Lead exposure in homes as modifying factors of blood lead levels among young children in Bihar, India.

More than 275 million children in India have elevated blood lead levels (BLLs). Previous studies in India have focused on children living in highly polluted areas. In addition to industrial sites, children are exposed to lead in their homes. The study aims to identify sources of lead exposure in a sample of children living in Bihar by assessing lead levels in the children's homes and products and their association with blood lead levels (BLLs). The study used a subset of a statewide BLL study in Bihar, India. From the larger sample, 150 children were selected, including those with a BLL ≥ 20 µg/dL and a random sample of those below this level. Blood samples from children aged 13 to 60 months were analyzed using the LeadCare II analyzer. A home-based assessment (HBA) was conducted to evaluate lead in soil, drinking water, paint, metal and ceramic cookware, spices, cosmetics, and toys. Lead levels were determined using a portable X-ray fluorescence analyzer and laboratory-based analyses. HBA results were compared with local and international limits. Sampling revealed elevated lead levels in metal foodware and spices. After adjustment, the odds of elevated BLL were associated with lead content in spices only (aOR = 1.35, 95% CI 1.17, 1.58). Elevated lead levels in spices and metal foodware are common in Bihar, India. To protect children's health, measures are needed to reduce lead exposure, including enforcing regulations on lead content in spices, implementing policies, and monitoring metal foodware items, as well as building public awareness.