Environmental Advances (Jul 2023)
Lead poisoning epidemiology, challenges and opportunities: First systematic review and expert consensuses of the MENA region
Abstract
Lead is the most ubiquitous heavy metal in the Earth's crust. Since prehistoric times, lead has widely propagated and mobilized in the environment, increasing its nonessential exposure. The amount of lead entering the atmosphere has reduced substantially in the majority of wealthy nations. Acute exposure becomes relatively low, but chronic exposure to low levels of lead remains a significant public health issue. However, disadvantaged groups are developing countries in the Middle East and North Africa (MENA). This current study provides the latest knowledge on lead poisoning, and it is the first attempt to place lead toxicology in the MENA regions under microscope. Our cohort created a lead exposure survey tool that will serve as an academic tool for toxicologists and public health professionals to conduct further research and implement preventive strategies. A comprehensive search was conducted between 1981 and 2018. The holistic Delphi identified various lead pollutants. The Mixed Method Appraisal Tool (MMAT) assessed the quality of identified studies to enter the systematic review synthesis, which passed only 34 studies, revealing 15 sources of lead genres with >70 subgenres. What stands out is that occupational threat (e.g., petrol filling and military personnel) is the most abundant genre, followed by cosmetics, particularly kohl. The frequency of each genre is modified in a descending order: occupational, cosmetics, residential, food, substance, environmental, socioeconomic, traditional remedies, foreign body, parental, pica, personal habits, cooking habits, sociocultural, and oral intake. The available data underscores how crucial it is to carry out investigations in areas with comparable features like the MENA countries. Exposure is anticipated to continue to be a significant public health risk in industrializing nations for many years due to increased industrialisation and the persistence of lead in the environment. For public health policies to be sensible, cost-effective screening, monitoring, intervention, and assessment are essential.
