Introduction Evidence-based data on chronic sub toxic effects of lead, nickel and cerium on blood pressure (BP) of children is insufficient.

Methods The target population consisted of a stratified sample of preschool 5–7-year-old children from Gus, 132 children participated (response 80%) and 211 school children 7–10 y.o. (response 60%), residing in central district of Moscow. BP was measured in accordance with National recommendations for children, 2003. Exposure assessment was based on the levels of scalp hair elements and lead in blood. The analysis was done using ICP-MS and AAS methods. Blood lead samples were analysed using the Lead Care instrument. Multiple logistic regression analysis was done with the adjustment for confounders.

Results Concentrations of studied elements were in subtoxic range, average levels were significantly higher in Gus, then in Moscow. In Gus were revealed strong positive associations of BP, especially diastolic, with the tertile rank of blood Lead (in the range 4.4 μg/dl and higher) and hair cerium (in the range 0.7 mkg/g and higher). OR for elevated diastolic BP due to Lead was 3.0; 95% CI 0.59 to 15.76; p<0.186); due to Cerium - 3.9; 95% CI 1.23 to 12.53; p<0.021). In Moscow BP was significantly correlated with the tertile rank of hair nickel (in the range 0.2 mk/g and higher). OR for elevated systolic BP due to nickel was 2.5 (95% CI 1.1 to 5.7, p<0.026); for diastolic BP - 5,6; 95% CI 2.2 to 14.6; p<0.001).

Conclusions The blood Lead, hair Nickel and Cerium levels, even in the low range of concentrations, positively associates with the risk of elevated blood pressure in children.