Environmental and Household Sources Associated with Elevated Blood Lead Levels Among Mexican Women of Childbearing Age: A Community-Based Screening Study
Aug 2026· Toxics· Vol 14, pp. 695· 0 citations· 53 references
Medicine
TL;DR
The findings support LGC as an important source of Pb exposure while identify home remodeling and residential proximity to highways as additional sources associated with elevated BLLs.
Abstract
Background: Lead (Pb) exposure remains a significant public health concern, particularly among women of childbearing age, because of its adverse effects on maternal–child health. Although lead-glazed ceramics (LGC) for cooking or storing food are a well-recognized source of Pb exposure in Mexico, other environmental and household sources remain insufficiently characterized. Objective: To identify environmental and household factors associated with elevated blood lead levels (BLLs) among women of childbearing age participating in a community-based screening in Mexico City. Methods: We conducted a cross-sectional analysis of 158 women aged 18–40 years. Capillary BLLs were measured using the LeadCare® II system. Participants completed a structured questionnaire assessing potential Pb sources of exposure. Elevated BLL was defined as ≥3.5 µg/dL. Associations between exposure sources and elevated BLL were evaluated using multivariable logistic regression adjusted for sociodemographic and lifestyle factors. Shapley decomposition was used to estimate the relative contribution of each exposure source to the model. Results: The prevalence of elevated BLLs was 31%. Women reporting both past and current use of LGC had higher odds of elevated BLLs than women who had never used LGC (adjusted OR = 9.43; 95% CI: 1.85–48.15). Living in or regularly visiting a recently remodeled home (adjusted OR = 3.21; 95% CI: 1.45–7.11) and living near a highway (adjusted OR = 2.41; 95% CI: 1.07–5.48) were also independently associated with elevated BLLs. LGC use was the largest contributor to the model performance (47.46%), followed by home remodeling (31.78%) and proximity to highways (20.76%). Conclusions: Our findings support LGC as an important source of Pb exposure while identify home remodeling and residential proximity to highways as additional sources associated with elevated BLLs. Together, these findings broaden the understanding of Pb exposure pathways among women of childbearing age and support the need for prevention and screening strategies.
BACKGROUND
Lead exposure can cause long-term developmental deficits in children. We examined associations between sociodemographic characteristics and blood lead testing and levels in Southern California, where environmental lead hazards might exacerbate blood lead risk.
METHODS
We conducted a population-based analysis using repeated annual observations among Kaiser Permanente Southern California (KPSC) members aged 6-30 months from January 1, 2016-September 30, 2025 (with 2025 observations available through September only) to assess trends over time. Measured exposures included individual- and neighborhood-level sociodemographic characteristics. Outcomes included receipt of blood lead testing and blood lead levels (BLLs) ≥3.5 μg/dL. Modified Poisson regression with generalized estimating equations was used to estimate adjusted prevalence ratios (aPRs), accounting for age, sex, race and ethnicity, county, Medi-Cal status, neighborhood deprivation index (NDI), and year.
RESULTS
Among 923,144 KPSC annual records from 529,869 unique children, testing was relatively stable over time, with a modest ∼1% annual decline (aPR, 0.99; 95% CI: 0.98-0.99). Testing was more common among Medi-Cal recipients and children residing in higher NDI quartiles. Among 324,291 total tests (277,361 unique children), 0.7% of tests had BLLs ≥3.5 μg/dL (n=2,134), and prevalence declined over time (aPR, 0.91; 95% CI: 0.88-0.94). BLLs ≥3.5 μg/dL were lower among Hispanic children compared with non-Hispanic White children, with variation observed by Medi-Cal status and NDI.
CONCLUSIONS
Blood lead testing rates changed little over time, whereas BLLs ≥3.5 μg/dL declined. However, differences in BLL ≥3.5 μg/dL persisted across sociodemographic groups, and a clinically important number of children continued to have elevated levels. Ongoing strategic prevention efforts remain important to reduce childhood lead exposure in Southern California.
C. Luc, Gloria C Chi, Rudy Patrick et al.· Environmental Research· 0 citations
Lead is a neurotoxic metal. No safe blood lead level (BLL) has been identified in children; the CDC reference value was lowered to 3.5 µg/dL in 2021, while Mexico’s regulatory threshold remains at 10 µg/dL. Lead-glazed earthenware is the main documented source of pediatric exposure in Mexico. We studied children 0–15 years insured by the Mexican Social Security Institute (IMSS) in two Jalisco municipalities: Tonalá (n = 500), historically a ceramic-producing center, and Zapopan (n = 374), an urban area without this tradition. BLL was measured by graphite furnace atomic absorption spectrophotometry, and sociodemographic, environmental, occupational, and household exposure data were collected by questionnaire and analyzed with bivariate tests and multivariable models. Median BLL was 1.16 µg/dL in Tonalá and 2.08 µg/dL in Zapopan. Few children reached 5 µg/dL (3.2% and 6.4%), roughly twice as many exceeded 3.5 µg/dL (6.6% and 16.3%), and most exceeded 1 µg/dL (59.4% and 93.6%). In Zapopan, household glazed earthenware use and younger age were independently associated with a higher BLL in every model; in Tonalá, paternal professional occupation was associated with a lower BLL, an exploratory finding given its small subgroup. Widespread low-level exposure at both sites supports sustained facility-level surveillance and alignment of Mexico’s regulatory criterion with current reference values.
Jesús García-Gómez, Oscar Humberto Rodríguez-Aguirre, Jorge A. Ruiz-Romero et al.· Toxics· 0 citations
Summary Background Depression and anxiety are common mental disorders globally but often overlooked in low- and middle-income countries (LMICs), with limited population-level evidence on the role of household environmental conditions (HECs), especially for women. This study examined associations of HECs with depression and anxiety among women in Bangladesh. Methods This cross-sectional study analysed data from ever-married women in the 2022 Bangladesh Demographic and Health Survey. Depression and anxiety symptoms were measured using validated PHQ-9 and GAD-7 scales. Exposures included seven HEC indicators—housing materials, overcrowding, household air pollution (HAP), water source and treatment, sanitation, and handwashing facilities—and a cumulative HEC score. Associations were assessed using multinomial logistic regression and reported as adjusted risk ratios (aRR) with 95% confidence intervals (95% CI), adjusting for age, education, employment, place and duration of residence, etc. Findings Among 19,012 women, prevalence of probable depression and generalised anxiety disorder (GAD) was 5·0% and 4·4%, respectively. More than half of households had ≥3 poor HECs. Compared with women in households with ≤1 poor HEC, those with three (aRR: 1·30, 95% CI: 1·13–1·83) or ≥4 poor HECs (aRR: 1·31, 95% CI: 1·02–1·67) had higher risk of depression but not GAD. High HAP exposure was associated with both depression (aRR: 1·58, 95% CI: 1·01–2·45) and GAD (aRR: 1·61, 95% CI: 1·02–2·57). Overcrowding was associated with probable GAD (aRR: 1·32, 95% CI: 1·07–1·63), and poor sanitation with depression (aRR: 1·21, 95% CI: 1·05–1·39) only. Interpretation Poor HECs are potential contributors to depression and anxiety among Bangladeshi women. Integrating environmental improvements, particularly reducing HAP, improving sanitation, and reducing household overcrowding, into mental health prevention strategies may complement existing efforts to reduce the burden of common mental disorders in Bangladesh and other similar LMICs. Funding The work was supported by UKRI Medical Research Council grant (grant no: MC_UU_00032/6).
Md. Mostaured Ali Khan, Kaniz Fatima, Md Niamul Islam Sium et al.· The Lancet Regional Health -...· 0 citations
Background Secondhand smoke (SHS) exposure remains a major public health concern, particularly for children who are highly vulnerable to the harmful effects of tobacco smoke. Despite comprehensive smoke-free policies in Hungary, children may still be exposed to SHS in private environments such as homes and outdoor settings. This study aimed to examine the prevalence and determinants of children’s exposure to SHS in Hungary. Methods This cross-sectional study used nationally representative data from the European Health Interview Survey (EHIS) 2019 conducted in Hungary. Of 964 eligible parents living with at least one child aged 0–15 years, 191 with missing outcome or covariate data were excluded, yielding a final analytic sample of 773 parents. Children’s exposure was assessed from parental reports of exposure to conventional cigarette smoke and/or e-cigarette aerosol during the previous week. Three outcome variables were analyzed: indoor exposure, outdoor exposure, and overall exposure. Associations between parental demographic, socioeconomic, health, and lifestyle factors and children’s exposure were examined using Pearson’s chi-square tests and weighted multivariable logistic regression models. Results Among the respondents, 8.8% reported indoor SHS exposure and 17.1% reported outdoor exposure among children, while 21.5% reported overall SHS exposure. Children’s exposure to SHS was significantly associated with several parental characteristics. Lower household income, non-registered marital status, poorer parental oral health, and active smoking were associated with higher odds of indoor SHS exposure. Outdoor exposure was associated with urbanization, poorer oral health, and parental smoking. Overall SHS exposure was higher among children of parents with lower income, non-registered marital status, poorer oral health, poorer mental health, and active smoking status. Conclusion A considerable proportion of children in Hungary remain exposed to SHS. Socioeconomic disadvantage, parental smoking, and parental health status are important determinants of children’s SHS exposure. Targeted public health interventions focusing on smoking cessation and promoting smoke-free home environments are essential to reduce children’s exposure to SHS.
B. Ulambayar, A. Nagy· Frontiers in Public Health· 0 citations
Background Foodborne illness poses a serious threat to public health in low-income countries. This study aims to assess the household food-handling practices of adult women in Gondar City, Northwest Ethiopia, and to examine associated factors. Methods A community-based cross-sectional survey was conducted from May 20 to June 19, 2024, and 636 women were randomly selected to participate. Data on socio-demographic, behavioral, and environmental factors were collected using a standardized, pretested questionnaire. Composite indices for knowledge, attitude, and practice were created, with scores of 70% or higher considered good performance. Both binary and multivariable logistic regression analyses were performed. To assess model fit, we used the Hosmer-Lemeshow test, which yielded a p-value of 0.72, and calculated the variance inflation factor, which was less than 2.5. Results Overall, 53.8% of individuals (95% CI: 49.9–57.6) handled food safely. Good practice was significantly associated with higher education (AOR: 4.22, 95% CI: 2.11–8.44), marriage (AOR: 4.25, 95% CI: 2.05–8.79), good knowledge (AOR: 2.30, 95% CI: 1.49–3.54), a positive attitude (AOR: 2.52, 95% CI: 1.23–5.16), and access to proper food-handling information (AOR: 3.25, 95% CI: 1.90–5.56). Conclusion Although more than half had good food-handling practices, substantial gaps remain in knowledge, attitudes, and environmental conditions. Improving women’s access to food-handling information and strengthening behavioral change interventions are suggested.
Mengesha Genet, Asmamaw Malede, Jember Azanaw et al.· Environmental Health Insight...· 0 citations
BACKGROUND
Persistently low fertility and rapid population aging have increased concern regarding subsequent childbearing in China. Although fertility intentions have been widely examined, the multidimensional pressure experienced by parous women when considering another child remains insufficiently understood.
METHODS
An online cross-sectional survey was conducted from January to June 2025 among 2097 parous women aged 18-49 years across 21 provinces and four municipalities in China. Subsequent fertility pressure was assessed using a validated 24-item scale. Guided by Becker's quantity-quality trade-off theory and the socio-ecological framework, hierarchical multiple linear regression was conducted by entering variables in four blocks: demographic characteristics, family and caregiving factors, socioeconomic and structural factors, and psychological and cultural factors.
RESULTS
The mean subsequent fertility pressure score was 118.17 ± 23.41, indicating that women experienced pressure across multiple economic, occupational, health, childcare, child-development, and family-relationship domains. Higher fertility pressure was associated with poorer self-rated health, having more existing children, maternal primary caregiving, the absence of affordable childcare, lower personal and household income, smaller housing area, lower self-perceived social status, lower subjective wellbeing, more frequent Internet use, a lower ideal number of children, and weaker endorsement of lineage continuation. Compared with government-provided childcare, market-based childcare was also associated with higher pressure. Greater partner participation in housework and having only daughters rather than only sons were associated with lower pressure. The final model explained 26.3% of the variance in fertility pressure (Adjusted R2 = 0.253).
CONCLUSIONS
Subsequent fertility pressure among parous women is a socially embedded experience shaped by physical capacity, cumulative caregiving demands, gendered household labor, material security, childcare provision, psychological resources, and fertility values. Policies should prioritize stable and affordable public childcare, a sustained redistribution of unpaid care through father-specific leave and paternal involvement, targeted economic and housing assistance, maternal health and mental health support, and protection of women's reproductive autonomy.
Sijing Chen, Liu-Lan Li, Yiman Liu et al.· Acta Psychologica· 0 citations
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