Investigating lead exposure in children in Copsa Mica, Romania, 2000--2010, spatial and temporal influences on exposure.

摘要

Background. There is overwhelming evidence that lead exposure in children is a significant global health problem. Copsa Mica, a typical northwestern Romanian village, is indicative of the burden many areas face with historical lead contamination. Starting in the late 1990s, local health authorities identified a significant lead exposure hazard to local children caused by a primary smelter that exceeded the recognized CDC, EPA, EU and WHO guidelines. Partnered with international organizations, health authorities, and local industry, the community has put forth a serious effort aimed at environmental remediation and reducing exposure. It has been ten years since the interventions began and the children's exposure remains uncertain.;Objective. Examine the trends of child lead exposure in Copsa Mica from 2000 to 2010 looking at temporal and spatial dynamics of common exposure variables such as hand washing and outdoor play.;Methods. Questionnaires were administered to study subjects. Soil and dust samples along with geographic coordinate data were collected in situ at play sites. Samples were analyzed for lead and mineral analytes using X-Ray Fluorescence Spectrometry. Correlation between subject BLLs and relevant exposure covariates from 2002, 2007 and 2009 was assessed using Pearson's rho and Fisher's Exact. Those with sufficient correlation were then fitted into a GLM with 95% confidence intervals. Basic kriging interpolation was used to determine predicted BLL in the area in 2009 and identify lead contaminated soil. Cluster analysis of blood lead level by site was assessed using Moran's Local Statistic for 2002, 2007 and 2009.;Results. Mean BLLs declined from year to year with mu = 53.04 mug/dL +/- 12.38 in 2002 and mu = 20.51 mug/dL +/- 8.3 in 2009. However, of those sampled in 2009, 91.18% (n=31) of children had BLLs greater than international standards. A majority of children reported inconsistent hygiene practices. BLL was found to be associated with time spent outdoors, playing in sand and playing outside at school in the summer. There were 30 positive tests for lead revealing top soil contamination with values ranging from 24.3 PPM to 4668.8 PPM at sites where children identified playing.;Conclusions. Despite remediation efforts, childhood BLLs are still high in the northwest region of Romania. Further remediation should occur, however, risk communication and efforts to modify behavior in school children are essential.