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Effects of Iron and/or Zinc Supplementation in Mexican School Children Exposed to Lead

Not Applicable
Completed
Conditions
Lead Poisoning
Interventions
Dietary Supplement: Ferrous fumarate
Dietary Supplement: Zinc oxide
Dietary Supplement: Placebo
Registration Number
NCT02346188
Lead Sponsor
Johns Hopkins Bloomberg School of Public Health
Brief Summary

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.

Detailed Description

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.

Recruitment & Eligibility

Status
COMPLETED
Sex
All
Target Recruitment
602
Inclusion Criteria
  • 1st grade child
Exclusion Criteria
  • Blood lead concentration =>45 ug/dL
  • Hemoglobin concentration < 9 g/dL

Study & Design

Study Type
INTERVENTIONAL
Study Design
FACTORIAL
Arm && Interventions
GroupInterventionDescription
Ferrous fumarateFerrous fumarateTablet formulated as ferrous fumarate, 30 mg. Given once daily for 6 months.
Zinc oxideZinc oxideTablet formulated as zinc oxide, 30 mg. Given once daily by mouth for 6 months.
Ferrous fumarate and zinc oxideFerrous fumarateTablet, formulated as ferrous fumarate 30 mg plus zinc oxide 30 mg. Given once daily by mouth for 6 months.
Ferrous fumarate and zinc oxideZinc oxideTablet, formulated as ferrous fumarate 30 mg plus zinc oxide 30 mg. Given once daily by mouth for 6 months.
PlaceboPlaceboSugar tablet formulated to look like the experimental arms of the study. Given daily by mouth for 6 months.
Primary Outcome Measures
NameTimeMethod
Blood lead concentration6-12 months
Secondary Outcome Measures
NameTimeMethod
Anthropometric composite6-12 months

Height, weight

Serum ferritin concentration6-12 months
Serum zinc concentration6-12 months
Hemoglobin concentration6-12 months
Peabody Picture Vocabulary Test, Math achievement test, tests of attention and memory6-12 months
Conners Behavior Rating Scales for parents and teachers6-12 months

Trial Locations

Locations (1)

Johns Hopkins Bloomberg School of Public Health

🇺🇸

Baltimore, Maryland, United States

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