Neurotoxicity and aggressiveness triggered by low-level lead in children: a review

Lead-induced neurotoxicity acquired by low-level long-term exposure has special relevance for children. A plethora of recent reports has demonstrated a direct link between low-level lead exposure and deficits in the neurobehavioral-cognitive performance manifested from childhood through adolescence. In many studies, aggressiveness and delinquency have also been suggested as symptoms of lead poisoning. Several environmental, occupational and domestic sources of contaminant lead and consequent health risks are largely identified and understood, but the occurrences of lead poisoning remain numerous. There is an urgent need for public health policies to prevent lead poisoning so as to reduce individual and societal damages and losses. In this paper we describe unsuspected sources of contaminant lead, discuss the economic losses and urban violence possibly associated with lead contamination and review the molecular basis of lead-induced neurotoxicity, emphasizing its effects on the social behavior, delinquency and IQ of children and adolescent

Conteúdo de flúor em diversos cereais matinais e salgadinhos encontrados no Brasil

Breakfast cereals and snacks are foodstuffs highly appreciated by children, and the possibility that they contain substantial amounts of fluoride, associated with their widespread consume, may make them important contributors to the total daily fluoride intake. The aim of this study was to analyze the fluoride content on several breakfast cereals (A) and snacks (B) purchased in Brazil. The analysis were made after HMDS-facilitated diffusion (Taves) using the ion-specific electrode (9609). Mean fluoride concentrations ± SD (range, unit mg F/g) were: A= 0.76 ± 0.60 (0.08-1.86, n=15) and B= 0.32 ± 0.09 (0.22-0.55, n=18). Our results suggest that the total amount of fluoride available in some products may contribute to the total daily fluoride intake. The product labels should provide information on their fluoride content to prevent fluorosis at the age of risk.Cereais matinais e salgadinhos são guloseimas altamente apreciadas pelas crianças, e a possibilidade de conterem quantidades substanciais de flúor, associada ao seu indiscriminado consumo, pode torná-los importantes contribuintes para a ingestão diária total de flúor. O objetivo deste estudo foi analisar o conteúdo de flúor em diversos cereais matinais (A) e salgadinhos (B) adquiridos no Brasil. As análises foram feitas após difusão facilitada por HMDS (Taves), usando o eletrodo íon específico (9609). As concentrações médias de flúor ± SD (amplitude, unidade mg F/g) foram: A= 0,76 ± 0,60 (0,08-1,86, n=15) e B= 0,32 ± 0,09 (0,22-0,55, n=18). Nossos resultados sugerem que a quantidade de flúor presente em alguns produtos pode contribuir com a ingestão diária total de flúor. Os rótulos dos produtos deveriam informar seu conteúdo de flúor para prevenir fluorose no período de risco

Cárie e fluorose dentária em escolares de 7 a 12 anos de idade em Catalão, Goiás, Brasil

INTRODUCTION: Over the last two decades, the prevalence of dental caries in children has decreased and the prevalence of dental fluorosis has increased. Knowledge on the epidemiologic conditions of a population is fundamental for the planning of health programs. OBJECTIVES: To determine the prevalence of dental caries and dental fluorosis among schoolchildren, in Catalão, Goiás, Brazil. METHODS: A random sample of 432 schoolchildren aged 7-12-years old was obtained. WHO (1997) criteria for dental caries and fluorosis diagnosis were used. RESULTS: The DMFT indexes were 0.97; 1.20; 1.80; 1.62; 2.40 and 2.51 for 7, 8, 9, 10, 11 and 12 years old, respectively. Analysis of dental fluorosis for the same ages presented higher prevalence at 12 years old and for the female gender. The percentage of questionable dental fluorosis (Dean's classification) was 34.0%. Only 3% of the sample presented dental fluorosis with scores very mild, mild and moderate. CONCLUSIONS: The prevalence of caries in schoolchildren of Catalão, Goiás, Brazil, was low. In average, private schools showed better results than public schools; however, all schools presented a low DMFT index. In this study, dental fluorosis is not a public health problem and has not damaged dental esthetics.INTRODUÇÃO: Nas últimas duas décadas, a prevalência de cárie dentária tem diminuído e a prevalência de fluorose dentária tem aumentado. Para se planejar programas de saúde é fundamental conhecer o perfil epidemiológico das populações. OBJETIVOS: Determinar a prevalência de cárie dentária e fluorose dentária em escolares do município de Catalão, Goiás, Brasil. MÉTODOS: A amostra randomizada foi composta por 432 escolares de 7 a 12 anos de idade. Os critérios utilizados para determinar a prevalência de cárie dentária e fluorose seguiram a metodologia proposta pela OMS, 1997. RESULTADOS: Os valores do Índice CPOD foram de 0,97; 1,20; 1,80; 1,62; 2,40 e 2,51 para as idades de 7, 8, 9, 10, 11 e 12 anos, respectivamente. Considerando o diagnóstico de fluorose dentária para as mesmas idades, houve maior prevalência nos estudantes de 12 anos de idade e no gênero feminino. A porcentagem de fluorose dentária questionável (classificação de Dean) foi de 34,0%. Somente 3,0% da amostra total, apresentou fluorose dentária nos escores muito leve, leve e moderado. CONCLUSÕES: A prevalência de cárie dentária em escolares de Catalão, Goiás, Brasil foi baixa. As escolas particulares mostraram melhores resultados que as escolas públicas, entretanto, em todas elas se verificou baixos valores do Índice CPOD. Neste estudo, a fluorose dentária não tem causado problemas à estética dental e não se caracterizou em um problema de Saúde Pública

Current issues regarding health surveillance of fluoride concentrations in foods

This study analyzed the position of the Federal (Brazil), State (Sao Paulo), and municipal (Bauru, Sao Paulo) governments, civil society representatives, the regulated sector, and research associations concerning issues with fluoride content in foods. Analysis of the interviews (N = 15) used a qualitative methodology (collective subject discourse theory). Various central ideas were identified, including the need for stronger health surveillance in monitoring and controlling fluoride levels, educational measures, and more research in the area. The study concludes that the health surveillance approach to fluoride levels in foods is necessary, but still incipient. There is a mismatch between research output and surveillance. Regulation alone does not suffice to solve all the issues. Health risk communication and health education measures need to be implemented. Issues with fluoride on food labels need further research for the intervention to be effective

Association of dental enamel lead levels with risk factors for environmental exposure

OBJECTIVE: To analyze household risk factors associated with high lead levels in surface dental enamel. METHODS: A cross-sectional study was conducted with 160 Brazilian adolescents aged 14-18 years living in poor neighborhoods in the city of Bauru, southeastern Brazil, from August to December 2008. Body lead concentrations were assessed in surface dental enamel acid-etch microbiopsies. Dental enamel lead levels were measured by graphite furnace atomic absorption spectrometry and phosphorus levels were measured by inductively coupled plasma optical emission spectrometry. The parents answered a questionnaire about their children's potential early (05 years old) exposure to well-known lead sources. Logistic regression was used to identify associations between dental enamel lead levels and each environmental risk factor studied. Social and familial covariables were included in the models. RESULTS: The results suggest that the adolescents studied were exposed to lead sources during their first years of life. Risk factors associated with high dental enamel lead levels were living in or close to a contaminated area (OR = 4.49; 95% CI: 1.69;11.97); and member of the household worked in the manufacturing of paints, paint pigments, ceramics or batteries (OR = 3.43; 95% CI: 1.31;9.00). Home-based use of lead-glazed ceramics, low-quality pirated toys, anticorrosive paint on gates and/or sale of used car batteries (OR = 1.31; 95% CI: 0.56;3.03) and smoking (OR = 1.66; 95% CI: 0.52;5.28) were not found to be associated with high dental enamel lead levels. CONCLUSIONS: Surface dental enamel can be used as a marker of past environmental exposure to lead and lead concentrations detected are associated to well-known sources of lead contamination.OBJETIVO: Analizar factores de riesgo en el ambiente domiciliar asociados con altos niveles de plomo en el esmalte dental superficial. MÉTODOS: Se realizó estudio transversal con 160 adolescentes brasileros (14 a 18 años), residentes en urbanizaciones pobres del municipio de Bauru, SP, de agosto a diciembre de 2008. La concentración de plomo en el esmalte dental fue evaluada por micro biopsias ácidas del esmalte dental superficial, cuantificada por espectrometría de absorción atómica con horno de grafito y la concentración de fósforo fue medida por espectrometría de absorción óptica con plasma inductivamente acoplado. Los padres de los adolescentes respondieron a cuestionario sobre posible exposición previa (5 primeros años de vida del adolescente) al plomo producto de fuentes de contaminación bien conocidas. Se usó regresión logística para identificar asociaciones entre concentración de plomo en el esmalte y factores de riesgo ambientales. Covariables familiares y sociales fueron incluidas en los modelos. RESULTADOS: Los resultados sugieren que los jóvenes evaluados fueron expuestos a fuentes de plomo durante sus primeros años de vida. Los factores de riesgo asociados con el resultado fueron residir en área contaminada por plomo o en sus proximidades (OR=4,49; IC 95%: 1,69;11,97) y haber convivido, en el mismo domicilio, con persona que trabajaba en fábrica de tintas, pigmentos, cerámicas o baterías (OR= 3,43; IC 95%: 1,31;9,00). Haber usado, en casa, cerámica vitrificada, juegos de baja calidad o piratas, haber aplicado zircón en portones de hierro sin cobertura esmaltada o almacenar baterías de carro usadas en la residencia (OR= 1,31; IC 95%: 0,56-3,03) y hábito de fumar no fueron asociados con altas concentraciones de plomo en el esmalte dental (OR=1,66; IC 95%: 0,52;5,28). CONCLUSIONES: El esmalte dental superficial puede ser utilizado como marcador de exposición ambiental pasada al plomo y las concentraciones encontradas de dicho metal están relacionadas con fuentes bien conocidas de contaminación por plomo.OBJETIVO: Analisar fatores de risco no ambiente domiciliar associados com altos níveis de chumbo no esmalte dentário superficial. MÉTODOS: Estudo transversal conduzido com 160 adolescentes brasileiros (14 a 18 anos), residentes em bairros pobres do município de Bauru, SP, de agosto a dezembro de 2008. A concentração de chumbo no esmalte dentário foi avaliada por microbiópsias ácidas do esmalte dentário superficial, quantificada por espectrometria de absorção atômica com forno de grafite e a concentração de fósforo foi medida por espectrometria de absorção óptica com plasma indutivamente acoplado. Os pais dos adolescentes responderam a questionário sobre possível exposição prévia (cinco primeiros anos de vida do adolescente) a chumbo decorrente de fontes de contaminação bem conhecidas. Usou-se regressão logística para identificar associações entre concentração de chumbo no esmalte e fatores de risco ambientais. Covariáveis familiares e sociais foram incluídas nos modelos. RESULTADOS: Os resultados sugerem que os jovens avaliados foram expostos a fontes de chumbo durante seus primeiros anos de vida. Os fatores de risco associados com o desfecho foram residir em área contaminada por chumbo ou nas suas proximidades (OR = 4,49; IC 95%: 1,69;11,97) e ter convivido, no mesmo domicílio, com pessoa que trabalhava em fábrica de tintas, pigmentos, cerâmicas ou baterias (OR = 3,43; IC 95%: 1,31;9,00). Ter usado, em casa, cerâmica vitrificada, brinquedos de baixa qualidade ou piratas, ter aplicado zarcão em portões de ferro sem cobertura esmaltada ou armazenar baterias de carro usadas na residência (OR = 1,31; IC 95%: 0,56;3,03) e hábito de fumar não foram associados com altas concentrações de chumbo no esmalte dentário (OR = 1,66; IC 95%: 0,52;5,28). CONCLUSÕES: O esmalte dentário superficial pode ser utilizado como marcador de exposição ambiental passada ao chumbo e as concentrações encontradas desse metal estão ligadas a fontes bem conhecidas de contaminação por chumbo

Fluoretação da água de abastecimento público e prevalência de fluorose dentária em bairro da periferia de Bauru, SP

OBJECTIVES: The objectives of this study were to assess the fluoride concentration in the public water supply and the prevalence of dental fluorosis in schoolchildren between 7 and 15 years old, living in a peripheral district of the municipality of Bauru. MATERIAL AND METHODS: For this, fifty two water samples were collected on three different days of one week. These samples were analyzed for fluoride by means of the ion-sensitive electrode method (Orion 9609) coupled to a potentiometer (Procyon, model 720). In this method, 1.0 mL of TISAB II (Orion) was added to 1.0 mL of the sample. For the epidemiological survey of fluorosis, 52 schoolchildren of both genders, aged between 7 and 15 were assessed, with prior authorization from their caretakers. Only one person examined the children, after supervised toothbrushing and drying with cotton wool rolls. The TF index was used. RESULTS: The fluoride concentrations in the water samples ranged from 0.62 to 1.20 mg/L, with a mean of 0.9 mg/L. The prevalence of dental fluorosis was 33%, with severity ranging from TF1 to TF4 (Kappa of 0.73 and concordance of 83.33%). CONCLUSIONS: The results from the analysis of water samples indicated a fluoride concentration greater than recommended for Bauru. The fluorosis levels found were higher than expected for a peripheral district, in which water is one of the few sources of fluoride.OBJETIVOS: Avaliar a concentração de flúor na água de abastecimento público e a prevalência de fluorose dentária de escolares entre 7 e 15 anos de idade, residentes em um bairro da periferia de Bauru. MATÉRIAL E MÉTODOS: Foram coletadas 52 amostras de água durante três dias de uma semana e analisadas utilizando-se o eletrodo íon sensível (Orion 9609), acoplado a um potenciômetro (Procyon, modelo 720), com 1,0 mL da amostra à qual foi adicionado 1,0 mL de TISAB II (Orion). Para o levantamento epidemiológico de fluorose foram examinados 52 escolares entre 7 e 15 anos de idade, de ambos os gêneros, mediante a obtenção de autorização prévia dos responsáveis. Somente um examinador realizou os exames após escovação supervisionada e secagem dos dentes com rolos de algodão. O índice utilizado foi o TF, estabelecido a partir do grau máximo verificado em cada indivíduo. RESULTADOS: A concentração de flúor na água variou entre 0,62 e 1,15 mg/L, mantendo uma média de 0,9 mg/L. A prevalência de fluorose dentária verificada foi de 33%, com severidade variando entre TF1 e TF4 (Kappa=0,73 e concordância de 83,33%). CONCLUSÕES: Os resultados da análise das amostras de água indicam uma concentração média de flúor acima do recomendado para Bauru. O índice de fluorose dentária verificado foi maior que o esperado para um bairro da periferia, onde a água é uma das poucas fontes de ingestão de flúor

O expossoma humano desvendando o impacto do ambiente sobre a saúde: promessa ou realidade?

Considering the innovative nature of the approach to human exposome, we present the state of the art of studies on exposome, and discuss current challenges and perspectives in this area. Several reading and discussion activities were conducted by the Expossoma e Saúde do Trabalhador (eXsat – Group Exposome and Worker’s Health), with systematization of the literature in the area published between January 2005 and January 2017, available in the databases PubMed and Web of Science. This comment brings a thematic analysis to encourage the dissemination of the exposome approach for studies in the Public Health area.Levando em consideração a natureza inovadora da abordagem do expossoma humano, apresentamos o estado da arte dos estudos sobre expossoma, e discutimos os desafios e perspectivas atuais nessa área. Foram realizadas diversas atividades de leitura e discussão pelo grupo eXsat (Expossoma e Saúde do Trabalhador), com sistematização da literatura da área publicada entre janeiro de 2005 e janeiro de 2017, disponíveis nas bases de dados PubMed e Web of Science. O presente comentário traz uma análise da temática de forma a incentivar a disseminação da abordagem do expossoma nos estudos da área de Saúde Pública

Is chemical exposure present in informal work associated with Sars-CoV-2 infection?

OBJECTIVE: To compare the incidence of Covid-19 symptoms between informal home-based workers and a control group and to assess the association of these cases with blood elements concentrations and other relevant risk factors for Sars-Cov-2 infection. METHODS: Welders chemically exposed to potentially toxic elements (PTEs) (n = 26) and control participants (n = 25) answered questionnaires on adherence to social distancing and signs and symptoms of the disease for five months during the Covid-19 pandemic. After follow-up, Covid-19 serology tests were performed on a subsample of 12 chemically exposed workers and 20 control participants. Before the pandemic, PTE concentrations in blood (As, Mn, Ni, Cd, Hg, Sb, Sn, Cu, Zn, and Pb) were measured by ICP-MS. RESULTS: The chemically exposed group had higher lead and cadmium levels in blood (p < 0.01). The control group presented lower adherence to social distancing (p = 0.016). Although not significant, welders had a 74% greater chance of having at least one Covid-19 symptom compared with control participants, but their adherence to social distancing decreased this chance by 20%. The use of taxis for transportation was a risk factor significantly associated with Covid-19 symptoms. CONCLUSION: The lower adherence to social distancing among the control group greatly influences the development of Covid-19. The literature lacks data linking exposure to PTEs and Sars-Cov-2 infection and/or severity. In this study, despite chemical exposure, working from home may have protected welders against Covid-19, considering that they maintained greater social distancing than control participants

Seven years of external control of fluoride levels in the public water supply in Bauru, São Paulo, Brazil

Fluoridation of the public water supplies is recognized as among the top ten public health achievements of the twentieth century. However, the positive aspects of this measure depend on the maintenance of fluoride concentrations within adequate levels. To report the results of seven years of external control of the fluoride (F) concentrations in the public water supply in Bauru, SP, Brazil in an attempt to verify, on the basis of risk/benefit balance, whether the levels are appropriate. From March 2004 to February 2011, 60 samples were collected every month from the 19 supply sectors of the city, totaling 4,641 samples. F concentrations in water samples were determined in duplicate, using an ion-specific electrode (Orion 9609) coupled to a potentiometer after buffering with TISAB II. After the analysis, the samples were classified according to the best risk-benefit adjustment. Means (±standard deviation) of F concentrations ranged between 0.73±0.06 and 0.81±0.10 mg/L for the different sectors during the seven years. The individual values ranged between 0.03 and 2.63 mg/L. The percentages of the samples considered “low risk” for dental fluorosis development and of “maximum benefit” for dental caries prevention (0.55-0.84 mg F/L) in the first, second, third, fourth, fifth, sixth, and seventh years of the study were 82.0, 58.5, 37.4, 61.0, 89.9, 77.3, and 72.4%, respectively, and 69.0% for the entire period. Fluctuations of F levels were found in the public water supply in Bauru during the seven years of evaluation. These results suggest that external monitoring of water fluoridation by an independent assessor should be implemented in cities where there is adjusted fluoridation. This measure should be continued in order to verify that fluoride levels are suitable and, if not, to provide support for the appropriate adjustmentsCNPq 403427/2004-5CNPq 403427/2004