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Am J Perinatol 2021; 38(S 01): e26-e32
DOI: 10.1055/s-0040-1705135
Original Article

Umbilical Cord Blood Lead Level Disparities between Flint and Detroit

Mona Hanna-Attisha
1   Pediatric Residency Program, Hurley Children's Hospital at Hurley Medical Center, Flint, Michigan
2   Department of Pediatrics and Human Development, Michigan State University College of Human Medicine, Flint, Michigan
,
Ashweena Gonuguntla
2   Department of Pediatrics and Human Development, Michigan State University College of Human Medicine, Flint, Michigan
3   Newborn Nursery, Hurley Children's Hospital at Hurley Medical Center, Flint, Michigan
,
Nadine Peart
1   Pediatric Residency Program, Hurley Children's Hospital at Hurley Medical Center, Flint, Michigan
2   Department of Pediatrics and Human Development, Michigan State University College of Human Medicine, Flint, Michigan
,
Jenny LaChance
4   Research, Hurley Medical Center, Flint, Michigan
5   Office of Medical Education Research and Development, Michigan State University College of Human Medicine, East Lansing, Michigan
,
D. Kay Taylor
4   Research, Hurley Medical Center, Flint, Michigan
5   Office of Medical Education Research and Development, Michigan State University College of Human Medicine, East Lansing, Michigan
,
Sanjay Chawla
6   Department of Pediatrics, Hutzel Women's Hospital and Children's Hospital of Michigan, Wayne State University, Detroit, Michigan
› Institutsangaben Funding This research was partially supported by the Dr. & Mrs. Mathias Pediatric Research and Education Fund, Hurley Medical Center.
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Abstract

Objective The lead-in-water impact of the Flint water crisis on the youngest and most neurodevelopmentally vulnerable population was largely unknown. The objective of this study was to investigate and compare cord blood lead levels (CBLLs) in newborns in Flint, Michigan, after the Flint water crisis, to a group of Detroit newborns.

Study Design Mothers of 99 Flint newborns were surveyed about potential lead exposures. These neonates were born after the recognition of population-wide lead-in-water contamination. CBLLs were measured and maternal–fetal metrics were reviewed. CBLLs and maternal–fetal metrics were then compared with those of a retrospective cohort of 116 Detroit newborns who previously shared the same water source. Analysis involved descriptive statistics, independent t-test, and χ 2 analysis.

Results CBLLs greater than or equal to 1 μg/dL (0.05 μmol/L) were more prevalent among Flint newborns (14%), as compared with Detroit newborns (2%; p = 0.001). This was a sevenfold disparity between Flint and Detroit newborns. No statistically significant differences were found in birth weight, head circumference, small for gestational age status, gestational age, or preterm status among the two groups.

Conclusion The Flint water crisis potentially exposed newborns to lead in utero, implicating maternal–fetal outcomes and future health and development. Primary prevention efforts, including identification and mitigation of lead exposure before conception and during pregnancy, are needed. New environmental exposure detection methods and long-term neurodevelopmental follow-up will complement the findings of this study.

Keywords

lead - newborn - infant - maternal–fetal health - cord blood - public health - Flint


Publikationsverlauf

Eingereicht: 11. Oktober 2019

Angenommen: 22. Januar 2020

Artikel online veröffentlicht:
06. März 2020

© 2020. Thieme. All rights reserved.

Thieme Medical Publishers, Inc.
333 Seventh Avenue, 18th Floor, New York, NY 10001, USA

 

  • References

  • 1 Pieper KJ, Martin R, Tang M. et al. Evaluating water lead levels during the Flint water crisis. Environ Sci Technol 2018; 52 (15) 8124-8132
    CrossrefPubMedGoogle Scholar
  • 2 Hanna-Attisha M, LaChance J, Sadler RC, Champney Schnepp A. Elevated blood lead levels in children associated with the Flint drinking water crisis: a spatial analysis of risk and public health response. Am J Public Health 2016; 106 (02) 283-290
    CrossrefPubMedGoogle Scholar
  • 3 Kennedy C, Yard E, Dignam T. et al. Blood lead levels among children aged <6 years—Flint, Michigan, 2013–2016. MMWR Morb Mortal Wkly Rep 2016; 65 (25) 650-654
    CrossrefPubMedGoogle Scholar
  • 4 Project SENSOR. Elevated blood lead levels in Flint, Michigan. Project SENSOR News. Spring 2016;27(2):1–3. Accessed May 21, 2019 at: http://www.oem.msu.edu/images/newsletter/ProjectSensor/v27n2..pdf
    PubMed
  • 5 Langlois DK, Kaneene JB, Yuzbasiyan-Gurkan V. et al. Investigation of blood lead concentrations in dogs living in Flint, Michigan. J Am Vet Med Assoc 2017; 251 (08) 912-921
    CrossrefPubMedGoogle Scholar
  • 6 Papanikolaou NC, Hatzidaki EG, Belivanis S, Tzanakakis GN, Tsatsakis AM. Lead toxicity update. A brief review. Med Sci Monit 2005; 11 (10) RA329-RA336
    PubMedGoogle Scholar
  • 7 Chawla S, Elbakoush F, Natarajan G. et al. Cord blood lead level in an urban inner-city hospital. J Neonatal Perinatal Med 2016; 9 (03) 291-293
    CrossrefPubMedGoogle Scholar
  • 8 Fenton TR, Nasser R, Eliasziw M, Kim JH, Bilan D, Sauve R. Validating the weight gain of preterm infants between the reference growth curve of the fetus and the term infant. BMC Pediatr 2013; 13: 92
    CrossrefPubMedGoogle Scholar
  • 9 White MA. A comparison of inductively coupled plasma mass spectrometry with electrothermal atomic absorption spectrophotometry for the determination of trace elements in blood and urine from non occupationally exposed populations. J Trace Elem Med Biol 1999; 13 (1-2): 93-101
    CrossrefPubMedGoogle Scholar
  • 10 Palmer CD, Lewis Jr ME, Geraghty CM, Barbosa Jr F, Parsons PJ. Determination of lead, cadmium and mercury in blood for assessment of environmental exposure: a comparison between inductively coupled plasma–mass spectrometry and atomic absorption spectrometry. Spectrochim Acta B At Spectrosc 2006; 61 (08) 980-990
    CrossrefPubMedGoogle Scholar
  • 11 World Health Organization & Inter-Organization Programme for the Sound Management of Chemicals. Brief guide to analytical methods for measuring lead in blood. World Health Organization; 2011. Accessed August 7, 2018 at: http://www.who.int/ipcs/assessment/public_health/lead_blood.pdf
    PubMed
  • 12 Borja-Aburto VH, Hertz-Picciotto I, Rojas Lopez M, Farias P, Rios C, Blanco J. Blood lead levels measured prospectively and risk of spontaneous abortion. Am J Epidemiol 1999; 150 (06) 590-597
    CrossrefPubMedGoogle Scholar
  • 13 Vigeh M, Yokoyama K, Kitamura F, Afshinrokh M, Beygi A, Niroomanesh S. Early pregnancy blood lead and spontaneous abortion. Women Health 2010; 50 (08) 756-766
    CrossrefPubMedGoogle Scholar
  • 14 Edwards M. Fetal death and reduced birth rates associated with exposure to lead-contaminated drinking water. Environ Sci Technol 2014; 48 (01) 739-746
    CrossrefPubMedGoogle Scholar
  • 15 Zahran S, Magzamen S, Breunig IM, Mielke HW. Maternal exposure to neighborhood soil Pb and eclampsia risk in New Orleans, Louisiana (USA): evidence from a natural experiment in flooding. Environ Res 2014; 133: 274-281
    CrossrefPubMedGoogle Scholar
  • 16 Poropat AE, Laidlaw MAS, Lanphear B, Ball A, Mielke HW. Blood lead and preeclampsia: a meta-analysis and review of implications. Environ Res 2018; 160: 12-19
    CrossrefPubMedGoogle Scholar
  • 17 Rodosthenous RS, Burris HH, Svensson K. et al. Prenatal lead exposure and fetal growth: smaller infants have heightened susceptibility. Environ Int 2017; 99: 228-233
    CrossrefPubMedGoogle Scholar
  • 18 Irgens A, Krüger K, Skorve AH, Irgens LM. Reproductive outcome in offspring of parents occupationally exposed to lead in Norway. Am J Ind Med 1998; 34 (05) 431-437
    CrossrefPubMedGoogle Scholar
  • 19 Committee on Obstetric Practice. Committee opinion No. 533: lead screening during pregnancy and lactation. Obstet Gynecol 2012; 120 (2 Pt 1): 416-420
    CrossrefPubMedGoogle Scholar
  • 20 Jones EA, Wright JM, Rice G. et al. Metal exposures in an inner-city neonatal population. Environ Int 2010; 36 (07) 649-654
    CrossrefPubMedGoogle Scholar
  • 21 Koyashiki GA, Paoliello MM, Tchounwou PB. Lead levels in human milk and children's health risk: a systematic review. Rev Environ Health 2010; 25 (03) 243-253
    CrossrefPubMedGoogle Scholar
  • 22 Brown MJ, Margolis S. Lead in drinking water and human blood lead levels in the United States. MMWR Suppl 2012; 61 (04) 1-9
    PubMedGoogle Scholar
  • 23 United States Census Bureau. American FactFinder. ACS demographic and housing estimates: 2013–2017 American Community Survey 5-year estimates for Detroit City, Michigan. Accessed January 7, 2020 at: https://factfinder.census.gov/bkmk/table/1.0/en/ACS/17_5YR/DP05/1600000US2622000
    PubMed
  • 24 United States Census Bureau. American FactFinder. ACS demographic and housing estimates: 2013–2017 American Community Survey 5-year estimates for Flint City, Michigan. Accessed January 7, 2020 at: https://factfinder.census.gov/bkmk/table/1.0/en/ACS/17_5YR/DP05/1600000US2629000
    PubMed
  • 25 Detroit Health Department. Lead report 2016. Detroit, MI: City of Detroit; 2016. Accessed August 24, 2018 at: http://www.detroitmi.gov/Portals/0/docs/Health/Lead/DHealth%20Lead%20Report%202016.pdf
    PubMed
  • 26 Michigan Childhood Lead Poisoning Prevention Program, Michigan Department of Health and Human Services Division of Environmental Health. 2015 data report on childhood lead testing and elevated blood lead levels: Michigan; 2017. Accessed August 24, 2018 at: https://www.michigan.gov/documents/lead/2015_annual_report_2_7_17_551735_7.pdf
    PubMed
  • 27 Michigan Childhood Lead Poisoning Prevention Program, Michigan Department of Health and Human Services Division of Environmental Health. 2016 data report on childhood lead testing and elevated levels: Michigan; Updated 2018. Accessed December 12, 2018 at: https://www.michigan.gov/documents/lead/2016_CLPPP_Annual_Report_5-1-18_621989_7.pdf
    PubMed
  • 28 CDC Advisory Committee on Childhood Lead Poisoning Prevention. Low level lead exposure harms children: a renewed call for primary prevention. Report of the Advisory Committee on Childhood Lead Poisoning Prevention of the Centers for Disease Control and Prevention; 2012. Accessed October 12, 2017 at: https://www.cdc.gov/nceh/lead/acclpp/final_document_030712.pdf
    PubMed
  • 29 Maas RP, Patch SC, Morgan DM, Pandolfo TJ. Reducing lead exposure from drinking water: recent history and current status. Public Health Rep 2005; 120 (03) 316-321
    CrossrefPubMedGoogle Scholar
  • 30 United States Census Bureau. QuickFacts. Flint City, Michigan; Detroit City, Michigan. [Web page]. Accessed May 15, 2019 at: https://www.census.gov/quickfacts/fact/table/flintcitymichigan,detroitcitymichigan/PST045218
    PubMed
  • 31 David RJ, Collins Jr JW. Differing birth weight among infants of U.S.-born blacks, African-born blacks, and U.S.-born whites. N Engl J Med 1997; 337 (17) 1209-1214
    CrossrefPubMedGoogle Scholar
  • 32 Collins Jr JW, David RJ, Rankin KM, Desireddi JR. Transgenerational effect of neighborhood poverty on low birth weight among African Americans in Cook County, Illinois. Am J Epidemiol 2009; 169 (06) 712-717
    CrossrefPubMedGoogle Scholar
  • 33 Division for Vital Records and Health Statistics, Michigan Department of Health & Human Services. Flint City health statistics tables. Accessed January 7, 2020 at: https://www.mdch.state.mi.us/pha/osr/chi/FullTableList.asp?RegionTYPE=3&REGIONcode=0473&Submit_City=Tables
    PubMed
  • 34 Roy S, Tang M, Edwards MA. Lead release to potable water during the Flint, Michigan water crisis as revealed by routine biosolids monitoring data. Water Res 2019; 160: 475-483
    CrossrefPubMedGoogle Scholar
  • 35 Zahran S, McElmurry SP, Sadler RC. Four phases of the Flint water crisis: evidence from blood lead levels in children. Environ Res 2017; 157: 160-172
    CrossrefPubMedGoogle Scholar
  • 36 Curry SJ, Krist AH, Owens DK. et al; US Preventive Services Task Force. Screening for elevated blood lead levels in children and pregnant women: US Preventive Services Task Force recommendation statement. JAMA 2019; 321 (15) 1502-1509
    CrossrefPubMedGoogle Scholar
  • 37 Ruckart PZ, Ettinger AS, Hanna-Attisha M, Jones N, Davis SI, Breysse PN. The Flint water crisis: a coordinated public health emergency response and recovery initiative. J Public Health Manag Pract 2019; 25 (Suppl 1, Lead Poisoning Prevention): S84-S90
    CrossrefPubMedGoogle Scholar