Blood lead and cadmium levels in preschool children and associated risk factors in São Paulo, Brazil

In Brazil, there are scarce data on lead (Pb) and cadmium (Cd) contamination, especially for more vulnerable populations such as preschool children. In this paper, we answer two questions: (1) What are the exposure levels of lead and cadmium in preschool children, in Sao Paulo, Brazil? and (2) What are the risk factors associated with this exposure? This cross-sectional study included 50 day care centers (DCCs), totaling 2463 children aged 1–4 years. Venous blood samples were analyzed by ICP-MS. Questionnaires were administered to the parents. Multiple logistic regression models were used to identify associations between blood lead levels (BLLs) and blood cadmium levels (BCLs) and potential risk factors. The geometric mean for BLLs was 2.16 μg/dL (95% CI: 2.10–2.22 μg/dL), and the 97.5th percentile was 13.9 μg/dL (95% CI: 10.0–17.3 μg/dL). For cadmium exposure, the geometric mean for BCLs was 0.48 μg/L (95% CI: 0.47–0.50 μg/L), and the 95th percentile was 2.57 μg/L (95% CI: 2.26–2.75 μg/L). The DCCs’ geographic region was associated with high BLLs and BCLs, indicating hot spots for lead and cadmium exposures. In addition, it was found that the higher the vehicles flow, the higher were the BLLs in children. Red lead in household gates was also an important risk factor for lead exposure. Comparing these results with the findings of the Fourth National Report on Human Exposure to Environmental Chemicals by CDC-2013, it was found that in Brazilian preschool children the BLLs are almost three times higher (97.5th percentile) and the BCLs are almost twelve times higher (95th percentile) than those in U.S. children. This information is essential to formulate public health policies. [Display omitted] •Blood lead and cadmium levels were found higher than those found in developed countries.•The higher the vehicle flow, the higher were the BLLs in children.•Red lead on household and day care center gates was also an important risk factor for lead exposure. Blood lead and cadmium levels were higher than those found in developed countries. Priority should be given to identify and control exposure sources in Sao Paulo, Brazil.