Individual and contextual characteristics of blood lead level among adults in Port-au-Prince, Haiti

Background: Lead toxicity is particularly high in low- and middle-income countries, including Haiti. This study aims to describe blood lead levels (BLL) in urban Haiti and identify individual, household, and environmental characteristics associated with high BLL. Methods: Using cross-sectional data from the Haiti Cardiovascular Disease Cohort study (2019–2021), individual, household, and environmental characteristics were described by BLL categories (≤3.3, >3.3 to <5, 5 to <10, and ≥10 μg/dL). Environmental characteristics were measured using OpenStreetMaps and ArcGIS. Multivariable linear quantile mixed models were used to identify characteristics associated with BLL at the 25th, 50th, and 75th quantiles. Results: Of the 3,005 participants, the median age was 40 (interquartile range: 27–55) years, and 58.1% were female. The median BLL was 4.6 (interquartile range: 3.3–6.3) μg/dL. Smoking, alcohol consumption, household polluting fuel use, and household work lead exposure were more prevalent among those in higher BLL categories, while households with bottled water were less prevalent. Homes in the highest BLL category had lower median altitudes and were near the coast. From the linear quantile mixed models, current/former smokers versus nonsmokers and those using nonbottled versus bottled water were associated with 0.81 (95% CI = 0.13, 1.50) and 0.39 (95% CI = 0.09, 0.69) μg/dL higher median BLL, respectively. Consuming ≥1 alcoholic drink/day was also associated with a 1.86 (95% CI = 0.69, 3.03) change in the 75th quantile of BLL. Conclusions: This study provides predictors of lead exposure in urban Haiti. Targeted exposure assessments of smoking substances, drinking water, and alcohol products are needed to confirm these findings.