The Environmental Protection Agency (EPA) provides access to information on a variety of topics related to the environment and strives to inform citizens of health risks. The EPA also has an extensive library network that consists of 26 libraries throughout the United States, which provide access to a plethora of information to EPA employees, scientists, and researchers. The EPA implemented a reorganization project to digitize their materials so they would be more accessible to a wider range of users, but this plan was drastically accelerated when the EPA was threatened with a budget cut. It chose to close and reduce the hours and services of some of their libraries. As a result, the agency was accused of denying users the “right to know” by making information unavailable, not providing an adequate strategic plan, and discarding vital materials. This case study explores the background of the digitization project, the practices implemented, and the critiques of the project.

/pdf/the-environmental-protection-agency-3gx4opzrjm.pdf

The Environmental Protection Agency

Lead toxicity continues to be a major public health concern in the United States and elsewhere. Levels of lead in umbilical cord blood and breast milk correlate closely with those in maternal blood. It appears that blood and tissue lead levels in women of reproductive age determine the body burden of lead in their children. The investigators sought determinants of the blood lead level (BLL) in 4394 women 20 to 49 years of age who participated in the most recently completed National Health and Nutritional Survey (NHANES III). Complete data were obtained from 3716 women. The geometric mean BLL was 1.78 μg/dL. Lead levels correlated inversely with educational level, hematocrit, thiamine intake, and serum folate level. Positive associations were found between BLL and ethnicity (blacks and Hispanics had relatively high levels), living in an urban area, older age, alcohol consumption, and cigarette smoking. In addition, the BLL correlated positively with serum protoporphyrin levels and with the intake of pyridoxine, iron, and folate. On logistic regression analysis, comparing subjects with a BLL above 4.0 μg/dL (upper decile) with those in the lowest decile (less than 0.7 μg/dL) showed high odds ratios for 4 significant variables: alcohol consumption, cigarette smoking, thiamine intake, and serum ascorbic acid concentration. This analysis controlled for many variables, including breast feeding, total fat intake, serum and red blood cell folate levels, and hematocrit. Women who drank alcohol were more than 5 times likelier than abstainers to be in the highest decile for BLL, and the odds ratio for smokers was 4.5. Women with a thiamine intake greater than 1 mg were 7.5 times less likely than those with a lower intake to be in the highest decile. A high serum ascorbic acid level correlated with a 2.5-fold lower chance of having a BLL in the highest decile. Women with the lowest serum folate levels had significantly higher BLLs than those with values in the upper decile. The investigators conclude that lowering the mother's body burden of lead can reduce blood lead toxicity in children. It may prove feasible to use vitamins such as thiamine and ascorbic acid to prevent (or treat) lead toxicity.

Determinants of the Blood Lead Level of U.S. Women of Reproductive Age

Previous evaluations of a birth cohort in the Munshiganj District of Bangladesh had found that over 85% of 397 children aged 2–3 years had blood lead concentrations above the United States Centers for Disease Control and Prevention’s reference level of 5 μg/dL. Studies in urban areas of Bangladesh have found elevated levels of lead in the air due to industries and remaining contamination from the historic use of leaded gasoline. Sources of lead in rural areas of Bangladesh remain unknown. We conducted air sampling in both residential and industrial sites in Munshiganj to determine whether children are exposed to elevated lead concentrations in the air and study the association between the children’s blood lead levels and sampled air lead concentrations. Residential and industrial air samples in Munshiganj were found to have elevated lead concentrations (mean 1.22 μg/m3) but were not found to be associated with the observed blood lead concentrations. Lead in air is an important environmental health exposure risk to the for children in Munshiganj, and further research may shed light on specific sources to inform exposure prevention and mitigation programs.

https://www.mdpi.com/1660-4601/15/9/1947/pdf

Lead in Air in Bangladesh: Exposure in a Rural Community with Elevated Blood Lead Concentrations among Young Children.

Childhood lead poisoning in Gaza Strip, the Palestinian Authority

Objective:Few studies have reported blood lead levels (BLLs) in Haitian children, despite the known presence of lead from environmental factors such as soil, water, leaded paint and gasoline, impro...

https://journals.sagepub.com/doi/pdf/10.1177/0033354918807975

Elevated Blood Lead Levels in Infants and Children in Haiti, 2015.

Context Limited data exist about blood lead levels (BLLs) and potential exposures among children living in Puerto Rico. The Puerto Rico Department of Health has no formal blood lead surveillance program. Objectives We assessed the prevalence of elevated BLLs (≥5 micrograms of lead per deciliter of blood), evaluated household environmental lead levels, and risk factors for BLL among children younger than 6 years of age living in Puerto Rico in 2010. Methods We used a population-based, cross-sectional sampling strategy to enroll an island-representative sample of Puerto Rican children younger than 6 years. We estimated the island-wide weighted prevalence of elevated BLLs and conducted bivariable and multivariable linear regression analyses to ascertain risk factors for elevated BLLs. Results The analytic data set included 355 households and 439 children younger than 6 years throughout Puerto Rico. The weighted geometric mean BLL of children younger than 6 years was 1.57 μg/dL (95% confidence interval [CI], 1.27-1.88). The weighted prevalence of children younger than 6 years with BLLs of 5 μg/dL or more was 3.18% (95% CI, 0.93-5.43) and for BLLs of 10 μg/dL or more was 0.50% (95% CI, 0-1.31). Higher mean BLLs were significantly associated with data collection during the summer months, a lead-related activity or hobby of anyone in the residence, and maternal education of less than 12 years. Few environmental lead hazards were identified. Conclusions The prevalence of elevated BLLs among Puerto Rican children younger than 6 years is comparable with the most recent (2007-2010) US national estimate (BLLs ≥5 μg/dL = 2.6% [95% CI = 1.6-4.0]). Our findings suggest that targeted screening of specific higher-risk groups of children younger than 6 years can replace island-wide or insurance-specific policies of mandatory blood lead testing in Puerto Rico.

/pdf/prevalence-of-elevated-blood-lead-levels-and-risk-factors-10ioquvqs1.pdf

Prevalence of Elevated Blood Lead Levels and Risk Factors Among Residents Younger Than 6 Years, Puerto Rico--2010.

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Prevalence of Elevated Blood Lead Levels and Risk Factors Among Residents Younger Than 6 Years, Puerto Rico--2010.