{"title":"Time-trends of blood lead levels from 2020 to 2023 in pregnant and breastfeeding women from Adjara, Georgia—A birth registry-based study","authors":"","doi":"10.1016/j.ijheh.2024.114482","DOIUrl":null,"url":null,"abstract":"<div><h3>Background</h3><div>In response to substantial lead exposure, the autonomous republic of Adjara in Georgia initiated complementary blood lead level (BLL) testing for pregnant women as part of their antenatal care services in 2020.</div></div><div><h3>Objectives</h3><div>To study the background BLLs in pregnant and breastfeeding women in Adjara and explore the time-trends of BLLs from September 2020 to July 2023.</div></div><div><h3>Methods</h3><div>We used data on BLLs during pregnancy or postpartum from the lead screening program in Adjara, combined with data from the Georgian Birth Registry, totaling 9,510 women. To study the temporal changes in BLLs, we used independent samples t-tests and chi-square tests.</div></div><div><h3>Results</h3><div>In 2020, the mean (standard deviation [SD]) BLL was 8.8 (5.4) μg/dL, declining annually by 1.0–2.2 μg/dL to reach 3.6 (2.5) μg/dL in 2023. The prevalence of pregnant women with BLLs ≥3.5, ≥5.0, and ≥10.0 μg/dL also decreased from 2020 to 2023. Specifically, 21.2% of women in their first trimester had BLLs ≥10 μg/dL in 2020, compared with 2.3% in 2023. Similarly, 73.5% had BLLs ≥5.0 μg/dL in 2020, which declined to 20.4% in 2023. Lastly, 89.1% had BLLs ≥3.5 μg/dL in 2020, decreasing to 38.6% in 2023.</div></div><div><h3>Discussion</h3><div>In 2023, nearly 40% of women in their first trimester had BLLs of ≥3.5 μg/dL, a level considered the reference value in the United States (US) and corresponding to the 97.5th percentile among US children. From 2020 to 2023, the mean BLL in pregnant women decreased by 59%, accompanied by a considerable decline in the prevalence of women with BLLs ≥3.5, ≥5.0, and ≥10.0 μg/dL. Despite the encouraging downward trend in BLLs throughout the study period, our data indicate that a considerable number of fetuses continue to be exposed to harmful levels of lead and that lead exposure remains a significant public health challenge in Adjara.</div></div>","PeriodicalId":13994,"journal":{"name":"International journal of hygiene and environmental health","volume":null,"pages":null},"PeriodicalIF":4.5000,"publicationDate":"2024-10-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"International journal of hygiene and environmental health","FirstCategoryId":"3","ListUrlMain":"https://www.sciencedirect.com/science/article/pii/S1438463924001639","RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q1","JCRName":"INFECTIOUS DISEASES","Score":null,"Total":0}
引用次数: 0
Abstract
Background
In response to substantial lead exposure, the autonomous republic of Adjara in Georgia initiated complementary blood lead level (BLL) testing for pregnant women as part of their antenatal care services in 2020.
Objectives
To study the background BLLs in pregnant and breastfeeding women in Adjara and explore the time-trends of BLLs from September 2020 to July 2023.
Methods
We used data on BLLs during pregnancy or postpartum from the lead screening program in Adjara, combined with data from the Georgian Birth Registry, totaling 9,510 women. To study the temporal changes in BLLs, we used independent samples t-tests and chi-square tests.
Results
In 2020, the mean (standard deviation [SD]) BLL was 8.8 (5.4) μg/dL, declining annually by 1.0–2.2 μg/dL to reach 3.6 (2.5) μg/dL in 2023. The prevalence of pregnant women with BLLs ≥3.5, ≥5.0, and ≥10.0 μg/dL also decreased from 2020 to 2023. Specifically, 21.2% of women in their first trimester had BLLs ≥10 μg/dL in 2020, compared with 2.3% in 2023. Similarly, 73.5% had BLLs ≥5.0 μg/dL in 2020, which declined to 20.4% in 2023. Lastly, 89.1% had BLLs ≥3.5 μg/dL in 2020, decreasing to 38.6% in 2023.
Discussion
In 2023, nearly 40% of women in their first trimester had BLLs of ≥3.5 μg/dL, a level considered the reference value in the United States (US) and corresponding to the 97.5th percentile among US children. From 2020 to 2023, the mean BLL in pregnant women decreased by 59%, accompanied by a considerable decline in the prevalence of women with BLLs ≥3.5, ≥5.0, and ≥10.0 μg/dL. Despite the encouraging downward trend in BLLs throughout the study period, our data indicate that a considerable number of fetuses continue to be exposed to harmful levels of lead and that lead exposure remains a significant public health challenge in Adjara.
期刊介绍:
The International Journal of Hygiene and Environmental Health serves as a multidisciplinary forum for original reports on exposure assessment and the reactions to and consequences of human exposure to the biological, chemical, and physical environment. Research reports, short communications, reviews, scientific comments, technical notes, and editorials will be peer-reviewed before acceptance for publication. Priority will be given to articles on epidemiological aspects of environmental toxicology, health risk assessments, susceptible (sub) populations, sanitation and clean water, human biomonitoring, environmental medicine, and public health aspects of exposure-related outcomes.