Keywords
sources
lead
soils
primary care
How to Cite
Abstract
The aim of this study is to describe the blood lead levels (BLLs) of the population living in informal settlements with soil lead levels above 400 mg/kg. This is a retrospective study of the visits people living in such informal settlements made to the UPA between 2011 and 2018. The population under study was a convenience sample including children up to 15 years of age and pregnant women who went to primary care centers on their own accord. Their BLLs were analyzed by differential pulse anodic stripping voltametry (DPASV) using a Lead Care II® Blood Analyzer. BLLs above 5 μg/dl were then confirmed by atomic absorption spectrometry (AAS). 606 individuals from 7 informal settlements (6 in Montevideo and 1 in Canelones) were seen during this period of time: 530 (87.4 %) were under 15 years of age, and 76 (12.6 %) older than 15, 2 of which (0.3 %) were pregnant women and 74 (12.3 %) relatives of the children. 32% (n = 194) of the patients had BLLs above 5 μg/dL, and of these, 54% (n = 106) were children under five. Of those cases with BLLs above 10 μg/dl (n = 55), 52 % (n = 29) were children under five. Contaminated soils are relevant points of exposure. According to the American Pediatrics Academy (AAP), children with BLLs above 5 μg/dL require more exposure and surveillance studies. Therefore, intersectoral interaction with the primary care network is a key tool for determining which communities are at risk and hence prioritize interventions.References
American Academy of Pediatrics (AAP). Prevention of Childhood Lead Toxicity. COUNCIL ON ENVIRONMENTAL HEALTH. Pediatrics. 2016; 138(1):e20161493. DOI: https://doi.org/10.1542/peds.2016- 1493.
World Health Organization (WHO). Childhood Lead Poisoning - 2010. [citado el 27 de enero de 2020] Disponible en: https://www.who. int/ceh/publications/leadguidance.pdf.
Agency for Toxic Substances and Disease Registry (ATSDR). 2020. Toxicological profile for Lead. Atlanta, GA: U.S. Department of Health and Human Services, Public Health Service. [citado el 22 de octubre de 2020] Disponible en: http://www.atsdr.cdc.gov/ toxprofiles/tp13.pdf.
Burger M, Pose D. Plomo, Salud y Ambiente. Experiencia en Uruguay. Universidad de la República, Uruguay. Organización Panamericana de la Salud/ Organización Mundial de la Salud. Montevide, 2010. [citado el 27 de enero de 2020] Disponible en: https://www.paho.org/uru/index.php?option=com_ docman&view=download&category_slug=publicaciones-salud- y-ambiente&alias=31-plomo-salud-y-ambiente-experiencia-en- uruguay&Itemid=307.
Mañay N, Cousillas AZ, Alvarez C, Heller T. Lead contamination in Uruguay: the “La Teja” neighborhood case. Rev Environ Contam Toxicol. 2008;195:93-115.
Cousillas A, Mañay N, Pereira L, Alvarez C, Coppes Z. Evaluation of lead exposure in Uruguayan children. Bull Environ Contam Toxicol. 2005; 75: 629–36.
Ley No 17775 Prevención de la contaminación por plomo 2004 - No 26512. [citado el 12 de diciembre de 2020] Disponible en: https://legislativo.parlamento.gub.uy/temporales/ leytemp3080940.htm.
Ordenanza 123 MSP/2009. [citado el 12 de diciembre de 2020] Disponible en: http://www.ciat.hc.edu.uy/images/stories/ materiales/resolucion007plomo_msp_1.pdf.
World Health Organization. WHO Children’s Environmental Health Units. [citado el 27 de enero de 2020] Disponible en: http://www.who.int/ceh/publications/childrensunit.pdf.
Laborde A. Clinical Practice of Environmental Pediatrics around the World. En Landrigan P, Etzel R. Textbook of Children’s Environmental Health. Oxford University Press 2013.
Moll MJ, Laborde A. Briefing on Children Environmental Health in Uruguay. En: Nriagu, J. (Ed.) Encyclopedia of Environmental Health vol. 1. Elsevier. 2019. pp. 460–4.
Intendencia de Montevideo. Servicio de Control de la Calidad Ambiental. [citado el 12 de diciembre de 2019] Disponible en: https://montevideo.gub.uy/institucional/noticias/fue-eliminada- contaminacion-en-10-asentamientos-0.
Programa de Mejoramiento de barrios (PMB). Ministerio de Vivienda Ordenamiento Territorial y Medio Ambiente (MVOTMA) [citado el 12 de diciembre de 2019] Disponible en: http://pmb.mvotma.gub.uy/noticias/los-vecinos-de-lavalleja- aprobaron-proyecto-integral-de-mejoramiento-del-barrio. http://www.mvotma.gub.uy/component/finder/search?q=plomo& Itemid=1014&b28b8241e720772e9caef6e063b5e063=.
Mielke H, Gonzales CR, Powell E, Jartun M, Mielke Jr P. Nonlinear association between soil lead and blood lead of children in metropolitan New Orleans, Louisiana: 2000–2005. Sci Total Environ. 2007; 388 (1-3):43–53.
Advisory Committee on Childhood Lead Poisoning Prevention (ACCLP). Low Level Lead Exposure Harms Children: A Renewed Call for Primary Prevention. Centers for Disease Control and Prevention. January 4, 2012. [citado el 29 de febrero de 2020] Disponible en: https://www.cdc.gov/nceh/lead/acclpp/Final_ Document_030712.pdf.
Wang A, Rezania Z, Haugen KMB, Baertlein L, Yendel SJ. Screening for Elevated Blood Lead Levels: False-Positive Rates of Tests on Capillary Samples, Minnesota, 2011-2017. J Public Health Manag Pract. 2019; 25:44-50.
American Academy of Pediatrics (AAP). Prevention of Childhood Lead Toxicity. Erratum. Council On Environmental Health. Pediatrics. 2017;14(2).
Pascale A, Sosa A, Bares C, Battocletti A, Moll MJ, Pose D, et al. E-Waste Informal Recycling: An Emerging Source of Lead Exposure in South America. Ann Glob Health. 2016; 82(1):197–201.
Huo X, Peng L, Xu X, Zheng L, Qiu B, Qi Z, et al. Elevated Blood Lead Levels of Children in Guiyu, an Electronic Waste Recycling Town in China. Environ Health Perspect. 2007 Jul; 115(7): 1113–7.
Heacock M, Kelly CB, Asante KA, Birnbaum LS, Bergman AL, Bruné MN, et al. E-waste and harm to vulnerable populations: a growing global problem. Environ Health Perspect. 2016; 124:550–5.
Arain AL, Neitzel R. A Review of Biomarkers Used for Assessing Human Exposure to Metals from E-Waste. Int. J. Environ. Res. Public Health. 2019; 16:1802.
Caravanos J, Carrelli J, Dowling R, Pavilonis B, Ericson B, Fuller R. Burden of disease resulting from lead exposure at toxic waste sites in Argentina, Mexico and Uruguay. Environ Health. 2016; 15:72.
Laborde A, Tomasina F, Bianchi F, Bruné MN, Buka I, Comba P, et al. Children’s Health in Latin America: the influence of environmental exposures. Environ. Health Perspect. 2015; 123:201–9.
The articles published in this journal are subject to the following terms and conditions:
- The journal retains copyright of the articles published, and encourages and permits their reuse under the licence indicated at point 2.
- The articles are published in the online edition of the journal under licence Creative Commons Attribution-Non Commercial 4.0 (CC BY-NC 4.0). They can be copied, used, disseminated, transmitted, and publicly displayed, providing that the authorship, URL address and the Journal are cited, and that no commercial use is made of them.
- The authors agree with terms of licence use of the journal, with the self-archiving conditions and with the open access policy.
- In the event of reuse of the articles published, the existence and specifications of the terms of licence use must be mentioned, in addition to citing the authorship and original source of the their publication.