Surveillance of childhood blood lead levels in 11 cities of China

Tao Li, Yao-Hua Dai, Xiao-Hua Xie, Zang-Wen Tan, Shuai-Ming Zhang, Zong-Han Zhu

Beijing, China

Author Affiliations: Department of Integrated Early Childhood Development Capital Institute of Pediatrics, Beijing, China (Li T, Dai YH, Xie XH, Tan ZW, Zhang SM); Chinese Pediatrician Association, Beijing, China (Zhu ZH)

Corresponding Author: Yao-Hua Dai, Department of Integrated Early Childhood Development, Capital Institute of Pediatrics, 2 Ya Bao Road, Chaoyang District, Beijing 100020, China (Tel: 8610 85636169; Fax: 8610 85622025; Email: yh.dai@263.net)

doi: 10.1007/s12519-014-0452-6

Background: Exposure to lead can be deleterious to children's health. Surveillance for blood lead levels (BLLs) is reported every year in the USA and some other countries. However, such reports are lacking in China which has the world's largest population of children. In this study, we provided the latest nationally representative data on BLLs among Chinese children living in cities, described the change in BLLs since 2004, and explored the risk factors for elevated BLLs (EBLLs) among children.

Methods: We studied 12 693 children aged 0-6 years in 2004 and 11 255 children aged 0-6 years in 2010. We evaluated the average BLLs and the prevalence of EBLLs, and a multivariate logistic regression model was used to estimate predictors of EBLLs.

Results: The geometric mean BLLs of children aged 0-6 years dropped by 16% (from 46.38±2.10 μg/L in 2004 to 38.95±1.83 μg/L in 2010), while the prevalence of EBLLs dropped by 87% (from 9.78% in 2004 to 1.32% in 2010). In a multivariate analysis, the following factors were associated with EBLLs: (1) children being cared for at home or at a boarding nursery (compared to children being cared for in a day nursery), (2) children having fathers with a lower education level, and (3) children often eating popcorn and chewing fingernails or sucking fingers were associated with EBLLs.

Conclusions: The results of this study demonstrated a substantial decline in BLLs from 2004 to 2010 among Chinese children 0-6 years living in cities. However, these levels were higher than levels in countries, such as the USA, Canada, Japan and Sweden. These data demonstrate that Chinese children's lead exposure remains a public health problem that requires additional effort and resources.

Key words: child; gasoline; lead; surveillance

World J Pediatr 2014;10(1):29-37