Lead-induced dysregulation of essential elements in pediatric populations

Lead exposure remains a major environmental and public health concern, particularly among children residing near informal battery smelting and recycling units. The present study was conducted to evaluate the effect of lead exposure on essential elements imbalance and associated risk factors included socio-demographic data, nutritional status, dietary assessment, and clinical symptoms.

A total of 258 children, aged between 4 and 12 years, were enrolled in the study, consisting of 129 participants in the study group and 129 in the control group. BPb levels along with essential elements were measured by using inductively coupled plasma optical emission spectroscopy (ICP-OES) following microwave digestion. A questionnaire was administered to gather information on socio-demographic and clinical symptoms. Nutritional status was assessed using anthropometric measurements, while dietary assessments were evaluated using a standardized food-frequency questionnaire (FFQ).

The findings indicated that the study group had significantly elevated Pb levels compared to the control group. The children were divided into two categories: those with BPb < 10 μg/dL (9.59 ± 0.28; 21%; Group A) and those with BPb > 10 μg/dL (22.67 ± 8.44; 79%; Group B). Socio-demographic factors like low social status, low parental educational, parental occupational exposure, type of house, source of water, average time spent outdoors were found to be significantly associated with high BPb levels. The mean concentrations of essential elements were notably lower in the study group compared with the control group. Moreover, the mean levels of Fe, Zn, Cu, Ca, Mn, Se, and P were significantly diminished in Group B relative to Group A. Higher BPb levels, accompanied by a concomitant decrease in essential elements, were more pronounced in boys than in girls. A statistically significant inverse relationship was observed between BPb levels and all essential elements. In addition, significant positive inter-element correlations were detected, suggesting a possible agonistic interaction between the metabolisms of these essential metals. Reduced body mass index (BMI), lean body mass and fat free mass, along with abnormal body fat percentage, reflected impaired growth and nutritional health among exposed children. A statistically significant inverse relationship was observed between BPb levels and consumption of plant & animal based food. Multivariate regression identified that socioeconomic status, parental education, essential elements, dietary intake, and nutritional status were independently associated with BPb. Common clinical manifestations observed included headache, anxiety, tiredness, lethargy, abdominal pain & constipation, hyperactivity, low academic performance, sleep disturbance, irritability, convulsion, eating disturbance, enuresis, speech disturbance, indicating multisystem involvement of chronic lead toxicity.

The findings highlight the urgent need for environmental regulation, nutritional intervention, routine health screening, and community awareness programs to reduce lead exposure and protect the health and development of vulnerable pediatric populations.