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Lead, cadmium and mercury levels in pregnancy: the need for international consensus on levels of concern

Published online by Cambridge University Press:  28 November 2013

C. M. Taylor ,
J. Golding  and
A. M. Emond
C. M. Taylor*
Affiliation:
Centre for Child and Adolescent Health, School of Social and Community Medicine, University of Bristol, UK
J. Golding
Affiliation:
Centre for Child and Adolescent Health, School of Social and Community Medicine, University of Bristol, UK
A. M. Emond
Affiliation:
Centre for Child and Adolescent Health, School of Social and Community Medicine, University of Bristol, UK
*
*Address for correspondence: C. M. Taylor, Centre for Child and Adolescent Health, School of Social and Community Medicine, University of Bristol, Oakfield House, Oakfield Grove, Bristol BS8 2BN, UK. (Email: [email protected])
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Abstract

For heavy metals that have any degree of transfer though the placenta to the fetus, it is unlikely that there are safe limits for maternal blood levels. The only means of reducing fetal exposure is to minimise maternal exposure. There are few recommendations for levels of concern. With the exception of US recommendations for maternal Pb levels, but there are no international levels of concern or cut-off levels specifically for pregnancy for heavy metals, so that comparisons can generally only be made with national reference values relating to similar physiological statuses or age groups. These include recommendations for Cd levels by Germany (reference value for non-smoking adults aged 18–69 years, 1 µg/l) and for Hg by Germany (reference value for adults age 18–60 years with fish intake ⩽3 times per month, 2.0 µg/l) and the USA (cut-off level for women, 5.8 µg/dl). To illustrate the lack of cohesion, we present data on blood Pb, Cd and Hg levels from pregnant women enroled in the UK Avon Longitudinal Study of Parents and Children study and compare the values with present levels of concern and recommended cut-off values. We also compare the levels with those found in other groups of pregnant women worldwide to strengthen the database for the development of levels of concern in pregnancy. The need for clarity of terminology in describing levels of concern is discussed. There is a pressing need for international consensus on levels of concern for all age groups and physiological statuses, particularly for pregnancy.

Keywords

ALSPACcadmiumleadlevels of concernmercurypregnancy
Type
Review
Information
Journal of Developmental Origins of Health and Disease , Volume 5 , Issue 1 , February 2014 , pp. 16 - 30
Copyright
Copyright © Cambridge University Press and the International Society for Developmental Origins of Health and Disease 2013 

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References

1. Jelliffe-Pawlowski, LL, Miles, SQ, Courtney, JG, Materna, B, Charlton, V. Effect of magnitude and timing of maternal pregnancy blood lead (Pb) levels on birth outcomes. J Perinatol. 2006; 26, 154–162.CrossRefGoogle ScholarPubMed
2. Vigeh, M, Yokoyama, K, Ramezanzadeh, F, et al. Lead and other trace metals in preeclampsia: a case-control study in Tehran, Iran. Environ Res. 2006; 100, 268–275.Google Scholar
3. Osman, K, Akesson, A, Berglund, M, et al. Toxic and essential elements in placentas of Swedish women. Clin Biochem. 2000; 33, 131–138.CrossRefGoogle ScholarPubMed
4. Canfield, RL, Henderson, CR Jr, Cory-Slechta, DA, et al. Intellectual impairment in children with blood lead concentrations below 10 microg per deciliter. New Engl J Med. 2003; 348, 1517–1526.CrossRefGoogle ScholarPubMed
5. Chandramouli, K, Steer, C, Ellis, M, Emond, A. Effects of early childhood lead exposure on academic performance and behaviour of school age children. Arch Dis Child. 2009; 94, 844–848.Google Scholar
6. Andrews, KW, Savitz, DA, Hertz-Picciotto, I. Prenatal lead exposure in relation to gestational age and birth weight: a review of epidemiologic studies. Am J Industr Med. 1994; 26, 13–32.Google Scholar
7. Shukla, R, Dietrich, KN, Bornschein, RL, Berger, O, Hammond, PB. Lead exposure and growth in the early preschool child: a follow-up report from the Cincinnati Lead Study. Pediatrics. 1991; 88, 886–892.Google Scholar
8. Schoeters, G, Den Hond, E, Zuurbier, M, et al. Cadmium and children: exposure and health effects. Acta Paediatr. 2006; 95, 50–54.Google Scholar
9.Committee on the Toxological Effects of Methylmercury, Board on Environmental Studies and Toxicology, National Research Council. Toxicological effects of methylmercury. 2000. Retrieved 18 November 2013 from http://www.nap.edu/catalog/9899.html Google Scholar
10. Centers for Disease Control and Prevention. Guidelines for the identification and management of lead exposure in pregnant and lactating women. Eds Ettinger, AS, Wengrovitz, AG, Portier, C and Brown, MJ, 2010. US Department of Health and Human Services: Atlanta, GA. Retrieved 18 November 2013 from http://www.cdc.gov/nceh/lead/publications/LeadandPregnancy2010.pdf Google Scholar
11. Association of Occupational and Environmental Clinics. Medical management guidelines for lead-exposed adults. 2007. Retrieved 18 November 2013 from http://www.aoec.org/documents/positions/mmg_final.pdf Google Scholar
12. American College of Obstetricians and Gynecologists. Lead screening during pregnancy and lactation. Committee opinion number 533. 2012. Retrieved 18 November 2013 from http://www.acog.org/~/media/Committee%20Opinions/Committee%20on%20Obstetric%20Practice/co533.pdf?dmc=1&ts=20131007T0412098105 Google Scholar
13. Schulz, C, Angerer, J, Ewers, U, Kolossa-Gehring, M. The German Human Biomonitoring Commission. Int J Hyg Environ Health. 2007; 210, 373–382.Google Scholar
14. US Environmental Protection Agency. Mercury. 2012. Retrieved 18 November 2013 from http://www.epa.gov/mercury/exposure.htm Google Scholar
15. Centers for Disease Control and Prevention. What do parents need to know to protect their children? 2012. Retrieved 18 November 2013 from http://www.cdc.gov/nceh/lead/ACCLPP/blood_lead_levels.htm Google Scholar
16. Mahaffey, KR, Clickner, RP, Bodurow, CC. Blood organic mercury and dietary mercury intake: National Health and Nutrition Examination Survey, 1999 and 2000. Env Health Persp. 2004; 112, 562–570.CrossRefGoogle ScholarPubMed
17. Australian Government, National Health and Medical Research Council. Blood lead levels for Australians. 2009. Retrieved 18 November 2013 from https://www.nhmrc.gov.au/guidelines/publications/new36new37 Google Scholar
18. Becker, K, Schroeter-Kermani, C, Seiwert, M, et al. German health-related environmental monitoring: Assessing time trends of the general population’s exposure to heavy metals. Int J Hyg Environ Health. 2013; doi:10.1016/j.ijheh.2013.01.002.Google Scholar
19. Taylor, CM, Golding, J, Emond, AM. Enviromental factors in relation to blood lead levels in pregnant women in the UK: the ALSPAC study. PloS One. 2013; 8, e72371.Google Scholar
20. Sanders, AP, Flood, K, Chiang, S, et al. Towards prenatal biomonitoring in North Carolina: assessing arsenic, cadmium, mercury, and lead levels in pregnant women. PloS One. 2012; 7, e31354.Google Scholar
21. Bloom, MS, Fujimoto, VY, Steuerwald, AJ, et al. Background exposure to toxic metals in women adversely influences pregnancy during in vitro fertilization (IVF). Reprod Toxicol. 2012; 34, 471–481.Google Scholar
22. Hansen, S, Nieboer, E, Sandanger, TM, et al. Changes in maternal blood concentrations of selected essential and toxic elements during and after pregnancy. J Environ Monit. 2011; 13, 2143–2152.Google Scholar
23. Gerhardsson, L, Lundh, T. Metal concentrations in blood and hair in pregnant females in southern Sweden. J Environ Health. 2010; 72, 37–41.Google Scholar
24. Gundacker, C, Frohlich, S, Graf-Rohrmeister, K, et al. Perinatal lead and mercury exposure in Austria. Sci Total Environ. 2010; 408, 5744–5749.CrossRefGoogle ScholarPubMed
25. Rastogi, S, Nandlike, K, Fenster, W. Elevated blood lead levels in pregnant women: identification of a high-risk population and interventions. J Perinat Med. 2007; 35, 492–496.Google Scholar
26. Harville, EW, Hertz-Picciotto, I, Schramm, M, et al. Factors influencing the difference between maternal and cord blood lead. Occup Environ Med. 2005; 62, 263–269.Google Scholar
27. Schell, LM, Denham, M, Stark, AD, et al. Maternal blood lead concentration, diet during pregnancy, and anthropometry predict neonatal blood lead in a socioeconomically disadvantaged population. Environ Health Persp. 2003; 111, 195–200.CrossRefGoogle Scholar
28. Al-Saleh, I, Shinwari, N, Mashhour, A, Mohamed Gel, D, Rabah, A. Heavy metals (lead, cadmium and mercury) in maternal, cord blood and placenta of healthy women. Int J Hyg Environ Health. 2011; 214, 79–101.CrossRefGoogle ScholarPubMed
29. Motawei, SM, Attalla, SM, Gouda, HE, El-Harouny, MA, El-Mansoury, AM. Lead levels in pregnant women suffering for pre-eclamsia in Dakahlia, Egypt. Int J Occup Environ Med. 2013; 4, 36–44.Google Scholar
30. Menai, M, Heude, B, Slama, R, et al. Association between maternal blood cadmium during pregnancy and birth weight and the risk of fetal growth restriction: the EDEN mother–child cohort study. Reprod Toxicol. 2012; 34, 622–627.Google Scholar
31. Njoku, CO, Orisakwe, OE. Higher blood lead levels in rural than urban pregnant women in Eastern Nigeria. Occup Environ Med. 2012; 69, 850–851.Google Scholar
32. Ugwuja, EI, Ibiam, UA, Ejikeme, BN, Obuna, JA, Agbafor, KN. Blood Pb levels in pregnant Nigerian women in Abakaliki, South-Eastern Nigeria. Environ Monitor Assess. 2013; 85, 3798–3801.Google Scholar
33. Tiwari, AKM, Mahdi, AA, Zahra, F, Sharma, S, Negi, MPS. Evaluation of low blood lead levels and its association with oxidative stress in pregnant anemic women: a comparative prospective study. Ind J Clin Biochem. 2012; 27, 246–252.Google Scholar
34. Adekunle, IM, Ogundele, JA, Oguntoke, O, Akinloye, OA. Assessment of blood and urine lead levels of some pregnant women residing in Lagos, Nigeria. Environ Monit Assess. 2010; 170, 467–474.Google Scholar
35. Vigeh, M, Yokoyama, K, Seyedaghamiri, Z, et al. Blood lead at currently acceptable levels may cause preterm labour. Occup Environ Med. 2011; 68, 231–234.Google Scholar
36. Al-Saleh, I, Shinwari, N, Mashhour, A, Mohamed, GED, Rabah, A. Heavy metals (lead, cadmium and mercury) in maternal, cord blood and placenta of healthy women. Int J Hyg Environ Health. 2011; 214, 79–101.Google Scholar
37. Abdelouahab, N, Huel, G, Suvorov, A, et al. Monoamine oxidase activity in placenta in relation to manganese, cadmium, lead, and mercury at delivery. Neurotoxicol Teratol. 2010; 32, 256–261.CrossRefGoogle ScholarPubMed
38. Mirghani, Z. Effect of low lead exposure on gestational age, birth weight and premature rupture of the membrane. J Pakistan Med Assoc. 2010; 60, 1027–1030.Google Scholar
39. Lin, CM, Doyle, P, Wang, DL, Hwang, YH, Chen, PC. The role of essential metals in the placental transfer of lead from mother to child. Reprod Toxicol. 2010; 29, 443–446.Google Scholar
40. Rollin, HB, Rudge, CV, Thomassen, Y, Mathee, A, Odland, JO. Levels of toxic and essential metals in maternal and umbilical cord blood from selected areas of South Africa – results of a pilot study. J Environ Monit. 2009; 11, 618–627.Google Scholar
41. Rudge, CV, Rollin, HB, Nogueira, CM, et al. The placenta as a barrier for toxic and essential elements in paired maternal and cord blood samples of South African delivering women. J Environ Monitor. 2009; 11, 1322–1330.Google Scholar
42. Tian, LL, Zhao, YC, Wang, XC, et al. Effects of gestational cadmium exposure on pregnancy outcome and development in the offspring at age 4.5 years. Biol Trace Element Res. 2009; 132, 51–59.Google Scholar
43. Al-Jawadi, AA, Al-Mola, ZW, Al-Jomard, RA. Determinants of maternal and umbilical blood lead levels: a cross-sectional study, Mosul, Iraq. BMC Res Notes. 2009; 2, 47.Google Scholar
44. Wang, P, Tian, Y, Shi, R, et al. Study on maternal-fetal status of Pb, As, Cd, Mn and Zn elements and the influence factors. Chin J Prevent Med. 2008; 42, 722–726.Google Scholar
45. Ettinger, AS, Lamadrid-Figueroa, H, Tellez-Rojo, MM, et al. Effect of calcium supplementation on blood lead levels in pregnancy: a randomized placebo-controlled trial. Environ Health Perspect. 2009; 117, 26–31.Google Scholar
46. Eik Anda, E, Nieboer, E, Dudarev, AA, Sandanger, TM, Odland, JO. Intra- and intercompartmental associations between levels of organochlorines in maternal plasma, cord plasma and breast milk, and lead and cadmium in whole blood, for indigenous peoples of Chukotka, Russia. J Environ Monit. 2007; 9, 884–893.Google Scholar
47. Reis, MF, Sampaio, C, Brantes, A, et al. Human exposure to heavy metals in the vicinity of Portuguese solid waste incinerators – Part 2: biomonitoring of lead in maternal and umbilical cord blood. Int J Hyg Environ Health. 2007; 210, 447–454.Google Scholar
48. Butler Walker, J, Houseman, J, Seddon, L, et al. Maternal and umbikical cord blood levels of mercury, lead, cadmium, and essential trace elements in Arctic Canada. Environ Res. 2006; 100, 295–319.Google Scholar
49. Kawata, K, Li, Y, Liu, H, Zhang, XQ, Ushijima, H. Specific factors for prenatal lead exposure in the border area of China. Int J Hyg Environ Health. 2006; 209, 377–383.Google Scholar
50. Lamadrid-Figueroa, H, Tellez-Rojo, MM, Hernandez-Cadena, L, et al. Biological markers of fetal lead exposure at each stage of pregnancy. J Toxicol Environ Health. Part A. 2006; 69, 1781–1796.CrossRefGoogle ScholarPubMed
51. Kirel, B, Aksit, MA, Bulut, H. Blood lead levels of maternal-cord pairs, children and adults who live in a central urban area in Turkey. Turkish J Pediatr. 2005; 47, 125–131.Google Scholar
52. Ris, MD, Dietrich, KN, Succop, PA, Berger, OG, Bornschein, RL. Early exposure to lead and neuropsychological outcome in adolescence. J Int Neuropsychol Soc. 2004; 10, 261–270.Google Scholar
53. Wang, C, Huang, L, Zhou, X, Xu, G, Shi, Q. Blood lead levels of both mothers and their newborn infants in the middle part of China. Int J Hyg Environ Health. 2004; 207, 431–436.Google Scholar
54. Hanning, RM, Sandhu, R, MacMillan, A, et al. Impact on blood Pb levels of maternal and early infant feeding practices of First Nation Cree in the Mushkegowuk Territory of northern Ontario, Canada. J Environ Monitor. 2003; 5, 241–245.Google Scholar
55. Yao, HY, Huang, XH. The blood lead level and pregnant outcome in pregnant women with non-occupational lead exposure. Chin J Obstetr Gynaecol. 2003; 38, 340–342.Google Scholar
56. Rahman, A, Hakeem, A. Blood lead levels during pregnancy and pregnancy outcome in Karachi women. J Pakistan Med Assoc. 2003; 53, 529–533.Google Scholar
57. Smargiassi, A, Takser, L, Masse, A, et al. A comparative study of manganese and lead levels in human umbilical cords and maternal blood from two urban centers exposed to different gasoline additives. Sci Total Environ. 2002; 290, 157–164.Google Scholar
58. Sanin, LH, Gonzalez-Cossio, T, Romieu, I, et al. Effect of maternal lead burden on infant weight and weight gain at one month of age among breastfed infants. Pediatrics. 2001; 107, 1016–1023.Google Scholar
59. Ataniyazova, OA, Baumann, RA, Liem, AK, et al. Levels of certain metals, organochlorine pesticides and dioxins in cord blood, maternal blood, human milk and some commonly used nutrients in the surroundings of the Aral Sea (Karakalpakstan, Republic of Uzbekistan). Acta Paediatr. 2001; 90, 801–808.Google Scholar
60. Durska, G. Levels of lead and cadmium in pregnant women and newborns and evaluation of their impact on child development. Annales Academiae Medicae Stetinensis. 2001; 47, 49–60.Google Scholar
61. Raghunath, R, Tripathi, RM, Sastry, VN, Krishnamurthy, TM. Heavy metals in maternal and cord blood. Sci Total Environ. 2000; 250, 135–141.Google Scholar
62. Bjerregaard, P, Hansen, JC. Organochlorines and heavy metals in pregnant women from the Disko Bay area in Greenland. Sci Total Environ. 2000; 245, 195–202.CrossRefGoogle ScholarPubMed
63. Wasserman, GA, Liu, X, Popovac, D, et al. The Yugoslavia prospective lead study: contributions of prenatal and postnatal lead exposure to early intelligence. Neurotoxicol Teratol. 2000; 22, 811–818.Google Scholar
64. Wasserman, GA, Musabegovic, A, Liu, X, et al. Lead exposure and motor functioning in 4(1/2)-year-old children: the Yugoslavia prospective study. J Pediatr. 2000; 137, 555–561.Google Scholar
65. World Economic and Financial Surveys. World Economic Outlook. Growth Resuming, Dangers Remain. International Monetary Fund: Washington, DC, 2012; Retrieved 18 November 2013 from http://www.imf.org/external/pubs/ft/weo/2012/01/pdf/text.pdf Google Scholar
66. Akesson, A, Berglund, M, Schutz, A, et al. Cadmium exposure in pregnancy and lactation in relation to iron status. Am J Public Health. 2002; 92, 284–287.Google Scholar
67. Kosanovic, M, Jokanovic, M, Jevremovic, M, Dobric, S, Bokonjic, D. Maternal and fetal cadmium and selenium status in normotensive and hypertensive pregnancy. Biol Trace Element Res. 2002; 89, 97–103.Google Scholar
68. Zhang, Y, Zhao, Y, Wang, J, et al. Effects of zinc, copper, and selenium on placental cadmium transport. Biol Trace Element Res. 2004; 102, 39–49.Google Scholar
69. Mokhtar, G, Hossny, E, el-Awady, M, Zekry, M. In utero exposure to cadmium pollution in Cairo and Giza governorates of Egypt. Eastern Mediterr Health J. 2002; 8, 254–260.Google Scholar
70. Miranda, ML, Edwards, S, Maxson, PJ. Mercury levels in an urban pregnant population in Durham County, North Carolina. Int J Environ Res Public Health. 2011; 8, 698–712.Google Scholar
71. Lederman, SA, Jones, RL, Caldwell, KL, et al. Relation between cord blood mercury levels and early child development in a World Trade Center cohort. Environ Health Persp. 2008; 116, 1085–1091.Google Scholar
72. Palkovicova, L, Ursinyova, M, Masanova, V, Yu, Z, Hertz-Picciotto, I. Maternal amalgam dental fillings as the source of mercury exposure in developing fetus and newborn. J Expos Sci Environ Epidemiol. 2008; 18, 326–331.Google Scholar
73. Sakamoto, M, Kaneoka, T, Murata, K, et al. Correlations between mercury concentrations in umbilical cord tissue and other biomarkers of fetal exposure to methylmercury in the Japanese population. Environ Res. 2007; 103, 106–111.Google Scholar
74. Morrissette, J, Takser, L, St-Amour, G, et al. Temporal variation of blood and hair mercury levels in pregnancy in relation to fish consumption history in a population living along the St. Lawrence River. Environ Res. 2004; 95, 363–374.Google Scholar
75. Schober, SE, Sinks, TH, Jones, RL, et al. Blood mercury levels in US children and women of childbearing age, 1999–2000. JAMA. 2003; 289, 1667–1674.Google Scholar
76. Ask, K, Akesson, A, Berglund, M, Vahter, M. Inorganic mercury and methylmercury in placentas of Swedish women. Environ Health Perspect. 2002; 110, 523–526.Google Scholar
77. Kim, BM, Lee, BE, Hong, YC, et al. Mercury levels in maternal and cord blood and attained weight through the 24 months of life. Sci Total Environ. 2011; 410–411, 26–33.Google Scholar
78. Santos, EO, De Jesus, IM, Camara, VD, et al. Correlation between blood mercury levels in mothers and newborns in Itaituba, Para State, Brazil. Cad Saude Publica. 2007; 23, S622–S629.Google Scholar
79. Fok, TF, Lam, HS, Ng, PC, et al. Fetal methylmercury exposure as measured by cord blood mercury concentrations in a mother–infant cohort in Hong Kong. Environ Int. 2007; 33, 84–92.Google Scholar
80. Hsu, CS, Liu, PL, Chien, LC, Chou, SY, Han, BC. Mercury concentration and fish consumption in Taiwanese pregnant women. Brit J Obstetr Gynaecol. 2007; 114, 81–85.Google Scholar
81. Unuvar, E, Ahmadov, H, Kiziler, AR, et al. Mercury levels in cord blood and meconium of healthy newborns and venous blood of their mothers: clinical, prospective cohort study. Sci Total Environ. 2007; 374, 60–70.CrossRefGoogle ScholarPubMed
82. Kim, EH, Kim, IK, Kwon, JY, Kim, SW, Park, YW. The effect of fish consumption on blood mercury levels of pregnant women. Yonsei Med J. 2006; 47, 626–633.Google Scholar
83. Amaral, JH, Rezende, VB, Quintana, SM, et al. The relationship between blood and serum lead levels in peripartum women and their respective umbilical cords. Basic Clin Pharmacol Toxicol. 2010; 107, 971–975.Google Scholar
84. Primatesta, P, Dong, W, Bost, L, Poulter, NR, Delves, HT. Survey of blood lead levels in the population in England, 1995. In IEH Report on Recent UK Blood Lead Surveys, Report R9 (ed. Gompertz D), 1998; pp. 9–34. Medical Research Council, Institute for Environmental Health: Norwich, UK.Google Scholar
85. Ebert-McNeill, A, Clark, S, Miller, J, et al. Cadmium intake and systemic exposure in postmenopausal women and age-matched men who smoke cigarettes. Toxicol Sci. 2012; 130, 191–204.CrossRefGoogle ScholarPubMed
86. Kovar, IZ, Strehlow, CD, Richmond, J, Thompson, MG. Perinatal lead and cadmium burden in a British urban population. Arch Dis Child. 1984; 59, 36–39.Google Scholar
87. Golding, J, Steer, C, Hibbeln, J, Lowery, T, Jones, R. Dietary predictors of maternal prenatal blood mercury levels in the ALSPAC birth cohort study. Env Health Perspect. 2013; doi:10.1289/ehp.1206115.Google Scholar
88. Hibbeln, JR, Davis, JM, Steer, C, et al. Maternal seafood consumption in pregnancy and neurodevelopmental outcomes in childhood (ALSPAC study): an observational cohort study. Lancet. 2007; 369, 578–585.Google Scholar
89. Caldwell, KL, Mortensen, ME, Jones, RL, Caudill, SP, Osterloh, JD. Total blood mercury concentrations in the U.S. population: 1999–2006. Int J Hyg Environ Health. 2009; 212, 588–598.CrossRefGoogle ScholarPubMed
90. British Geological Survey. Contaminant distribution in soil. Retrieved 18 November 2013 from http://mapapps2.bgs.ac.uk/bccs/home.html Google Scholar
91. City of Bristol Health and Environmental Service. Environmental Quality Section. Assessment of air quality in Bristol, 1 April 1994–31 March 1995, 1995. City of Bristol Health and Environmental Services, Environmental Quality Section: Bristol.Google Scholar
92. World Health Organization. Air Quality Guidelines for Europe. European Series, No. 91, 2nd edn, 2000. WHO Regional Publications: Copenhagen. Retrieved 18 November 2013 from http://www.euro.who.int/__data/assets/pdf_file/0005/74732/E71922.pdf Google Scholar
93. Zarembski, PM, Griffiths, PD, Walker, J, Goodall, HB. Lead in neonates and mothers. Clin Chim Acta. 1983; 134, 35–49.Google Scholar
94. Watt, GC, Britton, A, Gilmour, WH, et al. Is lead in tap water still a public health problem? An observational study in Glasgow. BMJ. 1996; 313, 979–981.Google Scholar
95. Alexander, FW, Delves, HT. Blood lead levels during pregnancy. Int Arch Occup Environ Health. 1981; 48, 35–39.Google Scholar
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