Blood lead levels and risk factors in young children in France, 2008-2009

Background: The exposure of children to lead has decreased in recent years, thanks notably to the banning of leaded gasoline. However, lead exposure remains a matter of public health concern, because no toxicity threshold has been observed, cognitive effects having been demonstrated even at low levels. It is therefore important to update exposure assessments. A national study was conducted, in 2008-2009, to determine the blood lead level (BLL) distribution in children between the ages of six months and six years in France. We also assessed the contribution of environmental factors. Methods: This cross-sectional survey included 3831 children recruited at hospitals. Two-stage probability sampling was carried out, with stratification by hospital and French region. Sociodemographic characteristics were recorded, and blood samples and environmental data were collected by questionnaire. Generalized linear model and quantile regression were used to quantify the association between BLL and environmental risk factors. Results: The geometric mean BLL was 14.9 ,mu g/I (95% confidence interval (CI)= [14.5-15.4]) and 0.09% of the children (95% Cl = [0.03-0.151) had BLLs exceeding 100 mu g/l, 1.5% (95% CI = [0.9-2.1] exceeding 50 mu g/l. Only slight differences were observed between French regions. Environmental factors significantly associated with BLL were the consumption of tap water in homes with lead service connections, peeling paint or recent renovations in old housing, hand-mouth behavior, passive smoking and having a mother born in a country where lead is often used. Conclusions: In children between the ages of one and six years in France, lead exposure has decreased over the last 15 years as in the US and other European countries. Nevertheless still 76,000 children have BLL over 50 mu g/I and prevention policies must be pursued, especially keeping in mind there is no known toxicity threshold. (c) 2013 Elsevier GmbH. All rights reserved.