Blood Lead Levels in Children 5 to 7 Years of Age from the Republic of Georgia: A Feasibility Study on Lead
Charlotta Rylander1, Erik Eik Anda1, Ciprian Mihai Cirtiu2
1Department of Community Medicine, UiT The Arctic University of Norway, Tromsø, Norway.
Insights
Lead exposure remains a significant concern for children in Georgia, with nearly 40% having elevated blood lead levels (BLLs). Volumetric absorptive microsampling (VAMS) proved effective for surveillance, identifying key risk factors like unpainted housing and metal toys.
Area of Science:
- Environmental Health
- Pediatric Public Health
- Toxicology
Background:
- Children in the Republic of Georgia have historically experienced high blood lead levels (BLLs).
- A national surveillance program was piloted from September 2023 to April 2024 to assess lead exposure in children.
- Volumetric absorptive microsampling (VAMS) was utilized for measuring BLLs in two western Georgian regions.
Purpose of the Study:
- To monitor BLLs in children aged 5-7 years in Adjara and Imereti regions.
- To identify predictors associated with elevated BLLs in this pediatric population.
- To demonstrate the feasibility and effectiveness of VAMS for BLL surveillance.
Main Methods:
- Randomly selected 1,635 children aged 5-7 years from Adjara and Imereti.
- Collected capillary blood samples using VAMS devices for lead analysis via ICP-MS.
- Employed multivariable logistic regression to analyze demographic, household, and lifestyle data against BLLs.
Main Results:
- Nearly 40% of participants had BLLs ≥ 5 µg/dL, with 20% ≥ 10 µg/dL and 4% ≥ 20 µg/dL.
- Male sex and unpainted housing were predictors for BLLs ≥ 5 µg/dL in both regions.
- Specific predictors for higher BLLs varied by region, including urban living, small household size, metal toys, housing type, spice use, and household lead bullet production.
Conclusions:
- Lead exposure is a persistent public health issue in the studied regions of Georgia.
- VAMS technology is a viable, less invasive, and resource-efficient method for large-scale BLL surveillance.
- Identifying specific risk factors is crucial for targeted interventions to reduce lead exposure in children.
Background:
For years, children in the Republic of Georgia, have experienced elevated blood lead levels (BLLs). From September 2023 to April 2024, the National Center for Disease Control and Public Health in Georgia piloted a national surveillance program for lead in children in two western regions of the country, using volumetric absorptive microsampling (VAMS) to measure BLLs.
Objectives:
We monitored BLLs and assessed predictors of elevated BLLs in children 5-7 years of age from two regions in the Republic of Georgia. We also aimed to demonstrate the feasibility of VAMS for BLL surveillance.
Methods:
Children 5-7 years of age were randomly selected from the regions of Adjara and Imereti, Georgia, and 1,635 children participated. A trained phlebotomist collected two capillary blood samples from the children's fingertips using VAMS devices. The samples were analyzed using inductively coupled plasma tandem mass spectrometry. Guardians completed a questionnaire detailing demographics, household, and lifestyle characteristics. We employed multivariable logistic regression models to identify predictors of BLLs or in Georgia.
Results:
Approximately 39.8%, 20%, and 4% of the participants had BLLs , , and , respectively. In both regions, male sex and unpainted housing predicted BLLs but not BLLs . In Imereti, urban living additionally predicted BLLs , while small household size and metal toys [metal vs. plastic toys: ; 95% confidence interval (CI): 1.66, 7.72] were associated with BLLs . In Adjara, age, housing type, use of certain spices (yes vs. no: ; 95% CI: 1.11, 1.94), and household lead bullet production (yes vs. no: ; 95% CI: 1.41, 31.6) predicted BLLs but not BLLs .
Discussion:
Our findings confirm that lead exposure remains a significant public health issue in two regions of the Republic of Georgia, despite a national decrease in BLLs over the past 5 years. To our knowledge, this research marks the first large-scale application of VAMS technology for national BLL surveillance, offering significant advantages as a less invasive lead testing method that is accurate and suitable for settings with limited resources to handle, store, and transport venous blood samples. https://doi.org/10.1289/EHP15788.
