Original Article | Published:

Lead exposure, IgE, and the risk of asthma in children

Journal of Exposure Science and Environmental Epidemiology volume 27, pages 478483 (2017) | Download Citation

Abstract

Lead (Pb) has adverse effects on our nervous system and renal systems. Young children are more vulnerable to Pb exposure. However, the role of low-level Pb exposure in the immune system and allergic diseases in children is not well established. The aims of this study are to investigate the associations between Pb exposure and allergic diseases; between Pb and immunoglobulin E (IgE) as an intervening variable; and gender-based differences. We used multistage stratified random sampling to recruit kindergarten children nationwide in Taiwan. Information about allergic diseases and environmental exposures was collected by questionnaire. We compared children with and without allergic diseases for blood Pb levels measured by inductively coupled plasma mass spectrometry. The association between blood Pb and allergic diseases was assessed by logistic regression and those between Pb and IgE by generalized linear models. We also conducted mediation analysis to evaluate how much risk of allergic diseases related to Pb exposure is explained by IgE. A total of 930 children completed specimen collections. There was a positive association between Pb and asthma. Blood Pb were also positively linked with serum IgE (β=0.26 kU/l per ln-unit increase Pb concentration; 95% CI 0.009–0.50 kU/l), after adjusting for potential confounders. Analyses stratified by gender revealed that blood Pb correlated with IgE only in boys (β=0.40 kU/l; 95% CI 0.03–0.76 kU/l). We estimated that 38% of the total effect of Pb exposure on asthma is mediated by IgE levels. In conclusion, Pb exposure is associated with both blood IgE and asthma in boys. Moreover, the effect of Pb exposure on asthma may be mediated by IgE levels.

Access optionsAccess options

Rent or Buy article

Get time limited or full article access on ReadCube.

from$8.99

All prices are NET prices.

References

  1. 1.

    , , , , , et al. The effects of environmental toxins on allergic inflammation. Allergy Asthma Immunol Res 2014; 6: 478–484.

  2. 2.

    , , , , , et al. In utero exposure to lead and cord blood total IgG. Is there a connection? Allergy 2003; 58: 589–594.

  3. 3.

    . Lead Poisoning: The Truth Behind Consumer Products and Legislation 2010: available at . (accessed 11 August 2016).

  4. 4.

    , , , , . Blood lead levels and increased bronchial responsiveness. Biol Trace Elem Res 2008; 123: 41–46.

  5. 5.

    U.S. Department of Health and Human Services. Toxicological Profile for Lead (update) Public Health Service Agency for Toxic Substances and Disease Registry, 2007, available at . (accessed 15 August 2016).

  6. 6.

    China Post. More Lead-Based Pipes Revealed in Greater Taipei 2015: available at . (accessed 15 August 2016).

  7. 7.

    . Explainer: How the Water Lead Contamination Scare Became a Citywide Concern. Hong Kong Free Press. 2015. (accessed 25 August 2016).

  8. 8.

    , . Flint water crisis shines light on lead pipes across U.S. Wall Street J2016. (accessed 30 August 2016).

  9. 9.

    . Lead toxicity. Occup Med (Lond) 2015; 65: 348–356.

  10. 10.

    , , , . Serum IgE elevation correlates with blood lead levels in battery manufacturing workers. Hum ExpToxicol 2004; 23: 209–213.

  11. 11.

    , , , . Incense burning at home and the blood lead level of preschoolers in Taiwan. Environ Sci Pollut Res Int 2014; 21: 13480–13487.

  12. 12.

    , , . New criteria for the diagnosis and management of asthma in children under 5 years old: GINA guidelines An. An Pediatr (Barc) 2009; 71: 91–94.

  13. 13.

    , , , , . Inductively coupled plasma mass spectrometry for direct multi-element analysis of diluted human blood and serum. J Anal At Spectrom 1997; 12: 1005–1009.

  14. 14.

    , . What level of lead in blood is toxic for a child? Am J Public Health 2004; 94: 8.

  15. 15.

    , , , , , . Neuropsychological function in children with blood lead levels <10 microg/dl. Neurotoxicology 2007; 28: 1170–1177.

  16. 16.

    , , , , . The mediation proportion: a structural equation approach for estimating the proportion of exposure effect on outcome explained by an intermediate variable. Epidemiology 2005; 16: 114–120.

  17. 17.

    CDC. What Do Parents Need to Know to Protect Their Children? 2012: available at . (accepted 7 February 2017).

  18. 18.

    , , , . The effect of lead exposure on tracheal responsiveness to methacholine and ovalbumin, total and differential white blood cells count, and serum levels of immunoglobulin E, histamine, and cytokines in guinea pigs. Hum ExpToxicol 2014; 33: 325–333.

  19. 19.

    , . Environmental lead exposure and increased risk for total and allergen-specific IgE in US adults. J Allergy Clin Immunol 2015; 135: 275–277.

  20. 20.

    , , , , , . Immune function biomarkers in children exposed to lead and organochlorine compounds: a cross-sectional study. Environ Health 2005; 4: 5.

  21. 21.

    , . Lead poisoning and asthma among low-income and African American children in Saginaw, Michigan. Environ Res 2011; 111: 81–86.

  22. 22.

    , , , . Blood lead levels and childhood asthma. Indian Pediatr 2015; 52: 303–306.

  23. 23.

    , , . The association of asthma, total IgE, and blood lead and cadmium levels. J Allergy Clin Immunol 2016; 138: 1701–1703.e6.

  24. 24.

    , , . Lead poisoning and asthma: an examination of comorbidity. Arch PediatrAdolesc Med 2002; 156: 863–866.

  25. 25.

    , , , , , . Lead exposure and increased food allergic sensitization in U.S. children and adults. Int Forum Allergy Rhinol 2015; 5: 214–220.

  26. 26.

    , , , . The relationship of blood lead with immunoglobulin E, eosinophils, and asthma among children: NHANES2005-2006. Int J Hyg Environ Health 2014; 217: 196–204.

  27. 27.

    , . IgE in asthma and atopy: cellular and molecular connections. J Clin Invest 1999; 104: 829–835.

  28. 28.

    , , , , , et al. Blood lead level and risk of asthma. Environ Health Perspect 2005; 113: 900–904.

  29. 29.

    , . Inhaled lead exposure affects tracheal responsiveness and lung inflammation in guinea pigs during sensitization. Biol Trace Elem Res 2013; 154: 363–371.

  30. 30.

    , , , , , et al. Multigenerational epigenetic inheritance in humans: DNA methylation changes associated with maternal exposure to lead can be transmitted to the grandchildren. Sci Rep 2015; 5: 14466.

  31. 31.

    , , , , . Influence of exposure to environmental lead on serum immunoglobulin in preschool children. Environ Res 2003; 92: 124–128.

  32. 32.

    Statistics Canada. Blood lead concentrations in Canadians, 2009 to 2011 2015: available at . (accessed 15 August 2016).

  33. 33.

    , , . Gender differences in blood lead and hemoglobin levels in Andean adults with chronic lead exposure. Int J Occup Environ Health 2001; 7: 113–118.

  34. 34.

    , , , , . Heavy metals in traditional Chinese medicine: ba-pao-neu-hwang-san. Zhonghua Min Guo Xiao Er Ke Yi Xue Hui Za Zhi 1993; 34: 181–190.

  35. 35.

    , , . Biological and clinical effects of continuous exposure to airborne particulate lead. Arh Hig Toksikol 1975; 26: 191–208.

  36. 36.

    , , . Kinetic analysis of lead metabolism in healthy humans. J Clin Invest 1976; 58: 260–270.

Download references

Acknowledgements

This study was supported by a grant from the Ministry of Science and Technology in Taiwan (MOST 105-2314-B-192-001). We thank Professor Yau-Huei Hwang, Miss Yi-Hseun Lin, and our colleagues for the data collection.

Author contributions

Conception and design, data analysis and interpretation, and manuscript writing: IJW. Interpretation and revisions of the manuscript: WJJK and CCY. All authors read and approved the final manuscript.

Author information

Affiliations

  1. Department of Pediatrics, Taipei Hospital, Ministry of Health and Welfare, Taipei, Taiwan

    • I-Jen Wang
  2. Institute of Environmental and Occupational Health Sciences, School of Medicine, National Yang-Ming University, Taipei, Taiwan

    • I-Jen Wang
    •  & Chen-Chang Yang
  3. Department of Health Risk Management, China Medical University, Taichung, Taiwan

    • I-Jen Wang
  4. Division of Epidemiology, Biostatistics, and Environmental Health, School of Public Health, University of Memphis, Memphis, Tennessee, USA

    • Wilfried J J Karmaus
  5. Division of Clinical Toxicology & Occupational Medicine, Department of Medicine, Taipei Veterans General Hospital, Taipei, Taiwan

    • Chen-Chang Yang

Authors

  1. Search for I-Jen Wang in:

  2. Search for Wilfried J J Karmaus in:

  3. Search for Chen-Chang Yang in:

Competing interests

The authors declare no conflict of interest.

Corresponding author

Correspondence to I-Jen Wang.

Supplementary information

Word documents

  1. 1.

    Supplementary Material

About this article

Publication history

Received

Accepted

Published

DOI

https://doi.org/10.1038/jes.2017.5

Supplementary Information accompanies the paper on the Journal of Exposure Science and Environmental Epidemiology website (http://www.nature.com/jes)