring; Blood lead levels; Children's health; Exposure; France; Lead poisoning