Thesis (M.S.)--Ball State University, 2009. / Title from PDF t.p. (viewed on June 08, 2010). Includes bibliographical references (p. [70]-71).

A lack of consistent, evidence-based practices for blood lead testing of children existed in a local public health department (LHD). No known blood lead level is safe, and toxicity can result in behavioral and cognitive impairments. The purpose of this project was to develop and analyze a clinical practice guideline to establish blood lead testing procedures in the LHD to improve testing procedures and enhance future testing within the jurisdiction. The RE-AIM framework was used to address the reach, effectiveness, adoption, implementation, and maintenance of the clinical practice guideline. Five experts evaluated the guideline using the Appraisal of Guidelines for Research and Evaluation instrument. The assessment results indicated 96.4% agreement across all domains. The experts agreed unanimously to recommend adoption of the clinical practice guideline. Implementation of the guideline might advance nursing practice and patient care in the LHD through incorporation of evidence-based practices. Implementation might also lead to early identification of lead-burdened children and may provide the opportunity for treatment to mitigate cognitive and behavioral deficits related to lead toxicity, thereby improving child health and decreasing related health care costs. Engagement of the clinical practice guideline will support positive social change through the empowerment of public health nurses to provide optimal care to a population of children at risk of deleterious and long-term side effects of lead exposure.

To understand why Kabwe, Zambia is one of the most lead polluted towns, one has to look at the source of this pollution and its extent. With a history of poor environmental regulation, policies, and public information, the lead pollution caused by mining activities in Kabwe went unmitigated for decades. The natural blood-lead level in humans is about 0.0016 µg/dl, in developed countries like the United States, strict enforcement has resulted into lead levels averaging figures below 10 µg/dl, but in Kabwe, averages lie between 60 µg/dl and 120 µg/dl. Levels over 10 µg/dl are unhealthy, while levels above 20 µg/dl can cause acute poisoning whereas levels over 120 µg/dl often result into death. New environmental and rehabilitation laws were only enacted after a new administration came into office in 1991; however, additional mitigation measures such as obtaining a reclamation bond prior to being issued a mining permit need to be considered. / text

Master of Science / Department of Geology / Saugata Datta / Children are the demographic most susceptible to and affected by lead poisoning. Lead contamination in soil has been recorded as being primarily from lead-based paint, historic leaded gasoline emissions, and from lead point-source emitters. The highest risk of elevated blood lead level (BLL) is correlated with living in an area dominated by pre-1950’s housing. From 1976 to 1994, midst the phasing out and removal of lead from gasoline, the blood lead levels of children in the United States decreased from 16 µg/dL to 3.2 µg/dL. There is evidence showing the irreversible effects of intellectual impairment still occur at levels of BLL below 10 µg/dL. In Kansas, Barton and Ellis counties residential soils were sampled, and chemical composition was examined with a handheld XRF and an HR ICP-MS. Particle size and pH were recorded for all samples. The presence or lack of of lead sulfate and lead carbonate was identified using XRD. Chemical tests revealed elevated Zn and As with increasing Pb concentrations. There was weak evidence of lead sulfate in one of eight tested samples. Barton county has courser sediments and the top five highest Pb concentrations recorded in this study. There is a significant correlation with Pb concentrations and age of housing for houses built prior to1950. Pb Isotopic analysis on eight samples showed multi-source contamination in the soil. We believe the source of most of the lead is from ambient lead mixed with historic leaded gasoline deposits and possible output from factories/coal, along with leaded paint in older homes. Three of the eight samples had paint chips which tested positive for lead. Maps were created showing central Kansas having elevated blood lead levels in children and overlays were made illustrating oil well density in counties. Five variables were used to create a risk assessment map for Kansas: housing age, poverty levels, blood lead levels, number of oil wells, and population.

No description available.

Thesis (doctoral)--Lund University, 1997. / Added t.p. with thesis statement inserted. Incorrect ISBN on t.p. verso.

Thesis (doctoral)--Lund University, 1997. / Added t.p. with thesis statement inserted. Incorrect ISBN on t.p. verso.

Lead is a toxic heavy metal associated with adverse health effects ranging from developmental neurotoxicity to reproductive effects. While lead affects people of all ages, infants and children are the most vulnerable and susceptible to the neuro-developmental effects of lead exposure. Maternal blood lead concentrations that do not produce clinical toxicity on pregnant women have been linked to adverse offspring development. Observed reproductive effects to low lead levels during pregnancy include the risk of spontaneous abortions, effects on birth weight and preterm birth. There are particular concerns with regard to reductions in IQ scores. Research evidence suggests that an incremental increase in blood lead levels of 1 µg/dL is associated with approximately 1 IQ point deficit. Of particular concern is that currently no threshold has been observed or exists for developmental neurotoxicity to the chronic low lead exposures levels. While the developed countries have built evidence for lead exposure sources, have identified the most vulnerable groups to lead exposure, and have instituted control actions for lead exposure, it is not the case in developing countries such as Botswana. Currently, there is very little knowledge about the potential sources of lead exposure among different population groups not only in Botswana but also in most developing nations. There is also an evident limited knowledge on the behaviours and practices of different population groups that could potentially expose them to lead in developing countries. This thesis explores the following questions: i) Are there specific risk behaviours and practices peculiar to pregnant women in Botswana that could potentially expose them to lead? ii) What are the environmental lead concentration levels and their potential to expose pregnant women? iii)What are the blood lead concentrations at each stage of pregnancy and after delivery in Botswana and, iv) Can we use the information from these three questions to predict lead exposure levels during pregnancy and after delivery? v) Can we use the new information to a develop a policy dissemination brief to inform policy on lead exposure sources in Botswana, develop guidelines for health professionals for assessing and screening lead exposure levels during pregnancy and after delivery, develop an awareness leaflet for lead education? To address the specific risk behaviour and practices of pregnant women, a comprehensive validated risk assessment questionnaire was administered among 142 pregnant women during the first trimester of pregnancy (defined as 8-12 weeks) in four villages of different geographical settings and nomenclature (small/rural, major and semi urban). For purposes of this work the validation process involved obtaining information (from experts in the field and communities) relevant to the purposes of the study and to confirm that the tools employed for collection of data in all trimesters were suitable in terms of both construct and content. Data was collected between September 2009 and February 2010. To address potential environmental sources of lead exposure during pregnancy soil (n=28), water (n=28) and traditional cosmetic clay - letsoku (n=3) samples were collected in November 2010, February 2011 and May 2011 from the homes and in the vicinity of the study population to determine lead concentrations. To know baseline blood lead levels at each stage of pregnancy, blood samples were collected from September 2009 to February 2011 from pregnant women between weeks 8-12 (first trimester, n=137), 20-24 (second trimester n=126) and weeks 34-36 (third trimester n=106). Blood lead levels of women who completed the entire study from trimester on until after delivery (n=63) were then used to construct blood lead prediction models using statistical models. Pregnant women in the study area ingested non-food items such as soil, match sticks, pencil, chalk and animal feed such as bone meal (86%). Women applied used and unused car oils (in particular brake fluid) and other harmful substances for “treatment of skin conditions and for beautification purposes (74%). Older women (defined as 35 years in this study) were at a significantly higher risk to ingest soils (p<0.01). Mean (±SEM) lead concentrations in water exceeded the WHO drinking water quality standards nineteen fold (0.19±0.019 ppm (n=28) Major villages, had significantly higher Pb concentrations (p<0.05) in soils and water compared to small villages. Mean blood lead levels (±SEM) for the first, second and third trimesters were 1.96(±0.14)µg/dL, 2.49(±0.17) µg/dL, 2.66(±0.19) µg/dL respectively. Blood lead levels increases from the first to third trimester ranged from 1.6-5%. Blood lead concentrations significantly differed among locations (p<0.01). The highest concentrations were observed in women from smaller villages that were poorer (p<0.02). Pica, multiple risk behaviours/practices (engaging in two or more risk behaviours/practices), trimester of pregnancy, poor food supplementation and diet were predictors of blood lead levels ≥ 2µg/dL. There was a dose response relationship between supplement intake and an increase in blood lead levels. These findings suggest that pregnant women and their unborn babies could potentially be exposed to lead because of the environment in which they live, their economic status, lifestyle, behaviors and practices. Drinking water is a potential threat for lead exposure, not only among pregnant women, but other vulnerable groups such as infants and children. This study is the first in Botswana and one of the few in Africa to investigate lead exposure sources at each stage of pregnancy and after delivery. It is also the first to identify new potential lead exposure behaviors and practices such as the application of auto oils by pregnant women for treatment of skin diseases. The findings suggest the need to train health workers and equip them with the skills and knowledge to assess and screen women who could potentially be exposed to lead. Further, pregnant women need to be sensitized on potential lead exposure sources, to prevent lead poisoning. This study has been able to use the results to develop a policy brief for disseminating the results to decision makers, guidelines for utilization by health workers to screen lead exposure levels and an awareness leaflet for pregnant women. These have been validated and pretested at community and Government levels. / Thesis (PhD)--University of Pretoria, 2013. / School of Health Systems and Public Health (SHSPH) / Unrestricted

No description available.

Lead is a central nervous system poison. Healthy People 2010 established a target blood lead level (BLL) for children of 0 μg/dL by 2010, but is silent with regard to any changes in BLLs standards for working age adults. In this paper, the relation of BLL to performance on two neurobehavioral tests was assessed in working age adults (N = 4909; Age 20 to 59 years; 51.4% Female) employing data from the Third National Health and Nutrition Survey (NHANES 111). Multiple linear regression analyses indicated a significant effect of BLL on time taken to complete an attention demanding cognitive task (Symbol Digit Substitution Task, SDST) but not accuracy of performance of the SDST or simple reaction time, after controlling for confounding variables of age, sex, race-ethnicity, and education. Persons with BLL ≥5 μg /dL took longer (multivariate adjusted mean = 23.6 Sec, SE = 0.30) compared to individuals with BLLs <5 μg /dL (mean = 22.5 Sec, SE = 0.14). The results suggest that lead burden in working age persons impairs central nervous processes involving executive mental functions (decision speed and attention). The findings, if confirmed by case control and or cohort studies would indicate a need to reconsider currently accepted lead levels in working age adults.