Abstract
Although studies have shown that a low socioeconomic status (SES) is associated with high blood lead levels (BLLs) in children, the mechanism underlying this observation is not well known. To determine how SES influences BLLs via environmental factors in Korean children, we conducted a population-based cross-sectional study of 4744 children aged 5⁻13 years. Questionnaires on sociodemographic information, environmental factors, and food consumption were administered to the children's parents. BLLs in the study subjects were measured.The complete set of hypothesized associations was assessed using regression analysis and structural equation modeling. SES was associated with high BLLs. The total effects of nutritional factors, lead in the air and total length of nearby roads, and agriculture on BLLs were -0.062 (p < 0.001), 0.068 (p = 0.005), and 0.038 (p = 0.035), respectively. The direct effects of playing outdoors and SES on BLLs were 0.113 (p < 0.001) and -0.111 (p < 0.001), respectively. Although playing outdoors had a greater direct effect on BLLs than did SES, the total effect of SES (standardized β = -0.132, p < 0.001) was greater than that of other sources owing to indirect effects (β = -0.020, p = 0.004). A low SES was a major risk factor for elevated BLLs via environmental factors.