Exposition au plomb des enfants en France : niveaux d'imprégnation et déterminants

Blood lead levels (BLLs) have substantially decreased in children in France over the past 20 years, thanks to the ban of leaded gasoline. However, further reducing exposure is a public health goal because there is no clear toxicological threshold. It is therefore important to update the blood lead level distribution and to estimate the contribution of environmental sources of lead to improve and adapt prevention strategies. We have carried out two cross-sectional surveys in 2008-2009: (1) a biomonitoring study called Saturn-Inf which enrolled 3831 children aged from 6 months to 6 years and (2) a nested survey called Plomb-Habitat which enrolled 484 children. We measured lead concentrations in blood and environmental samples (water, soils, household settled dusts, paints, cosmetics and traditional cookware). We performed two models: a multivariate generalized additive model on the geometric mean (GM), and a quantile regression model on the 10th, 25th, 50th, 75th and 90th quantiles of BLLs. The GM of BLLs was 14.9 μg/L (95% confidence intervals [95% CI]: 14.5-15.4); 0.09% of the children (95% CI = [0.03-0.15]) had BLLs exceeding 100 μg/L and 1.5% (95% CI = [0.9-2.1]) exceeding 50 μg/L. Household and common area dust, tap water, interior paint, ceramic cookware, traditional cosmetics, playground soil and dust, and environmental tobacco smoke were associated with the GM of BLLs. Household dust and tap water made the largest contributions to both the GM and the 90th quantile of BLLs. The concentration of lead in dust was positively correlated with all quantiles of BLLs even at low concentrations. Lead concentrations in tap water above 5 μg/L were also positively correlated with the GM, 75th and 90th quantiles of BLLs in children drinking tap water. Preventative actions must target household settled dust and tap water to reduce the BLLs of children in France. The use of traditional cosmetics should be avoided whereas ceramic cookware should be limited to decorative purposes.