What are the blood lead levels of children living in Latin America and the Caribbean?
Information on the prevalence of lead exposure is essential to formulate efficient public health policies. Developed countries have implemented successful public policies for the prevention and control of lead poisoning. In the United States, Canada, Japan and the European Union, for instance, periodically repeated prevalence studies show that blood lead levels (BLLs) in children have decreased overall. Although BLL of Latino children in the U.S. have also dropped in recent years, the geometric mean remains higher than that of white children. Little is known about lead exposure in children in Latin America and the Caribbean (LAC). In this review, we responded to two questions: What is currently known about lead sources and levels in children in LAC? Are there public policies to prevent children's exposure to lead in LAC?



We conducted a literature review covering the period from January 2000 to March 2014 in the PubMed and Lilacs databases to obtain English, Portuguese and Spanish language studies reporting the prevalence of BLLs in children aged 0-18years living in LAC countries. No specific analytical method was selected, and given the scarcity of data, the study was highly inclusive.



Fifty-six papers were selected from 16 different LAC countries. The children's BLLs found in this review are high (≥10μg/dL) compared to BLLs for the same age group in the U. S. However, most studies reported an association with some type of "lead hot spot", in which children can be exposed to lead levels similar to those of occupational settings. Only Peru and Mexico reported BLLs in children from population-based studies.



Most BLLs prevalence studies carried out in LAC were in areas with known emission sources. The percentage of children at risk of lead poisoning in LAC is unknown, and probably underestimated. Thus, there is an urgent need to establish public health policies to quantify and prevent lead poisoning, specifically by prioritizing the identification and control of "hot spots".
Departamento de Saúde Ambiental, Faculdade de Saúde Pública, Universidade de São Paulo, São Paulo, SP, Brazil. Electronic address: kellypko@usp.br.
Kelly Polido Kaneshiro
KP
Olympio
Departamento de Controle Ambiental/Grupo Técnico Permanente de Áreas Contaminadas - Secretaria do Verde e Meio Ambiente de São Paulo, Brazil.
Cláudia Gaudência
CG
Gonçalves
Departamento de Saúde Ambiental, Faculdade de Saúde Pública, Universidade de São Paulo, São Paulo, SP, Brazil.
Fernanda Junqueira
FJ
Salles
Departamento de Saúde Ambiental, Faculdade de Saúde Pública, Universidade de São Paulo, São Paulo, SP, Brazil.
Ana Paula Sacone da Silva
AP
Ferreira
Sustainable Development and Health Equity, Pan American Health Organization, Washington, DC, United States.
Agnes Silva
AS
Soares
Departamento de Ciências Biológicas, Faculdade de Odontologia de Bauru, Universidade de São Paulo, Bauru, SP, Brazil.
Marília Afonso Rabelo
MA
Buzalaf
Departamento de Epidemiologia, Faculdade de Saúde Pública, Universidade de São Paulo, São Paulo, SP, Brazil.
Maria Regina Alves
MR
Cardoso
Departamento de Química Fundamental, Instituto de Química, Universidade de São Paulo, São Paulo, SP, Brazil.
Etelvino José Henriques
EJ
Bechara
D000293:Adolescent; D017691:Caribbean Region / Q000453:epidemiology; D002648:Child; D000067576:Child Health; D002675:Child, Preschool; D004781:Environmental Exposure; D004784:Environmental Monitoring; D005260:Female; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D007843:Latin America / Q000453:epidemiology; D007854:Lead / Q000097:blood*; D007855:Lead Poisoning / Q000097:blood / Q000453:epidemiology* / Q000517:prevention & control; D008297:Male; D011159:Population Surveillance; D015995:Prevalence
D007854:Lead
Blood; Caribbean; Children; Latin America; Lead