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Nitin Jain, MD, MSPH, Channing Laboratory, Brigham & Women's Hospital, Harvard Medical School, VAMC-HMS, 1400 VFW Parkway, West Roxbury, MA 02132, 6173237700, ext. 5160, Nitin_Jain@hms.harvard.edu, Francine Laden, ScD, Exposure, Epidemiology and Risk Program, Department of Environmental Health, Harvard School of Public Health, 181 Longwood Ave, Boston, MA 02115, and Eric Garshick, MD, MOH, Pulmonary and Critical Care Medicine Section, VA Boston Healthcare System, Pulmonary 111B, West Roxbury, MA 02132.
Background: Lead pollution is an enormous problem in developing countries such as India. The US Centre for Disease Prevention and Control recommends blood lead levels (BLLs) <10µg/dL in children, based on its neurological toxicity. The US Environmental Protection Agency suggests a threshold BLL of 20-40µg/dL for risk of childhood anemia, but there is little information relating BLLs below 40µg/dL to anemia. We therefore examined the relationship between BLLs as low as 10µg/dL and anemia in Indian children. Methods: BLLs in children (n=1,078) aged <3 years from two metropolitan cities (Mumbai and Delhi) were determined from the Indian National Family Health Survey. Anemia was divided into: mild (hemoglobin: 10-10.9 g/dL), moderate (hemoglobin: 8-9.9 g/dL), and severe (hemoglobin: <8 g/dL) anemia
Results: BLLs <10µg/dL were detected in 568 children (53%), 413 (38%) had BLLs >10-19.9µg/dL, and 97 (9%) had levels >20µg/dL, with 3 of those having BLLs >40µg/dL. Adjusting for standard of living, parent’s education, father’s occupation, maternal anemia, and number of siblings, children with BLLs ≥10µg/dL were 1.3 (95% CI=0.9, 1.8) times more likely to have moderate anemia compared to children with BLLs <10µg/dL. Similarly, the odds ratio for severe anemia among these children was elevated (OR=2.0, 95% CI=1.2, 3.3).
Conclusions: BLLs ≥10µg/dL were significantly associated with increased risk of severe anemia, which leads to increased morbidity and mortality in children. Since lead poisoning is an entirely preventable condition the regulatory and health agencies in India should consider this a priority and make substantial efforts to curb lead pollution and its harmful effects.
Learning Objectives: At the conclusion of the session, the participant (learner) in this session will be able to
Keywords: Lead, Environmental Health
Presenting author's disclosure statement:
I do not have any significant financial interest/arrangement or affiliation with any organization/institution whose products or services are being discussed in this session.