Abstract
Lead (Pb) is profoundly used heavy metal despite its known toxic effects. Children in particular are more susceptible to Pb toxicity. Thus, the present study was carried out to estimate the prevalence of lead toxicity in Indian children, to observe serum levels of biochemical parameters and to evaluate psychopathological implications of Pb toxicity using population specific scale—Childhood Psychopathological Measurement Schedule (CPMS) in children. Children between 9 and 15 years of age were included in the study (N = 70). Demographic details and information regarding the source of lead exposure were collected using a self-made questionnaire. All biochemical investigations were performed in Beckman Coulter Auto-analyser AU680 and Blood Lead Levels (BLL) were estimated by Graphite Furnace Atomic Absorption Spectrophotometer. The neurobehavioral state of the children was assessed by a population-specific scale i.e., CPMS, which evaluates for neurobehavior under 8 factors, titled, Low intelligence with behavioural problems, Conduct disorder, Anxiety, Depression, Psychotic symptoms, Special symptoms, Physical illness with emotional problems, and Somatization. The median BLL of the study population was 4.9 μg/dL. Habit of frequently consuming roadside food, proximity of residence to vehicular traffic and educational status of the mother were observed to be significant contributing factors for high BLL (≥ 5 μg/dL). Serum alkaline phosphatase (P = 0.02) and phosphorous levels (P = 0.04) were significantly lower in children belonging to high BLL group. A significantly high adverse neurobehavioral score was observed in high BLL group children compared to low BLL group (P < 0.05). There was high prevalence of Pb toxicity with 50% of children having BLL > 5 μg/dL. Further, certain lifestyle characteristics such as proximity of residence to vehicular traffic, frequent consumption of roadside food and lower educational status of the mother could be possible risk factors for higher Pb exposure in children. Evaluation of neurobehavior in children with high BLL revealed a high prevalence of adverse neurobehavior in them when compared to children in low BLL group.
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References
Mamtani R, Stern P, Dawood I, Cheema S. Metals and disease: a global primary health care perspective. J Toxicol. 2011. https://doi.org/10.1155/2011/319136.
Maria MPS, Hill BD, Kline J. Lead (Pb) neurotoxicology and cognition. Appl Neuropsychol Child. 2019;8:272–93. https://doi.org/10.1080/21622965.2018.1428803.
White BM, Bonilha HS, Ellis C. Racial/ethnic differences in childhood blood lead levels among children <72 months of age in the United States: a systematic review of the literature. J Racial Ethn Health Disparities. 2016;3:145–53. https://doi.org/10.1007/s40615-015-0124-9.
Mitra P, Sharma S, Purohit P, Sharma P. Clinical and molecular aspects of lead toxicity: an update. Crit Rev Clin Lab Sci. 2017;54:506–28. https://doi.org/10.1080/10408363.2017.1408562.
Mitra P, Goyal T, Singh P, Sharma S, Sharma P. Assessment of circulating miR-20b, miR-221, and miR-155 in occupationally lead-exposed workers of North-Western India. Environ Sci Pollut Res Int. 2021;28:3172–81. https://doi.org/10.1007/s11356-020-10676-5.
Bellinger DC, Stiles KM, Needleman HL. Low-level lead exposure, intelligence and academic achievement: a long-term follow-up study. Pediatrics. 1992;90:855–61.
Sharma P, Chambial S, Shukla KK. Lead and neurotoxicity. Indian J Clin Biochem. 2015;30:1–2. https://doi.org/10.1007/s12291-015-0480-6.
Malavika L, Mitra P, Goyal T, Sharma S, Purohit P, Sharma P. Association of blood lead levels with neurobehavior and BDNF expression in school going children. J Trace Elem Med Biol. 2021;66:126749. https://doi.org/10.1016/j.jtemb.2021.126749.
Mohan VR, Sharma S, Ramanujam K, Babji S, Koshy B, Bondu JD, et al. Effects of elevated blood lead levels in preschool children in urban Vellore. Indian Pediatr. 2014;51:621–5. https://doi.org/10.1007/s13312-014-0464-2.
Blood Lead Levels in Children Aged 1–5 Years — United States, 1999–2010 n.d. https://www.cdc.gov/mmwr/preview/mmwrhtml/mm6213a3.htm (accessed May 10, 2018).
Hrubá F, Strömberg U, Černá M, Chen C, Harari F, Harari R, et al. Blood cadmium, mercury, and lead in children: an international comparison of cities in six European countries, and China, Ecuador, and Morocco. Environ Int. 2012;41:29–34. https://doi.org/10.1016/j.envint.2011.12.001.
Lead poisoning and health n.d. https://www.who.int/news-room/fact-sheets/detail/lead-poisoning-and-health (accessed April 4, 2020).
Committee on Environmental Health. Lead exposure in children: prevention, detection, and management. Pediatrics. 2005;116:1036–46. https://doi.org/10.1542/peds.2005-1947.
Goyal T, Mitra P, Singh P, Sharma S, Sharma P. Assessement of blood lead and cadmium levels in occupationally exposed workers of Jodhpur, Rajasthan. Indian J Clin Biochem. 2020. https://doi.org/10.1007/s12291-020-00878-6.
ATSDR - Toxicological Profile: Lead n.d. https://www.atsdr.cdc.gov/toxprofiles/tp.asp?id=96&tid=22 (accessed July 15, 2020).
Levander OA. Lead toxicity and nutritional deficiencies. Environ Health Perspect. 1979;29:115–25. https://doi.org/10.1289/ehp.7929115.
Staudinger KC, Roth VS. Occupational lead poisoning. Am Fam Phys. 1998;57:719.
Chambial S, Shukla KK, Dwivedi S, Bhardwaj P, Sharma P. Blood Lead Level (BLL) in the adult population of Jodhpur: a pilot study. Indian J Clin Biochem IJCB. 2015;30:357–9. https://doi.org/10.1007/s12291-015-0496-y.
Muntner P, Menke A, DeSalvo KB, Rabito FA, Batuman V. Continued decline in blood lead levels among adults in the United States: the national health and nutrition examination surveys. Arch Intern Med. 2005;165:2155–61. https://doi.org/10.1001/archinte.165.18.2155.
Malhotra S, Varma VK, Verma SK, Malhotra A. Childhood psychopathology meausrement schedule: development and standardization. Indian J Psychiatry. 1988;30:325–31.
Fewtrell LJ, Prüss-Ustün A, Landrigan P, Ayuso-Mateos JL. Estimating the global burden of disease of mild mental retardation and cardiovascular diseases from environmental lead exposure. Environ Res. 2004;94:120–33. https://doi.org/10.1016/s0013-9351(03)00132-4.
Kalra V, Sahu JK, Bedi P, Pandey RM. Blood lead levels among school children after phasing-out of leaded petrol in Delhi. India. Indian J Pediatr. 2013;80:636–40. https://doi.org/10.1007/s12098-013-0999-6.
Jain NB, Hu H. Childhood correlates of blood lead levels in Mumbai and Delhi. Environ Health Perspect. 2006;114:466–70. https://doi.org/10.1289/ehp.8399.
Johnson et al. - ADVISORS Prof. (Dr.) H. B. Mathur Prof. (Dr.) H. C.pdf n.d.
Pounds JG, Long GJ, Rosen JF. Cellular and molecular toxicity of lead in bone. Environ Health Perspect. 1991;91:17–32. https://doi.org/10.1289/ehp.919117.
Dobrakowski M, Boroń M, Birkner E, Kasperczyk A, Chwalińska E, Lisowska G, et al. The effect of a short-term exposure to lead on the levels of essential metal ions, selected proteins related to them, and oxidative stress parameters in humans. Oxid Med Cell Longev. 2017;2017:1–9. https://doi.org/10.1155/2017/8763793.
Quintanar-Escorza MA, González-Martínez MT, Navarro L, Maldonado M, Arévalo B, Calderón-Salinas JV. Intracellular free calcium concentration and calcium transport in human erythrocytes of lead-exposed workers. Toxicol Appl Pharmacol. 2007;220:1–8. https://doi.org/10.1016/j.taap.2006.10.016.
Quintanar-Escorza MA, González-Martínez MT, del Pilar I-OM, Calderón-Salinas JV. Oxidative damage increases intracellular free calcium [Ca2+]i concentration in human erythrocytes incubated with lead. Toxicol In Vitro. 2010;24:1338–46. https://doi.org/10.1016/j.tiv.2010.05.002.
Nicolescu R, Petcu C, Cordeanu A, Fabritius K, Schlumpf M, Krebs R, et al. Environmental exposure to lead, but not other neurotoxic metals, relates to core elements of ADHD in Romanian children: performance and questionnaire data. Environ Res. 2010;110:476–83. https://doi.org/10.1016/j.envres.2010.04.002.
Surkan PJ, Zhang A, Trachtenberg F, Daniel DB, McKinlay S, Bellinger DC. Neuropsychological function in children with blood lead levels < 10 μg/dL. Neurotoxicology. 2007;28:1170–7. https://doi.org/10.1016/j.neuro.2007.07.007.
Mazumdar M, Bellinger DC, Gregas M, Abanilla K, Bacic J, Needleman HL. Low-level environmental lead exposure in childhood and adult intellectual function: a follow-up study. Environ Health Glob Access Sci Source. 2011;10:24. https://doi.org/10.1186/1476-069X-10-24.
Roy A, Bellinger D, Hu H, Schwartz J, Ettinger AS, Wright RO, et al. Lead exposure and behavior among young children in Chennai. India Environ Health Perspect. 2009;117:1607–11. https://doi.org/10.1289/ehp.0900625.
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The study was funded by the All India Institute of Medical Sciences, Jodhpur, Rajasthan.
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This study involves the participation of human subjects with the approval from the Institutional Ethical Committee (IEC), All India Institute of Medical Sciences, Jodhpur, Rajasthan India. (AIIMS/IEC/2018/640). The study was performed in accordance with down in the 1964 Declaration of Helsinki and its later amendments or comparable ethical standards.
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Malavika, L., Goyal, T., Mitra, P. et al. Risk Factors for Lead Toxicity and its Effect on Neurobehavior in Indian Children. Ind J Clin Biochem 37, 294–302 (2022). https://doi.org/10.1007/s12291-021-00995-w
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DOI: https://doi.org/10.1007/s12291-021-00995-w