title: Blood lead levels in Mexico and pediatric burden of disease implications.
abstract: BACKGROUND
  Although there has been success in reducing lead exposure with the phase-out of leaded gasoline, exposure to lead in Mexico continues to threaten the health of millions, much of which is from lead-based glazes used in pottery that leaches into food.
  
  
  OBJECTIVE
  An extensive historical review and analysis of available data on blood lead levels in Mexican populations was conducted. We used a calculated geometric mean to evaluate the effect of lead on the pediatric burden of disease.
  
  
  METHODS
  An extensive bibliographic search identified 83 published articles from 1978 to 2010 with blood lead level (BLL) data in Mexican populations representing 150 data points from more than 50,000 study participants. Values from these publications were categorized into various groupings. We then calculated the incidence of disease and disability-adjusted life-years resulting from these BLLs using the World Health Organization's burden of disease spreadsheets for mild mental retardation.
  
  
  RESULTS
  Reviewing all relevant studies, the geometric means of Mexican BLLs in urban and rural areas were found to be 8.85 and 22.24 ug/dL, respectively. Since the phase-out of leaded gasoline, the mean in urban areas was found to be 5.36 ug/dL and the average in rural areas is expected to be much higher. The U.S. Centers for Disease Control and Prevention's (CDC) upper limit of blood lead in children under the age of 6 years is 5 ug/dL and the current U.S. average is 1.2 ug/dL. Our results indicate that more than 15% of the population will experience a decrement of more than 5 IQ points from lead exposure. The analysis also leads us to believe that lead is responsible for 820,000 disability-adjusted life-years for lead-induced mild mental retardation for children aged 0 to 4 years.
  
  
  CONCLUSIONS
  Lead continues to threaten the health of millions and remains a significant cause of disability in Mexico. Additional interventions in reducing or managing lead-based ceramic glazes are necessary to protect the public health.
authors.affiliation: Environmental and Occupational Health Sciences Program, City University of New York, School of Public Health, New York, NY; Blacksmith Institute, New York, NY. Electronic address: jcaravan@hunter.cuny.edu.
authors.forename: Jack
authors.initials: J
authors.lastname: Caravanos
authors.affiliation: Blacksmith Institute, New York, NY.
authors.forename: Russell
authors.initials: R
authors.lastname: Dowling
authors.affiliation: Instituto Nacional de Salud Pública, Universidad No. 655 Colonia Santa María Ahuacatitlán, Cerrada Los Pinos y Caminera C.P. Cuernavaca, Morelos, México.
authors.forename: Martha María
authors.initials: MM
authors.lastname: Téllez-Rojo
authors.affiliation: Instituto Nacional de Salud Pública, Universidad No. 655 Colonia Santa María Ahuacatitlán, Cerrada Los Pinos y Caminera C.P. Cuernavaca, Morelos, México.
authors.forename: Alejandra
authors.initials: A
authors.lastname: Cantoral
authors.affiliation: Blacksmith Institute, New York, NY; Department of Preventive Medicine, Icahn School of Medicine at Mount Sinai, New York, NY.
authors.forename: Roni
authors.initials: R
authors.lastname: Kobrosly
authors.affiliation: Blacksmith Institute, New York, NY.
authors.forename: Daniel
authors.initials: D
authors.lastname: Estrada
authors.affiliation: Departments of Pediatrics and Environmental Health Sciences, Columbia University, New York, NY.
authors.forename: Manuela
authors.initials: M
authors.lastname: Orjuela
authors.affiliation: Blacksmith Institute, New York, NY.
authors.forename: Sandra
authors.initials: S
authors.lastname: Gualtero
authors.affiliation: Blacksmith Institute, New York, NY.
authors.forename: Bret
authors.initials: B
authors.lastname: Ericson
authors.affiliation: Blacksmith Institute, New York, NY.
authors.forename: Anthony
authors.initials: A
authors.lastname: Rivera
authors.affiliation: Blacksmith Institute, New York, NY.
authors.forename: Richard
authors.initials: R
authors.lastname: Fuller
mesh_terms: D002675:Child, Preschool; D004781:Environmental Exposure / Q000009:adverse effects*; D006801:Humans; D015994:Incidence; D007223:Infant; D007231:Infant, Newborn; D008607:Intellectual Disability / Q000139:chemically induced / Q000453:epidemiology*; D007854:Lead / Q000097:blood* / Q000633:toxicity*; D008800:Mexico / Q000453:epidemiology; D012424:Rural Population; D014505:Urban Population
chemical_list: D007854:Lead
keywords: DALY; Mexico; blood lead level; burden of disease; children; disability-adjusted life-year; lead; pottery