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Jamal Safi,¹ Alf Fischbein,² Sameer El Haj,³ Ramzi Sansour,³ Madi Jaghabir,⁴ Mohammed Abu Hashish,¹ Hassan Suleiman,¹ Nimer Safi,¹ Abed Abu-Hamda,⁵ Joyce K. Witt,⁶ Efim Platkov,² Steven Reingold,⁷ Amber Alayyan,⁸ Tamar Berman,⁶ Matti Bercovitch,⁹ Yogesh Choudhri,¹⁰ and Elihu D. Richter⁶

¹Environmental Protection and Research Institute, Gaza, Palestinian Authority; ²Sanz Medical Center, Netanya, and Selikoff Center for Environmental Health and Human Development, Ra'anana, Israel; ³Center for Environmental and Occupational Health Sciences, Birzeit University, Birzeit, Palestinian Authority; ⁴Department of Community and Preventive Medicine, School of Medicine, Jordan University, Amman, Jordan; ⁵Kupat Holim Meuhedet, Yerka, Israel; ⁶Hebrew University-Hadassah School of Public Health and Community Medicine, Jerusalem, Israel; ⁷Department of Pediatrics, Maimonides Hospital, Brooklyn, New York, USA; ⁸School of Medicine, New York University, New York, New York, USA; ⁹Pharmacology and Clinical Toxicology Unit, Assaf Harofeh Medical Center, Zerifin, Israel; ¹⁰Health Canada, Ottawa, Ontario, Canada

Abstract
In the Middle East, the major sources of lead exposure have been leaded gasoline, lead-contaminated flour from traditional stone mills, focal exposures from small battery plants and smelters, and kohl (blue color) in cosmetics. In 1998–2000, we measured blood lead (PbB) levels in children 2–6 years of age in Israel, Jordan, and the Palestinian Authority (n = 1478) , using a fingerstick method. Mean (peak ; percentage > 10 µg/dL) PbB levels in Israel (n = 317) , the West Bank (n = 344) , Jordan (n = 382) , and Gaza (n = 435) were 3.2 µg/dL (18.2 ; 2.2%) , 4.2 µg/dL (25.7 ; 5.2%) , 3.2 µg/dL (39.3 ; < 1%) , and 8.6 µg/dL (> 80.0 ; 17.2%) , respectively. High levels in Gaza were all among children living near a battery factory. The findings, taken together with data on time trends in lead emissions and in PbB in children in previous years, indicate the benefits from phasing out of leaded gasoline but state the case for further reductions and investigation of hot spots. The project demonstrated the benefits of regional cooperation in planning and carrying out a jointly designed project. Key words: ambient lead pollution, blood lead, childhood lead exposures, Middle East regional project. Environ Health Perspect 114:917–922 (2006) . doi:10.1289/ehp.8339 available via http://dx.doi.org/ [Online 24 January 2006]

Address correspondence to E.D. Richter, Hadassah School of Public Health and Community Medicine, P.O. Box 12272, Jerusalem 91120 Israel. Telephone: 972-2-6758147. Fax: 972-2-6784010. E-mail: elir@cc.huji.ac.il

We thank L. Rosenblum (deceased) , R. Walling, H. Falk, and G. Noonan of the U.S. Department of Health and Human Services and the many fieldworkers in this project for their support and encouragement.

This project was funded by grants from U.S. Agency for International Development–Middle East Regional Cooperation,the Government of Canada via the Israel–Palestinian Center for Research Information, the American Friends of Sanz Medical Center, and Friends of the Selikoff Center for Environmental Health and Human Development.

The authors declare they have no competing financial interests.

Received 19 May 2005 ; accepted 23 January 2006.

Correction

The order of authors has been changed from that in the original published online, and two co-authors, Matti Bercovitch and Efim Platkov, have been added.