LEAD Action News

LEAD Action News Volume 7 No 4, 2000, ISSN 1324-6011
Incorporating Lead Aware Times ( ISSN 1440-4966) and Lead Advisory Service News ( ISSN 1440-0561)
The journal of The LEAD (Lead Education and Abatement Design) Group Inc.

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Indoor & Outdoor Dust & Soil Lead Levels

By: Thomas D. Matte, MD, MPH - Division of Environmental Hazards and Health Effects,
National Center for Environmental Health, Centers for Disease Control and Prevention, Atlanta, Georgia, USA.

The following is an extract of the June 23/30 Journal of the American Medical Association. Editorial - Reducing Blood Lead Levels - Benefits and Strategies [June 23/30 JAMA. 1999;281(24):2340-2342] AMA 1999 All rights reserved. http://jama.jamanetwork.com/article.aspx?articleid=190470

The study by Simon and Hudes [11] concerns …potential interventions to reduce the risk of lead toxic effects… An …unfortunate limitation of this study is the lack of data on the group of greatest interest—children younger than 6 years. Even though a beneficial effect of ascorbic acid supplements on lead levels is supported by a recent report from a small randomized trial in adult smokers, [15] more evidence from controlled intervention trials is needed to demonstrate the real value, if any, of increased ascorbic acid intake, especially in young children. Even if a nutritional manipulation is proven effective in reducing blood lead levels, reliance on such an intervention places most of the burden for prevention on those most affected and least responsible for the underlying environmental causes of lead toxicity. [16] Nutritional interventions, therefore, must never substitute for efforts to reduce lead exposure to safe levels. On the other hand, when used as an adjunct to environmental measures, some nutritional changes may prove to have benefits beyond any impact on lead toxicity. For example, studies have suggested benefits of higher ascorbic acid intake on blood pressure, [17] blood lipid profiles, [18] and respiratory symptoms. [19] What needs to be done to hasten the reduction of lead exposure, especially for the populations most affected? While existing efforts, such as screening and responding to lead-poisoned children, need to continue, it would seem reasonable to propose expanded activity on 2 fronts in particular. First, public and private efforts should be made to increase the testing and remediation of residential lead hazards from deteriorated paint and contaminated dust before children develop lead toxic effects. Interior dust lead measurements, available at relatively low cost, can now be used to help identify the most immediately hazardous dwellings, [20] and interventions are available to substantially reduce residential lead exposure. [21] The use of this relatively inexpensive test should be expanded, thus decreasing the reliance on elevated blood lead levels in children to identify hazardous home environments. Second, additional research is needed regarding the sources, fate, and remediation of contaminated exterior dust and soil, which can have major effects on blood lead levels. [20,22] Approximately 11% of pre-1980 homes are estimated to have soil lead concentrations exceeding 1000 ppm, [23] and lead levels in some urban communities may be comparable to those found in communities contaminated by smelting and mining operations. [20] Practical interventions and the resources to implement them in large urban areas are currently lacking.

Editorials represent the opinions of the authors and THE JOURNAL and not those of the American Medical Association. Reprints are not available from the author.

[Selected] References

11. Simon JA, Hudes ES. Relationship of ascorbic acid to blood lead levels. JAMA. 1999;281:2289-2293.
15. Dawson EB, Evans DR, Harris WA, Teter MC, McGanity WJ. The effect of ascorbic acid supplementation on the blood lead levels of smokers. J Am Coll Nutr. 1999;18:166-170.
16. Hu H, Kotha S, Brennan T. The role of nutrition in mitigating environmental insults: policy and ethical issues. Environ Health Perspect. 1995;103(suppl 6): 185-190.
17. Ness AR, Chee D, Elliott P. Vitamin C and blood pressure—an overview. J Hum Hypertens. 1997;11:343-350.
18. Simon JA, Hudes ES. Relation of serum ascorbic acid to serum lipids and lipoproteins in US adults. J Am Coll Nutr. 1998;17:250-255.
19. Schwartz J, Weiss ST. Dietary factors and their relation to respiratory symptoms: the Second National Health and Nutrition Examination Survey. Am J Epidemiol. 1990;132:67-76.
20. Lanphear BP, Matte TD, Rogers J, et al. The contribution of lead-contaminated house dust and residential soil to children's blood lead levels. Environ Res. 1998;79:51-68.
21. Farfel MR, Chisolm JJ Jr, Rohde CA. The longer-term effectiveness of residential lead paint abatement. Environ Res. 1994;66:217-221.
22. Bornschein RL, Succop P, Kraft KM, Clark CS, Peace B, Hammond PB. Exterior surface dust lead, interior house dust lead and childhood lead exposure in an urban environment. In: Hemphill DD, ed. Trace Substances in Environmental Health, XX: Proceedings of University of Missouri's 20th Annual Conference, June 1986. Columbia: University of Missouri; 1987:322-332.
23. Environmental Protection Agency. Distribution of Soil Lead in the Nation's Housing Stock. Washington, DC: Office of Pollution Prevention and Toxics. Environmental Protection Agency; 1996. Report No. EPA 747-R-96-003.

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