Manioc Flour Consumption as a Risk Factor for Lead Poisoning in the Brazilian Amazon

Abstract
Recent studies reported elevated blood lead (Pb) levels in riparian populations of the Amazon. For this reason, the aim of the present study was to assess the risk to riparians in the Brazilian Amazon to Pb exposure due to the intake of contaminated manioc flour. Lead levels were determined in whole blood (n = 74) and in manioc flour samples (n = 30) in three different communities. Mean blood Pb levels were 16.8 μg/dl, with individuals living in Açaituba presenting the highest mean blood Pb level (22.4 μg/dl), followed by Nova Canaã (17.3 μg/dl) and Santa Cruz (9.8 μg/dl). The minimum blood Pb level found was 0.83 μg/dl and the maximum was 44.3 μg/dl. The estimated daily intake (EDI) was calculated and compared to the benchmark dose lower confidence limit (BMDL) for neurotoxicity. Mean Pb in manioc flour was 0.34 μg/g while EDI was 79 μg/d, corresponding to 260% of the BMDL (varying from 168 to 308%). This finding is of great importance since this high EDI may exert adverse effects on the nervous system of this population. Manioc flour intake may thus present considerable risk of Pb exposure in this region. Risk management strategies and further studies on adverse effects in this population are needed.