Éditeur(s) : HAL CCSD MDPI
Résumé : International audience
The decline in children's Blood Lead Levels (BLL) raises questions about the ability of current lead poisoning screening criteria to identify those children most exposed. The objectives of the study were to evaluate the performance of current screening criteria in identifying children with blood lead levels higher than 50 µg/L in France, and to propose new criteria. Data from a national French survey, conducted among 3831 children aged 6 months to 6 years in 2008-2009 were used. The sensitivity and specificity of the current criteria in predicting blood lead levels higher than or equal to 50 µg/L were evaluated. Two predictive models of BLL above 44 µg/L (for lack of sufficient sample size at 50 µg/L) were built: the first using current criteria, and the second using newly identified risk factors. For each model, performance was studied by calculating the area under the ROC (Receiver Operating Characteristic) curve. The sensitivity of current criteria for detecting BLL higher than or equal to 50 µg/L was 0.51 (0.26; 0.75) and specificity was 0.66 (0.62; 0.70). The new model included the following criteria: foreign child newly arrived in France, mother born abroad, consumption of tap water in the presence of lead pipes, pre-1949 housing, period of construction of housing unknown, presence of peeling paint, parental smoking at home, occupancy rates for housing and child's address in a cadastral municipality or census block comprising more than 6% of housing that is potentially unfit and built pre-1949. The area under the ROC curve was 0.86 for the new model, versus 0.76 for the current one. The lead poisoning screening criteria should be updated. The risk of industrial, occupational and hobby-related exposure could not be assessed in this study, but should be kept as screening criteria
ISSN: 1660-4601

hal-01239804
https://hal-univ-rennes1.archives-ouvertes.fr/hal-01239804
DOI : 10.3390/ijerph121214989
PUBMED : 26633457

Éditeur(s) : HAL CCSD Elsevier
Résumé : International audience
Background: Blood Lead Levels (BLLs) have substantially decreased in recent decades in children in France. However, further reducing exposure is a public health goal because there is no clear toxicological threshold. The identification of the environmental determinants of BLLs as well as risk factors associated with high BLLs is important to update prevention strategies. We aimed to estimate the contribution of environmental sources of lead to different BLLs in children in France.Methods: We enrolled 484 children aged from 6 months to 6 years, in a nationwide cross-sectional survey in 2008-2009. We measured lead concentrations in blood and environmental samples (water, soils, household settled dusts, paints, cosmetics and traditional cookware). We performed two models: a multivariate generalized additive model on the geometric mean (GM), and a quantile regression model on the 10th, 25th, 50th, 75th and 90th quantile of BLLs. Results: The GM of BLLs was 13.8 μg/L (=1.38 µg/dL) (95% Confidence Intervals (CI): 12.7-14.9) and the 90th quantile was 25.7 μg/L (CI: 24.2-29.5). Household and common area dust, tap water, interior paint, ceramic cookware, traditional cosmetics, playground soil and dust, and environmental tobacco smoke were associated with the GM of BLLs. Household dust and tap water made the largest contributions to both the GM and the 90th quantile of BLLs. The concentration of lead in dust was positively correlated with all quantiles of BLLs even at low concentrations. Lead concentrations in tap water above 5 µg/L were also positively correlated with the GM, 75th and 90th quantiles of BLLs in children drinking tap water.Conclusions: Preventative actions must target household settled dust and tap water to reduce the BLLs of children in France. The use of traditional cosmetics should be avoided whereas ceramic cookware should be limited to decorative purposes.
ISSN: 0160-4120

Droits : info:eu-repo/semantics/OpenAccess
hal-01099719
https://hal.archives-ouvertes.fr/hal-01099719
https://hal.archives-ouvertes.fr/hal-01099719/document
https://hal.archives-ouvertes.fr/hal-01099719/file/Manuscript_Etchevers_EI_V3_no%20%20changes%20marked.pdf
DOI : 10.1016/j.envint.2014.10.007