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Lead screening in children presenting to three hospitals in Lebanon
  1. Tharwat El Zahran1,
  2. Hala Mostafa1,
  3. Hani Hamade1,
  4. Moustafa Al Hariri1,
  5. Aed Saab1,
  6. Hani Tamim2,
  7. Rasha Tohme3,
  8. Dany A Al Hamod3,
  9. Durriyah Sinno4,
  10. Rasha Dorothy Sawaya1,
  11. Ziad Kazzi1,5
  1. 1Department of Emergency Medicine, American University of Beirut Medical Center, Beirut, Lebanon
  2. 2Biostatistics Unit, Clinical Research Institute, American University of Beirut Medical Center, Beirut, Lebanon
  3. 3Department of Pediatrics, Saint George Hospital University Medical Center, Beirut, Lebanon
  4. 4Department of Pediatrics, American University of Beirut Medical Center, Beirut, Lebanon
  5. 5Emergency Medicine, Emory University School of Medicine, Atlanta, Georgia, USA
  1. Correspondence to Dr Tharwat El Zahran, Department of Emergency Medicine, American University of Beirut Medical Center, Beirut, Lebanon; te15{at}aub.edu.lb

Abstract

Background Lead damages most body organs and its effects are most profound in children. In a study in Beirut in 2003, before banning the leaded gasoline, 79% of the participants showed blood lead levels (BLLs) higher than 5 µg/dL. The prevalence of lead exposure in Lebanon after the ban on leaded gasoline has not been studied. This study assessed the BLL in Lebanese children aged 1–6 years.

Methods This cross-sectional study was conducted in three hospitals in Beirut. The children’s BLLs were tested, and their caregiver completed a questionnaire to identify subgroups at risk of exposure. Participants were provided with a WHO brochure highlighting the risks of lead.

Results Ninety children with a mean age of 3.5±1.5 years were enrolled in the study and had a mean BLL of 1.1±0.7 µg/dL, with all values being below 5.0 µg/dL, showing a marked decrease in BLL compared with the mean BLL before the ban on leaded gasoline in 2002. Having a father or a mother with a college degree (p=0.01 and p=0.035, respectively) and having a monthly household income greater than $1000 (p=0.021) were associated with significantly lower BLL. Having more rooms at home and residing close to construction sites were associated with a significantly lower BLL (p=0.001 and p=0.026, respectively). Residing in a house aged >40 years and receiving traditional remedies were associated with a significantly higher BLL (p=0.009 and p<0.0001, respectively).

Conclusion BLLs have declined among Lebanese children and this could be attributed to multiple factors including the ban of leaded gasoline. It would be beneficial to conduct a larger study with a nationally representative sample to better characterise the BLL.

  • toxicology
  • epidemiology
  • statistics
  • data collection
  • health services research

Data availability statement

Data are available upon reasonable request.

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Data availability statement

Data are available upon reasonable request.

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Footnotes

  • Collaborators Drs Ali Zeitoun, Karima Wehbe and Batoul Abdallah from Bahman Hospital collaborated with us on this project.

  • Contributors TEZ and HM had equal contributions to the manuscript and are co-first authors. TEZ—conception and design of the work, acquiring funding, and interpretation of data; drafting the manuscript and revising it; approved the final version submitted; agrees to be accountable for all aspects of the work in ensuring that questions related to the accuracy or integrity of any part of the work are appropriately investigated and resolved. HM—design of the work, acquiring data, and interpretation of data; drafting the manuscript and revising it; approved the final version submitted; agrees to be accountable for all aspects of the work in ensuring that questions related to the accuracy or integrity of any part of the work are appropriately investigated and resolved. HH—design of the work, acquiring funding, and acquiring data; drafting the manuscript; approved the final version submitted; agrees to be accountable for all aspects of the work in ensuring that questions related to the accuracy or integrity of any part of the work are appropriately investigated and resolved. MAH—design of the work, acquiring funding, and analysing data; drafting the manuscript; approved the final version submitted; agrees to be accountable for all aspects of the work in ensuring that questions related to the accuracy or integrity of any part of the work are appropriately investigated and resolved. AS—interpreting and acquiring data; drafting the manuscript; approved the final version submitted; agrees to be accountable for all aspects of the work in ensuring that questions related to the accuracy or integrity of any part of the work are appropriately investigated and resolved. HT—interpreting data; extensively revising and editing the manuscript; approved the final version submitted; agrees to be accountable for all aspects of the work in ensuring that questions related to the accuracy or integrity of any part of the work are appropriately investigated and resolved. RT—acquiring and interpreting data; extensively revising and editing the manuscript; approved the final version submitted; agrees to be accountable for all aspects of the work in ensuring that questions related to the accuracy or integrity of any part of the work are appropriately investigated and resolved. DAAH—interpreting data; extensively revising and editing the manuscript; approved the final version submitted; agrees to be accountable for all aspects of the work in ensuring that questions related to the accuracy or integrity of any part of the work are appropriately investigated and resolved. DS—interpreting data; extensively revising and editing the manuscript; approved the final version submitted; agrees to be accountable for all aspects of the work in ensuring that questions related to the accuracy or integrity of any part of the work are appropriately investigated and resolved. RDS—design of the work and interpretation of data; extensively revising and editing the manuscript; approved the final version submitted; agrees to be accountable for all aspects of the work in ensuring that questions related to the accuracy or integrity of any part of the work are appropriately investigated and resolved. ZK—design of the work and interpretation of data; extensively revising and editing the manuscript; approved the final version submitted; agrees to be accountable for all aspects of the work in ensuring that questions related to the accuracy or integrity of any part of the work are appropriately investigated and resolved.

  • Funding This work was supported by the Medical Practice Plan at AUBMC grant number 320181.

  • Competing interests None declared.

  • Provenance and peer review Not commissioned; internally peer reviewed.

  • Supplemental material This content has been supplied by the author(s). It has not been vetted by BMJ Publishing Group Limited (BMJ) and may not have been peer-reviewed. Any opinions or recommendations discussed are solely those of the author(s) and are not endorsed by BMJ. BMJ disclaims all liability and responsibility arising from any reliance placed on the content. Where the content includes any translated material, BMJ does not warrant the accuracy and reliability of the translations (including but not limited to local regulations, clinical guidelines, terminology, drug names and drug dosages), and is not responsible for any error and/or omissions arising from translation and adaptation or otherwise.

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