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Miroslav Cikrt,¹ Zdenek Smerhovsky,^1,2,3 Karel Blaha,¹ Jana Nerudova,¹ Viera Sediva,² Helena Fornuskova,¹ Jana Knotkova,¹ Zdenek Roth,¹ Miloslav Kodl,¹ Edward Fitzgerald³

¹National Institute of Public Health, Prague, Czech Republic; ² District Hygienic Station, Pribram, Czech Republic; ³ New York State Department of Health, Albany, NY 12203 USA

Abstract
The area around the Pribram lead smelter has been recognized to be heavily contaminated by lead (Pb) . In the early 1970s, several episodes of livestock lead intoxication were reported in this area ; thereafter, several epidemiological and ecological studies focused on exposure of children. In contrast to earlier studies, the recent investigation (1992-1994) revealed significantly lower exposure to lead. From 1986-1990, recorded average blood lead levels were about 37.2 µg lead (Pb) /100 ml in an elementary school population living in a neighborhood close to the smelter (within 3 km of the plant) . The present study, however, has found mean blood lead levels of 11.35 µg/100 ml (95% CI = 9.32 ; 13.82) among a comparable group of children. In addition to blood lead, tooth lead was used to assess exposure among children. Statistically significant differences (p <0.05) were observed between the geometric mean tooth lead level of 6.44 µg Pb/g (n = 13 ; 95% CI = 3.95 ; 10.50) in the most contaminated zone and 1.43 µg Pb/g (n = 35 ; 95% CI = 1.11 ; 1.84) in zones farther away from the point source. Both biomarkers, blood and tooth lead levels, reflect a similar pattern of lead exposure in children. This study has attempted a quantitative assessment of risk factors associated with elevated lead exposure in the Czech Republic. Content of lead in soil, residential distance from the smelter, consumption of locally grown vegetables or fruits, drinking water from local wells, the mother's educational level, cigarette consumption among family members, and the number of children in the family were factors positively related (p<0.05) to blood lead levels. The resulting blood lead level was found to be inversely proportional to the child's age. Key words: blood lead, children, lead, risk factors of exposure, tooth lead. Environ Health Perspect 105:406-411 (1997)

Address correspondence to Z. Smerhovsky, New York State Department of Health, 2 University Place, Albany, NY 12203 USA

This study was supported by WHO Regional Office for Europe, European Center for Environment and Health, Bilthoven Division, and Ministry of Health of the Czech Republic. The authors gratefully acknowledge the assistance of Henry Wyes and Michael Krziszanowski for review of preliminary reports on the program to reduce environmental lead exposure in children living in contaminated areas.

Received 28 June 1996 ; accepted 21 January 1997.