LEAD Action News
LEAD Action News Volume 12 Number 3, May 2012, ISSN 1324-6011
Incorporating Lead Aware Times ( ISSN 1440-4966) and Lead Advisory Service News (ISSN 1440-0561)
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Info Pack – Reproductive Health and Lead

By Elizabeth O'Brien, BSc, Grad Dip in Educational Studies (Health Educ’n), Manager, Global Lead Advice & Support Service (GLASS) run by The LEAD Group Inc. Australia

The Hertz-Picciotto 2000 (see below) article about miscarriage concludes that “lead exposures in the range of 10-25 µg/dL could have adverse effects on pregnancy” and “the odds ratio for spontaneous abortion was 1.8 (95% confidence interval 1.1-3.1) for every 5 µg/dL increase in blood lead”.

Another Mexican lead and miscarriage study found that “Maternal blood lead levels during the first 12 weeks of gestation were associated with spontaneous abortion.” (Borja-Aburto 1999)

Our volunteer researcher Robert Taylor is going to start on an article about mothers passing lead to their unborn babies, after he completes another article he’s researching (on leaded aviation fuel) and since he has written “Fact Sheet: Alcohol’s link to higher lead and iron levels” at Alcohol_link_to_higher_lead_and_iron_levels_20110831.pdf and “Fact

Sheet: Cigarette Smoking & Lead Toxicity” at Taylor_Cigarette_Smoking_and_Lead_20101005.pdf.

The National Toxicology Program (NTP), US Department of Health and Human Services (DHHS) has published a NTP MONOGRAPH ON HEALTH EFFECTS OF LOW-LEVEL LEAD June 13, 2012 including: APPENDIX E: HUMAN STUDIES OF REPRODUCTIVE AND DEVELOPMENTAL EFFECTS OF LEAD CONSIDERED IN DEVELOPING CONCLUSIONS. http://ntp.niehs.nih.gov/?objectid=4F04B8EA-B187-9EF2-9F9413C68E76458E 

Health Effects of Low-level Lead Evaluation

  • NTP Monograph on Health Effects of Low-level Lead (June 2012)

It’s a crying shame that all these topics are not part of medical training or Continuing Medical Education, and the health department don’t seem to make any effort to educate doctors about lead and reproductive effects or lead exposure in general.

No Australian state health department has ever to my knowledge had a policy on the target blood lead level to be reached prior to attempting conception or during the pregnancy.

Until a state or national Australian policy can be developed, a very useful document from the US is: "Medical Management Guidelines for Lead-Exposed Adults" at www.aoec.org/documents/positions/MMG_FINAL.pdf

You will see that on page 8 of the US Guidelines, the target blood lead level (BLL) for a woman (and presumably also for a man) wishing to conceive is given as 0.24 micromoles per litre (µmol/L) which is equivalent to 5 micrograms per decilitre (5 µg/dL):

"Because fetal blood contains approximately 80% of the blood lead concentration of the mother, and because of the risk of spontaneous abortion, the panel’s recommendation is that the mother’s BLL should be kept below 5 µg/dL (0.24 µmol/L) from the time of conception through pregnancy."

The US Guidelines have other useful recommendations and are well worth a read by a couple wishing to conceive or already pregnant, and by their doctors.

It is my understanding that Medicare will cover the cost of up to 4 blood lead tests in any 6 month period so if you have a result which exceeds the target blood lead level, you can have the first retest as soon as lead sources have been eradicated and nutrition attended to, then you will know how close you are to the target blood lead level.

Calcium, iron and zinc are recommended for couples wishing to conceive and for pregnant women although the doctor would likely want to order iron studies before recommending an iron supplement. See the articles in our Nutrition Info Pack (following) for further details.

The components of our Info Pack 6 on Reproductive Health and Lead which are available in electronic format are as follows:

www.lead.org.au/lanv4n3/lanv4n3-13.html - This article is useful but it states: "Both partners should aim to have their blood lead levels below normal (readings of 5 micrograms per decilitre (5 µg/dL) or 0.24 micromoles per litre (0.24 µmol/L)) prior to conception" and no study has been done in Australia indicating what exactly "normal levels" are. In the USA, the most recent in a series of large-scale national blood lead surveys found a geometric mean blood lead level for women aged between 20 and 59 of 1.7 micrograms per decilitre and for men in the same age range, the mean was 2.9 µg/dL. [Reference: Table 2 in "Blood Lead Levels --- United States, 1999--2002 [NHANES IV] at www.cdc.gov/mmwr/preview/mmwrhtml/mm5420a5.htm ] www.lead.org.au/lanv5n3/lan5n3-5.html - "Lead and pregnancy" published in Lead Action News LANV5N3 p 5. www.lead.org.au/lanv6n2/update005.html - "Pregnant or Planning a Pregnancy?"

www.lead.org.au/lanv6n2/update002.html - "Breastfeeding And Lead - What do Mothers Need to Know?"

"Declining Sexual Health - a victim of modern day diets and lifestyles" by Janette Roberts [The Foresight Association, Australian Branch, AND Balmain Wellness Centre], at http://www.articleslog.com/2008/01/16/90764-declining-sexual-health--a-victim-of-modern-day-diets-and-lifestyles.html

"Preconception Care: What can our preconception plan do for you?" by Lane Cove Wellness Centre, at http://www.naturaltherapypages.com.au/connect/wellnesscentre/preconception_care/lane_cove_wellness_centre_pharmacy_preconception_care

“The evidence that lead increases the risk for spontaneous abortion” by Irva Hertz-Picciotto, published in AMERICAN JOURNAL OF INDUSTRIAL MEDICINE 38:300±309 (2000), AVAILABLE FOR PURCHASE AT http://onlinelibrary.wiley.com/doi/10.1002/1097-0274(200009)38:3%3C300::AID-AJIM9%3E3.0.CO;2-C/abstract

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