P. Bruaux

Exposure To Lead By the Oral and the Pulmonary Routes of Children Living in the Vicinity of a Primary Lead Smelter

Abstract Yearly from 1974 to 1978, a medical survey was carried out among 11-year-old children attending schools situated less than 1 and 2.5 km from a lead smelter. Age-matched control children from a rural and urban area were examined at the same time. The blood lead levels (PbB) of the children living in the smelter area (mainly those attending schools located less than 1 km from the smelter) were higher than those of rural and urban children. The mean PbB levels were usually lower in girls than in boys, especially in the smelter area. Despite a slightly decreasing trend in the annual mean airborne lead concentration at less than 1 km (mean PbA: from 3.8 μg/m3 in 1974 to 2.3 μg/m3 in 1978) the PbB levels there did not improve, whereas 2.5 km from the plant a significant tendency to normalization of PbB became apparent. Therefore, in the third survey, the medical examination was combined with an environmental study which demonstrated that lead in school-playground dust and in air strongly correlated. Lead on the childrens hands (PbH) was also significantly related to lead in air or lead in dust. Less than 1 km from the factory boys and girls had on the average 436 and 244 μg Pb/hand, respectively, vs 17.0 and 11.4 μg Pb/hand for rural boys and girls, respectively. Partial correlations between PbB, PbA, and PbH indicated that in the smelter area the quantitative contribution of PbA to the childrens PbB is negligible compared to that of PbH. Thus, the control of airborne lead around the lead smelter is not sufficient to prevent excessive exposure of children to environmental lead. In view of the importance of lead transfer from dust and dirt via hands to the gastrointestinal tract remedial actions should be directed simultaneously against the atmospheric emission of lead by the smelter and against the lead particulates deposited on soil, dust, and dirt.

Lowering time trend of blood lead levels in Belgium since 1978

Since 1978, the biological screening of the Belgian population was regularly monitored by measuring blood lead levels. Over 11 years, 6070 samples were analyzed in urban, rural, and industrial areas. The median values of blood lead concentration dropped from 170 to 78 micrograms/liter of blood, i.e., a lowering of about 55%. The trend persists when taking into account some individual characteristics which influence blood lead levels such as gender, age, tobacco, and areas. These influences and the possible environmental causes of the observed trend are discussed.

Lead and cadmium absorption among children near a nonferrous metal plant: A follow-up study of a test case

Abstract During a first survey (1974) increased lead absorption accompanied by impaired heme biosynthesis was found among children (11 yr) attending schools situated at less than 1 km (subgroup A) and 2.5 km (subgroup B) from a lead smelter. Eighteen months after major improvements had been introduced in the factory to reduce its lead emission, a second survey (1976) was carried out in the same schools (lead smelter and rural area) on other groups of children which were comparable with those of the first survey. The continuous air monitoring revealed for the lead smelter area a considerable decrease in airborne lead. The median values dropped from 3.2 to 1.2 μg Pb/m3 at less than 1 km and from 1.6 to 0.5–0.8 μg Pb/m3 at 1.5 km from the plant; in the rural area it remained unchanged at 0.3 μg Pb/m3. In order to evaluate the efficiency of the technological improvements we assessed the lead and cadmium exposure of the children by measuring lead concentration in blood (PbB) and urine (PbU), erythrocyte δ-aminolevulinic acid dehydratase (ALAD) activity, free erythrocyte porphyrin (FEP) concentration, δ-aminolevulinic acid excretion in urine (ALAU), and cadmium concentration in blood (CdB) and urine (CdU). Subgroups A and B exhibited higher PbB and CdU levels, and lower ALAD activity than the rural group; but PbU, CdB, FEP, and ALAD were significantly increased only in subgroup A. Compared with the results of the first survey, a significant tendency to a normalization of PbB was found at 2.5 km, but at less than 1 km the biological parameters (particularly PbB, ALAD, FEP) did not improve. The PbB percentile distribution in subgroup B lies now under the tentative PbB percentile distribution proposed in the PbB Directive of the Commission of the European Communities (CEC): that of subgroup A, however, is still above that of the CEC proposal. Taking into account the higher degree of vulnerability to lead exposure as compared to adults a more restrictive PbB percentile distribution has been proposed for children. Two hypotheses have been put forward to explain the lack of significant improvements in the biological parameters of the children living at less than 1 km from the lead smelter. Ingestion of dust and dirt (probably due to hand contamination) from their surroundings in the course of their normal everyday activity may represent, in addition to air, a supplementary cause of increased lead accumulation in these children. Indeed, dust and dirt samples collected on the school playgrounds at less than 1 km from the factory contained (mean ± SD) 3541 ± 1310 and 5466 ± 831 μg Pb/g, whereas at 2.5 km and in the rural area it only amounted to 397 ± 33 and 152 ± 41 μg Pb/g, respectively. The alternative explanation is that a continuous resuspension of dust and dirt particles from the highly contaminated soil around the lead smelter may maintain a very high airborne lead concentration at the breathing height of the children. In addition to a lasting reduction of lead emission from the plant, the remedial actions should also take into consideration these two possibilities.

Impact of Environmental Cadmium Pollution on Cadmium Exposure and Body Burden

The body burden of cadmium, as estimated from 24-h urine cadmium levels, was determined in 1,523 subjects who were not occupationally exposed and who lived in five areas of Belgium. Urinary cadmium levels differed significantly with place of residence. These differences persisted after standardization for the other significant determinants (i.e., age, body mass index, smoking habits, social class, alcohol consumption, and menopause). The highest 24-h urine cadmium levels were found in subjects who lived in areas that contained cadmium-polluted soils. The body burden overload has been attributed mainly to the consumption of locally grown vegetables and the use of contaminated well water for cooking and drinking. Blood cadmium levels were also dependent on place of residence. However, the geographical differences in blood cadmium did not parallel those of urine cadmium. Blood cadmium is more influenced by recent exposure; therefore, this latter observation might reflect the recent implementation of preventive measures in some areas.

Repeated surveillance of exposure to cadmium, manganese, and arsenic in school-age children living in rural, urban, and nonferrous smelter areas in Belgium

Abstract Once a year from 1974 to 1978, the intensity of exposure to Cd, As, Mn in groups of school-age children living around a lead smelter was assessed. By comparison, groups of children living in an urban and a rural area were also examined. The metal content of blood, urine, hand-rinsing, air, dust, and dirt collected in the school-playground was compared. The urinary excretion of cadmium in children living around the lead smelter is greater than in those living in the urban and in the rural area. In the latter there seems to exist a time-dependent trend in the renal accumulation of cadmium. This suggests that the overall pollution of the environment by cadmium in Belgium is progressively increasing. In the smelter area, both the oral and pulmonary routes play a role in the childrens exposure to cadmium. Their relative contribution to the amount of cadmium absorbed appears similar. The concentration of arsenic in urine of children living around the smelter is significantly higher than that of rural children. Speciation of the chemical forms of arsenic in urine indicates that the difference is not due to different dietary habits of the children examined but to different intensity of exposure to inorganic arsenic. The amount of arsenic on the hand of children living at less than 1 km from the smelter (X = 17.6 μg As/hand) was more than 10 times that found in children living at 2.5 km from the plant (X = 1.5 μg As/hand) whereas that found in children living in urban and rural areas was below 0.2 μg As/hand. The arsenic concentration of dust and dirt collected in the school-playground in the different areas follows the same trend. As expected, there are strong interrelationships between the degree of hand contamination by lead, cadmium, and arsenic (r ⩾ 0.8). No statistically significant influence of the dwelling place of the children on the manganese level in blood, urine, and hand rinsing was found. Our results demonstrate that by comparison with the rural and urban children, those living in the vicinity of a nonferrous smelter may be more exposed not only to lead, but also to cadmium and arsenic. The possible long-term effects of such exposure deserve further evaluation.

Effects of exposure to cadmium on calcium metabolism: a population study.

The objective was to investigate the hypothesis that environmental exposure to cadmium may affect calcium metabolism in the population at large. The 1987 participants (965 men and 1022 women), from 20 to 80 years old, constituted a random sample of the population of four Belgian districts. The urinary excretion of cadmium, a measure of lifetime exposure, averaged 9.3 nmol/24 h in men (range 0.4-324 nmol/24 h) and 7.1 nmol/24 h (range 0.1-71 nmol/24 h) in women. Serum alkaline phosphatase activity and the urinary excretion of calcium correlated significantly and positively with urinary cadmium excretion in both men and women, and serum total calcium concentration negatively with urinary cadmium excretion in men only. The regression coefficients obtained after adjustment for significant covariates indicated that when urinary cadmium excretion increased twofold, serum alkaline phosphatase activity and urinary calcium excretion rose by 3-4% and 0.25 mmol/24 h respectively, whereas in men serum total calcium concentration fell by 6 mumol/l. After adjustment for significant covariates the relation between serum total calcium concentration and urinary cadmium excretion was not significant in women. The findings suggest that even at environmental exposure levels calcium metabolism is gradually affected, as cadmium accumulates in the body. The morbidity associated with this phenomenon in industrialised countries remains presently unknown and requires further investigation.

Environmental pollution by cadmium and cadmium body burden: an autopsy study.

The industrial area of Liège in Belgium is polluted by cadmium mainly because of past emission from non-ferrous metal industries. Persons who have lived in that area have accumulated significantly more cadmium in the renal cortex and in the liver than those who have resided in other regions of the country.

Determinants of serum zinc in a random population sample of four Belgian towns with different degrees of environmental exposure to cadmium

This report investigated the distribution of serum zinc and the factors determining serum zinc concentration in a large random population sample. The 1977 participants (959 men and 1018 women), 20–80 years old, constituted a stratified random sample of the population of four Belgian districts, representing two areas with low and two with high environmental exposure to cadmium. For each exposure level, a rural and an urban area were selected. The serum concentration of zinc, frequently used as an index for zinc status in human subjects, was higher in men (13.1 μmole/L, range 6.5–23.0 μmole/L) than in women (12.6 μmole/L, range 6.3–23.2 μmole/L). In men, 20% of the variance of serum zinc was explained by age (linear and squared term, R = 0.29), diurnal variation (r = 0.29), and total cholesterol (r = 0.16). After adjustment for these covariates, a negative relationship was observed between serum zinc and both blood (r = −0.10) and urinary cadmium (r = −0.14). In women, 11% of the variance could be explained by age (linear and squared term, R = 0.15), diurnal variation in serum zinc (r = 0.27), creatinine clearance (r = −0.11), log γ-glutamyltranspeptidase (r = 0.08), cholesterol (r = 0.07), contraceptive pill intake (r = −0.07), and log serum ferritin (r = 0.06). Before and after adjustment for significant covariates, serum zinc was, on average, lowest in the two districts where the body burden of cadmium, as assessed by urinary cadmium excretion, was highest. These results were not altered when subjects exposed to heavy metals at work were excluded from analysis.

Does environmental exposure to cadmium represent a health risk? Conclusions from the Cadmibel Study

Cadmium is a very dispersive pollutant which has progressively accumulated in the environment mainly in the areas where nonferrous smelters have been in operation. An important toxicological feature of cadmium is its exceptionally long biological half-life in the human body. For the general population mainly exposed to cadmium by the diet and smoking, the kidney is the main target organ. Some studies have also suggested that cadmium might play a role in the pathogenesis of hypertension. A cross-sectional study (called Cadmibel) was undertaken to assess whether environmental pollution by cadmium in Belgium might represent a health risk. This paper does not present the detailed results of this study which are published elsewhere but simply report its main conclusions. A total number of 2327 subjects (stratified according to age and sex) was randomly sampled in two urban (Liège and Charleroi) and two rural (Hechtel-Eksel and Noorderkempen) areas, with different environmental pollution by cadmium. After allowing for the various factors known to influence cadmium accumulation, it was estimated that the cadmium body burden of the residents of the most polluted district (Noorderkempen) was 50 to 85% higher than in the less polluted areas. No statistical association was found between environmental exposure to cadmium and blood pressure elevation or the prevalence of cardiovascular diseases. However, the study has shown that the environmental exposure of the general population to cadmium may induce slight renal tubular dysfunction and may probably also affect cadmium homeostasis. The probability of tubular dysfunction (as assessed by sensitive tests) is about 10% when cadmium in urine reaches 2 micrograms/day. The morbidity associated with the changes in the renal proximal tubule and the calcium metabolism observed when the body burden of cadmium exceeds this value remains to be assessed.

Lead Neurotoxicity in Clinically Asymptomatic Children Living in the Vicinity of an Ore Smelter

(1981). Lead Neurotoxicity in Clinically Asymptomatic Children Living in the Vicinity of an Ore Smelter. Clinical Toxicology: Vol. 18, No. 11, pp. 1257-1267.