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A pilot study of lead and cadmium exposure in young children in Stockholm, Sweden: methodological considerations
M Bérglund1, B Lind, E Lannerö
1Institute of Environmental Medicine, Karolinska Institute, Stockholm, Sweden.
Insights
This study found that capillary blood microsampling can reliably measure blood lead (Pb) levels in young children, provided strict quality control is used to prevent contamination. However, this method is not suitable for measuring low blood cadmium (Cd) concentrations.
Area of Science:
- Environmental Health
- Pediatric Toxicology
- Analytical Chemistry
Background:
- Lead (Pb) and cadmium (Cd) exposure in children poses significant health risks.
- Accurate monitoring of blood lead (BPb) and blood cadmium (BCd) concentrations is crucial for public health interventions.
- Capillary blood microsampling offers a less invasive alternative to traditional venipuncture for pediatric blood collection.
Purpose of the Study:
- To evaluate the reliability of a capillary blood microsampling technique for determining blood lead (BPb) and blood cadmium (BCd) concentrations in urban young children.
- To assess the impact of strict quality control measures on the accuracy of capillary blood microsampling for Pb and Cd monitoring.
- To compare BPb concentrations between young children and their parents and explore potential exposure sources.
Main Methods:
- A fingerstick capillary blood microsampling technique was employed on 41 children (13-20 months) and their parents in Stockholm.
- Rigorous quality control measures were implemented, including contamination control, handwashing protocols, comparison with venous blood samples, and external quality assessment.
- Blood lead (BPb) and hemoglobin (Hb) concentrations were analyzed, with Pb and Cd levels assessed using linear regression analysis.
Main Results:
- Blood sampling materials can contaminate samples with Pb and Cd, significantly affecting results at low concentrations (< 100 µg Pb/L, < 1 µg Cd/L).
- Reliable BPb concentrations (> 10 µg Pb/L) can be obtained using the tested capillary method with strict quality control, but not reliable BCd concentrations (< 1 µg Cd/L).
- Children's median BPb (27 µg/L) was similar to their parents' (27 µg/L), but the correlation was poor (R² = 0.20), suggesting different exposure sources.
Conclusions:
- Capillary blood microsampling is a viable and well-accepted method for monitoring blood lead (Pb) in young children when stringent quality control is applied.
- The tested capillary method is not suitable for accurately measuring low blood cadmium (Cd) concentrations due to potential contamination issues.
- The poor correlation between child and parent BPb levels highlights the need to investigate distinct environmental Pb exposure pathways for different age groups.
Abstract:
A capillary blood microsampling technique was tested among urban young children in Stockholm. Blood lead (BPb) and hemoglobin (Hb) concentrations were determined in capillary blood obtained by fingerstick from 41 children, 13-20 months old, and the accompanying parent. The quality control included control for lead (Pb) and cadmium (Cd) contamination of material and equipment used for blood sampling, washing procedures for the hands and fingers to be punctured, comparisons of Pb and Cd concentrations in blood obtained by fingerstick and by brachial vein puncture from the same individuals, analysis of external quality control samples for Pb and Cd in blood together with the collected samples, and evaluation of the analytical performance using linear regression analysis. The results showed that blood sampling material may contaminate the blood samples with amounts of Pb and Cd that would seriously influence the monitoring results in the low concentration range (< 100 micrograms Pb/L and < 1 microgram Cd/L). However, it is possible to obtain reliable BPb concentrations (> 10 micrograms Pb/L), but not BCd concentrations (< 1 microgram Cd/L), with the capillary blood microsampling technique tested provided that a strict quality control is applied. The sampling procedure tested was well accepted by the children and their parents. The children's median BPb concentration (27 micrograms/L; range 9-73 micrograms/L) was similar to the median BPb concentration of their parents (27 micrograms/L; range 7-74 micrograms/L). However, the correlation between child and parent BPb concentrations was poor (R2 = 0.20), which may indicate different sources to Pb exposure in children and parents.