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. 2020 Oct 19;17(20):7625.
doi: 10.3390/ijerph17207625.

Environmental Lead Exposure and Influenza and Respiratory Syncytial Virus Diagnoses in Young Children: A Test-Negative Case-Control Study

Marina Oktapodas Feiler  1 , Mary T Caserta  2 , Edwin van Wijngaarden  1   3 , Kelly Thevenet-Morrison  3 , Dwight J Hardy  4 , Yan Victoria Zhang  5 , Ann M Dozier  3 , B Paige Lawrence  1   4 , Todd A Jusko  1   2   3
Affiliations

Environmental Lead Exposure and Influenza and Respiratory Syncytial Virus Diagnoses in Young Children: A Test-Negative Case-Control Study

Marina Oktapodas Feiler et al. Int J Environ Res Public Health. .

Abstract

Experimental and epidemiological evidence suggests that environmental toxicants may influence susceptibility to influenza and respiratory syncytial virus (RSV). The objective of the present study was to estimate the association between blood lead concentrations and the odds of child influenza or RSV infection. A test-negative, case-control study was conducted among 617 children, <4 years of age, tested for influenza/RSV from 2012-2017 in Rochester, NY. There were 49 influenza cases (568 controls) and 123 RSV cases (494 controls). Blood lead concentrations reported in children's medical records were linked with influenza/RSV lab test results. Covariables were collected from medical records, birth certificates, and U.S. census data. In this sample, evidence of an association between blood lead levels and RSV or influenza diagnosis was not observed. Children with a lead level ≥1 μg/dL vs. <1 μg/dL had an adjusted odds ratio (aOR) and 95% confidence limit of 0.95 (0.60, 1.49) for RSV and 1.34 (0.65, 2.75) for influenza. In sex-specific analyses, boys with lead concentrations ≥1 μg/dL vs. <1 μg/dL had an aOR = 1.89 (1.25, 2.86) for influenza diagnosis, while the estimates were inconsistent for girls. These results are suggestive of sex-specific associations between blood lead levels and the risk of influenza, although the sample size was small.

Keywords: Pb; RSV; blood lead; environment; exposure; flu; immunotoxicology; infectious disease; pediatric; respiratory infection; sex-specific influenza.

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Conflict of interest statement

The authors declare no conflict of interest.

Figures

Figure 1
Figure 1
Flowchart Describing Collection of Influenza and Respiratory Syncytial Virus (RSV), Data Sources, Covariables of Interest, and Missingness for the Sample with Complete Data.
Figure 2
Figure 2
Distribution of Peak Lead Values (N = 617).
See this image and copyright information in PMC

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