Lead exposure is a legacy issue that continues to affect vulnerable population groups globally, but particularly in low and middle-income countries (LMICS). We take a multi-disciplinary approach to examine the patterns of lead exposure in these countries, discuss the underlying injustices and socio-political causes, and the economic costs that are associated with exposure. We conclude with some lessons we drew from our discussion of lead across the disciplines and advocate for a number of approaches to solving this ongoing issue. These include (i) biomonitoring that could be integrated into existing health surveys or public health programs targeting young children; (ii) greater civic engagement to push for solutions; and, (iii) environmental control policies that represent a continuum of local, context-specific to broad, national-level, and even global approaches.

The objective of this study is to determine if consumption of fish and other dietary elements are related to the serum PCB levels of a group of adolescents. A dietary pattern approach is used to provide a more complete dietary exposure profile rather than a single food/group approach. Additionally, dietary patterns are examined in relation to traditional PCB groupings as well as derived PCB congener profiles. The sample is comprised of 246 Mohawk adolescents between the ages of 10-16.9 years of age residing at the Akwesasne Mohawk Nation. Food frequency data was collected and serum PCB levels were (101 congeners) quantitated during a cross-sectional study investigating adolescent exposure to environmental pollutants. Principal component analysis identified four dietary patterns: "well-rounded" "snacks and sweets" "fruits and vegetables" "fish and dairy" and four PCB congener profiles: "1248-like", Persistent/"1260-like", "mono-ortho", and "1254-like". In a multiple regression models, the "fish and dairy" dietary or traditional PCB determinants (age, sex, prior breastfeeding, BMI, pattern) were each predictors of one or more of three of the identified PCB congener profiles. However, the "1248-like" pattern was not related to either dietary pattern or any of the typical PCB determinants, suggesting an alternative source/exposure pathway for this congener profile. Even relatively low levels of fish consumption within the composite dietary matrix of adolescents at Akwesasne remains a pathway of exposure to postnatally acquired PCBs. In addition, there is evidence of an unidentified, perhaps airborne, exposure pathway that warrants further attention as this congener profile accounted for 50% of the total variance within the adolescents' serum PCB levels.