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Childhood lead exposure in Kampala, Uganda

Environ Health Perspect. 2010 Mar 1.

Childhood Lead Exposure After the Phase-out of Leaded Gasoline: An Ecological Study of School-Age Children in Kampala, Uganda.

Graber LK, Asher D, Anandaraja N, Bopp RF, Merrill K, Cullen MR, Luboga S, Trasande L.  Yale University School of Medicine.

Background: Tetraethyl lead was phased out of gasoline in Uganda in 2005. Recent mitigation of an important source of lead exposure suggests examination and re-evaluation of the prevalence of childhood lead poisoning in this country. Ongoing concerns persist about exposure from the Kiteezi landfill in Kampala, the country’s capital.

Objectives: To determine blood lead (BLL) distributions among Kampala schoolchildren, and identify risk factors for elevated blood lead levels (EBLL; >/=10 microg/dL). 

Analytical Approach: Using a stratified, cross-sectional design, we obtained blood samples, questionnaire data, and soil and dust samples from the homes and schools of 163 4-8 year old children, representing communities with different risks of exposure.

Results: The mean BLL was 7.15 microg/dL; 20.5% were found to have EBLL. Multivariable analysis found participants whose families owned fewer household items, ate canned food, or used the community water supply as their primary water source to have higher BLL and likelihood of EBLL. Distance <.5 mi from the landfill was the factor most strongly associated with increments in BLL (5.51 microg/dL, p<.0001) and likelihood of EBLL (OR=4.71,  p=.0093). Dust/soil lead was not significantly predictive of BLL/EBLL.

Conclusions: Lead poisoning remains highly prevalent among school-aged children in Kampala. Confirmatory studies are needed, but further efforts are indicated to limit lead exposure from the landfill, whether through water contamination or through another mechanism. While African nations are to be lauded for the removal of lead from gasoline, this study serves as a reminder that other sources of exposure to this potent neurotoxicant merit ongoing attention.

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