Prevalence and Risk Factors for Elevated Blood Lead Levels in 0-6-Year-old Children in China: a national cross-sectional study

Minming Li ^1,2 Xian Ting Jiao ^3,4 Jing Zhang ² Zhen-Yan Gao ³ Jia Cao ^1,5 Jun-Xia Liu ³ Yun-Lin Yang ^2* Chonghuai Yan ^3*

• ¹ Shanghai Key Laboratory of Children’s Environmental Health, School of Medicine, Shanghai Jiao Tong University, Shanghai, China
• ² Shanghai Center for Women and Children's Health, Shanghai, China
• ³ Shanghai Key Laboratory of Environment and Child Health, Xinhua Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai, China
• ⁴ Department of Pediatric Infectious Diseases, Xinhua Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai, China
• ⁵ The Women’s and Children’s Department, Shanghai Key Laboratory of Maternal Fetal Medicine, Shanghai First Maternity and Infant Hospital, School of Medicine, Tongji University, Shanghai, China, shanghai, China

Aims: to evaluate the prevalence and risk factors of elevated blood lead levels (EBLL) among the pediatric population in China.Questionnaire investigation about Lead exposure information, venous blood samples collection and BLL detection are conducted. A total of 32,543 subjects aged 0-6 years old (from 1 month old to under 7 years old) were recruited from May 2013 to March 2015 in 15 provinces of China.The overall weighted prevalence of EBLL which is defined as BLL ≥ 50 μg/L in this study is 4.1%, as for different geographical regions, with lowest prevalence in the western region of China, lowest prevalence in Shaanxi province and highest in Hebei province. In 0-3-Year-old children, female weighted prevalence of EBLL (4.0%) is higher than male (2.4%), while in 3-6-Year-old children, male (8.3%) is higher than female (6.3%). Bad hygienic habits, some kind of custom, using folk prescriptions, living on the ground floor, poor drinking water quality, indoor air pollution and passive smoking exposure remain risk factors of EBLL (BLL ≥ 50 μg/L) of 0-6-year-old (from 1 month old to under 7 years old) children in China, after adjustment of gender, age, geographical region, annual household income, educational background and occupation of the parents and caregivers.Conclusions: This study reveals the prevalence and risk factors for EBLL (BLL ≥ 50 μg/L) in 0-6-Year-old Children of China. We hope this study will help public health education and inform policy for preventing and eradicating children's lead poisoning in China.