Lead is negatively linked to nutritional status, behavior and cognition in children. Despite extensive knowledge of its toxicity and efforts to reduce exposure, lead continues to be a problem in developed and developing countries. When lead exposure is unavoidable due to its pervasive nature, effective means of protecting or disrupting that exposure need to be developed. Nutritional interventions are one such option. We conducted a 2x2 factorial, placebo-controlled trial of 6-month iron and zinc supplementation among lead-exposed children in Torreón, Mexico (altitude 1060 m). Nine schools were selected based on proximity to a lead smelter and first-graders were individually randomized to daily treatment with 30 mg iron, 30 mg zinc, both, or placebo. In addition to biochemical indicators, cognitive functions and behavior were evaluated at baseline, after the 6-month supplementation period, and again after another 6 months (without supplementation). At baseline, 602 children ages 6.2-8.5 years were enrolled.
We conducted a 2x2 factorial, placebo-controlled trial of 6-month iron and zinc supplementation among lead-exposed children in Torreón, Mexico (altitude 1060 m) to test the hypothesis that supplementation with iron, zinc or both will reduce blood lead concentrations of the children and improve their cognition and behavior. Nine schools were selected based on proximity to a lead smelter and first-graders were individually randomized to daily treatment with 30 mg iron, 30 mg zinc, both, or placebo. In addition to biochemical indicators (blood lead, serum ferritin, CRP, serum zinc, urinary arsenic concentrations), cognitive functions and behavior were measured. Assessments were conducted at three time points: at baseline, after the 6 month treatment, and again after another 6 months without treatment. At baseline, 602 children ages 6.2-8.5 years were enrolled.
Study Type
INTERVENTIONAL
Allocation
RANDOMIZED
Purpose
TREATMENT
Masking
QUADRUPLE
Enrollment
602
Tablet formulated from 30 mg ferrous fumarate.
Tablet formulated from 30 mg zinc oxide
Johns Hopkins Bloomberg School of Public Health
Baltimore, Maryland, United States
Blood lead concentration
Time frame: 6-12 months
Anthropometric composite
Height, weight
Time frame: 6-12 months
Serum ferritin concentration
Time frame: 6-12 months
Serum zinc concentration
Time frame: 6-12 months
Hemoglobin concentration
Time frame: 6-12 months
Conners Behavior Rating Scales for parents and teachers
Time frame: 6-12 months
Peabody Picture Vocabulary Test, Math achievement test, tests of attention and memory
Time frame: 6-12 months
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