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Assessment of Blood Lead Level of School Children in 10 Cities of India: A Cross-Sectional Study

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Indian Journal of Pediatrics Aims and scope Submit manuscript

Abstract

Objectives

To assess the blood lead level (BLL) of school children in 10 cities of India.

Methods

This multi-centric cross-sectional study enrolled participants from randomly selected schools. Data on demographic details, socioeconomic status (SES) and anthropometric indicators was collected. Samples were collected for assessment of lead level in blood. Inductively coupled plasma-optical emission spectrometry technique was used to assess BLL.

Results

From April 2019 through February 2020, 2247 participants were recruited from sixty schools (62.6% government schools) with equal gender distribution. The overall median (interquartile range) BLL was 8.8 (4.8, 16.4) µg/dl. The highest median (interquartile range) BLL was in Manipal 30.6 (23.0, 46.7) and lowest in Dibrugarh 4.8 (3.2, 7.0). Overall, 82.5% of participants had BLL above ≤4 µg/dl. Significant negative correlation was observed between BLL and SES (correlation= -0.24, p <0.001), anthropometric indicators (correlation= -0.11, p <0.001), hemoglobin level (correlation= -0.045, p = 0.03) and multivariate regression model showed association with gender, SES and anthropometric indicators.

Conclusions

BLL are elevated in urban school going children and there is intercity variation. Hence, urgent focus is needed to reduce exposure to lead in India.

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Data Availability

All relevant data are within the manuscript.

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Funding

Hindustan Unilever Limited, through Grant Number: 212332, provided financial support to this study. The Hindustan Unilever Limited was not involved in design or implementation of study nor in collection and interpretation of data and manuscript writing.

Author information

Authors and Affiliations

  1. Department of Pediatrics, King George’s Medical University, Lucknow, Uttar Pradesh, India

    Divas Kumar, Shally Awasthi & Anuj Kumar Pandey

  2. Department of Biochemistry, King George’s Medical University, Lucknow, Uttar Pradesh, India

    Abbas Ali Mahdi

  3. Department of Psychiatry, King George’s Medical University, Lucknow, Uttar Pradesh, India

    Shweta Singh

  4. Department of Statistics, University of Lucknow, Lucknow, Uttar Pradesh, India

    Girdhar G. Agarwal

  5. Department of Community Medicine, Government Medical College, Thiruvananthapuram, Kerala, India

    Thekkumkara Surendran Anish

  6. Department of Pediatrics, M. S. Ramaiah Institute of Medical Sciences, Bangalore, Karnataka, India

    Somashekar A.R.

  7. Department of Community Medicine, Kalinga Institute of Medical Sciences, Bhubaneswar, Orissa, India

    Sonali Kar

  8. School of Public Health, DY Patil Deemed to be University, Navi Mumbai, Maharashtra, India

    Suma Nair

  9. Department of Pediatric Medicine, Post Graduate Institute of Medical Sciences, Chandigarh, India

    Joseph L. Mathew

  10. Department of Pediatrics, Sher-i-Kashmir Institute of Medical Sciences, Srinagar, Jammu & Kashmir, India

    Mushtaq A. Bhat

  11. Department of Medicine, Assam Medical College, Dibrugarh, Assam, India

    B. N. Mahanta

  12. Department of Pediatrics, All India Institute of Medical Sciences, Jodhpur, Rajasthan, India

    Kuldeep Singh

  13. Department of Community & Family Medicine, All India Institute of Medical Sciences, Patna, Bihar, India

    C. M. Singh

Authors
  1. Divas Kumar
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  2. Shally Awasthi
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  3. Abbas Ali Mahdi
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  4. Shweta Singh
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  6. Girdhar G. Agarwal
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  7. Thekkumkara Surendran Anish
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  8. Somashekar A.R.
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  9. Sonali Kar
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  11. Joseph L. Mathew
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  13. B. N. Mahanta
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  14. Kuldeep Singh
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  15. C. M. Singh
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Contributions

SA conceptualized the project and was the principal investigator, responsible for the supervision, implementation, data management, analysis and manuscript writing. DK contributed to study implementation, data management, analysis and manuscript writing. AAM contributed to biochemical analysis. AKP and GGA did data management, statistical analysis and manuscript writing. TSA, SAR, SK, SN, JLM, MAB, BNM, KS and CMS are site investigators and contributed in the study supervision and implementation at their respective sites. SS contributed to manuscript review. All authors read and approved the final manuscript. SA will act as guarantor for this manuscript.

Corresponding author

Correspondence to Shally Awasthi.

Ethics declarations

Ethical Approval and Consent

This study was conducted according to the guidelines laid down in the Declaration of Helsinki and all procedures involving human subjects/patients were approved by the Institutional Ethics Committees for Sher-i-Kashmir Institute of Medical Sciences [approval reference number (ARN): IEC/SKIMS Protocol # RP 175/2018], PGIMER, Chandigarh (ARN: PGI/IEC/2019/000152), All India Institute of Medical Sciences, Jodhpur (ARN: AIIMS/IEC/2017/765), King George's Medical University (ARN: 9334/Ethics/R.Cell-16), All India Institute of Medical Sciences, Patna (ARN: IEC/AIIMS/PAT/153/2017), Assam Medical College (ARN: AMC/EC/1430), Kalinga Institute of Medical Sciences, Bhubaneswar (ARN: KIMS/KIIT/IEC/112/2016), Kasturba Medical College (ARN: IEC:388/2019), MS Ramaiah Medical College and Hospital, Bangalore (ARN: MSRMC/EC/AP-02/02-2019) and Medical College, Thiruvananthapuram (ARN: HEC.No.04/34/2019/MCT). Written informed consent was obtained from parents of all study participants. The study was prospectively registered with Clinical Trial Registry of India. Registration number is: CTRI/2019/02/017783 [Clinical Trials Registry - India (CTRI)].

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Kumar, D., Awasthi, S., Mahdi, A.A. et al. Assessment of Blood Lead Level of School Children in 10 Cities of India: A Cross-Sectional Study. Indian J Pediatr (2023). https://doi.org/10.1007/s12098-023-04864-7

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