Journal Article

Relation between Blood Lead Levels and Childhood Anemia in India

Nitin B. Jain, Francine Laden, Ulrich Guller, Anoop Shankar, Shamsah Kazani and Eric Garshick

in American Journal of Epidemiology

Published on behalf of Johns Hopkins Bloomberg School of Public Health

Volume 161, issue 10, pages 968-973
Published in print May 2005 | ISSN: 0002-9262
Published online May 2005 | e-ISSN: 1476-6256 | DOI:
Relation between Blood Lead Levels and Childhood Anemia in India

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Lead pollution is a substantial problem in developing countries such as India. The US Centers for Disease Control and Prevention has defined an elevated blood lead level in children as ≥10 μg/dl, on the basis of neurologic toxicity. The US Environmental Protection Agency suggests a threshold lead level of 20–40 μg/dl for risk of childhood anemia, but there is little information relating lead levels <40 μg/dl to anemia. Therefore, the authors examined the association between lead levels as low as 10 μg/dl and anemia in Indian children under 3 years of age. Anemia was divided into categories of mild (hemoglobin level 10–10.9 g/dl), moderate (hemoglobin level 8–9.9 g/dl), and severe (hemoglobin level <8 g/dl). Lead levels <10 μg/dl were detected in 568 children (53%), whereas 413 (38%) had lead levels ≥10–19.9 μg/dl and 97 (9%) had levels ≥20 μg/dl. After adjustment for child's age, duration of breastfeeding, standard of living, parent's education, father's occupation, maternal anemia, and number of children in the immediate family, children with lead levels ≥10 μg/dl were 1.3 (95% confidence interval: 1.0, 1.7) times as likely to have moderate anemia as children with lead levels <10 μg/dl. Similarly, the odds ratio for severe anemia was 1.7 (95% confidence interval: 1.1, 2.6). Health agencies in India should note the association of elevated blood lead levels with anemia and make further efforts to curb lead pollution and childhood anemia.

Keywords: anemia; child; India; lead; lead poisoning; CI, confidence interval

Journal Article.  4132 words. 

Subjects: Public Health and Epidemiology

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