Machmud Putri B, Prihartono Indira, Prihartono Nurhayati A
Department of Epidemiology, Faculty of Public Health, Universitas Indonesia, Jakarta, Indonesia.
Department of International Health, John Hopkins Bloomberg School of Public Health, Baltimore, UNITED States.
Narra J. 2025 Apr;5(1):e2059. doi: 10.52225/narra.v5i1.2059. Epub 2025 Mar 11.
Evidence has shown that unregulated lead battery recycling is a significant contributor to lead exposure in many countries. The aim of this study was to investigate the factors associated with blood lead levels (BLLs) among children aged 1 to 5 who reside within 250 meters of used lead-acid battery recycling areas in three metropolitan neighborhoods in Indonesia. Using a cross-sectional approach, data was collected through in-person household visitations. The assessed risk factors included socio-demographic data, nutritional status, immunization, breastfeeding status, and daily food intake. BLLs were measured using the LeadCare II portable device and confirmed with plasma mass spectrometry, then classified based on the recommendations of the Centers for Disease Control and Prevention (CDC). A multivariate multinomial logistic regression was used to analyze the association between children's characteristics and daily eating habits as predictors of BLLs. Out of a total of 433 eligible children, 361 were included in this study. High monthly household income (adjusted odds ratio (aOR): 0.16; 95% confidence interval (95%CI): 0.04-0.67), child's age (aOR: 0.21; 95%CI: 0.07-0.64), and being boy (aOR: 2.19; 95%CI: 1.17-4.10) were associated with medium BLLs in comparison to low BLLs. In addition, high fruit consumption (AOR: 1.91; 95%CI: 0.99-3.66) and high dairy consumption (aOR: 0.42; 95%CI: 0.27-0.76) were associated with medium BLLs in comparison to low BLLs. Our study also indicated that being a boy (aOR: 5.53; 95%CI: 1.68-18.25), completed breastfeeding history (aOR: 3.47; 95%CI: 1.18-10.23), short outdoor activity duration (aOR: 0.30; 95%CI: 0.09-0.97), high heme-rich iron consumption (aOR: 0.32; 95%CI: 0.10-1.00), and high dairy consumption (aOR: 0.13; 95%CI: 0.04-0.44) were associated with high BLLs in comparison to low BLLs. This study highlights the necessity for further investigation into the impact of various dietary groups on the BLLs of children living around used lead-acid battery recycling areas.
有证据表明，在许多国家，无监管的铅电池回收是导致铅暴露的一个重要因素。本研究的目的是调查印度尼西亚三个大都市社区中，居住在距废旧铅酸电池回收区250米范围内的1至5岁儿童血铅水平（BLLs）的相关因素。采用横断面研究方法，通过入户访问收集数据。评估的风险因素包括社会人口统计学数据、营养状况、免疫接种、母乳喂养状况和每日食物摄入量。使用LeadCare II便携式设备测量BLLs，并通过等离子体质谱法进行确认，然后根据疾病控制与预防中心（CDC）的建议进行分类。采用多变量多项逻辑回归分析儿童特征和日常饮食习惯作为BLLs预测因素之间的关联。在总共433名符合条件的儿童中，361名被纳入本研究。与低BLLs相比，高家庭月收入（调整优势比（aOR）：0.16；95%置信区间（95%CI）：0.04 - 0.67）、儿童年龄（aOR：0.21；95%CI：0.07 - 0.64）和男孩（aOR：2.19；95%CI：1.17 - 4.10）与中等BLLs相关。此外，与低BLLs相比，高水果摄入量（优势比（AOR）：1.91；95%CI：０.99 - 3.66）和高乳制品摄入量（aOR：0.42；95%CI：0.27 - 0.76）与中等BLLs相关。我们的研究还表明，与低BLLs相比，男孩（aOR：5.53；95%CI：1.68 - 18.25）、完整的母乳喂养史（aOR：3.47；95%CI：1.18 - 10.23）、户外活动时间短（aOR：0.30；95%CI：0.09 - 0.97）、高铁含量丰富的食物摄入量高（aOR：0.32；95%CI：0.１0 - 1.00）和高乳制品摄入量（aOR：0.13；95%CI：0.04 - 0.44）与高BLLs相关。本研究强调有必要进一步调查各类饮食对居住在废旧铅酸电池回收区附近儿童BLLs的影响。
