November 15, 2021 - Podcast

Episode 203—Addressing lead poisoning in children, and treating insomnia among people with HIV

Lead poisoning in children can cause attention deficit, memory lapses, agitation, and even tremors. In fact, there is no real safe level for lead in children’s blood. While the U.S. Centers for Disease Control and Prevention recently updated its guidance on blood lead levels for children, lowering it from 5 micrograms of lead per deciliter of blood to 3.5 micrograms, Indiana University environmental scientist Gabriel Filippelli says it’s not enough to protect all children. Children are most often exposed to lead in urban soils contaminated from degraded paint, gasoline, and industrial sources, Filippelli says, and the most lead-contaminated neighborhoods in cities are often the poorest and home to the highest percentage of nonwhite children. Residents in these zones can have significantly higher rates of elevated blood lead levels than people in wealthier neighborhoods, he says. Many U.S. cities and towns also have lead water lines which, if treated properly, do not contaminate the water. However, some cities, such as Flint, Michigan, change water sources or treatment processes in ways that allow lead to be carried to household taps, and these water crises also disproportionately affect communities of color. Although childhood lead poisoning in the U.S. has been falling since the 1970s, Filippelli says Black children and children living in poverty continue to have average blood lead levels substantially higher than the national average, which means many of those children are at risk. Filippelli also says that systematic testing for children in poverty is lacking. His research has shown that in areas with the highest potential risks based on poverty levels, less than 6% of eligible children had lead test results reported to the county health department. Without more screening and more work to eliminate lead exposure in the communities most at risk, he says, childhood lead poisoning won’t be solved for a long time.

In other news, for people with HIV, insomnia is a significant health issue, with up to 50% of people with HIV reporting sleep disturbances. Now, researchers at IUPUI are looking at how to reduce insomnia among people with HIV, which in turn may reduce systemic inflammation that can lead to serious non-AIDS health events such as diabetes, cardiovascular disease, and cognitive impairment. Jesse Stewart, a professor of psychology, and Samir Gupta, a professor at the IU School of Medicine, are studying whether cognitive-behavioral therapy can treat insomnia. Cognitive-behavioral therapy is effective for a broad range of mental health conditions. For insomnia, cognitive skills include identifying and changing unhelpful thoughts related to sleep and insomnia. Behavioral skills include developing good sleep habits and making changes to the sleeping environment, typically the bedroom. In a clinical trial, the researchers will examine the impact of three months of cognitive behavioral therapy for insomnia versus three months of sleep education on biomarkers in the blood that indicate systemic inflammation. The therapy option will be offered via SHUTi, a convenient internet-based program that offers interactive content very similar to traditional face-to-face therapy. The researchers hope to show that successful treatment of insomnia in people with HIV reduces systemic inflammation, which could ultimately lead to preventing negative health outcomes and improving the quality of life of people with HIV.