Blood lead level and risk of asthma

Christine L.M. Joseph, Suzanne Havstad, Dennis Randall Ownby, Edward L. Peterson, Mary Maliarik, Michael J. McCabe, Charles Barone, Christine Cole Johnson

Research output: Contribution to journalArticle

35 Citations (Scopus)

Abstract

Asthma and lead poisoning are prevalent among urban children in the United States. Lead exposure may be associated with excessive production of immunoglobulin E, possibly increasing asthma risk and contributing to racial disparities. The objective of this study was to examine racial differences in the association of blood lead level (BLL) to risk of developing asthma. We established and followed a cohort prospectively to determine asthma onset, using patient encounters and drug claims obtained from hospital databases. Participants were managed care enrollees with BLL measured and documented at 1-3 years of age. We used multiple variable analysis techniques to determine the relationship of BLL to period prevalent and incident asthma. Of the 4,634 children screened for lead from 1995 through 1998, 69.5% were African American, 50.5% were male, and mean age was 1.2 years. Among African Americans, BLL ≥ 5 and BLL ≥ 10 μg/dL were not associated with asthma. The association of BLL ≥ 5 μg/dL with asthma among Caucasians was slightly elevated, but not significant [adjusted hazard ratio (adjHR) = 1.4; 95% confidence interval (CI), 0.7-2.9; p = 0.40]. Despite the small number of Caucasians with high BLL, the adjHR increased to 2.7 (95% CI, 0.9-8.1; p = 0.09) when more stringent criteria for asthma were used. When compared with Caucasians with BLL < 5 μg/dL, African Americans were at a significantly increased risk of asthma regardless of BLL (adjHR = 1.4-3.0). We conclude that an effect of BLL on risk of asthma for African Americans was not observed. These results demonstrate the need for further exploration of the complex interrelationships between race, asthma phenotype, genetic susceptibilities, and socioenvironmental exposures, including lead.

Original languageEnglish (US)
Pages (from-to)900-904
Number of pages5
JournalEnvironmental Health Perspectives
Volume113
Issue number7
DOIs
StatePublished - Jul 1 2005

Fingerprint

Asthma
African Americans
Lead
Confidence Intervals
Lead Poisoning
Managed Care Programs
Genetic Predisposition to Disease
Immunoglobulin E
Databases
Phenotype

Keywords

  • Asthma
  • Atopy
  • Environment
  • Immunoglobulin E
  • Incidence
  • Lead poisoning
  • Racial disparity

ASJC Scopus subject areas

  • Public Health, Environmental and Occupational Health
  • Health, Toxicology and Mutagenesis

Cite this

Joseph, C. L. M., Havstad, S., Ownby, D. R., Peterson, E. L., Maliarik, M., McCabe, M. J., ... Johnson, C. C. (2005). Blood lead level and risk of asthma. Environmental Health Perspectives, 113(7), 900-904. https://doi.org/10.1289/ehp.7453

Blood lead level and risk of asthma. / Joseph, Christine L.M.; Havstad, Suzanne; Ownby, Dennis Randall; Peterson, Edward L.; Maliarik, Mary; McCabe, Michael J.; Barone, Charles; Johnson, Christine Cole.

In: Environmental Health Perspectives, Vol. 113, No. 7, 01.07.2005, p. 900-904.

Research output: Contribution to journalArticle

Joseph, CLM, Havstad, S, Ownby, DR, Peterson, EL, Maliarik, M, McCabe, MJ, Barone, C & Johnson, CC 2005, 'Blood lead level and risk of asthma', Environmental Health Perspectives, vol. 113, no. 7, pp. 900-904. https://doi.org/10.1289/ehp.7453
Joseph CLM, Havstad S, Ownby DR, Peterson EL, Maliarik M, McCabe MJ et al. Blood lead level and risk of asthma. Environmental Health Perspectives. 2005 Jul 1;113(7):900-904. https://doi.org/10.1289/ehp.7453
Joseph, Christine L.M. ; Havstad, Suzanne ; Ownby, Dennis Randall ; Peterson, Edward L. ; Maliarik, Mary ; McCabe, Michael J. ; Barone, Charles ; Johnson, Christine Cole. / Blood lead level and risk of asthma. In: Environmental Health Perspectives. 2005 ; Vol. 113, No. 7. pp. 900-904.
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abstract = "Asthma and lead poisoning are prevalent among urban children in the United States. Lead exposure may be associated with excessive production of immunoglobulin E, possibly increasing asthma risk and contributing to racial disparities. The objective of this study was to examine racial differences in the association of blood lead level (BLL) to risk of developing asthma. We established and followed a cohort prospectively to determine asthma onset, using patient encounters and drug claims obtained from hospital databases. Participants were managed care enrollees with BLL measured and documented at 1-3 years of age. We used multiple variable analysis techniques to determine the relationship of BLL to period prevalent and incident asthma. Of the 4,634 children screened for lead from 1995 through 1998, 69.5{\%} were African American, 50.5{\%} were male, and mean age was 1.2 years. Among African Americans, BLL ≥ 5 and BLL ≥ 10 μg/dL were not associated with asthma. The association of BLL ≥ 5 μg/dL with asthma among Caucasians was slightly elevated, but not significant [adjusted hazard ratio (adjHR) = 1.4; 95{\%} confidence interval (CI), 0.7-2.9; p = 0.40]. Despite the small number of Caucasians with high BLL, the adjHR increased to 2.7 (95{\%} CI, 0.9-8.1; p = 0.09) when more stringent criteria for asthma were used. When compared with Caucasians with BLL < 5 μg/dL, African Americans were at a significantly increased risk of asthma regardless of BLL (adjHR = 1.4-3.0). We conclude that an effect of BLL on risk of asthma for African Americans was not observed. These results demonstrate the need for further exploration of the complex interrelationships between race, asthma phenotype, genetic susceptibilities, and socioenvironmental exposures, including lead.",
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